Farmworkers and COVID-19: Community-Based Partnerships to Address Health and Safety

As COVID-19 spread rapidly throughout the United States, among the population’s most disproportionately affected were those on the front lines of the food system. The majority of the estimated 2 million farmworkers in the United States, who have worked through the pandemic as “essential” workers to ensure the functioning of US food systems, are Latino/a, immigrants, and those with low incomes; nearly half lack authorization to work in the United States.¹ Despite their essential status, farmworkers were left vulnerable to COVID-19 because of the lack of workplace protections overlayed with numerous occupational and social factors.² Amid the pandemic, however, new partnerships and community initiatives between farm employers and clinicians, advocates, and public health authorities serving farmworkers made unprecedented efforts to support the health and safety of farmworkers and their families in the absence of sufficient government response.³

Farmworkers and their families are frequently subject to overlapping and amplifying occupational risks and adverse social and structural determinants of health, which in turn affect their underlying health and increase their risk of COVID-19. Farmworkers lack many of the basic occupational protections afforded to other workers, which may favor the employer but intensifies cycles of poverty and poor health among farmworkers. Farmworkers have been historically excluded from basic labor laws, such as the right to organize, minimum wage, and paid sick leave, although these rights vary by state. Without these protections, farmworkers who are ill may feel forced to work because of the fear of lost wages and the lack of a workplace safety net.

Additionally, farmworkers have been systematically excluded from health and safety regulations that are afforded to other workers. The Occupational Safety and Health Administration, for instance, is prohibited from using federal funds for occupational safety enforcement on farms employing 10 or fewer workers and not providing housing, leaving many farmworkers unprotected. These long-standing occupational and health and safety exclusions, matched with low wages, intermittent work, and frequent migration, lock farmworkers and their families into poverty and reduce their access to health care. Further, rural locations, limited access to transportation, language and cultural differences, and fear of exposing immigration status reduce farmworkers’ ability to seek care even when struggling with acute pain or chronic conditions.⁴

As the pandemic struck the rural United States, this lack of basic federal workplace protections, compounded by poverty and poor access to care, sharpened. In June 2020, several months into the pandemic, the Centers for Disease Control and Prevention offered recommendations to employers on how to protect farmworkers from COVID-19. Employers were not required to carry out these suggested protections. The Occupational Safety and Health Administration, typically the lead agency to enforce worker health, remained silent on worker, including farmworker, protection from COVID-19. As of June 2021, no federal emergency standards for farmworkers have been issued, and only 14 states have adopted emergency protections for essential workers to require basic protections such as physical distancing, mask wearing, sanitation, and the provision of personal protective equipment.⁵

With few financial resources and limited housing opportunities in rural locations, many farmworkers and their families rely on employer-provided housing, which is frequently communal and often substandard, and employer-provided transportation to the farm, which may be crowded and poorly ventilated, further increasing the risk of contracting COVID-19. Most farmworkers speak English as a second language, and many have limited levels of formal education, erecting language and literacy barriers to information on the rapidly shifting COVID-19 situation, including ways to stay safe. The political rhetoric on Latino/a immigrants under the Trump administration further jeopardized the health of immigrants. Some have shown distrust of the US government during early phases of the COVID-19 vaccine rollout, and many prefer to stay silent over workplace abuses or personal health concerns rather than expose their immigration status or risk losing their job.

Unsurprisingly, these multiple levels of failures to protect farmworkers have resulted in farmworkers suffering higher rates of COVID-19 infection than the overall population.⁶ COVID-19 has been conclusively tied to occupation and employment circumstances, whereby a lack of COVID-19 protections, such as masks, physical distancing, and sanitation, are made more dangerous by the many disparities farmworkers face. This has been largely contrary to rhetoric from government and business officials throughout the pandemic attempting to blame cultural “differences” for the spread of the virus. Research confirms that COVID-19 spread has likely been a result of workplace conditions⁷—not cultural preferences and not only multigenerational housing. Workplaces continue to operate without sufficient protections, and workers are carrying the virus back to their homes.

Farmworker advocates, clinicians, community health workers, and outreach staff work directly with farmworker communities to address some of the many factors that endanger their health. These clinicians and advocates have been at times considered adversaries by employers, who may have liability, safety, or other concerns related to health provision at the farm or farmworker housing or who may fear exposure of farm practices to outside scrutiny. However, farm employers feared COVID-19–related labor shortages and public response to outbreaks, both of which could cause large-scale disruption of farm operations. Community health centers and health departments, in doing outreach during the early weeks of the pandemic, discovered that some employers were less reluctant to partner than they were before the pandemic; other employers were eager to have health authorities assist them in determining the best manner to protect their workers from infection.⁸

New coalitions and partnerships quickly developed early in the pandemic. In Monterey County, California, a new farmworker coalition of advocates, clinicians at the health department and at a community health center, county government staff, agricultural industry representatives, academics, and others worked to call on the California government to provide masks to farmworkers.⁸ In Maine, where clinicians and employers had time to prepare before the late spring influx of migrant workers, Maine Mobile Health Program, a community health center, partnered with the state’s health department, state laboratory, and other state officials to support employers by testing workers as they arrived and providing quarantine and isolation housing accordingly, preventing potential outbreaks.⁹

These partnerships may have longevity. Some coalitions have shifted focus to ensure that farmworkers have access to the COVID-19 vaccine, despite barriers to accessing health care and limited supply. Additionally, many clinicians and advocates are hopeful that these partnerships have benefits beyond the COVID-19 pandemic, providing important communication conduits and building trust to reduce long-standing exploitative practices and improve farmworker health. Nonetheless, those on the front lines underscore the importance of meaningful federal and state regulations on safety and health measures to prevent workplace illness and injury, including from COVID-19. They are critical for not only protecting farmworker health but also supporting and guiding the efforts of these partnerships to ensure that such regulations are put into action.

Food system outbreaks of COVID-19 have demonstrated that basic worker protections such as minimum wage, paid sick leave, and safety precautions on the job are not “worker benefits.” They are basic public health policies to keep our food systems stable; to protect the health of all community members; and to ensure that workers do not have to choose between basic economic survival and exposure, infection, and, possibly, death. Partnerships like those in Maine and California provide a template for community-based, localized approaches by inviting diverse voices to join together, including those who may have been adversaries before the pandemic; finding common ground and building trust on early wins; and keeping an eye on postpandemic priorities to maintain the relationships. Such community-level, diverse partnerships must be prioritized and then bolstered by COVID-19 regulations to protect farmworkers from occupational exposure while they perform their “essential” contributions to the US food system. Additionally, government officials must recognize and address the underlying weaknesses in farmworker protection that existed before COVID-19 to ensure that, in the future, farmworkers are provided safe and healthy workplaces.