Farmworker Housing Quality and Health

Abstract

On 11 November 2014, Farmworker Housing Quality and Health: A Transdisciplinary Conference was convened to draw together experts from the variety of disciplines who contribute to research and practice focused on farmworker housing and health in order to delineate current knowledge and propose next steps. The conference addressed three specific aims: (1) to consolidate current knowledge on characteristics and quality of housing provided for farmworkers; (2) to delineate pertinent directions and areas for farmworker housing health and safety research and policy; and (3) to facilitate the development of working groups to support the implementation of research, education, and engineering projects to improve farmworker housing. This article provides an overview of the conference.

Introduction

The central importance of housing conditions for health status has been well under-stood in the public health community for more than a century. The first specific effort to address the living conditions of hired farm laborers was California’s 1915 Labor Camp Act, a response to horrific camp conditions that led to the Wheatland Hop Riot of 1913. There have been serious improvements in housing conditions of many migrant farm laborers, but virtually all recent health survey research has demonstrated that much of this workforce is still experiencing unwarranted risks to health associated with their housing conditions. Pesticides carried into a residence on work clothes, lack of refrigeration for food storage, absence of sanitary facilities, and extreme overcrowding have all been linked to adverse health outcomes in farm laborers.… The issue is complex: socioeconomic status, housing conditions, risky behavior, workplace exposure, and immigrant worker acculturation may all be linked in unknown ways to observed health outcomes. The challenge to public health investigators to untangle those factors is daunting, and the committee recommends that NIOSH pursue such efforts without further delay.¹

Agricultural production in the United States often requires the hand labor of workers. Much of this agricultural labor is provided by immigrants, who are largely Latinos/Hispanics from Mexico and other Central American nations.² Farmworkers are exploited workers in the United States.³ Migrant and seasonal farmworkers overwhelmingly reside in poor housing conditions.^4–6 Farmworker housing is an issue of environmental health and justice; farmworkers have limited access to any housing, and the housing they have is often a component of their work environment (and compensation). Unfortunately, this housing results in exposure to many toxicants—chemical (e.g., pesticides, lead), biological (e.g., contaminated water, infectious disease), physical (e.g., electrical hazards, falls hazards), and psychological (e.g., crowding, isolation).⁷ Adequate housing is a fundamental human right,^8,9 yet the limited research to date demonstrates that inadequate housing is the most basic of all of the unjust and inequitable conditions endured by farmworkers in the United States^1,6,10–16 Housing quality affects farmworker physical and mental health.⁷ Peer-reviewed research has begun to document that the housing provided to farmworkers increases their risk for injury and illness^17–24 and is associated with poor health.^25–27

Current research on farmworker housing and health is scattered in the literature, with much data presented in non-peer-reviewed sources. On 11 November 2014, Farmworker Housing Quality and Health: A Transdisciplinary Conference was convened to draw together experts from the variety of disciplines who contribute to research and practice focused on farmworker housing and health to delineate current knowledge and propose next steps. This one-day conference addressed three specific aims: (1) to consolidate current knowledge on characteristics and quality of housing provided for farmworkers and the associations of farmworker housing characteristics with farmworker health; (2) to delineate pertinent directions and areas for farmworker housing health and safety research and policy; and (3) to facilitate the development of working groups to support the implementation of research, education, and engineering projects that can address the major directions and areas identified during the conference.

The conference was organized by the Center for Worker Health, Wake Forest School of Medicine, California Rural Legal Assistance, Inc., and Farmworker Justice. The aims of the conference were carried out in three steps. First, groups of experts were commissioned to complete reports on the current state of farmworker housing. Four reports were written: one each on farmworker housing policy and regulation in the United States, the current state of knowledge on farmworker housing characteristics and the health effects linked to housing exposures, recommendations for comparative research on farmworker housing and its association with health, and social factors that support better policies to improve farmworker housing and health. These reports were distributed to participants in advance of the conference for their review.

Second, each report was presented and discussed at the one-day conference. The seventy-one conference participants represented a great range of backgrounds and expertise, including architecture and planning, law, medicine, nursing, public health, social and behavioral sciences, and toxicology. Participants came from academic institutions, government agencies, nonprofit advocacy and service organizations, and legal services programs. Participants worked in seventeen states and the District of Columbia.

The leaders for each report briefly summarized its content, and then all conference participants asked questions, presented criticisms, and made suggestions for improving the content of each report. The final step is the most difficult. It entails a long-term commitment to build an ongoing program that improves the housing and health of farmworkers in the United States, through research and policy initiatives based on the knowledge summarized in the conference reports.

Conference Reports

The reports produced for this conference addressed different features of the discussion surrounding farmworker housing and health, and they are included as articles in this issue of New Solutions. Each article presents recommendations for research, policy, and direct service.

The first article, Farmworker Housing in the United States and Its Impact on Health,²⁸ reviews the literature of exposure studies that examine the link between housing conditions experienced while working in the United States to farmworker health. The goals of this report are to (1) describe the state of current farmworker housing, based on data from peer-reviewed, government, and other documents and (2) review published evidence for health effects linked to housing exposures.

The second article, Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time,²⁹ provides guidelines for research on farmworker housing and its association with health. The purpose of this report is to establish a standard for study design, so that research conducted in different communities and regions can be compared and used to inform housing policy and regulations. A substantial literature has documented methods for investigating housing quality and health;³⁰ therefore, the report concentrates on topics and measures specific to physical and social environments of farmworkers, including housing location, immigration status, links between employment and housing, and income.

The third article, Understanding the Role of Social Factors in Farmworker Housing and Health,³¹ addresses the role of the social factors in the effects of housing on farmworker health in an effort to encourage attention to social factors in farmworker health research and to support better policy design with regard to farmworker housing. Unfortunately, little research directly addresses the influence of farmworker housing on social determinants of health. This report combines a discussion of the known social influences of housing on farmworker health with parallel cases of housing influencing health through social influences in nonfarmworker situations.

The final article addresses national housing standards and regulations. Federal Farmworker Housing Standards and Regulations, Their Promise and Limitations, and Implications for Farmworker Health³² discusses laws and regulations pertaining to farmworker housing, highlights the literature on health risks associated with inadequate housing, and proposes specific recommendations to strengthen enforcement and reduce the risks of substandard housing for the health of farmworkers and their families.

Next Steps

Conferences are important activities for elucidating issues and forming alliances. However, these discussions do little to improve the quality of farmworker housing and farmworker health directly. Conference participants have begun to organize to address the recommendations presented in each paper. Anyone interested in participating in this endeavor should contact the conference organizers: Thomas A. Arcury, Center for Worker Health, Wake Forest School of Medicine; Ilene Jacobs, California Rural Legal Assistance, Inc.; or Virginia Ruiz, Farmworker Justice.

Biographies

Thomas A. Arcury is professor and vice chair for research in the Department of Family and Community Medicine and director of the Center for Worker Health at Wake Forest School of Medicine in Winston-Salem. He also directs the Program in Community Engagement, Wake Forest University Translational Science Institute. His research and practice address occupational health and justice for immigrant workers.

Ilene J. Jacobs is a statewide director of Litigation, Advocacy & Training for California Rural Legal Assistance, Inc. (CRLA) and project director of the CRLA rural fair housing project. She has dedicated her legal career to advocacy for housing rights and civil rights of minority, farmworker, homeless, and other low-income urban and rural communities. She has held leadership positions on state and national task forces, boards and commissions addressing rural housing and poverty, and served on the National Census Advisory Committee.

Virginia Ruiz is director of Occupational and Environmental Health at Farmworker Justice. She focuses on administrative advocacy and community education for farmworkers and other low-income Latino communities on issues related to occupational health and safety, and labor and employment rights.