Latinx Farmworkers in the Eastern United States: Health, Safety, and Justice

Contents
About the Authors
Chapter 1: The Health and Safety of Latinx Farmworkers in the Eastern United States: A Renewed Focus on Social Justice
	1.1 A Renewed Focus on Social Justice
	1.2 Organization of the Chapters
	1.3 Definitions and Conventions
	1.4 The Chapters
	References
Chapter 2: Latinx Farmworkers and Farm Work in the Eastern United States: The Context for Health, Safety, and Justice
	2.1 Introduction
	2.2 Farmworkers Defined
	2.3 Geographic Context
	2.4 Agricultural Context
		2.4.1 From Family Farm to Commercial Agriculture
		2.4.2 The Risk and Safety Culture of US Farmers
		2.4.3 Regional Crops in the Eastern US with Farmworker Involvement
		2.4.4 Livestock and Poultry
	2.5 Demographic Context
		2.5.1 Number of Farmworkers
		2.5.2 Farmworker Personal Characteristics
	2.6 Housing Context
		2.6.1 Employer-Provided Housing
		2.6.2 Non-Employer-Provided Farmworker Housing
	2.7 Cultural Context
		2.7.1 General Beliefs and Values of Latinx Farmworkers
		2.7.2 Health Values, Beliefs, Behaviors
			2.7.2.1 General Health Beliefs
			2.7.2.2 Lay-Defined Illness
			2.7.2.3 Self-Treatment Versus Medical Care
	2.8 Political Context
		2.8.1 Political Processes
		2.8.2 Political Organizations
	2.9 Summary and Recommendations to Address Health, Safety, and Justice
	References
Chapter 3: Occupational Injury and Illness in Farmworkers in the Eastern United States
	3.1 Introduction
		3.1.1 The Role of Culture in Farmworker Occupational Injury
		3.1.2 Data on Farmworker Occupational Illness and Injury
			3.1.2.1 Numerator Problems
			3.1.2.2 Denominator Problems
	3.2 Access to Optimal Health Care
	3.3 Common Occupational Health Problems
		3.3.1 Heat Stress
			3.3.1.1 Work-Related Hyperthermia
			3.3.1.2 Prevention of Heat Injury
			3.3.1.3 Other Heat Considerations
		3.3.2 Health Effects of Pesticide Exposure
			3.3.2.1 The Ubiquity of Farmworker Pesticide Exposure
			3.3.2.2 The Health Effects of Farmworker Pesticide Exposure
			3.3.2.3 Reducing Pesticide Exposure
		3.3.3 Musculoskeletal Injuries and Illness
			3.3.3.1 Musculoskeletal Injuries Affecting Farmworkers
			3.3.3.2 Diagnosis and Treatment of Musculoskeletal Disorders
			3.3.3.3 Musculoskeletal Disorder Solutions
		3.3.4 Skin Disease
			3.3.4.1 Skin Disorders Affecting Farmworkers
			3.3.4.2 Skin Disease Solutions
		3.3.5 Hearing Loss
			3.3.5.1 Hearing Loss Occurring in Eastern Agriculture
			3.3.5.2 Causes of Hearing Loss in Farmworkers
			3.3.5.3 Hearing Loss Solutions
		3.3.6 Eye Injury
			3.3.6.1 Eye Injuries Affecting Eastern Farmworkers
			3.3.6.2 Chronic Irritation of the Eyes
			3.3.6.3 Cataract and Pterygium
			3.3.6.4 Eyesight and Eye Care
			3.3.6.5 Eye Injury Solutions
		3.3.7 Transportation
			3.3.7.1 Transportation Injuries Affecting Farmworkers
			3.3.7.2 Transportation Solutions
	3.4 Commodity-Specific Occupational Illness and Injury
		3.4.1 Orchard Work
			3.4.1.1 The Nature of Orchard Work
			3.4.1.2 Occupational Health Problems Associated with Orchard Work
			3.4.1.3 Orchard Work Injury Solutions
		3.4.2 Tobacco Production
			3.4.2.1 The Nature of Tobacco Production Work
			3.4.2.2 Occupational Health Problems Associated with Tobacco Production
			3.4.2.3 Occupational Health Solutions in Tobacco Production
		3.4.3 Vegetables
		3.4.4 Wild Blueberries
			3.4.4.1 The Work of Harvesting Wild Blueberries
			3.4.4.2 Occupational Injury Associated with Wild Blueberry Work
			3.4.4.3 Solutions for Injuries in Wild Blueberry Work
	3.5 Personal Protection
	3.6 Conclusions
	3.7 Recommendations
	References
Chapter 4: Stress and Distress: Mental Health Among Latinx Farmworkers in the Eastern United States
	4.1 Introduction
	4.2 Evidence of Distress Among Farmworkers
		4.2.1 Anxiety
		4.2.2 Depression
		4.2.3 Alcohol Use Disorders
	4.3 Stress
	4.4 Coping
	4.5 Situational Stressors
		4.5.1 Family Separation and Responsibilities
		4.5.2 Social Marginalization
		4.5.3 Housing Conditions
		4.5.4 Working Conditions and Work Demands
		4.5.5 Poor Physical Health
	4.6 Structural Stressors
		4.6.1 Discrimination
		4.6.2 Acculturation
		4.6.3 Documentation Status
		4.6.4 Poverty
		4.6.5 Limited Access to Health Care
	4.7 Discussion
	4.8 Conclusions and Recommendations
	References
Chapter 5: Occupational Justice for Latinx Livestock Workers in the Eastern United States
	5.1 Introduction
	5.2 Structural Change, Latinx Workforces, and Risk of Injury in Animal Agriculture Industries
	5.3 Dairy
		5.3.1 Dairy Worker Tasks
	5.4 Poultry
	5.5 Swine
	5.6 Horses
	5.7 Occupational Safety and Health Risks Faced by Latinx Workers in Livestock Industries
		5.7.1 Traumatic Injury
		5.7.2 Musculoskeletal Disorders
		5.7.3 Respiratory Illness or Dysfunction
		5.7.4 Zoonotic Infections
		5.7.5 Mental Health Disorders
	5.8 Preventive and Remedial Measures for Occupational Injuries among Latinx Livestock Workers
		5.8.1 Safety and Health Training and Use of Personal Protective Equipment
		5.8.2 Limited Access to Healthcare
	5.9 Justice for Latinx Livestock Workers: Research and Policy Recommendations
		5.9.1 Research
		5.9.2 Policy Recommendations
	References
Chapter 6: The Health of Women Farmworkers and Women in Farmworker Families in the Eastern United States
	6.1 Introduction
	6.2 Characteristics of Women Farmworkers and Women in Farmworker Families
		6.2.1 Social, Socioeconomic, and Domestic Context
			6.2.1.1 Documentation Status
			6.2.1.2 Workplace Harassment and Discrimination
				Unfair Labor Practices and Discrimination
				Harassment
			6.2.1.3 Domestic Obligations
			6.2.1.4 Physical, Social, and Linguistic Barriers in Community of Residence
	6.3 Health
		6.3.1 Occupational Injuries and Exposures
			6.3.1.1 Heat Stress
			6.3.1.2 Musculoskeletal Injuries
			6.3.1.3 Pesticide Exposure
		6.3.2 Reproductive Health
			6.3.2.1 Pregnancy
			6.3.2.2 Reproductive Cancers
				Breast Cancer
				Cervical Cancer
			6.3.2.3 HIV
				Risk Factors and Barriers to Preventive Behaviors
				Barriers to Prevention and Treatment Services
				Interventions
			6.3.2.4 Other Sexually Transmitted Infections
				Chlamydia and Gonorrhea
				Syphilis
				Hepatitis B
		6.3.3 Mental Health
		6.3.4 Oral Health
	6.4 Conclusions and Recommendations
	References
Chapter 7: The Health of Children in the Latinx Farmworker Community in the Eastern United States
	7.1 Introduction
	7.2 Children in Farmworker Families
		7.2.1 Access to Healthcare
		7.2.2 Growth and Obesity
		7.2.3 Oral Health
		7.2.4 Vision
		7.2.5 Environmental Health
			7.2.5.1 Housing and Neighborhoods
			7.2.5.2 Pesticides
	7.3 Health of Hired Child Farmworkers
		7.3.1 What We Know About Child Farmworkers from National Data
			7.3.1.1 National Demographics of Hired Child Farmworkers
		7.3.2 Regional Information About Hired Child Farmworkers
			7.3.2.1 Non-eastern States
			7.3.2.2 Eastern States
		7.3.3 Model of Risks Stemming from Organization of Work
		7.3.4 What Do We Know About the Work Child Farmworkers Perform
			7.3.4.1 Nationally
			7.3.4.2 Regionally
			7.3.4.3 Critical Aspects of Organization of Work for Child Farmworkers
		7.3.5 Exposures and Health Outcomes for Child Farmworkers
			7.3.5.1 Injuries and Fatalities
				Nationally
				Regionally
			7.3.5.2 Pesticides
			7.3.5.3 Tobacco and Nicotine
			7.3.5.4 Heat
			7.3.5.5 Social Exposures
	7.4 Conclusions
	7.5 Recommendations
	References
Chapter 8: Community-Based Participatory Research (CBPR) and Other Community-Engaged Research with Latinx Farmworker Communities in the Eastern United States
	8.1 Introduction
	8.2 Community-Based Participatory Research
		8.2.1 CBPR: A Form of Community Engagement
		8.2.2 Reasons for Using CBPR
		8.2.3 A Model of CBPR
	8.3 CBPR to Address Latinx Farmworker Health, Safety, and Justice
		8.3.1 CBPR with Latinx Communities in the Eastern US
		8.3.2 CBPR with Farmworker Communities Across the United States
		8.3.3 CBPR with Farmworker Communities in the Eastern United States
	8.4 Latinx Farmworker CBPR in the Eastern United States: Commonalities and Lessons Learned
		8.4.1 Commonalities
			8.4.1.1 Community-Based Organizations
			8.4.1.2 Advisory Committees
			8.4.1.3 Student Involvement
			8.4.1.4 Literature Review
			8.4.1.5 Community Members
			8.4.1.6 Lay Health Advisors
			8.4.1.7 Social Marketing
			8.4.1.8 Equipment Redesign
			8.4.1.9 Safety Training
			8.4.1.10 Risk Mapping
			8.4.1.11 Returning Individual Results
			8.4.1.12 Community Education
			8.4.1.13 Policy Briefs
			8.4.1.14 Implementation
		8.4.2 Lessons Learned
	8.5 Recommendations: Research, Advocate, Educate
	References
Chapter 9: Farm Labor and the Struggle for Justice in the Eastern United States
	9.1 Introduction
	9.2 Immigration and Farm Labor
		9.2.1 Immigration from Mexico
		9.2.2 Recent Immigration Trends
		9.2.3 Migrant and Seasonal Farmworkers
		9.2.4 Recruitment Fraud
	9.3 Agricultural Exceptionalism
		9.3.1 Federal Exemptions
		9.3.2 State Protections
		9.3.3 Enforcement
	9.4 The Birth of a Movement
	9.5 Organizing for Change
		9.5.1 Alinsky Organizing
		9.5.2 Women-Centered Organizing
		9.5.3 Worker-Driven Social Responsibility
		9.5.4 Community Organizing and Leadership Development
	9.6 Legal and Advocacy
		9.6.1 Policy Advocacy
		9.6.2 Legal Services
	9.7 Service to Workers
	9.8 Conclusion
	References
Chapter 10: Conclusions: An Updated Agenda for Farmworker Social Justice in the Eastern United States
	10.1 Introduction
	10.2 Common Themes
		10.2.1 Trends Since 2009
		10.2.2 Lack of Information About Farmworkers
		10.2.3 Continuing Concerns for Farmworker Health and Justice
		10.2.4 The Consequences of Agricultural Labor Policy
	10.3 An Agenda for Farmworker Social Justice
		10.3.1 Changing the Perspective of the US Consumer
		10.3.2 Research Needs: Documenting the Conditions of Farm Work and Testing Interventions
		10.3.3 Advocacy for Policy Change
			10.3.3.1 Labor Policy
			10.3.3.2 Housing Policy
			10.3.3.3 Pesticide Policy
			10.3.3.4 Healthcare Policy
			10.3.3.5 Immigration Policy
			10.3.3.6 Enforcement of Regulations
	10.4 Conclusion
	References
Index