by Kim Krisberg
For many migrant farmworkers, the health risks don't stop at the end of the workday. After long, arduous hours in the field, where workers face risks ranging from tractor accidents and musculoskeletal injuries to pesticide exposure and heat stroke, many will return to a home that also poses dangers to their well-being. And quite ironically for a group of workers that harvests our nation's food, one of those housing risks is poor cooking and eating facilities.
A group of researchers and advocates recently decided to take a closer look at such facilities among migrant farmworker communities in North Carolina, home to an estimated 150,000 farmworkers during peak season and one of the largest such worker populations in the country. While a number of previous studies have uncovered the substandard housing conditions migrant farmworkers often experience, this was the first study to zero in on kitchen and eating facilities. The study, which was published in the March issue of the American Journal of Public Health (AJPH), found that the most common violations were improper refrigeration temperature, cockroach infestation and drinking water contamination.
"For migrant farmworkers, this is an occupational hazard because their housing is part of their jobs," said Sara A. Quandt, a co-author of the study and a professor in the Wake Forest University Division of Public Health Sciences' Department of Epidemiology & Prevention. "About two-thirds are guest workers and provision of housing is part of the terms of employment, so they don't have a lot of choice in where they live. ...They arrive, they go to work, they work very long days and very long weeks, and their employers are responsible for the provision and maintenance of their housing."
To conduct the study, Quandt and her colleagues studied more than 180 migrant farmworker camps in 16 eastern North Carolina counties. They inspected the cooking and eating facilities using standards from the North Carolina Department of Labor (the agency charged with inspecting migrant farmworker housing) and also took drinking water samples. The housing types ranged from barracks to old houses and trailers; kitchen facilities also varied, from those built to look like a commercial kitchen to the type of kitchen you'd find in a small apartment. Study authors Quandt, Phillip Summers, Werner Bischoff, Haiying Chen, Melinda Wiggins, Chaya Spears and Thomas Arcury write:
Food contamination during storage or preparation, lack of appropriate kitchen facilities, and undercooking can increase the risk of food-borne illnesses. In the long term, absence of safe food storage or cooking facilities can constrain the type of foods consumed and lead to elevated chronic disease risk. For example, the inability to safely store fresh fruits and vegetables can lead to low consumption, a known risk factor for diabetes and cancer.
Researchers found eight of the 15 standards assessed were violated in about 10 percent of farmworker camps. Coliform bacteria was detected in water samples from nearly 35 percent of kitchens; in more than 65 percent of inspections, at least one fridge had a temperature greater than the safe level of 45 degrees; and about 21 percent of kitchens were rated as unsanitary for food preparation.
Cockroach infestation was found in nearly 46 percent of kitchens inspected and rodent inspection in nearly 29 percent. More than 25 percent of kitchens had improper or damaged flooring and about 12 percent had structural issues, both of which up the risk for animal and insect infestation. Farmworker camps with H-2A visa holders, which permits legal entry in the country for seasonal agricultural work, were home to significantly fewer violations than camps with undocumented workers.
Having previously worked with migrant farmworkers and spent time in their homes, Quandt told me she wasn't particularly surprised by the findings. However, she said she was surprised by the high number of refrigerators operating at above-safe temperatures — temperatures that make it easier for bacteria to quickly multiply. She said that some of the fridges were simply in disrepair, while in some housing, overcrowding meant the fridge was opened so often it was hard to maintain safe temperatures.
"But in many cases, they're just old fridges and in dwellings that are extremely hot in the summer, so it's very difficult for them to cool adequately," Quandt said.
Quandt said the danger of food- and water-borne illness is far greater than issues of malnutrition, though migrant farmworkers often report food insecurity problems tied to low wages as well. She noted that it's difficult to track the health outcomes that could stem from poor kitchen facilities, especially as many related diseases are likely under-reported among farmworkers and there are other reasons such workers would experience gastrointestinal distress, such as extreme heat or overexposure to nicotine from tobacco leaf harvesting.
"These are folks who are working with food crops, so if in fact they do have (food- and water-borne) illnesses those may well be passed on to consumers and that's something we really haven't looked at in this country," Quandt told me. "Growers aren't necessarily getting rich, but some of the only elasticity they really have is labor, so you scrimp on what you pay people and where they live. That is the human cost of the food that we eat in this country."
Quandt said one message she and her colleagues want to get across with the study is that the current inspection system in North Carolina isn't adequate — "it's not uncovering problems that are threats to health and safety." She said not only is the inspection system underfunded, but inspections only take place before housing is occupied, unless a specific complaint is lodged after occupancy. Melinda Wiggins, executive director of Student Action with Farmworkers and a co-author of the AJPH study, said inspectors would uncover many of the violations the researchers did if they returned after housing was occupied. For example, inspectors don't examine kitchen facilities in the midst of overcrowded conditions or in the middle of the growing season when housing looks very different.
Wiggins also told me the state often spends its limited resources inspecting the same migrant farmworker housing over and over again, instead of directing its efforts at some of the most egregious violators, which are often farms employing workers without H-2A visas. She said it's this type of housing that inspectors rarely see — "we want (the state) to think about how to be more creative with its limited resources to really focus on the worst violators," she said. Wiggins and fellow advocates have previously tried to push more comprehensive farmworker housing standards through the state's General Assembly, but were unsuccessful. However, they're going to try again this spring. The AJPH study findings have already been translated into a user-friendly policy brief that will be used to educate legislators.
"Poor housing in general is a huge issue that impacts farmworkers," Wiggins said. "Because otherwise, we're talking about a fairly healthy population. But when they're put in the situation of hazardous work and hazardous housing, they become one of the most unhealthy populations around."
Quandt noted that not all the farmworker housing they see is bad — "we saw some really exemplary places and these are growers who have really made an effort." Still, she said inspection policies should change to truly protect farmworkers' health.
"Many people will say, 'Well, these places are still better than where they live in Mexico,' but farmworkers just scoff at that," she said. "They may be poor, but they don't live in conditions like this."
To read the AJPH study, click here. To read about how it is possible to create healthy living conditions for migrant farmworkers, check out this account of a brand new healthy and green farmworker community in Florida.
Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for the last decade.