At the height of the COVID-19 pandemic, farmworkers were acknowledged as essential workers, responsible for getting food to all our plates. Now, with H5N1 spreading among farm animals, farm labor rights advocates and community health workers say outreach to agricultural and migrant communities is key to keeping us all safe.
Most people are not currently at risk for H5N1 bird flu, but three farmworkers were reported to have developed symptoms of bird flu so far this year. Farmworkers who handle cows and chickens are more vulnerable to getting sick.
To better understand how community health workers could reach rural areas more effectively, Public Good News spoke with Dr. Lisbeth Iglesias-Ríos, a social epidemiologist at the University of Michigan School of Public Health who interviewed farmworkers in 2019 for The Michigan Farmworker Project.
Iglesias-Ríos shared more about the health and safety challenges farmworkers face, and how understanding the fuller landscape can provide answers to keeping communities safe.
Here’s what Iglesias-Ríos said.
[Editor’s note: This interview has been edited for clarity and length.]
PGN: How did you connect to the people you interviewed for the Michigan Farmworker Project?
LIR: Our project was successful in part because I was on the ground. I’m Mexican, so there was a very natural connection with the workers we interviewed. Not only do I know the language and the culture, but I also know how to relate to them.
I spent a lot of time with them in taquerías, laundromats, just hanging out in the labor camp. You know, I was with them, [so] I developed that connection, so they were very open with what was happening or not happening. You need to develop that trust.
It’s very scary for [these communities], because many of them are undocumented, so they’re not going to come forward.
We found in our research that these workers suffer from threats of being deported, coercion, being separated from their families—all of these issues. The fear is very real. So I imagine that the situation is very similar today.
PGN: What’s important for community health workers to understand as they build bridges with farmworkers?
LIR: To be honest, it’s a very political issue. Farmworkers are a group where many issues intersect, right? Issues of immigration, social issues—so people don’t want to talk about that.
I don’t think we’ve been very upfront. Even as researchers—there’s a lot of public health research on farmworkers—but we just keep repeating the same message: They’re poor, they’re marginalized—but this goes beyond that. This is labor exploitation.
For example, the situation of the H-2A [visa for] farmworkers is just a new federal program that is the legacy of that Bracero Program that we had during World War II, when there was a shortage in labor and they brought workers from Mexico. That’s what they’re doing here. Nobody wants to hear these words: labor exploitation.
And then we have, you know, agencies like the Michigan Occupational Health and Safety Administration, [which] are underfunded. They’re understaffed. We are lacking inspectors. Do you know how many farms we have in Michigan? There are thousands.
So we’re not doing a good job. We’re not investing in [solutions.] The benefit that these workers bring to the state is in the billions of dollars. Dairy is one of the most important industries for the state of Michigan. So I think that we don’t value them. We don’t acknowledge their work and their contributions.
PGN: How can your study’s recommendations to help stop the spread of COVID-19 help agricultural companies promote a healthy and safe working environment for their farmworkers? How can community health workers apply this information to bird flu and generalized health outreach to people who work on farms?
LIR: The current landscape is probably very similar to what we found in the early days of COVID-19. [At that time,] we did interviews with workers by phone. And there were a lot of misconceptions—a lot of fear within the workers. They didn’t have protective equipment.
Today, we’re hearing that the Centers for Disease Control and Prevention is here in Michigan, but they don’t know [how to get the point across with their public health messages] to these workers. I mean, workers are not going to wear the big goggles and hazmat suits 24 hours a day. That’s not going to happen.
The issue is that the approach that they’re taking is more like top-down. Like, ‘This is what we know you need to do…,’ instead of talking with and understanding the situation of the workers. I think that’s a mistake.
[Health guidance] would be totally different if it was developed more from a community-based approach.
In my experience with COVID-19 and The Michigan Farmworker Project, it was very difficult for the workers. There was, you know, a lot of misinformation on many levels, fears, and there weren’t really easy ways to reach them.
[When] I interviewed workers that had gotten sick with COVID-19, they didn’t have anyone to help them get food. So I contacted outreach services that I know in those areas to say, okay, these workers are here, and they need food, or they need medical services.
[People don’t want to say] that [this is] similar to COVID-19, but I think it’s very similar to COVID-19 in some ways. I think there’s fear, you know, not not only in the community, but also agencies.
It’s complicated, but the main problem is that we haven’t learned how to engage workers. We haven’t learned that top-down approaches don’t work. You know, these people work with cows 24 hours a day. They’re the experts.
This article is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award to the CDC Foundation totaling $69,392,486 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. In addition, the CDC Foundation does not guarantee and is not responsible for the accuracy or reliability of information or content contained in this article. Moreover, the CDC Foundation expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on any information contained within this article. This article are not intended as, and should not be interpreted by you as, constituting or implying the CDC Foundation’s endorsement, sponsorship, or recommendation of the information, products, or services found therein.