Health and dignity for Michigan farmworkers

Speaker 1: Public health touches our lives every day, from preventing infectious diseases to ensuring access to high quality, affordable health care, and everything in between. Earning your Master of Public Health online makes it easy to gain the skills and knowledge you need to find lasting solutions to our most pressing public health issues, locally and globally. With the online MPH from the University of Michigan School of Public Health, you can make the biggest impact on the communities you care about. Learn more at publichealth.umich.edu/online-mph.

Host: Before we begin, we want to let you know that there will be some descriptions of workplace abuse that may be difficult for some listeners to hear. Please take care.

Alexis Handal: When we do this kind of research and we work with community partners and work with other stakeholders who have dedicated decades working with the farmworker community, we are always cognizant and aware of the importance of the resiliency of this population, right, of these workers and how important their contributions are to our society. They are essential workers. They are picking the food that goes into the grocery stores that you're buying as a consumer and putting on the table to feed your family. And without these workers, we wouldn't have that. They're human beings. They have families. They contribute positively to the communities where they live. And they have a lot of pride in the work that they do. And that came out in the interviews. There is a lot of pride about the work that's being done. And what was brought up by farmworkers is that they want to be included into the communities, treated like human beings and respected for the work that they do.

Host: Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. Join us as we dig into important health topics, stuff that affects the health of all of us at a population level. From the microscopic to the macroeconomic, the social to the environmental, from cities to neighborhoods, states to countries and around the world. According to the Michigan Department of Agriculture and Rural Development, the food and agriculture industry contributes nearly $105 billion annually to the state's economy.

Host: The seasonal and migrant farmworkers who provide much of the industry's labor are an essential part of our food supply chain and economy. And yet many remain on the margins of society. Researchers found that many farmworkers face unstable employment, unsafe conditions and lack of workplace protections on farms across the US. Because their personal lives are often deeply intertwined with their employment, the conditions they face disproportionately influence the health and well-being of these workers and their families. The biggest hurdle to better conditions? Data. Collecting the stories and experiences of farmworkers can reveal inequities, guide policy decisions and lead to better allocation of resources.

Host: We sat down with two researchers from the University of Michigan School of Public Health who are seeking to enhance the reservoir of data that can make a difference in the lives of Michigan's agricultural workers. Alexis Handal is a professor of epidemiology and global public health, and Lisabeth Iglesias-Rios is a research investigator in the Department of Epidemiology. Together, Handal and Iglesias-Rios developed the Michigan Farmworker Project in 2019. With the support and collaboration of organizations and government agencies, the pair has been able to execute social epidemiological research that calls attention to the needs of this marginalized community of workers. Here's Alexis Handal.

AH: I have conducted studies with agricultural workers now for just about 20 years, mainly in Latin America and mainly with female agricultural workers. But I have a very strong interest in understanding how the work context, whether it's the social, the structural or the chemical exposures, impact female farmworkers, their families and their communities. And so when I was transitioning to come to the University of Michigan after having been at the University of New Mexico, I reconnected with Lisabeth. And we started talking about our mutual interests, about trying to understand what was going on with the farmworkers in Michigan and what their experiences are, what their living conditions and their working conditions are and how they affect health. And so we came together. And so that's kind of how this project and this research program evolved and kind of came to be.

Host: Iglesias Rios' path to this research was personal. It connected her with Handal and led her to form the relationships that would eventually support the development of the project.

Lisabeth Iglesias-Rios: I did my PhD at the University of Michigan at the Department of Epidemiology and my dissertation was on human trafficking. And I got very interested in this topic. It's very personal to me because my grandmother is a survivor of human trafficking. These are topics that are usually not well connected still in public health. So I was able to connect with some researchers in London and they collected data on Southeast Asia on survivors of human trafficking. And so after that experience with my dissertation, I was very interested in this topic and I attended a conference on human trafficking. I was in the process of becoming a postdoc. And in this conference, I met an attorney, Deanna Marin, from the Michigan Immigrant Rights Center. And she was just making a presentation about the situation of labor trafficking for farmworkers in Michigan.

LI: And so we connected. That was our first connection with community organizations. And from that initial contact, we started to develop connections with community organizations working with farmworkers. So when we started to develop these connections with community organizations, we all have the common realization that it was important to develop research to inform policies and interventions for farmworkers in the state, because there's very little research, formal research that has been done with this population in the state. So we want to understand how precarious employment and labor exploitation affect the health of workers within the context of occupational and environmental epidemiology and looking at more structural factors that drive these issues of precarity and labor exploitation. Because in the public health world there's a lot of work that has been done with farmworkers. But if you go to the literature, there's usually the exposure to pesticides in the workers, the injuries, the accidents. But there's a need to contextualize why this is happening to the workers. And that's, I think, the main focus of the work that we're doing.

AH: When we started this project, Lisabeth and I were kind of coming in as this new set of researchers. We're not going to just come in and say, oh, we're going to do this research as university epidemiologists without honoring and acknowledging the breadth of knowledge and connection that the partners with whom we work have with the farmworker community. That is always the foundational kind of aspect of the way we do our work. And then we are a very diverse partnership in the sense not just from what we do in terms of being researchers, us being epidemiologists and other partnerships, but also we're ethnically and linguistically diverse as well. We are bilingual. We are able to conduct the research in Spanish, for example, which is really important. We're able to analyze the data in Spanish, which I think is important so that we don't lose context with our partners.

AH: We actually, for the first study of the 2019 study, we actually did analysis of the transcripts of the data with community partners so that we could get their perspectives and their knowledge and understanding incorporated into our process of analysis and interpretation of the findings. And so I think all of those different aspects of diversity is what makes our team special and what makes our work and our approach successful, even in this very challenging context.

Host: Working to improve understanding of the lives of farmworkers in the state of Michigan is a task that has historically been slow moving.

LI: Well, there's very little research, formal research that has been done with this population in the state. With that in mind, in 2010, the Michigan Department of Civil Rights through the Michigan Civil Rights Commission held a public forum in Kalamazoo. And they were focusing on the rights of migrant and seasonal farmworkers. And the commission in this public forum heard presentations from groups that work with and advocate for farmworkers. And they also hear testimony from farmworkers. The commission, they put together a report and they found that they were substandard living and working conditions for farmworkers and that they haven't significantly changed in 45 years in the state. Since these reports, the Michigan Department of Civil Rights wrote that they will work closely with leaders from several state departments and the Interagency Migrant Service Committee to address these issues.

LI: This committee is a committee where several agencies come together basically to discuss issues in the farmworker community. Today, our research is showing that many of these issues uncovered in 2010 keep being salient issues for farmworkers. For instance, the report showed lack of drinking water, the lack of bathrooms and workers not having breaks, child labor issues.

Host: In addition, in 2013, a study was performed to record the approximate number of farmworkers living and working in the state of Michigan. The number reported was just shy of 100,000 people, including workers' families. According to Handal and Iglesias-Rios, the 10-year-old study is the only kind of approximation that we have of the numbers of farmworkers in the state. And it has been guiding the way the state and its agencies are addressing issues for the workers.

AH: When we met with our partners, they continued to say that this work that we're doing is so important because there is no data, right? The last formal study and approximation was this enumeration study conducted 10 years ago. So it wasn't just what motivated the beginning of the project, but what keeps us going, which is we need to gather more evidence, more data to really, truly understand the reality for these workers in terms of their working conditions, their living conditions and the broader structural and social factors that can have health implications.

Host: Having data, of course, helps enable action. But for the researchers, it's most important to realize these numbers represent the lived experiences of real humans. Iglesias-Rios shares more about the people they're working to support and the challenges many encounter when they come to work on our Michigan farms.

LI: So seasonal farmworkers are usually workers that live in Michigan, work in Michigan doing the seasonal crops. Migrant farmworkers are those that are coming from other states and they're traveling here in Michigan. Then they follow basically a route Florida, Texas, North Carolina, Michigan. And then we have H2A farmworkers that are workers that are recruited, usually in Mexico, and they come with non-immigrant visas to work for six, eight months, and then they return back to their country of origin. So within our studies, we have observed different experiences in this type of farmworkers. So, for example, some of the workers reported that they were forced to work on their extreme weather conditions. One is extreme heat conditions and where it's raining, which is very unsafe for the workers. There is some workers sharing experiences of physical and emotional abuse.

LI: This is actually stated by the workers that they were treated like animals and they have this sense of being disposable for the employer. Like if you don't do what I ask you to do, well, you are fired. In general, there was not adequate protective equipment. There was also, for example, in packing plants, there's a lot of noise from the machines. The workers have some earplugs that are not appropriate because they slip from their ears, so they ended up not using them. Workers living in housing provided by the employer felt that they don't have privacy because the employer can come to their house at any time. So all of these conditions are dangerous. There was issues of threats, coercion that they will call immigration if they complain or that for H2A farmworkers, they will put them in a blacklist. That means that they basically tell the worker, you are not going to be invited to come to work next year if you complain about something. And those workers really rely on their job. All of these issues, it creates this kind of culture of silence that is, I think, very dangerous for occupational health and the safety of these workers.

AH: When we look at these conditions for the workers and the examples that they brought to our attention when we conducted these interviews, really fell in kind of these broad categories of feeling exploited or having conditions that feel exploitative and dehumanizing, having very challenging workplace dynamics between coworkers as well as with the crew leaders and the growers. And then finally, the connection, the really important connection with housing. Oftentimes these workers are reliant on their employers to get housing and then face a lot of substandard kind of living conditions and issues of the privacy and not really having access to safe living conditions.

Host: What is clear from the data that they've collected so far is that without policies that enforce adequate protections, the overall health and well-being of these workers is in jeopardy. The interviews the team has conducted with female farmworkers in particular have shed light on not just the health implications but also the tremendous indignities that some of these individuals face.

LI: Some workers, and these were interviews conducted with women working in a packing plant, they were forbidden to use the bathroom and these lead to urinary infections in these workers. They timed the breaks in the bathroom. They have to sign a paper when they go to the bathroom. They work with very light plastic aprons. They wash the fruit so there's a lot of splash of water and they have to be working with these wet clothes for many, many hours. There was no special provisions for pregnant working women.

AH: Particularly for the female farmworkers this is kind of an area that is really important, has not received as much attention and is a focus of the work I've done for quite a long time. The female farmworkers that were interviewed, they brought their concerns about getting exposed during pregnancy, having a lot of physical strain where they're having to crouch a lot, they're having to bend a lot, particularly if they're working more out in the fields. There was this issue of hygiene and sanitation that's come out that I think is important around menstruation and not having the ability, particularly for women working in the fields, to go and change sanitary pads, for example, and having to change their pads in the field, which is what was commented on during the study.

AH: Also, just having a real fear of disclosing pregnancy, which you can imagine is not good for pregnancy because the women may be hiding their pregnancy and therefore doing still a lot of the difficult work, potentially having exposures because they're just fearful that they will be let go or they'll lose their job or be treated in a different way because of the pregnancy. What came out, particularly for the female workers but also workers with families, is that they felt that they had such long working hours that they didn't have that connection and the ability to appropriately care for their children. They felt that it was very difficult to balance the working hours and then taking care of children, and having to find childcare seemed to be always a constant source of stress for families and particularly for the female workers.

LI: In all of these examples, we need to keep in mind that work is an important determinant of health and is connected to many social determinants of health, like housing, economic stability, social connections, access to care, education. In the US, farmworkers are a workforce that has faced this long history of marginalization, product of colonialism, slavery practices and these policies that keep farmworkers exempt from labor and social protections. There is a long history in which inequality originates from these oppressive structures that are driven by racism, discrimination, economic interests and politics, creating these disparate work trajectories for different segments of the population, so for different people in the workforce. The benefits of being employed, like having a regular paycheck, health insurance, sick leave, maternity leave, are not the same for all the workers. It's not equally advantageous.

Host: Iglesias-Rios says there are not enough resources and far too much risk for many of these workers to be able to report health and safety issues, let alone advocate for themselves.

LI: I don't think there is an integrated response to address the issues of this vulnerable workforce, in my opinion. The state regulatory agencies and organizations providing services to workers are underfunded and understaffed. The role of their outreach workers from the migrant resource councils in Michigan have to manage an excessive amount of cases. And even though some of these outreach workers are bilingual and have a lot of knowledge of the communities they serve, I don't think they are compensated properly. Why? Because there is not enough, I think, investment and funding from the state. Then we have the Michigan Occupational Safety and Health Administration, MIOSHA, that doesn't manage issues related to threats or coercion or abuses for workers, but this is a reality for workers. And if you go to their website to file complaints, they say that if the workers are facing some of these situations, they need to call the police. So given the social marginalization of these workers, it's very unlikely that any of these workers faced with these situations of abuse, coercion, will call the police.

LI: And then we have the Michigan Migrant Labor Housing Program who performs inspections of all housing in agricultural work sites. And as far as we know, this organization from the state operates with only eight non-bilingual housing inspectors. Yet in their 2022 report, they indicate that these inspectors, the eight inspectors, conducted more than 3000 housing inspections for more than 28,000 farmworkers in Michigan. So to me, this is an extremely low ratio of non-bilingual inspectors to housing inspections and kind of calls into question the rigor and quality of these inspections. I also think that it's needed that we have higher fines for housing and labor violations. Just to give you an example, in 2022, a worker in a farm in Michigan was killed when he fell from the tractor trailer and the fine for the employer was only $77,000. It doesn't help anyone to have agencies that don't have the capacity to enforce the policies or regulations for the safety and health of these workers.

Host: Despite the limitations of current resources and services, the importance of Handal and Iglesias Rios' work remains. Since its creation, the Michigan Farmworker Project has continued to be successful in obtaining both the qualitative and quantitative data that can support meaningful improvements to the lives of farmworkers and their families. But it has not come easily. Completing this research has required creativity, quick thinking, and most importantly, an abundance of compassion.

AH: The reason that we are able to highlight these experiences and this level of understanding of the context of what the farmworkers are facing is because we conducted qualitative research and did these very in-depth interviews with the farmworkers as well as with stakeholders. And we were able to learn so much more and both Lisabeth and I feel very strongly that it is important as epidemiologists that we also think about the approach of using qualitative methodology to get this deeper understanding of the context. Because you wouldn't get this necessarily if you were just conducting maybe a more close-ended survey.

AH: We've had a lot of challenges in implementation that come from this kind of study and I think they kind of fall in a couple of broad categories. We didn't necessarily have funds to be able to compensate community organizations, compensate for the use of facilities and in some instances, even if the funds were available, there were organizational policies that didn't allow us to compensate organizations. So we did have to be more creative and think about ways that we could support the community organizations that were supporting us. So for example, buying school supplies for some of the farmworkers' children was one approach. We organized the clothing and basic needs drive at the U of M School of Public Health as well.

AH: So those are kind of alternatives that we came up with on just a more general implementation level. Developing and maintaining these partnerships, which are really important, can be challenging because over time leadership may change. And that can impact decisions that we've made with partners about how we're going to implement a study or the methods that we're going to take. And this happened to us in the first study in 2019 where we had some leadership changes and some of the partners we were working with, the field team and namely Lisabeth, who was doing the interviews, had to find alternative locations to be able to do the in-person interviews and to kind of deal with some of these other barriers that came from having new leadership.

LI: I guess I will share something that happened to me. For six months I was visiting this work site and getting to know the workers. I went when the priest came and to give the mass and I got involved in many events with them because I want to be more present with them so that we can develop this trust. And so the workers were super excited to participate in the study. I conducted my first two interviews with H2A farmworkers in a safe location because that was another challenge, right? We didn't want to jeopardize the employment situation of the workers or even worse. So I did my interviews.

LI: The next day I came back for the next two workers to do the interviews and apparently I was reported or someone called to the contractor, which is the one that manages the workers, H2A workers. And I was told that I needed to exit the site. They didn't say to me directly, but basically they say there's a woman doing investigation. And so that tells you about the complex dynamics to be able to even have that connection with the workers. And that was a big setback to the study because we spend a lot of time trying to develop those connections. And we was very unfortunate that we were shut down in this way.

AH: The biggest challenges that we face in implementation of these kinds of studies stem from the fact that this is a population of workers who have been marginalized, who are often very invisible, who are at high risk of being exploited. And so because of this, there is always this underlying kind of fear, mistrust, perhaps, and rightly so by farmworkers, by the community and their community. And so when we do conduct this type of research, it is so imperative that we work closely with our community partners in a very participatory way and that we develop our field methods and we develop our implementation approaches with this important context in mind.

LI: Before we even started projects, we spent a lot of time in the field developing connections with the community. I attended many committees in the state to learn. So what is going on? What is happening? What organizations are doing? We spent time in the field talking with the workers wherever I found them, talking with crew leaders, talking with outreach workers, with community leaders. So there was a lot of preparation, even to think about the logistics of how we were going to do this project before we even started. And that was extremely helpful. And I think that's why we were very successful in developing these connections, not only with the community partners, but with the workers and have the data that we have.

Host: In the five years since the Michigan Farmworker Project began, Handal and Iglesias-Rios have navigated complex challenges like these to give voice to the individuals and families that provide essential work in our state. Ultimately, their hope is to continue to expand the breadth of data that can be used to improve the lives of farmworkers in the state.

AH: Kind of the underlying theme of the work that we've been doing is that data is needed. Evidence is needed to be able to inform policy changes, to inform programmatic changes that can make service provision more efficient and better for the farmworker community. And so the way we see it as researchers, as epidemiologists, is that we want to contribute by conducting rigorous, high quality epidemiologic studies to be able to gather these data and this evidence to use those data for change. This population of workers has been able to have the strength to survive through these very complex experiences that is their lived reality. The farmworkers face a lot of challenges and a lot of difficulties, but they have this positive attitude. They are proud about what they're doing, but they want to be respected and they want to be treated as human beings that deserve all of the rights that everyone should have in our society.

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