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BACKGROUND: A healthy agricultural workforce is an essential component of the local economy in Sonoma County, CA, with wine grapes alone grossing nearly $600 million in 2012. Agriculture is one of the most demanding and high risk industries for hired workers, but there has never been local data to quantify the health and wellbeing of Sonoma County farmworkers. This study assessed the overall health of Sonoma County farmworkers with the goal of identifying preventable health disparities.
METHODS: The Farmworker Health Survey was a cross-sectional study of Sonoma County farmworkers ≥18 years. Venue-based and convenience sampling were used between September 2013 and January 2014. The bi-lingual survey included validated questions on housing, health, demographics, and others. Univariate, bivariate, and age-adjusted statistics were calculated.
RESULTS: The 293 farmworkers surveyed were mostly male (91%), Latino or Hispanic (95%), and permanent residents of Sonoma County (88%). An estimated 92% of farmworker families did not earn enough to meet their family’s basic needs in Sonoma County. Farmworkers were significantly more likely to experience food insecurity (17%) when compared to the poorest Sonoma County residents (11%), after adjusting for age (p<0.0001). Two-thirds (67%) of farmworkers lived in overcrowded housing, and farmworkers living with families were significantly more likely to live in overcrowded dwellings (p=0.03). Farmworkers had a three-fold higher age-adjusted prevalence of self-reported fair or poor health in general (44%) when compared to Sonoma County adults (13%, p<0.0001), and the age-adjusted prevalence of ever being diagnosed with diabetes among farmworkers (15%) was three times higher when compared to Sonoma County adults (5%, p=0.002). Prevalence of binge drinking among farmworkers (47%) was higher than binge drinking among US adults (18%). After adjusting for age, 30% of farmworkers had health insurance in the US as compared to 86% of Sonoma County adults (p<0.0001). Insured farmworkers were significantly more likely to be female (p=0.003) and living with a spouse/partner and children in the US (p=0.03). Full-time farmwokers employed by the farm owner or grower had a marginally higher prevalence of health insurance (p=0.07).
CONCLUSIONS: Farmworkers experienced poorer general health and a greater prevalence of diabetes, and farmworker families lived in extreme poverty, potentially leading to food insecurity and overcrowded housing. Farmworkers had unequal health as compared to other Sonoma County adult populations, suggesting that more research is needed in order to reduce health disparities in Sonoma County, and farmworker-specific interventions should aim to reduce these identified disparities.