A portrait of California farmworkers: Aging, underinsured, stressed

SACRAMENTO — Many farmworkers in the state lack access to health care at a time when this group as a whole is aging, a new report says.

The Public Policy Institute of California held an online forum on the topic Thursday. It included a grower representative based in Modesto and a labor attorney and a lawmaker from Fresno.

The report, by PPIC research fellow Paulette Cha, said coverage has improved for workers who are documented immigrants, but not so much for the others. It also said their average age is rising, and more have permanent homes here as the migrant portion of farm labor shrinks.

State Assemblyman Joaquin Arambula, D-Fresno, talked of his efforts to expand Medi-Cal coverage for undocumented workers. The lawmaker, who also is a physician, said health depends also on workers having adequate housing, food and drinking water.

“I believe it’s important for us to make sure we’re addressing those social determinants of health, those factors outside of the four walls of health care, to make sure we’re adequately addressing the real needs of our farmworker communities,” Arambula said.

He and attorney Estella Cisneros both said the insurance gap became acute amid COVID19 because these workers had to continue their essential jobs despite the infection risk.

“They were working in person throughout the entire pandemic and so it really showed us the preexisting problems of how difficult it is for farmworkers to access health care,” Cisneros said. She is legal director for the Agriculture Worker Program at California Rural Legal Assistance.

Panelist Teresa Kiehn is president and CEO of AgSafe, a nonprofit that helps growers and processors reduce illness and injuries among employees.

She noted one upside of the pandemic: more attention to workers’ overall health, rather than just occupational risks such as heat stress, pesticides and tractors.

“We (used to) have these conversations about what you do at work, but now we’re having the conversations about what happens at home as well,” Kiehn said.

The PPIC is based in San Francisco and researches a range of topics, including health, education, politics, crime and the environment. Cha specializes in the health of immigrants, children and other underserved people.

The new report says 91% of the state’s documented immigrants have health coverage, including Medi-Cal and the federal employer mandate. Only 51% of undocumented people are covered.

California expanded Medi-Cal in 2020 to undocumented residents through age 25. The program would add 26- to 49-yearolds in 2024 under Gov. Gavin Newsom’s proposed budget.

Arambula introduced a measure, Assembly Bill 4, that would provide Medi-Cal coverage regardless of age or immigration status. He said Thursday that he also would like to do more to protect farmworkers from air pollution, along with the extreme heat waves expected with climate change.

The PPIC report offered other details on the roughly 160,000 farmworkers in California:

• The average age is about 42, up from 32 in 1998

• About 15% migrate annually from their home country, down from nearly half in 1998

• 97% are Latino

• 70% are male

• 44% do not speak English

• 74% did not complete high school

• 59% are undocumented.