In the summer of 2018, I worked as a migrant outreach worker with Advocates for Basic Legal Equality, a non-profit that provides free and low-cost legal services to marginalized populations. This entailed driving around rural Ohio to meet with the migrant and seasonal farmworkers who come to work in the state every summer. Some of these people live and work in the United States, following the crops throughout the year. Others are H-2A workers, coming from other countries to work on U.S. farms with a seasonal and temporary H-2A visa.
As someone who has lived in Ohio for most of her life, I felt like I had entered a hidden world, an Ohio that existed right alongside my Ohio and yet was entirely distinct from it. The experience left me with a number of questions, many of them fundamentally geographic in nature. Some of them were mundane: How do these workers get to the grocery store? How do the rural communities where they live accommodate the seasonal presence of non-English speakers? What happens if an H-2A worker gets sick? Others were more philosophical: Do the H-2A workers develop a sense of belonging or connection to place when they’re here temporarily? If you worked in Ohio for 8 months out of the year and only spent 4 months in Mexico, which place was home?
I entered the PhD program knowing I was curious about these workers and more specifically, how this kind of guestworker program impacts their health. I understood from my training as an outreach worker that while all agricultural workers are considered a vulnerable population, the H-2A experience was fundamentally different from that of other migrant and seasonal farmworkers. For example, US-based farmworkers often travel with their families, while H-2A workers must leave their loved ones at home. Most migrant and seasonal farmworkers, even undocumented ones, are covered under the Agricultural Workers Protection Act, but the law does not extend to H-2A workers. On the other hand, H-2A workers are paid more and their housing is provided, free of charge, by their employers. However, their visa is tied directly to their employer, making them particularly vulnerable to exploitation and poor working conditions.
The social determinants of health, which has established that health outcomes are profoundly influenced by the conditions in which people live, would indicate that given these differences, H-2A workers’ health would be different than that of other migrant and seasonal farmworkers. However, no research has been done to prove this empirically and perhaps more importantly, establish what the health needs and challenges of this population are.
Figure a: Changes in the locations of the H-2A population in Ohio over time. When compared with map C, they show the geographic mismatch between worker and health clinic location
My research focuses on filling in some of this basic information at the state level. I will be surveying H-2A workers in Ohio, gathering both the demographic information mentioned above and asking questions about their healthcare access, occupational health and safety, and recording self-reported measures of health. The end goal is to provide actionable data for the organizations and state agencies within Ohio that serve the H-2A population and advocate for their rights.
Because I’m only at the beginning of my research, I don’t have a satisfying conclusion to this blog post. I have exactly zero answers to the questions I posed above. What I can say, though, is that the questions are urgent, and relevant to all of us. The plants for sale in the Lowe’s nursery, the cucumbers I slice up for my daughter’s lunch, the blueberries you put on top of your granola, all of it was produced by a farmworker, and quite possibly an H-2A worker. Understanding and advocating for their health and safety is one step in creating a more just and sustainable food system for all.
PhD Candidate, Department of Geography
Great questions. Caring and learning about “hidden” populations that we take for granted is an important endeavor that promotes social justice and equity in our country.
Linden Qualls
Thank you for sharing this important research, Anisa. Based on the maps you display, I’m also struck by the spatial mismatch between where H-2A farmworkers live and where they can obtain health care at federally funded clinics. At a first pass, I’d like to know why the clinics are located mostly in northwestern Ohio and Michigan. It’s my understanding that migrant health centers are public-private partnerships that receive federal funding, where the operating entity is usually a local nonprofit or a state/local health department. It would be really interesting to know more about the process for siting migrant health centers. On one hand, do local nonprofits approach the federal government to ask for funding to open a clinic? If so, what drives local nonprofits to take that step—farmworkers themselves, their policy and legal advocates, some combination, or something else entirely? On the other, what about county and municipal governments? I wonder whether progressive/pro-immigrant municipalities seek to attract migrant health centers to their localities, and whether anti-immigrant municipalities seek to repel them. We could think of this as a sort of sanctuary city dynamic. A quick glance at the map shows that there are basically no clinics in conservative southwestern Ohio. Ditto the rural hinterlands outside Columbus and all of southeastern Ohio. That said, I wouldn’t identify Toledo as a bastion of pro-immigrant/progressive values either, and the clinics cluster there—what gives? I hope you’re able to get out in the field this summer, and I can’t wait to see what you turn up!
Brookes
Thanks for your comment, Brookes!
The clinics are clustered in the NW part of Ohio because that is where, historically, we have had most of our agriculture. Migrant and seasonal agricultural workers (MSAW), mostly Latinx, have worked on farms in that region for around 100 years. However, the more “traditional” ag workers- that is families that either follow the crops, or live in the area and do the labor seasonally, are being replaced with H2A workers. Generally speaking, this is due to a combination of the draconian immigration policies of the previous administration and a general aging of the US based farm worker population. In the southern part of the state, there is just less agriculture (largely because it’s hilly), H2A or otherwise. Many of the farms in the north employ 50-300 workers, while in the south, it’s more common to see 2-10. As for the siting of the clinics, they are all “federally qualified health centers” (FQHC), which receive money from the federal government to serve all low-income populations. Those that are in places with a large MSAW population then, as far as I can tell, do some extra legwork (documentation, grant writing, etc) to become official Migrant Health Clinics. There are many FQHCs in the state not pictured on this map, but none of them have the training, funds, or personnel to provide services to this specific population. I hope that helps clarify things!