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More than 500,000 people are employed in California’s massive agriculture industry, serving in all capacities from picking crops to working at packing plants.

Crowded housing and work sites, along with daily exposure to poor air quality, harmful pesticides and a host of underlying conditions make California ag workers highly vulnerable to a COVID-19 infection. In 25 farm-worker communities, infection rates were about 2.5 times higher than the state average.

(Above, l-r): Dr. Ilan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer at AltaMed; Ed Kissam, member of the National Center for Farmworker Health Advisory Committee to the Centers for Disease Control and Prevention; Noe Paramo, Director of the California Rural Legal Assistance Foundation at the California Rural Legal Assistance Foundation; and Arcenio Lopez, Executive Director, Mixteco/Indigena Community Organizing Project. (EMS)

At a briefing held by Ethnic Media Services and California Department of Public Health / Vaccinate All 58, Dec. 21, 2022, speakers ­– Dr. Ilan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer at AltaMed; Ed Kissam, member of the National Center for Farmworker Health Advisory Committee to the Centers for Disease Control and Prevention; Noe Paramo, Director of the Sustainable Rural Communities Project at the California Rural Legal Assistance Foundation; and Arcenio Lopez, Executive Director, Mixteco/Indigena Community Organizing Project – discussed the challenges of getting accurate data about the farm-worker community; the impact of expanded MediCal, which aims to provide health insurance to all Californians regardless of immigration status; the need for continuing a vigorous vaccination campaign including updated boosters and their families; and measures to expand access to anti-viral treatment for farm-workers.

Dr Shapiro gave an overview on the state of health of our agricultural workforce, especially during the pandemic.

“My experience for the past seven years has been from L.A County to Orange County, serving more than 400,000 patients. I worked in Fort Myers, Florida, where I was serving a lot of migrant workers. The reality is that we have had good moments during the pandemic. We need to continue making sure that we can fix and improve the health of our communities.

“The first thing is the way that we deliver health care. In 2019, from education, communication, and all the campaigns that we were doing were quite different. We knew that going to our farm workers was essential, but we never felt that until we were struggling in 2020, when most of the communities were at home.

“They were out there making sure that we had opportunities to have something to feed our families, while they were getting exposed, working as an essential worker for our community. Right now, the things and take-home messages that I would say is, ‘How can we better communicate?

“Right now our communities need information and how are we going to deliver that information? As we have seen in California, we put a lot of coverage out there, from radio when they were working to going out there and talking one by one to make sure that they understood the importance of being protected; being there for their families and having that equal opportunity to treatments and preventive services.

“COVID-19 opened a lot of conversations for our communities from farm workers and other essential workers to the point that now we know that we need to start putting concordant doctors in areas that our communities needed.

“When we went to the fields, when we go out there and do the campaigns, and they hear me speaking Spanish or we can bring some other indigenous languages, they smile.

“The cultural aspect of herbs, medications, and other things are essential part of how we deliver care in our fields for that specific community. COVID-19 hurt our community. It’s a struggle and it’s hard recognizing the things that we have and making sure that we are helping our community leaders.

“As a doctor I can tell you for sure that even if you give me all the money of the world, all the hospitals, all the doctors, I can just change 20 percent of the health care, wellness of someone. The other 80 percent depends on information and the things that happen literally where they live, it could be technology, it could be our amazing promoters, our community health workers we need to choose and make sure that we do not roll back to 2018. it’s essential for our community and it’s essential for the entire country to make sure that our farm workers are healthy, taken care of, and if it’s COVID-19, Influenza, Diabetes, Hypertension, any of these things that we are struggling with, need to be accounted for, and the resource is given, because oxygen is essential, our food is essential, it is essential to be together with the family,” said Dr Shapiro.

Paromo spoke on behalf of California Rural Legal Assistance Foundation, “The need for providers the disparities that were exacerbated during the pandemic, then for equity in applying these principles for our underserved marginalized farmworker communities, and also the need for providers, brings to mind a recent conversation with the assembly member Dr Arambola, who really focused on the need to have providers in these rural areas such as the San Joaquin Valley.

“The Foundation worked with senator Ana Caballero-spearheaded a funding policy fiscal policy to update Farm worker Health Data that was over 20 years old and UC Merced has completed the study, where they interviewed over 1,100 farm workers.

“Hundreds of medical exams and this up-to-date data to address these social determinants of health demographics and these health behaviors, the results will be disseminated soon as they’re being gone through the California Department of Public Health approval process, said Paromo.

Kissam, a member of the National Center for Farm Worker Health Advisory Committee to the Centers for Disease Control, said, “California agricultural counties started doing outreach to farm workers in a very uneven way, some worked early and hard, and others dragged their feet. Overall, I’m estimating that about half of California’s farm workers are vaccinated and that’s about 20 percentage points below the national average.

“Moreover, one of the issues that’s really crucial at this point with the new Omicron variants is that simply being vaccinated doesn’t provide the kind of protection we’d like to see, and for once, I’m part of the mainstream.

“The CDC is calling for a huge emphasis on people getting up to date with vaccination. Our progress nationally on that front is really worrisome with only about 14 percent of the eligible people in the nation having gotten the up-to-date vaccinations.

“Unfortunately, once again farm workers are disproportionately left behind with the rate of new boosters, the mRNA boosters, the bivalent vaccine being about five to six percent in most of the agricultural counties of California, that’s why treatment is important because without being up to date with vaccination there’s going to be a disproportionate number of people who are at risk of very serious illness,” said Kissam.

“We started being more aware and worry about the farm market communities, their mental health situations as a consequence of going through three years of COVID. Many of our farm worker families lost their families and there’s a lot of increase in anxiety, stress, and the mistrust that our communities has with the health system,” said Lopez.

“There was a lot of miscommunications when COVID was happening. There were lots of doubts when farm workers got COVID like, if they should go and be hospitalized or not, because it was part of the miscommunication that they were getting.

“They felt that if based on what they were seeing with other families, those who ended in the hospital, it was for sure they died versus those that stay home and take home remedies for COVID, like tea, or any of that, they survived.

“Historically, there’s been a lot of mistrust between indigenous communities farm worker communities and the western health, that we need to be aware of.

“Our language plays a very crucial role into reaching out or providing services to to our communities.

“The complexity of farm workers communities is that they are almost impossible to reach because we don’t know where they are. They’re very mobile. They might be in Oxnard for a week and they might be moved to up North California next week. In three months you will not see those workers because they went they went back to Mexico,” said Lopez.