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Description
Background: Farmworkers have a substantial need for health services to do the hazards of their occupation and to their lifestyle. Farmworkers are among the poorest of United States workers. The majority of farmworkers are immigrants, and many do not have legal documentation status. Farmworkers have low health services utilization which put them at risk for poor health outcomes. This study hypothesized that there are differences in the use of health services within the U.S. farmworker population due to documentation status. Additionally, this study examined the relationship between demographic, social, cultural, and economic characteristics in relation to the utilization of health services among the U.S. farmworker population. Understanding farmworker health behavior in relation to use of health care can help plan interventions at the individual, family, community, and societal levels. Methods: This cross sectional study design examined the significance of a farmworker's documentation status and other factors on his or her utilization of health services using data from the 2009-2010 cycle of the National Agricultural Workers Survey. Descriptive statistics, univariate analysis, and multivariate analysis were conducted. Results: Just over half of farmworkers (58%) used health services during the previous two years. After controlling for other factors, documented farmworkers were more likely to have used healthcare in the United States within the past two years than undocumented farmworkers [AOR=1.65, CI95 (1.29, 2.10)]. Age, gender, farmworker separation from family, educational attainment, total family annual income, and having health insurance were significantly associated with utilization of healthcare. Gender, educational attainment and total annual family income were found to be the strongest predictors of non-use of health care. Discussion: Given the high disease burden that the population faces, the low rate of health care use is of concern. Factors that have been identified in other health care utilization studies were also found to be significant predictors in multivariate models of farmworker health services utilization. Future outreach efforts should be targeted at undocumented, male, separated from family, lower educational attainment, lower annual family income, and uninsured farmworkers. Better characterization of health care use would be beneficial. Further studies on number of health care visits, sources of regular health care, purpose of visits, quality of care, and additional needs would be helpful to provide the population with appropriate health care.
