Elevated Depressive Symptoms Among Hired Crop Workers in the United States: Variation by Sociodemographic and Employment Characteristics.

We present prevalence rates, along with demographic and economic characteristics associated with elevated depressive symptoms (EDS), in a nationally representative sample of hired crop workers in the United States. We analyzed in-person interviews with 3,691 crop workers collected in 2009-2010 as part of a mental health and psychosocial supplement to the National Agricultural Workers Survey. The prevalence of EDS was 8.3% in men and 17.1% in women. For men, multivariate analysis showed that EDS was associated with years of education, family composition, having a great deal of difficulty being separated from family, having fair or poor general health, ability to read English, fear of being fired from their current farm job, and method of payment (piece, salary, or a combination). Interactions were found between region of the country and family composition. Multivariate analyses for women showed that fear of being fired, fair or poor general health, having children ≤15 years of age, being unaccompanied by their nuclear family, expectation for length of time continuing to do farm work in the United States, and authorization status were associated with EDS. Interactions were found with Hispanic ethnicity and region of the country, as well as presence of the nuclear family and region. The present study identifies important risk factors in this first population-based assessment of EDS in a nationally representative sample of U.S. crop workers. The importance of social support from family, job insecurity, and high prevalence of EDS in female crop workers support the need for screening and outreach in this primarily rural group of men and women crop workers.

Collecting Comparative Data on Farmworker Housing and Health: Recommendations for Collecting Housing and Health Data Across Places and Time.

The substandard nature of the housing in which most farmworkers live has detrimental effects on their health, as well as on their children's health and development. However, little research has directly documented associations between farmworker housing and health; existing research is not always comparable due to differences in design and measurement. Comparative data can help determine actual causal links between housing characteristics and farmworker health and help to evaluate the efficacy of current housing policy. The goal of this paper is to provide guidelines promoting comparable research on farmworker housing and the association of this housing with health. This paper reviews general concepts relevant to measuring farmworker housing and health, issues that should be considered in designing farmworker housing and health research, data collection methods, and measures. It concludes with recommendations for a research agenda on farmworker housing and health.

Evaluating Job Demands and Control Measures for Use in Farm Worker Health Surveillance.

Workplace stress likely plays a role in health disparities; however, applying standard measures to studies of immigrants requires thoughtful consideration. The goal of this study was to determine the appropriateness of two measures of occupational stressors ('decision latitude' and 'job demands') for use with mostly immigrant Latino farm workers. Cross-sectional data from a pilot module containing a four-item measure of decision latitude and a two-item measure of job demands were obtained from a subsample (N = 409) of farm workers participating in the National Agricultural Workers Survey. Responses to items for both constructs were clustered toward the low end of the structured response-set. Percentages of responses of 'very often' and 'always' for each of the items were examined by educational attainment, birth country, dominant language spoken, task, and crop. Cronbach's α, when stratified by subgroups of workers, for the decision latitude items were (0.65-0.90), but were less robust for the job demands items (0.25-0.72). The four-item decision latitude scale can be applied to occupational stress research with immigrant farm workers, and potentially other immigrant Latino worker groups. The short job demands scale requires further investigation and evaluation before suggesting widespread use.

Job control, psychological demand, and farmworker health: evidence from the national agricultural workers survey.

OBJECTIVE: Improve understanding of the potential occupational health impact of how agricultural jobs are organized. Exposure to low job control, high psychological demands, and high job strain were hypothesized to have greater risk for poor self-rated physical health and elevated depressive symptoms. METHODS: Cross-sectional data (N = 3691) obtained using the Work Organization and Psychosocial Factors module of the US National Agricultural Workers Survey fielded in 2009-2010. RESULTS: More than one fifth (22.4%) of farmworkers reported fair/poor health, and 8.7% reported elevated depressive symptoms. High psychological demand was associated with increased risk of fair/poor health (odds ratio, 1.73; 95% confidence interval, 1.4 to 2.2) and elevated depressive symptoms (odds ratio, 2.6; 95% confidence interval, 1.9 to 3.8). CONCLUSIONS: The organization of work in field agriculture may pose risks for poor occupational health outcomes among a vulnerable worker population.

Impact of individual-, environmental-, and policy-level factors on health care utilization among US farmworkers.

OBJECTIVES: We examined individual-, environmental-, and policy-level correlates of US farmworker health care utilization, guided by the behavioral model for vulnerable populations and the ecological model. METHODS: The 2006 and 2007 administrations of the National Agricultural Workers Survey (n = 2884) provided the primary data. Geographic information systems, the 2005 Uniform Data System, and rurality and border proximity indices provided environmental variables. To identify factors associated with health care use, we performed logistic regression using weighted hierarchical linear modeling. RESULTS: Approximately half (55.3%) of farmworkers utilized US health care in the previous 2 years. Several factors were independently associated with use at the individual level (gender, immigration and migrant status, English proficiency, transportation access, health status, and non-US health care utilization), the environmental level (proximity to US-Mexico border), and the policy level (insurance status and workplace payment structure). County Federally Qualified Health Center resources were not independently associated. CONCLUSIONS: We identified farmworkers at greatest risk for poor access. We made recommendations for change to farmworker health care access at all 3 levels of influence, emphasizing Federally Qualified Health Center service delivery.

Measuring job characteristics and mental health among Latino farmworkers: results from cognitive testing.

BACKGROUND: Few research instruments used in occupational stress research have been evaluated for acceptability and validity among immigrant Latino farmworkers. METHODS: Cognitive testing was completed with 40 migrant and seasonal farmworkers (21 women, 19 men) through two focus groups and 16 one-on-one interviews conducted in Texas and Florida. Participants responded to the K-6, a short form instrument designed to measure psychological distress, selected items from the Job Content Questionnaire (JCQ) and standard health items. RESULTS: The K-6 items were characterized as too long and using a higher "class" language than farmworkers use. Further, the cultural connotation of several items in the K-6 was viewed as inappropriate by farmworkers. Demand items from the JCQ were interpreted inconsistently, whereas decision latitude items were consistently understood but viewed as irrelevant to farmworkers. CONCLUSIONS: The results highlight the difficulties involved in conducting research with immigrant farmworkers, and they suggest that researchers interested in studying antecedents and consequences of farmworker mental health need to select instruments cautiously.