Many refugee, immigrant, and migrant (RIM) community members experience significant cultural, linguistic, and logistical barriers to accessing health information and healthcare, including accurate information about COVID-19, COVID-19 vaccines, and vaccination opportunities. Bringing information and services directly to RIM communities in the places where they live, work, and gather is a promising practice to ensure culturally and linguistically appropriate access and to build trust between RIM community members and health workers.
Agricultural workers, most of whom are immigrants and migrants, were designated essential workers and have been expected to work throughout the COVID-19 pandemic to ensure the continuity of U.S. food supplies. These workers face significant COVID-19 exposure risks due to the nature of their jobs and workplaces. They often live, work, and travel in crowded conditions with limited access to personal protective equipment and sanitation supplies. At the same time, agricultural workers have been hard to reach for health workers providing COVID-19 safety information, testing, and vaccination, because of barriers such as limited English proficiency, low levels of formal education and health literacy, physical and social isolation, lack of transportation, and distrust related to immigration status. As a result, they have been disproportionately impacted by COVID-19. As of August 2022, there were approximately 5 million COVID-19 cases among agricultural workers.
Some organizations have reported successful outcomes bringing health information and services directly to farms. They have made COVID-19 resources available to agricultural workers on site and in the workers’ languages. Coordinating with employers has been an essential part of this outreach.
Bringing Health Education to the Fields in California
Nuestra Comunidad, a community organization in Sonoma County, California, offers programs for immigrants and migrants that range from community-focused disaster preparedness to health and wellness. Working in partnership with the Sonoma County Department of Health Services, Nuestra Comunidad has been an integral part of the local COVID-19 response by disseminating information and facilitating access to testing and vaccine clinics. One notable part of Nuestra Comunidad’s work has been on-site trainings about COVID-19 and vaccines in Sonoma wineries. Using easy-to-follow visuals, Nuestra Comunidad’s presenters have taught workers in the fields, reaching not only those who speak Spanish, but also those who speak indigenous Mexican languages like Mixteco or Triqui.
Alma Bowen, the Executive Director of Nuestra Comunidad, says: “What allows our organization to be effective in the work that we do is that we have fostered, literally over years, relationships with not only the workers, but also their employers … because you’re more than likely not going to get your foot in the door the first, the second, the third, the tenth time you contact these companies or organizations. Over time, we’ve been able to show that what we say we’re going to do is what we do, that we’re trusted, that we’re there to help the workers.”
Partnering with Agricultural Employers in Washington
When COVID-19 affected the migrant food worker community in Washington, Chelan-Douglas Health Department and Columbia Valley Community Health collaborated with three major fruit companies. In addition to developing testing and screening protocols, they formed a mobile outreach team comprised of medical assistants, nurses, and providers to offer testing and education in the migrant work sites. The partnership allows public health to communicate COVID-19 responses between the health department, the clinic, and employers so the outreach team can mobilize quickly and go on site for testing or CICT.