Susan Bauer, MA, MPH

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What Price Our Produce? The Impact of Farming
on the Health and Wellbeing ofOur Children

• Susan Bauer, MA, MPH
• Executive Director
• Community Health Partnership of Illinois
• sbauer_at_chpofil.org
• October 18, 2012

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Community Health Partnership of Illinois Four
Decades Serving Farmworkers, Rural Communities

• Primary Health Care Clinics (FQHC) Aurora,
  Woodstock, Kankakee, Rantoul, Mendota, Harvard
• School/Head Start based Services
• Environmental/Occupational Health Promotion
• Chronic Disease Management
• Cancer Prevention and Screening
• Peer-led Health Promotion/Advocacy
• Patient Majority Governing Board

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Trouble on the Farm NRDC 1998 Report

• Pre-WWII life on the farm healthy living
• Today pervasive use of pesticides on farms,
  exurban encroachment potential for higher
  exposure to toxins for farm, rural, exurban
  children
• Increased consciousness re health risks to
  children who consume products treated with
  agricultural chemicals
• Increasing body of evidence that those risks are
  compounded by environmental exposures for
  children on, near farms that use agricultural
  chemicals on crops (Lu et. al, 1999)

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FOOD FOR THOUGHT

• Agriculture consistently ranks among top 2-3 most
  hazardous jobs in US, yet least regulated, fueled
  by the Great American Agrarian Myth
• Occupational health risks are indistinguishable
  from environmental health risks
• Child labor is alive and well, tragically
• Children as young as 16 can (and do) perform
  hazardous jobs
• Children as young as 12 can work on any farm
• Younger children can (and do) work legally with
  permission of parent

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What Realities Do Migrant Farmworkers Face
Every Day?

• 1.5-3 million farm laborers in the US 65,000 in
  Illinois (6 are children (90,000-180,000 based
  on 2000 NAWS)
• Workers (including children), lack legal
  protections, immigration status, very low income,
  uninsurable
• 80 farms/nurseries in Kane County

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Systemic Barriers to Healthy, Safe Farms

• OSHA/IDPH Field Sanitation only and only for
  farms with 11/10 workers, IL does not cover
  workers who do not travel from home (e.g., local
  teen detasslers)
• EPA Worker Protection Standard Delegates
  enforcement to Depts. of Ag. Child Labor Laws
  inadequate to protect children

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Realities of Migrant Farmworkers that Impact
Health Status

• Natl Ag Worker Survey (2000)
• Young (50lt31 6 lt18)
• Male (75)
• Immigrants from Mexico (71)
• CHP UDS (20110
• Uninsured, Uninsurable (93 AGE 20
• Sub-poverty wages (90)

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IMPACT ON CHILDREN WHO LIVE NEAR FARMSStudy of
109 children, median house dust concentrations
for organophosphates inhouse dust were 7 times
higher for agricultural family children than
others. Median concentrations of pesticide
metabolites in agricultural childrens urine were
5 times higher than for other children.
Proximity to farmland increased exposures. In
some cases the distinction between farmland and
residence is blurred, as when a home is in the
midst or on the boundary of an orchard (Lu et
al, 1999, Washington state)

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What is Being Done to Address the
Problem?

• Blueprint for Protecting Children in Agriculture
  (Marshfield Clinic, WI)
• Regulatory Reform (Ag Child Labor Hazardous
  Occupation Orders, NIOSH)
• Proposed CARE Act (Childrens Act for Responsible
  Employment)
• Exposure Prevention Education (NRDC, MCN,NCFH)
• Peer-Led Health Education and Advocacy
• Community Health Workers
• Promotores/as de Salud (Health Promoters)

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WHILE WE CONTINUE TO FIGHT FOR MEANINGFUL REFORM
IN AGRICULTURE PRACTICES/LAWS, WHAT CAN WE DO
TODAY?

• Initiated in 1996 with NIOSH occupational health
  research grant
• Preceded by many years of assistance from MHP
• First step gain support of clinical staff
• Tailored to special needs of MSFW population

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Leadership Development Around Health and
Wellness

• Community health educators, advocates
• National Award in 2005
• Expanded to three clinic sites (Aurora)
• Grounded in principles of Popular Education
  (Paolo Freire)

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Underlying Principles of CHPs Promotores de
Salud Program

• Asset-based Model of Community Assessment,
  Response
• Community is not the object of the
  intervention, but a key partner in the delivery
  of the intervention
• Most effective strategies to modify risk
  perception, behavior are created, delivered by
  the community

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Who Are OurPromotores de Salud?

• Farmworkers with
• Natural leadership skills
• Trust of their peers
• Interest in health, safety
• Desire to learn and share what they learn
• Everyday interaction with target community
• Support of family to make commitment necessary to
  do their work

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Promotores Roles and Activities

• Research (administer surveys, recruit
  participants, review tools, conduct
  intervention/observations)
• Promote safe workplace practices with managers
• Health Promotion (one on one, small group
  platicas)
• Model desired behavior (e.g., Protective
  Eyewear)
• Referrals/Transportation for Appointments
• ID, communicate to clinic unmet individual,
  community needs

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CLOSING THOUGHTS

• Antiquated US child labor laws, and inadequate
  regulation and enforcement of Ag protective laws,
  at worst have proved fatal, and at a minimum
  compromise the health and wellbeing of children
  who work or live on farms
• Urgent need to expand our locus of concern re
  pesticide exposure in child consumers to include
  children involved in crop production, and those
  who live on or near farms that employ harmful
  chemical in crop production
• Work to pass the CARE Act

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RESOURCES and REFERENCES

• http//www.marshfieldclinic.org/nccrahs
• http//www.nrdc.org/health/kids/farm/farminx.asp
• http//www.cdc.gov/niosh/topics/childag
• http//www.hrw.org/support-care
• www.farmworkerjustice.org
• www.ncfh.org
• www.migrantclinician.org
• www.migranthealth.org
• www.spcpweb.org