Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Daniel Carrión

Second Advisor

Robert Dubrow

Abstract

Due to climate change exacerbating high heat days, it is speculated that farmworkers will bear the brunt of this in the fields. High heat is only one of many consequences of climate change but was chosen as the occupational exposure of study due to its lack of literature in northeastern states like Connecticut. This study has three aims. The first aim is to explore the health impacts of extreme and prolonged heat exposure in Connecticut migrant farmworkers. Second, understand the current awareness among health care providers and the intervention methods that are being taken, if any. Finally, understand what barriers exist in improving farmworker conditions and protections. This study was conducted through qualitative interviews with a range of farmworkers and associated groups throughout Connecticut. This includes interviews with a nurse, social worker, community health worker, workplace safety officers, physicians, healthcare workers, and farmworkers (N=39). Non-farmworker interviewees were reached through cold calling and cold emailing, followed by snowball recruitment. Farmworkers were reached through a non-farmworker interviewee introduction. Thematic analysis was conducted using Nvivo software, yielding the following themes: adverse health outcomes, work environment, barriers to improving work conditions, barriers to receiving healthcare, and solutions and interventions. Adverse health outcomes included heat-related illnesses, poor mental health, and other chronic and acute illnesses. The work environment was described as dependent on type of work and employer, and that workers depended on outside entities for providing heat-related personal protective equipment. Barriers to work conditions included a lack of enforcement by outside agencies, exploitative practices by the growers, fear of exercising worker protections, and lack of knowledge of the minimal existing work protections. Barriers to receiving healthcare included reluctance to take time off, ability to pay, and overwhelmed federally qualified health centers. Finally, solutions and interventions identified were placing the responsibility on farmworkers to protect themselves through providing them with personal protective equipment and prevention education, as well as shifting their work hours to avoid heat, and scheduling them for clinic visits on bad weather days. These findings highlight that while treatment in Connecticut is deemed better, farmworkers still face systemic structural restraints that lead to adverse health outcomes, as well as additional barriers to improving health care access and better work conditions. Targeting these findings will be helpful to improve poor health outcomes.

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This is an Open Access Thesis.

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