Methods: Assessments were conducted via face-to-face interviews for 179 Mexican-origin indigenous and mestizo migrant farmworkers that were part of the Migrant Health Outreach Project. Analysis was conducted using two outcome measures: (a) Use of medical care, measured by the question “Have you been to the doctor in the last twelve months? (Yes/No); and (b) Use of dental services, measured by the question “Have you been to the dentist in the last twelve months? (Yes/No). Key predictors were classified as predisposing, enabling or need factors using the BMVP Model. Descriptive statistics were calculated for all study variables. Hierarchical logistic regression was performed to examine the influence of need, enabling and predisposing factors for both outcome variables.
Results: The majority of migrant farmworkers interviewed were female (71%) and indigenous (69%). Their average age was 31 years-old. Although they had an average of four family members living in the US, they sent almost half of their income (46%) back to their families in Mexico. Three out of four workers (74%) said they attended religious services. Very few workers had health insurance (4% in the US; 9% in Mexico). Almost half of the workers (49%) said they had poor/fair physical health; while 58% said they had poor/fair dental health. Despite this relatively high levels of need, only over a third of farmworkers (37%) used medical care and even less (20%) used dental care in the last twelve months. Multivariate analyses showed that female and older workers were more likely to use medical services. On the other hand, those workers with larger families and sent more of their income as remittances, were less likely to utilize medical care. Farmworkers attending church were more likely to access dental services.
Implications: This study provides new insights into the challenges migrant farmworkers face when trying to access medical and dental services. The very low rates of health insurance in both the US and Mexico pose a significant barrier to use of medical and dental services. The strongest predictor of medical care utilization was being a female worker which provides support for efforts to expand women's health services, including prenatal care. In the case of dental care, it is interesting that church attendance was a significant enabling factor. We consider that the connection with religious groups allowed workers to access services. Given that their most “urgent” need related to their dental health, it is understandable that it would take priority over other needs.
