Health-related quality of life in a California hired farm worker cohort

Introduction: California’s agricultural workforce is largely comprised of Latino immigrants. Over 500,000 hired farm workers are employed each year, providing 85% of the state’s farm labor. We examine socioeconomic status, immigration and physical activity associated with health-related quality of life (HRQOL) in an immigrant, farm worker population.  

Methods: MICASA is a population-based cohort study examining occupational exposures, lifestyle and health in California farm worker families. Participants were 18-55, Mexican/Central American descent, residents of Mendota, CA, with one household member engaged in farm work. Trained interviewers contacted households and interviewed both head of household and spouse. Interviews at baseline (2006-2007) and follow-up (2008-2010) assessed demographics, occupational/environmental factors, physical activity, HRQOL, food security, acculturation, smoking status, respiratory and mental health.  

Results: Data were collected from interviews at baseline (n=843) and follow-up (n=640). Mean age at baseline was 41 years. 66% were born in Mexico, 30% in Central America. Mean years residing in the U.S. was 15. Average immigration age was 23 years. At follow-up, 46% were male, 65% reported primary education level, and 11% were current smokers. 46% reported annual incomes less than $20,000. 45% were classified as poor/fair health, and 5% with frequent mental distress. Older participants, women, older immigration age, current smokers and being food insecure had higher odds of poor/fair health. Women, those with incomes less than $10,000 and those not working in agriculture in the past year were more likely to report frequent mental distress. Older immigration age and more physically active work were associated with lower odds of frequent mental distress.

Discussion: The high prevalence of poor/fair health highlights a significant public health problem. Food security, income and immigration factors likely play a role in understanding the complexity of HRQOL in farm workers. Future research should focus on establishing temporality in furthering knowledge of etiology and designing interventions.