Farmworkers' dilemma: Not eating what they grow
Field laborers in Salinas are having increased problems with obesity, according to medical school research.
BY TRACIE WHITE
In the middle of John Steinbeck country, the "salad bowl of America," most of the Mexican farmworkers who harvest the fruits and vegetables that feed the nation aren't eating enough of it themselves.
Underpaid and overworked, Salinas farmworkers are eating at fast-food restaurants where the food is high-fat but low-cost. As a result, despite long hours in the fields, the Latino farmworkers, particularly those single, young men living in the labor camps, are facing a very American problem: obesity.
"They often eat someplace that's cheap and fast with high fat content," said Marilyn Winkleby, PhD, associate professor of medicine, who has spent years visiting farm laborers in the Salinas Valley in an ongoing partnership with the Monterey County Health Department. "Their jobs are becoming increasingly mechanized and less active."
Winkleby is the senior author of a study, published in the February issue of Ethnicity and Health, that examines the changes in cancer-related health behaviors within the Salinas Latino population—most of whom are of Mexican origin—over the 10-year period between 1990 and 2000. The study surveyed almost 2,000 Latino women and men from both the community at large and within 29 agricultural labor camps.
The goal was to detect changes in diet, physical activity, smoking and alcohol use as well as cancer health screenings in order to help design future public health interventions. Latinos, the country's fastest-growing minority group, suffer disproportionately from poor health exacerbated by poverty, poor education and a lack of health insurance and medical care, according to the study. Furthermore, they suffer disproportionately from some types of cancer and are 20 percent more likely to die from a malignancy than non-Latino whites.
Not all the news was bad. Among the positive behavior changes noted in the survey were continued low rates of smoking among women and men and a substantial drop in alcohol consumption among men. But most striking among the results were the increasing obesity rates, particularly within the labor camps, where it was up 90 percent.
The majority of the Mexican-American population in Salinas has now been living in the United States for at least 10 years, long enough to have been exposed to the "high-fat, low-exercise American environment," the study states.
On the positive side, there were some changes in diet that showed marked improvements: a shift away from the use of whole-fat to lower-fat milk among both labor camp men and women from the community and a decrease in the use of lard or meat fat for cooking among both men and women within the community. Fried food remained high on the menu.
Also on the positive side, the surveys showed significant increases in screenings for breast and cervical cancer with a significant increase in the rates of pap screenings and mammograms. Mammography screening showed especially large gains, from 15 percent in 1990 to 53 percent in 2000.
But researchers were concerned that annual blood stool testing for colon cancer remained infrequent—0 percent to 17 percent across the groups—and unchanged over the 10 years of the study. That's roughly half the percentage of the non-Latino white population.
Winkleby said public health policymakers have been working with community partners to enhance health behaviors among the Latino population in Salinas. She points to a grant awarded to the Monterey County Health Department for $5 million called "Steps to a Healthier United States," which she helped to launch and is now evaluating. The five-year program is funded from 2003-08 and has helped the health department to partner with agricultural employers, fast-food restaurants, churches, schools, senior centers, small stores and even shopping malls to foster healthier behaviors such as asking taquerias and corner stores to offer low-fat milk and to increase their fruit and vegetable supplies.
"For example, the health department negotiated with the main agricultural employers to provide healthy lunches and paid time off for workers to attend a wellness program," Winkleby said. Senior centers have received healthier government foods from food banks that supply much of their menu.
"If you want to effect change it's not enough to educate people," Winkleby said. "Individual behavior is influenced by the environments in which you live. Men living in the labor camps are primarily single, poor; they live in housing without cooking facilities."
Dropping off leaflets about the health effects of a poor diet isn't enough to affect change, Winkleby concluded. Both policy and health professionals must work toward enhancing the environments in which the laborers live and work.