Why are migrant agricultural workers considered a vulnerable population, and what specific health risks do they face according to the chapter?

Migrant agricultural workers are vulnerable because they combine poverty, limited English proficiency, lack of insurance, and constant mobility, which makes it hard to establish residency, obtain benefits, and access health care. Their health risks include higher rates of tuberculosis and other communicable diseases, poor nutrition, exposure to pesticides and dangerous farm work, and substandard housing. Children of migrant workers are especially vulnerable, with more than half having unmet medical needs.

The chapter explains that migrant agricultural workers are a distinct vulnerable group because their lives are characterized by poverty, transience, and exclusion from the usual supports. In 2017 only about 31% reported speaking English well, 27% could not speak English at all, over one-third were uninsured, and 63.5% lived below the poverty level. Their need to move from place to place to follow crop seasons means they often lack stable housing, cannot establish residency for federal benefits, and usually have no access to workers' compensation or disability compensation. Farm work typically pays hourly or by piece and offers no sick time or paid leave, and workers face practical barriers to care such as cost, lack of local providers, lack of transportation, and language or cultural barriers. These circumstances produce specific health consequences. The chapter states that migrant and seasonal farmworkers have a higher incidence of tuberculosis and other communicable diseases, poor nutrition, and daily exposure to the hazards of farming and pesticides. Crowded housing and working conditions make them six times more likely than other workers to develop tuberculosis. Children of migrants are also at risk: an estimated 300,000 to 500,000 children under 18 do agricultural work, mothers may be exposed to toxic pesticides during pregnancy, and more than half of migrant workers' children have unmet medical needs. Policy gaps, such as the ACA not covering undocumented workers and exemptions for farms with seasonal workers, leave many without insurance.