Legal Status, Precarious Employment

& Self-Rated Health in Foreign-born CA Farm Workers

(MICASA Project)

Western Center for Agricultural Health and SafetyGraduate Student Seminar

Emily Sousa University of California, Davis

Background

Mexican & Central American migrants in the US:

Undocumented migrants: 4% of US population5% of US workforce28% of US Immigrants

Reasons for migration

Unequal Distribution of

Resources

Labor Migrants

Health of Foreign-Born Workers

Would be 5th Largest State:

14.7 million (2010)

1 2 3 4

• Estimated 500,000 farm workers employed each year in CA

• 85% of California’s farm labor• Majority are Latino

– mostly Mexican immigrants

Background

• Farm work is dangerous • High risk for illness & injury • Risk may be associated with

SES and Legal Status

MICASA PROJECT• Cohort of farmworker families in Mendota, CA

• Representative random sample of households by census block

• Data collected in 2006, 2008, 2011– 504 Interviews in 2011

• Participants: males & females, 18-55 years old

Assess the relationships between documentation status, precarious employment, and self-rated health

H1 Undocumented status positively associated with precarious employment

H2a Undocumented status positively associated with poor self-rated health

H2b The association between precarious employment and poor self-rated health will be stronger than that between undocumented status and poor self-rated health, but both with remain significant in the joint model.

Project Goal

Questions to Assess Documentation Status

• Are you a citizen of the United States?

• Are you a legal permanent resident of the United States?

• Do you have a picture identification document issued by any United States government office?

If no to all, classified as Undocumented

Precarious Employment: Lack of regulations that support the standard employment relationship, making workers more vulnerable

Employment Precariousness Scale (EPRES) 6 Dimensions:

• Job Instability

• Empowerment

• Vulnerability

•Wage Level

•Workers’ Rights

•Capacity to Exercise Rights

Outcome Variable: Self-Rated Health

“Would you say that in general your health is…” Excellent, Very Good, Good/Fair, Poor

Dichotomous outcome (good or poor health)

Associations: mortality, gender, age, SES

(Idler & Benyamini, 1997)

Chapter 2 Methods

Data Set: MICASA 2nd Follow-Up (2011-2012)

Outcome Self-rated healthExposures Documentation status &

Precarious employment (EPRES)

Covariates Sex, age, age at migration, education

AnalysesUnivariate/descriptiveLog-binomial

Current Status

• Focus Group: Responsive to questions, modified questionnaire from original (Spain)

– Workers’ Rights– Mayordomo vs. Ranchero

• Data collection complete: 504 interviews~ 80 % response rate

• Data expected to be ready for analysis this month

Preliminary ResultsLegal Status:

US Citizen Legal Resident Undocumented

n=130 (26%)

n=59 (12%)

n=315 (62%)

Legal Status by Sex

US citizen Legal Resident Undocumented

Males Females

n=161 (72%)

n=24 (11%)n=37

(17%)

n=164 (58%)

n=83 (30%)

n=35 (12%)

Do you feel that your immigration status has affected your health in any way?

Undocumented

Legal Resident

US Citizen

Never94%

Never88%

Never68%Sometimes

10%

Sometimes14%

Sometimes3%

Often2%

Often11%

Often3%

Next Steps• Continue Data Cleaning

• Univariate & Bivariate Analyses

• Construct Log-Binomial Model – relationships between:• documentation status• precarious employment• self-rated health

• Imperfect measure of documentation status• Cross-sectional design: temporality• Subjective outcome

Limitations

Strengths• Large sample size• First look at documentation status & precarious

employment in California farmworkers

Policy ImplicationsEffective Interventions need to:

• Extend Rights• Enforce Rights• Provide a Right to Recourse

Definition of precarious employment: lack of regulations to support the standard employment relationship, making workers more vulnerable

If precariousness varies between social groups, we can use this to identify areas of need for policies that work to ensure healthy employment relationships

Thank You!Dr. Marc SchenkerDr. Maria Stoecklin-Marois Tamara Hennessy-BurtDiane MitchellSandra FreelandWestern Center for Agricultural Health and Safety/NIOSH

Alejandra Vives VivesJoan BenachGREDS-EMCONET

Dr. Dan TancrediDr. David KyleDr. Danielle HarveyDr. Stephen McCurdyDr. Thomas Farver

Dr. Xochitl CastenedaPIMSAHealth Initiative of the Americas

And especially to the field team and participants

References

(United Nations, Department of Economic and Social Affairs, Population Division (2011). Trends in International Migrant Stock: Migrants by Age and Sex (United Nations database, POP/DB/MIG/Stock/Rev.2011)) 1. Manning, P., Migration in world history. Themes in world history. 2005, New York: Routledge. ix, 193 p.2. Zimmerman, C., L. Kiss, and M. Hossain, Migration and health: a framework for 21st century policy-making. PLoS Med, 2011. 8(5): p. e1001034.3. Breslau, J., et al., Immigration to the USA and risk for mood and anxiety disorders: variation by origin and age at immigration. Psychol Med, 2009. 39(7): p. 1117-27.4. Newbold, K.B., Self-rated health within the Canadian immigrant population: risk and the healthy immigrant effect. Soc Sci Med, 2005. 60(6): p. 1359-70.5. Abraido-Lanza, A.F., et al., The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses. Am J Public Health, 1999. 89(10): p. 1543-8.6. Idler, E.L. and Y. Benyamini, Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav, 1997. 38(1): p. 21-37.7. Guendelman, S., et al., Birth outcomes of immigrant women in the United States, France, and Belgium. Matern Child Health J, 1999. 3(4): p. 177-87.8. Bollini, P., et al., Pregnancy outcome of migrant women and integration policy: a systematic review of the international literature. Soc Sci Med, 2009. 68(3): p. 452-61.9. Stoecklin-Marois MT, H.-B.T., Schenker MB. , Engaging a hard-to reach population in research: Sampling and recruitment of hired farm workers in the MICASA study. Submitted, 2011.10. Agudelo-Suarez, A.A., et al., [The migratory process, working conditions and health in immigrant workers in Spain (the ITSAL project)]. Gac Sanit, 2009. 23 Suppl 1: p. 115-21.11. Savu, A., Q. Liu, and Y. Yasui, Estimation of relative risk and prevalence ratio. Stat Med, 2010. 29(22): p. 2269-81.12. Spiegelman, D. and E. Hertzmark, Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol, 2005. 162(3): p. 199-200.13. Skov, T., et al., Prevalence proportion ratios: estimation and hypothesis testing. Int J Epidemiol, 1998. 27(1): p. 91-5.14. Greenland, S., Model-based estimation of relative risks and other epidemiologic measures in studies of common outcomes and in case-control studies. Am J Epidemiol, 2004. 160(4): p. 301-5.15. Rodriguez, M.A., A.V. Bustamante, and A. Ang, Perceived quality of care, receipt of preventive care, and usual source of health care among undocumented and other Latinos. J Gen Intern Med, 2009. 24 Suppl 3: p. 508-13.16. Vives, A., et al., The Employment Precariousness Scale (EPRES): psychometric properties of a new tool for epidemiological studies among waged and salaried workers. Occup Environ Med, 2010. 67(8): p. 548-55.17. Virtanen, M., et al., Temporary employment and health: a review. Int J Epidemiol, 2005. 34(3): p. 610-22.18. Quandt, S.A., et al., Workplace, household, and personal predictors of pesticide exposure for farmworkers. Environ Health Perspect, 2006. 114(6): p. 943-52.19. de Leon Siantz, M.L., The Mexican-American migrant farmworker family. Mental health issues. Nurs Clin North Am, 1994. 29(1): p. 65-72.20. Grzywacz, J.G., et al., Evaluating short-form versions of the CES-D for measuring depressive symptoms among immigrants from Mexico. Hispanic Journal of Behavioral Sciences, 2006. 28(3): p. 404-424.21. Burnam, M.A., et al., Development of a brief screening instrument for detecting depressive disorders. Med Care, 1988. 26(8): p. 775-89.22. Gjesfjeld, C.D., C.G. Greeno, and K.H. Kim, A confirmatory factor analysis of an abbreviated social support instrument: The MOS-SSS. Research on Social Work Practice, 2008. 18(3): p. 231-237.23. Sherbourne, C.D. and A.L. Stewart, The MOS social support survey. Soc Sci Med, 1991. 32(6): p. 705-14.

Global Remittances

World Bank, 2013

Analyses

Precarious Employment

Poor Self-Rated Health

Undocumented Status

12a

2b: Overall Model

Precarious Employment

Lack of regulations that support the standard employment relationship, making workers more vulnerable

** Measured on a continuum **

(Benach & Muntaner, 2007)

Job InstabilityDuration of Current Job, Time in Temporary Contract in Past Year

EmpowermentHow did you settle your work schedule/weekly hours/wages?

VulnerabilityDiscrimination, Fears of being fired, Feeling replaceable

Wage LevelCover basic needs, unexpected expenses, $

Workers’ RightsHolidays, Maternity Leave, Severance, Weekends, Day off for Doctor vs.Overtime, Workers’ Comp, Safety Training, Shade, Water, Restroom

Capacity to Exercise Rights

Employment Precariousness Scale (EPRES)

Precarious Employment Q ChangesTemporariness

Mayordomo vs Ranchero, instead of ContractDuration of current job?

DisempowermentCollective Bargaining?

VulnerabilitySame as EPRES

WagesFamily Income vs Individual Income

Rights & Capacity to Exercise RightsWorking Conditions vs Employment Conditions