Health Care for Children of Migrant Families

Abstract

Migrant and seasonal/farm workers constitute a major portion of the labor force in the American food industry. By harvesting and processing farm crops, they contribute positively to agricultural communities and the American economy. Currently, the office of Migrant Health estimates that nationwide there are between 3 and 5 million migrant and seasonal farm workers and dependents. The average annual income for migrant and seasonal farm workers is well below the poverty level (US Dept of Health and Human Services, unpublished data, 1988). Because health care insurance is invariably beyond the reach of migrant family budgets, and employers of farm workers rarely provide health care benefits for their employees, these families are usually uninsured. In some cases, these families lack US citizenship or are in this country illegally, which complicates obtaining health care for their children. Medicaid enrollment is also complicated by migration because aliens must meet eligibility requirements in each state to which they migrate, and only US citizens are eligible. Because of their income and mobile life-style, migrant worker families often find that comprehensive child health care (health maintenance, anticipatory guidance, and preventive medicine) essentially is not available. Migrating families must seek health care whenever it is available. This results in a pattern of service that usually is fragmented and ad hoc. Migration not only interrupts continuity of care but it also contributes to a lack of knowledge about a community's health services and/or jeopardizes eligibility for these services by conflicting with residency requirements. Other problems that delay or prevent access to health care for the children of migrant families include language barriers and differences in culture.