National prevalence of diabetes and barriers to care among U.S. farmworkers and associations with migrant worker status

Abstract

<p dir="ltr">Objectives. To quantify the prevalence of diabetes and barriers to care in U.S. migrant farmworkers (i.e., who travel from their permanent residence for seasonal farmwork).</p><p dir="ltr">Research Design and Methods. Age-adjusted prevalence of self-reported diabetes and barriers to care were calculated in adult U.S. farmworkers from 2008-2017 National Agricultural Workers Surveys. Results. Among 16,913 farmworkers, 30.7% reported one or more barriers to care, most often cost. Age-adjusted self-reported prevalence of diabetes was 13.51% (95% CI 10.0 – 17.1) amongst migrants and 10.8% (95% CI 9.0 – 12.6) amongst non-migrants with access to healthcare. Migrants without recent access had 83% lower odds of reporting diabetes (aOR 0.17, 95% CI 0.06 – 0.54) compared to non-migrants, likely due to poor healthcare access and/or a healthy worker effect. </p><p dir="ltr">Conclusion. Many migrant farmworkers face barriers to care which may lead to significant underdiagnosis of diabetes in this vulnerable population.</p>