Arthur L. Frank, MD, PhD, Amy K. Liebman, MPH, MA, Bobbi Ryder, BA, Maria Weir, MAA, MPH, and Thomas A. Arcury, PhD

Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in theUS is comprised primarily of Latino immigrants. Health care access for these workersis limited and increases health disparities.

Methods This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

Contents Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers.C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Am. J. Ind. Med.

ACA Toolkit:

Available in English and Spanish

Health Insurance Guide:

Available in English and Spanish and Haitian Creole

Older Guides:

Available in English, Spanish, and Haitian Creole for workers on employer-provided health insurance

Created by Farmworker Justice.

The world continues to deal with COVID-19 and herd immunity is not reached and skepticism, resistance and hesitation about vaccines continues representing a major obstacle. During the first few months of the vaccination effort, filmmaker Chris Newberry and his team followed a diverse set of health professionals as they gained the trust of at-risk communities across Minnesota. The resulting documentary is a tribute to the doctors, nurses, organizers and influencers who are embracing community-led efforts to overcome vaccine doubts.

Watch the conversation with the film's creators and a panel of experts:

Our partners at NRC RIM have put together a series of discussion guides for clinicians, community groups, and community health workers in English and Spanish for the documentary can be found here.

For anyone who would like to contact the producers with questions or for help in organizing their own TRUSTED MESSENGER event, they can reach us here:

http://www.terminal1.tv/contacta

MCN's 2019 in Review

A depression diagnosis that warrants treatment or treatment change, needs at least one of the first two questions endorse as positive (little pleasure, feeling depressed) indicating the symptom has been present more than half the time in the past two weeks.

In addition the tenth question about difficulty at work or home or getting along with others should be answered at least "somewhat difficult".

When a depression diagnosis has been made patient preferences should be considered, especially when choosing between treatment recommendations of antidepressant treatment and psychotherapy.

These resources from the Health Insurance Marketplace can be used to help direct clients to information about the Affordable Care Act.

The Hesperian provides excellent patient education material on COVID-19 in a number of languagues for use internationally or with immigrant communiites in the United Sates.