Legal Status, Precarious Employment & Self-Rated Health in Foreign-born CA Farm Workers (MICASA Project)

1. Legal Status, Precarious Employment & Self-Rated Health in Foreign-born CA Farm Workers(MICASA Project) Western Center for Agricultural Health and Safety Graduate Student Seminar Emily Sousa University of California, Davis

2. Background 1 2 3 4 • Would be 5th Largest State: • 14.7 million (2010) Mexican & Central American migrants in the US: Undocumented migrants:4% of US population 5% of US workforce 28% of US Immigrants Reasons for migration Labor Migrants Health of Foreign-Born Workers Unequal Distribution of Resources

3. Background • Estimated 500,000 farm workers employed each year in CA • 85% of California’s farm labor • Majority are Latino • mostly Mexican immigrants • Farm work is dangerous • High risk for illness & injury • Risk may be associated with • SES and Legal Status

4. 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

5. Project Goal 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.

6. 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

7. Precarious Employment: Lack of regulations that support the standard employment relationship, making workers more vulnerableEmployment Precariousness Scale (EPRES) 6 Dimensions: • Job Instability • Empowerment • Vulnerability • Wage Level • Workers’ Rights • Capacity to Exercise Rights

8. 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)

9. Chapter 2 Methods Data Set: MICASA 2nd Follow-Up (2011-2012) Outcome Self-rated health Exposures Documentation status & Precarious employment (EPRES) Covariates Sex, age, age at migration, education Analyses Univariate/descriptive Log-binomial

10. 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

11. Preliminary Results Legal Status: n=59 (12%) n=315 (62%)

12. Legal Status by Sex Males Females n=24 (11%) n=35 (12%) n=37 (17%) n=83 (30%) n=164 (58%) n=161 (72%)

13. Do you feel that your immigration status has affected your health in any way? Often 3% Often 11% Sometimes 3% Sometimes 14% Never 94% Never 68% Often 2% Sometimes 10% Never 88%

14. Next Steps • Continue Data Cleaning • Univariate & Bivariate Analyses • Construct Log-Binomial Model • relationships between: • documentation status • precarious employment • self-rated health

15. Limitations • Imperfect measure of documentation status • Cross-sectional design: temporality • Subjective outcome Strengths • Large sample size • First look at documentation status & precarious employment in California farmworkers

16. Policy Implications Effective 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

17. Thank You! Dr. XochitlCasteneda PIMSA Health Initiative of the Americas Dr. Marc Schenker Dr. Maria Stoecklin-Marois Tamara Hennessy-Burt Diane Mitchell Sandra Freeland Western Center for Agricultural Health and Safety/NIOSH Alejandra VivesVives Joan Benach GREDS-EMCONET Dr. Dan Tancredi Dr. David Kyle Dr. Danielle Harvey Dr. Stephen McCurdy Dr. Thomas Farver And especially to the field team and participants My Grandpa, who taught me the value of hard work & fresh fruit.

18. 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.SocSci 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 SocBehav, 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.SocSci 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)].GacSanit, 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.NursClin 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.SocSci Med, 1991. 32(6): p. 705-14.

19. Global Remittances World Bank, 2013

20. Analyses Undocumented Status 1 2a Precarious Employment Poor Self-Rated Health 2b: Overall Model

21. Precarious Employment Lack of regulations that support the standard employment relationship, making workers more vulnerable ** Measured on a continuum ** (Benach & Muntaner, 2007)

22. Employment Precariousness Scale (EPRES) Job Instability Duration of Current Job, Time in Temporary Contract in Past Year Empowerment How did you settle your work schedule/weekly hours/wages? Vulnerability Discrimination, Fears of being fired, Feeling replaceable Wage Level Cover basic needs, unexpected expenses, $ Workers’ Rights Holidays, Maternity Leave, Severance, Weekends, Day off for Doctor vs. Overtime, Workers’ Comp, Safety Training, Shade, Water, Restroom Capacity to Exercise Rights

23. Precarious Employment Q Changes Temporariness Mayordomovs Ranchero, instead of Contract Duration of current job? Disempowerment Collective Bargaining? Vulnerability Same as EPRES Wages Family Income vs Individual Income Rights & Capacity to Exercise Rights Working Conditions vs Employment Conditions