Mexican migrant and seasonal farm workers (MSFWs) and their families represent the majority of patients the KLC serves. The seasonal farm worker population lives in Knights Landing and the smaller community of La Tijera year-round. The migrant farm worker population lives in Knights Landing and the nearby migrant labor camps from February/March-August each year.
Mexican MSFWs and their families are a highly vulnerable and underserved population that is difficult to care for. In the U.S., there are an approximate 3 million MSFWs whose work enables a multi-billion dollar agricultural industry to thrive.1 According to Rosenbaum & Shin, “California is the largest domicile state, representing 30% of all farmworkers.”2 In Yolo County where the KLC operates, it was estimated that 20,521 MSFWs and the family members who accompany them lived there in 2000.3 These farm worker families contribute enormously to this state’s economy yet they “confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care.”3 The farm workers themselves “are often in poor health and they are at elevated risk for an enormous range of injuries and illnesses.”2
The Mexican MSFWs in and near Knights Landing are part of this largely uninsured Californian farm worker population that also has low medical care-seeking behavior in the U.S. In California, approximately 91% of crop workers were Mexican-born in 1999 and a survey of a cohort of this group that year suggested that 73% of them were uninsured, 25% had never had a medical or clinic visit, and 38% of the undocumented compared to 23% of the documented had not had a doctor or clinic visit in the U.S.4 In fact, the Mexican migrant subpopulation uses several strategies to resolve health problems and seeking medical care in the U.S. is not the primary one: a) self-medication, b) telephone consultation with relatives, c) utilization of private services (in U.S.) d) travel to border towns, e) return to place of birth, f) getting medical care during their visits to places of origin.5
Migrant farm workers face other obstacles to seeking medical care that contribute to preventable poor health outcomes. Other than insurance, other barriers migrants face when wanting to seek medical care include finances, fear of deportation, working long hours during clinic hours, and transportation.6 Ralston & Escandell add that discrimination and lack of knowledge of the U.S. healthcare system and English language skills are also contributing factors.7 The preventable poor health outcomes associated with this limited medical care include: chronic non-infectious diseases, allergic conditions, work-related physical injuries, and infectious diseases.6
Apart from the MSFW population aspect, the KLC serves a rural community that faces the low resource environment that plagues most rural areas across the country.