NATIONAL COVID-19 RESILIENCY NETWORKPreparedNationalby COVID-19 Resiliency Network (NCRN) HISPANIC/LATINO MIGRANT WORKERS AUDIENCE PROFILE
480,000 agricultural workers—many of whom are Hispanic/Latino—have tested positive for COVID-19 nationwide.12 73% of laboratory-confirmed COVID-19 cases in the food processing and agriculture industries were from Hispanic/Latino individuals.13 83% of the close to 3 million agricultural workers in the United States self-identify as Hispanic/Latino.14
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+ California + Texas + Florida + New York + Arizona + Illinois + New Jersey + Colorado + Georgia + New Mexico TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant WorkersPage 2
The Hispanic/Latino population in the United States comes from different Spanish-speaking countries; therefore, depending on the country of origin, their traditions, language (including regional variations and slang), beliefs, education, and acculturation level may vary.9 Studies show that the majority of Hispanic/Latino migrant workers come from Mexico and countries in Central America.10
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In addition, according to a Centers for Disease Control and Prevention (CDC) study published in 2020 that compared data for food manufacturing and agriculture workers in 30 states, Hispanics/Latinos make up approximately 37% of the workforce in manufacturing and agriculture companies.
Key concepts and themes for Hispanic/Latino migrant workers in the United States, regardless of their background, include the importance of family and community (familismo), their love of food and spending quality time with friends and loved ones, a shared respect for authority figures, and faith. In contrast to the general Hispanic/Latino population, migrant worker communities are not as active online or on social media. They rely more on traditional media (radio and television), word of mouth, and community sources for news and health information.
Many Hispanic/Latino migrants avoid seeking medical services because they fear deportation.6 This can contribute to an increase in COVID-19 rates. Additionally, the stigma associated with COVID-19 prevents some individuals in Hispanic/Latino communities from seeking testing or vaccination.7 Lack of insurance coverage, lack of culturally responsive healthcare, and lack of familiarity with U.S. health systems significantly impact healthcare access and prevention and treatment needs for this population.
2 However, Hispanics/Latinos in the United States have been disproportionately affected by a number of diseases and chronic illnesses, most recently COVID-19.3 This is in part due to the fact that more than 4 in 10 frontline workers are Black, Hispanic, or Asian-American/Pacific Islander.
Hispanics/Latinos represent nearly 20% of the U.S. total population; and according to a 2019 U.S. Census Bureau report,1 this percentage is expected to continue to increase by 2030.
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10 States with the highest Hispanic/Latino population:1 California and Florida employ the largest number of agricultural workers.15
Profile Summary
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TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant Workers Page 3
In Texas, where 11.5 million Hispanics/Latinos live, 36% of COVID-19 cases and 47% of COVID-19 confirmed deaths are associated to this group. Many states have also experienced COVID-19 case disparities among this population.3 In turn, Hispanic/Latino migrant worker communities across the United States have been significantly impacted by the COVID-19 pandemic. The pandemic has accentuated the difficulties this population has confronted for decades, with numerous reports indicating that meatpacking plants, which usually employ large numbers of Hispanic/Latino immigrants, became centers for COVID-19 outbreaks.16 According to Purdue University estimates, more than 480,000 agricultural workers—many of whom are Hispanic/Latino—have tested positive for COVID-19 nationwide.12
COVID-19 Impact on Migrant Workers
The majority of Hispanic/Latino migrant workers speak Spanish, so they rely on community leaders and communitybased organizations to help them access health information and other services. They are less likely to own a computer device and primarily communicate via phone. During the COVID-19 pandemic, state and local governments and philanthropic and grassroots organizations have taken steps to fill the information gaps.18 When it comes to media consumption, this population relies on traditional media outlets (radio and television) and mainly receives information through word of mouth and materials distributed within their Hispanic/Latinocommunities.migrant workers who were part of the qualitative research conducted by Morehouse School of Medicine19 consistently indicated that the COVID-19 pandemic has significantly impacted their health, their family’s health, and their community’s health. More than half of participants had COVID-19 themselves, and all have close friends, family members, or coworkers who have tested positive for COVID-19. Most participants indicated that the COVID-19 pandemic has affected their jobs and income and has separated their family, while those with children said they have been greatly affected due to school closures.
While migrants have historically struggled with similar challenges as other populations that are underserved, they face the additional barriers of mobility, language, and cultural differences; lack of familiarity with local healthcare services; and limited eligibility for publicly and privately funded healthcare programs.17 All of this has directly impacted their lives over the past year, especially given that Hispanic/Latino workers employed in food production or agriculture had a substantially higher prevalence of COVID-19 compared to other workers in those industries. Among the 31 states that reported data, only 37% of workers in those industries were Hispanic/Latino, but they represented 73% of laboratoryconfirmed COVID-19 cases in the food processing and agriculture industries.13
As of May 2021, about 30% of Hispanic/Latino individuals in the United States have been diagnosed with COVID-19, and 19% have died. In California, where the estimated Hispanic/Latino population is 15.5 million, they represent 61% of COVID-19 cases and 49% of COVID-19 deaths. For the state of Florida, Hispanics/Latinos total over 5.5 million and account for 41% of both cases and deaths from COVID-19.
+ Trusted organizations among migrant workers include local clinics and community centers.
+ All migrant workers who participated in the focus groups have received at least one dose of the COVID-19 vaccine. They mainly were vaccinated to protect themselves and their families; because they had been infected with the virus at some point; or to protect their elderly neighbors and community members.
+ Despite the spread of misinformation, conspiracy theories, and discussions around the negative outcomes from the vaccines, migrant workers still decided to get vaccinated, noting that the potential negative effects of getting the virus are worse than the vaccine side effects.
+ Some participants expressed concern about contracting the virus from the vaccine. Other participants noted that the vaccine may not be effective long term and that booster doses may be needed in the future. However, these points did not prevent them from getting vaccinated.
COVID-19 Perceptions
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+ Similar to the general Hispanic/Latino audience, migrant workers can easily access COVID-19 testing. The main difference, compared to the general population, is that migrant workers have the support and guidance of promotoras or community health workers (CHWs), local community leaders, and grassroots organizations, which provide information about testing and vaccination sites, as well as printed materials and safety resources.
+ Focus group participants noted that coworkers or others close to them had been vaccinated. Some also mentioned how important family referents influenced their decision and even scheduled vaccine appointments for them.
+ Some of the preferred methods for receiving COVID-19 testing or vaccine information are through promotoras or other trusted community sources, via phone calls or text messages, and through printed materials distributed within the community or delivered via mail.
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant WorkersPage 4
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Migrant worker employers are also providing information about the COVID-19 vaccines and have encouraged their workers to get vaccinated. Some employers are supporting their workers by scheduling vaccine appointments for them.
+ Some focus group participants explained that they trusted the vaccine and therefore were not nervous to take it. Also, some participants described non-healthrelated negative outcome expectations, namely concern over ID requirements for vaccination.
The COVID-19 pandemic13 has directly and indirectly impacted Hispanic/Latino migrant workers. They generally perceive themselves to be very susceptible to getting COVID-19 and think the virus can be severe as well as deadly.
Focus group participants also mentioned local doctors who are affiliated with community organizations as trusted sources.
+ Friends and family members. Hispanics/Latinos tend to seek information and advice from family members and loved ones first, as many important decisions are made collectively as a family. This is still true for Hispanic/Latino migrant workers. Older Hispanics/ Latinos (specifically parents and grandparents) play a vital role in their multigenerational households. Their opinions and views are held in high esteem by other family members. They are often the main decision makers in the home, exerting a heavy influence on behaviors and media consumption.23
Findings regarding the Hispanic/Latino general audience, listed below, remain relevant for this audience.
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant Workers Page 5
+ Promotoras or CHWs. Studies like "A Community Health Worker-Led Lifestyle Behavior Intervention for Latina (Hispanic) Women: Feasibility and Outcomes of a Randomized Controlled Trial" prove the importance of promotoras and CHWs to effectively reach and influence behavior for the Hispanic/Latino community being especially helpful with engaging underserved communities.21 Promotoras and CHWs are links between communities and health and social service providers. They are community members who act as helpers and liaisons to meaningful information and resources for their neighbors and neighborhoods. Because they share the same language, culture, ethnicity, status, and experiences of their communities, they are trusted within their community and are considered strong influencers.22
+ Churches and faith leaders. A significant number of Hispanics/Latinos in the United States have close ties with their community churches. Churches and religious communities are considered a powerful resource and support system to improve health, particularly for Hispanic/Latina women.24
Trusted Sources and Influencers
+ Community-based organizations. These organizations are closely related to families in the community and are seen as credible and trusted sources of information.25
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant WorkersPage 6
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Migrant worker focus group participants indicated receiving COVID-19 testing or vaccine information from two main Spanish local news television outlets (Univision and Telemundo), and some mentioned watching Mexican news channels.19 In addition to local news television channels, most participants indicated receiving information about COVID-19 from: Community-based organizations and their promotoras Local clinics Community venues such as local shops or supermarkets, churches, and local schools with Spanish-language information Worksites (e.g., fields or meatpacking facilities)
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+ According to a CDC study, promotoras, who are trusted people in the community that act as a connecting point between the community and the healthcare system, can positively impact knowledge and behavior in Hispanics/Latinos. Promotoras provide that sense of belonging and representation that creates emotional connections with the community and positively drives a message into the population.
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+ Migrant workers also receive and share information through word of mouth and printed materials.11
Health Behavior and Information Seeking
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+ Due to the increased number of religious Hispanics/Latinos across Central and South American countries, religious leaders and churches are also considered trusted sources of information.11
Considerations for Messaging
Hispanics/Latinos come from a collectivist culture in which activities are predominantly conducted in groups and responsibility and accountability are shared. This is particularly important for Hispanic/Latino agricultural workers, who tend to live in multigenerational households and whose housing is often substandard or overcrowded.26
Language and Acculturation
+ Maintaining traditions and cultural values is important for Hispanics/Latinos. Seventy-three percent of U.S. Hispanics/Latinos agree that it is important to them that their children continue their family’s cultural traditions, and 73% also agree that their cultural ethnic heritage is an important part of who they are.36
According to a Pew Research study, more than 6 in 10 Hispanics/Latinos say that religion is very important in their lives.33
+ Fatalism can lead Hispanics/Latinos to ignore their doctor’s advice to follow healthy behaviors, including getting enough physical activity, abstaining from smoking, and eating enough fruits and vegetables.34 Religion is closely tied with the idea of fatalism, a key factor in Hispanic/Latino attitudes toward aging and health in general. Many people believe in destiny and the idea that everything that happens is God’s will.
+ Seventy-two percent of Hispanics/Latinos (and 75% of Hispanic/Latino households) speak Spanish at home.10
+ Natural or home remedies (also known as traditional or alternative medicine) are prevalent among Hispanics/Latinos, primarily among women.32 Botanicas play a vital role for many Hispanics/Latinos—primarily immigrants—seeking medicinal plants, herbs, and teas, as well as religious objects and artifacts to treat illness.
+ Migrant workers, especially agricultural workers, are more comfortable speaking Spanish.35
+ Respeto is another core value for Hispanics/Latinos and is manifested in several domains, including obedience to authority, deference, decorum, and public behavior.28
+ Machismo describes beliefs and expectations regarding the role of men in society; it is a set of values, attitudes, and beliefs about masculinity, or what it means to be a man. It encompasses positive and negative aspects of masculinity, including bravery, honor, dominance, aggression, sexism, sexual prowess, and reserved emotions, among others.29 30 Machismo also includes attitudinal beliefs that consider it appropriate for women to remain in traditional roles, and thus it encourages male dominance over women.31
+ Language preference among Hispanics/Latinos can be tied to age, level of acculturation, education, and socioeconomic status. Those who arrived recently to the United States and have little to no education or a low socioeconomic status tend to prefer speaking Spanish and may be less proficient in English. In many instances, this becomes a barrier to receiving important health messages and information.
+ Familismo is an important value seen across Hispanic/Latino cultures. It promotes loyalty, cohesiveness, and obedience within the family, and it places a higher emphasis on the family unit as it relates to respect, support, and obligation.27 Familismo refers to the central role and importance that family and family structure play in the life of Hispanic/Latino individuals. This concept is often reflected in Hispanic/Latino media and entertainment—movies, novelas (soap operas), folk stories, and campaigns.
Understanding the cultural values and constructs listed below, which are part of the lives of different Hispanics/Latinos, is vital to communicating effectively with this population.
+ Religion occupies a central role in the lives of many Hispanics/Latinos. Eighty-three percent of Hispanics/Latinos claim a religious affiliation, with most of these individuals (62%) reporting Catholic affiliation.
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant Workers Page 7
+ California and Florida employ the largest numbers of agricultural laborers. The Great Lakes, Northern Pacific, Corn Belt, and Southern Plains regions also employ large numbers of farmworkers each growing season.15
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant WorkersPage 8
+ Local print media. Hispanic/Latino-owned newspapers are part of the community, and the content makes this audience feel represented. Newspapers are a very cost-effective way to reach Hispanic/Latino adults ages 34–54.34
Geographic Data
+ Storytelling. This is one of the most effective ways to reach Hispanic/Latino audiences. Personal stories shared by health ambassadors (community members or public figures) create a connection with the audience, adding a personal and real touch to the communication messages. When an emotional connection is created, the message becomes more effective.36
Community outreach. Leveraging well-established organizations, groups, promotoras, or community health centers has proven to be effective, as they really know the community and their needs. Also, working with community organizations will facilitate quick mobilization because they already have well-organized and established networks to disseminate information.39
+ Of the 10 states with the highest Hispanic/Latino population in the country, California, Texas, and Florida are home to 54% of the population.
+ Twenty-nine percent of foreign-born farmworkers have spent 20 or more years in the United States, 26% have been in the United States for 10–19 years, 19% have been in the United States for 5–9 years, and 26% have been in the United States for 4 or less years.43
+ Trusted sources. Engaging trusted messengers, such as faith-based and community leaders, increases the effectiveness of the message—it is better received coming from someone in the community.41
Traditional media. The use of traditional media like radio and television has been effective when reaching Hispanics/Latinos. Radio gives Hispanics/Latinos a sense of nostalgia because it reminds them of their home country.37 About 22% of Hispanics/Latinos consider cable television news to be their primary source for COVID-19 information, and 62% prefer radio for COVID-19 information. On a weekly basis, Hispanics/Latinos spend about 33 more minutes listening to radio than the total market.38
+ Adaptation. Hispanics/Latinos want to see themselves reflected in communication materials; this is why there is not a one-size-fits-all strategy. Also, it is important to consider that there are subcultures within the Hispanic/Latino culture in which the meaning of certain words, situations, and traditions varies among the subcultures.34
Focus group findings also showed that migrant workers prefer traditional media, as they are not as active on social media compared to the Hispanic/Latino general population. Some participants, however, shared they use Facebook.
The majority of Hispanic/Latino migrant workers in the United States come from Mexico, with many others coming from other countries in Latin America, including El Salvador, Colombia, and the Dominican Republic.42
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+ Mobile clinics. Mobile clinics or consulates have proven to be a successful way to reach farm workers. Due to transportation limitations, farm workers do not have the means to access medical care. Bringing medical assistance and health services to their communities can address this gap and ensure they receive necessary treatment or preventive services.40
Proven Strategies
Agricultural Workers There are approximately 2.5–3 million agricultural workers in the United States. Within the population, 19% identify as migrant workers, while 81% are seasonal agricultural workers.14 44
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Education and Economic Implications
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The average age of agricultural workers in the United States is 38. When it comes to crop workers, approximately 68% are male, and 32% are female.35 The average level of completed education is 8th grade. Half of farmworkers in the United States are undocumented.45,46 Thirty-three percent of agricultural worker families had family income levels below the national poverty guidelines. Farmworkers reported an average hourly wage of $10.60.35 The average individual farmworker annual income is $12,500–$14,999, and the average total family annual income is $17,500–$19,999.43 Most agricultural worker housing is often substandard or overcrowded. A single building may house several dozen workers or more, and they often sleep in dormitory-style quarters, making quarantining or social distancing efforts difficult if not impossible. Limited access to restrooms and sinks, at home and in the field, may complicate hygiene prevention efforts.47
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TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant Workers COVID-19 Perceptions Trusted Sources and Influencers Health Behavior and Information Seeking Considerations for Messaging Language and Acculturation Proven Strategies Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant Workers Page 9
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Most migrant farmworkers are Latino fathers, husbands, and sons who leave the countries in which they were born with the hope of making enough money to support their families back home, then ultimately returning to their homeland.52
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Health
Meatpacking Workers
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Farmworkers often receive bundled services from cluster clinics, which deliver services, from lab work to foot exams, in a culturally sensitive way. At these clinics, healthcare providers evaluate the literacy and understanding level of patients to make sure that language and cultural barriers do not impede learning about health and diseases, such as diabetes. These clinics are often brought to schools, churches, or farms.
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Even though most Hispanic/Latino households in the United States have access to internet and it is an essential part of their lives, this does not hold true for Hispanic/Latino migrant workers. This population relies on mobile phones to communicate and carry out their daily activities. In part due to the lack of resources, very few, if any, own a computer or laptop, and they are less likely to use the internet to seek information and services.
+ Hispanic/Latino migrant workers’ decision making is influenced by family members, religious leaders, and Hispanic/Latino nurses or doctors. Workers Sources Influencers Behavior Strategies
Geographic Data Education and Economic Implications Meatpacking Workers Other Psychographic Data References NCRN Hispanic/Latino Migrant WorkersPage 10
+ Nearly half of frontline meatpacking workers (45%) live in low-income families (below 200% of the federal poverty line, or less than $52,400 for a family of four in 2020) and about 1 in 8 (12%) have income below the poverty line.51
and Information Seeking Considerations for Messaging Language and Acculturation Proven
+ According to the U.S. Bureau of Labor Statistics, Texas meatpacking companies employ the highest number of workers, who earn a mean average of $22,700 per year.50
+ Rural healthcare infrastructure is inadequate.39
+ Many farmworkers do not know the basics of how to get medical treatment, and they lack access to healthcare facilities due to financial barriers. Fear of deportation and contact with governmental agencies makes access to healthcare even more complicated.
Of those who are immigrants, more than half of workers in meat and poultry plants are from Latin America, and of these, more than two-thirds came to the United States from Mexico and Central America.49
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+ Meatpacking workers disproportionately lack health insurance (15.5 percent), have one or more children to care for (44.3 percent), and are less educated (2.5 percent have a college degree or more).48
More than half (52%) of frontline meatpacking workers are immigrants, and out of those 44% are Hispanic/Latino. About one-quarter (25%) of these workers live in households in which all the members (age 14 or older) have limited proficiency in English.48
Other Psychographic Data
TABLE OF CONTENTS Click sections to access topics of interest. Profile COVID-19SummaryImpact on Migrant
COVID-19 Perceptions Trusted
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40.
12. Purdue Food and Agriculture Vulnerability Index. Purdue University. Accessed October 1, 2020.
29. Mirandé A. Hombres y machos: Masculinity and Latino culture. Boulder: Westview Press; 1977.
18. Chishti M, Bolter J. Vulnerable to COVID-19 and in frontline jobs, immigrants are mostly shut out of U.S. relief. Migration Policy Institute. April 24, 2020. Findings from qualitative research conducted by MSM. Migrant worker audience research activities, ICF Next.
2. 2017 National Population Projections Tables: Main Series. U.S. Census Bureau.
32. Green RR, Santoro N, Allshouse AA, Neal-Perry G, Derby C. Prevalence of complementary and alternative medicine and herbal remedy use in hispanic and nonhispanic white women: results from the study of women’s health across the Nation. J Altern Complement Med. 2017;23(10):805–811.
7. COVID-19 and the Latinx community: Skills to Reduce Stress, Stigma, and Substance Use. National Hispanic and Latino Addiction Technology Transfer Center Network; 2021. 8. Escarce J, Kapur K. Access to and quality of health care. In: Tienda M, Mitchell F, eds. Hispanics and the Future of America. National Research Council Panel on Hispanics in the United States; 2006. 9. Noe-Bustamante L. Key facts about U.S. Hispanics and their diverse heritage. Pew Research Center. September 16, 2019.
1. Profile: Hispanic/Latino Americans. Office of Minority Health, U.S. Department of Health and Human Services; 2021.
17. Migrant Health Issues. Migrant Clinicians Network.
5. Callahan C. Hispanic food processing and farm workers more likely to be diagnosed with COVID-19. Today.com. October 21, 2020.
24. Bergland JE, Heuer L, Lausch C. The use of prayer by Hispanic migrant farmworkers with type 2 diabetes. J Cult Divers. 2007
21. Koniak-Griffing, Brecht ML, Takayanagi S, et al. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: Feasibility and outcomes of a randomized controlled trial. Int J Nurs Stud. 2015;52(1):75–87.
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28. Calzada EJ, Fernandez Y, Cortes DE. Incorporating the cultural value of respeto into a framework of Latino parenting. Cultur Divers Ethnic Minor Psychol. 2010;16(1):77.86.
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33. Politics, Values, and Religion. Pew Research Center; 2012. 34. Ramirez AS. Fatalism and cancer risk knowledge among a sample of highly-acculturated Latinas. J Cancer Educ. 2014;29(1): 50–55. Hernandez T, Gabbard S. Findings from the National Agricultural Workers Survey (NAWS) 2015–2016: A demographic and employment profile of United States farmworkers. JBS International; 2018. 36. Descubrimiento Digital: The Online Lives of Latinx Consumers. Nielsen; 2018. Cultural Insights: Communicating With Hispanics/Latinos. Centers for Disease Control and Prevention. Cultural Connectivity Transformed: How Latinos Are Connecting While Social Distancing. Nielsen; 2020. Rural Communities [Archived webpage]. Centers for Disease Control and Prevention; 2021. Jacobsen K. Supporting rural communities across southern Minnesota with a mobile health clinic. Mayo Clinic; 2021. The National Influenza Vaccination Disparities Partnership (NIVDP) Resource Kit. NIVDP, Centers for Disease Control and Prevention. Van Hook J, Bean FD, Passel J. Unauthorized migrants living in the United States: A mid-decade portrait. September 1, 2005. Farmworker Health Fact Sheet. National Center for Farmworker Health; September 2012.
13. Waltenburg MA, Rose CE, Victoroff T, et al. Early release—Coronavirus disease among workers in food processing, food manufacturing, and agriculture workplaces. Emerg Infect Dis. 2021;27(1):243–249.
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31. Nuñez A, González P, Talavera GA, et al. Machismo, Marianismo, and negative cognitive-emotional factors: Findings from the Hispanic Community Health Study/ Study of Latinos Sociocultural Ancillary Study. J Lat Psychol. 2016;4(4):202–217.
30. Niemann YF. Stereotypes of Chicanas and Chicanos: Impact on family functioning, individual expectations, goals, and behavior. In: Velasquez RJ, Arellano LM, McNell BW, eds. The Handbook of Chicana/o Psychology and Mental Health. Mahwah: Lawrence Earlbaum Associates. 2004:61–82.
10. The foreign-born population in the United States: 2003. U.S. Census Bureau; August 2004.
11. Arcury TA, Jensen A, Mann M, et al. Providing health information to Latino farmworkers: The case of the Affordable Care Act. J Agromedicine. 2017;22(3):275–281.
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14. Facts About Agricultural Workers. National Center for Farmworker Health; 2020. 15. Farmworkers in the United States. MHP Salud. 16. House, HR, Vakkalanka, JP, Behrens, NG, et al. Agricultural workers in meatpacking plants presenting to an emergency department with suspected COVID-19 infection are disproportionately Black and Hispanic. Acad Emerg Med. 2021; 00: 1– 7.
26. Vallejos QM, Quandt SA, Grzywacz JG, et al. Migrant farmworkers’ housing conditions across an agricultural season in North Carolina. Am J Ind Med. 2011;54(7):533–544.
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3. Despres C. Update: Coronavirus case rates and death rates for Latinos in the United States. Salud America! July 10, 2021.
25. Clayman ML, Manganello JA, Viswanath K, et al. Providing health messages to Hispanics/Latinos: Understanding the importance of language, trust in health information sources, and media use. Journal Health Commun. 2010;15(suppl 3):252–263.
4. Rho HJ, Brown H, Fremstad S. A basic demographic profile of workers in frontline industries. Center for Economic and Policy Research; 2020.
22. Who Are Promotores? Visión y Compromiso. 23. The New American Vanguard, Latinos 50+: Healthy, Wealthy and Wise. Nielsen. October 13, 2015.
27. Valdivieso-Mora E, Peet CL, Garnier-Villarreal M, Salazar-Villanea M, Johnson DK. A systematic review of the relationship between familism and mental health outcomes in Latino population. Front Psychol. 2016;7:1632.
6. Cooney E. Immigration status, housing, and food-service work explain Covid-19’s burden on Latinos. STAT. August 27, 2020.
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44. 2017 Agricultural Worker Population Estimates [Private Data Source]. National Center for Farmworker Health; 2020. 45. Reid A, Schenker MB. Hired farmworkers in the US: demographics, work organisation, and services. Am J Ind Med. 2016; 59(8): 644–655. 46. Tang C, Mahoney MK, Manna M. CARES Act: foreign national and immigrant eligibility for paid leave, unemployment benefits, and stimulus rebates. The National Law Review. April 23, 2020. 47. Pena A, Teather-Posadas E. Field sanitation in U.S. agriculture: Evidence from NAWS and Future Data Needs. J Agromedicine. 2018;23(2). 48. Fremstad S, Rho HJ, Brown H. Meatpacking workers are a diverse group who need better protections. CEPR. April 29, 2020. 49. Immigrant Workers in the United States Meat and Poultry Industry. Human Rights Watch. December 15, 2005. 50. Occupational Employment and Wages, May 2017. U.S. Bureau of Labor Statistics. 51. American Community Survey (2014–2018) Public Use Microdata Sample. U.S. Census Bureau. 52. Diaz R. A need for diabetes education for migrant farmworkers. November 28, 2017. References (cont.) NCRN Hispanic/Latino Migrant WorkersPage 12