A scoping review on physical therapy services for migrant farmworkers in the US
Creators: name: Andrion, Jeffrey
name: Queen, Monica
name: Golamb, Leslie
name: Damian, Jose
Publisher: name: figshare
Year: 2025
Subjects: classificationCode: 420106
subject: Physiotherapy

description: In the United States (US), there are several classifications of farm workers (Brock, et.al., 2012; Findeis, et.al,, 2009; Cooper, et.al., 2006; US Department of Labor, 2005). It is recognized that the distinctions between these types of workers are arbitrary and dependent on several contextual factors such as political and economic conditions (Sakala, 1987). Generally speaking, a migrant farmworker (MFW) is someone who works temporarily or seasonally in various agricultural and industrial areas that also includes those working in the US as “guest workers” under the H2-A Visa program (Migrant Clinician Network, 2025). Strictly speaking however, there are distinct characteristics that make each type of farm worker unique as outlined by Farmworker Justice (2015). MFWs are those who travel at least 75 miles within the previous year and follow crop harvesting schedules in various states. On the other hand, “settled farm workers” refer to those who work locally in agricultural areas and live in permanent houses. Seasonal farmworkers are another type but who are only temporary workers, with precarious housing arrangements, and whose primary residences are outside of the US. Regardless of their classification, the work of MFWs is vital to the agricultural industry in the US. They are the backbone of the trillion dollar agricultural industry which requires a sizable and flexible labor force to support the world’s major producer and consumer of fruits and vegetables (Shepherd, 2010). Understanding both their history and struggles is important given their substantial contribution to the US economy.<br><br>As explained by Shepherd (2010), small farms were essential to the birth of America alongside its rich history. At the outset, these farms benefited from family work and cheap labor from locals and slaves. By the 1850s the agricultural industry grew and there was more seasonal demand for laborers, prompting the temporary migration of workers from other countries such as China, Japan, and Mexico. In the South during the Civil War, the labor force was primarily composed of slaves and once it ended, former slaves, Native Americans, and poor Anglos became the workforce. During World War I, a high demand for immigrant labor ensued which prompted the US again to enact the Immigration and Nationality Act of 1917 that allowed the entry of 73,000 Mexican laborers. However over 400,000 Mexican immigrants were eventually deported back to Mexico during the Great Depression. Ironically, World War II saw the resurgence of immigrant laborers leading to the Bracero Act of 1943 which brought in over 5 million Mexican field laborers until the program's termination in 1964. During this time, there was increased public awareness of the poor conditions of MFWs. The poor conditions of MFWs were also accompanied by a public outcry that denounced the situation of the workers that eventually led to the creation of several legislations and development of programs in an effort to improve their living and working conditions. The Migrant Health Act was signed by President John F. Kennedy in 1962 that allowed for the development of health clinics to serve this community (Bauer &amp; Kantayya, 2010). As noted by Connor and colleagues (2010), the Farm Worker Family Health Program (FWFHP) involves school partnerships that provide healthcare services to MFWs. These services are provided by students in health professions from a variety of disciplines for a short period of time. The FWFHP team promotes health, provides health screens, disease prevention education, and strategies to treat common health problems to MFWs, while at the same time respecting their unique social situation and cultural backgrounds. An example of FWFHP involves physical therapy students from Georgia State University who participate in a two-week interdisciplinary service learning opportunity that provides physical therapy services to MFWs and their children (Garcia &amp; Frank, 2017). Other MFW-related legislations that aimed to improve MFW health include the Migrant and Seasonal Agricultural Workers Protection Act of 1983, the Immigration Reform and Control Act of 1986, and the Health Centers Consolidation Act of 1996 (Shepherd, 2010).According to the National Center for Farmworker Health (2022), there are approximately 2.9 million agricultural workers in the US currently. The majority of these workers are Latino immigrants where 15% of them identify as migratory while 85% are seasonal. Because of their ongoing challenges related to poverty and poor labor conditions, there is a great need for healthcare services for this group. Specifically, as they perform intense labor in extreme conditions, they also suffer a wide variety of work-related injuries and disorders (Farmworker Justice Fund, 1986; Shepherd, 2010). As explained by Luo &amp; Escalante (2018), these hazardous activities include excessive physical demands, prolonged exposure to chemicals such as pesticides, engaging in accident-prone operations, and working in mentally stressful tasks. MFWs are also especially susceptible to work-related pain associated with musculoskeletal injuries. This susceptibility is influenced by various factors including demographics, workplace hazards, limited access to medical care, and cultural health beliefs (Brock, et.al., 2012). As MFWs experience a plethora of disability-causing conditions, access to care also remains problematic for this population, including the absence of or limitation in medical care and delay in obtaining prescribed medications (Hu, et.al, 2016). The latter study also suggests that MFWs experience the negative social determinants of health, including issues related to transportation and linguistic and cultural competence. These problems are further compounded by the limited involvement of occupational health professionals in their care, a problem that has been identified as far back as 1987 (Sakala, 1987).While the National Center for Farmworker Health, Inc. (2022) provides a comprehensive picture of MFWs, there are currently no studies that demonstrate the depth and breadth of physical therapy services provided to this group in the US. Given this limited understanding, this scoping study is conducted to identify the type of illnesses encountered by physical therapists working with MFWs, the type of physical therapy interventions provided, and the settings where these services are rendered.Brock, M., Northcraft-Baxter, L., Escoffery, C., &amp; Greene, B. L. (2012). 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