Depression, Social Factors, and Farmworker Health Care Utilization


  • Funding: Funding was provided by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, and by the US Department of Labor, Employment and Training Administration. The paper was reviewed by the National Institute for Occupational Safety and Health. The findings and conclusions in this report are those of the authors, and do not necessarily represent the views of the National Institute for Occupational Safety and Health, nor the US Department of Labor.

  • Acknowledgments: We would like to thank the farmworkers and interviewers for their participation. We would also like to thank our colleague Dr. Marcia Gomez at Health Resources and Services Administration (HRSA) for her support and collaboration. This surveillance project received approval from the National Institute for Occupational Safety and Health Human Subjects Review Board.

For further information, contact: Annie Georges, PhD, JBS International, Inc., Aguirre Division, 555 Airport Boulevard Suite 400, Burlingame, CA 94010; e-mail:



Farmworkers frequently live in rural areas and experience high rates of depressive symptoms. This study examines the association between elevated depressive symptoms and health care utilization among Latino farmworkers.


Data were obtained from 2,905 Latino farmworkers interviewed for the National Agricultural Workers Survey. Elevated depressive symptoms were measured using the Center for Epidemiologic Studies Depression short-form. A dichotomous health care utilization variable was constructed from self-reported use of health care services in the United States. A categorical measure of provider type was constructed for those reporting use of health care.


Over 50% of farmworkers reported at least 1 health care visit in the United States during the past 2 years; most visits occurred in a private practice. The odds of reporting health care utilization in the United States were 45% higher among farmworkers with elevated depressive symptoms. Type of provider was not associated with depressive symptoms. Women were more likely to seek health care; education and family relationships were associated with health care utilization.


Latino farmworkers who live and work in rural areas seek care from private practices or migrant/Community Health Clinics. Farmworkers with elevated depressive symptoms are more likely to access health care. Rural health care providers need to be prepared to recognize, screen, and treat mental health problems among Latino farmworkers. Outreach focused on protecting farmworker mental health may be useful in reducing health care utilization while improving farmworker quality of life.