Abstract
Extant research has well established that exposure to infectious disease can be a significant problem for vulnerable populations that have been deemed “essential” during widespread health crises. We contribute to this growing body of literature by delineating the utility of the critical environmental justice (CEJ) framework for investigating infectious disease in the context of at-risk groups such as farmworker communities. Specifically, we highlight how the four pillars of CEJ are applicable to potential or real exposure to pathogens in farmworkers' living and working spaces, and how responses and support for these essential workers can be shaped by intersectional factors, the “expendability” of farmworkers, and broader state and corporate structural influences. We draw from a case study of Florida farmworker outreach professionals to center the perceptions and experiences of individuals working directly with farmworker communities during the COVID-19 pandemic. We conclude with a discussion of how our research contributes to the broader understanding of CEJ in the context of widespread health threats, as well as an overview of lessons learned for regulatory and health agencies.
INTRODUCTION
Extant research has well established that exposure to infectious disease—especially in widespread health events such as pandemics—is a significant issue for vulnerable populations and essential workers such as farmworkers. 1 , 2 In this article, we argue that there is analytical utility in examining pandemics as an environmental justice issue.
Decades of research have delved into the multifaceted nature of environmental injustice in the United States; yet comparatively little research has attended to the relationship between environmental injustice and infectious diseases.3–5 Drawing on the work of David Pellow and his colleagues, we highlight how the four pillars of critical environmental justice (CEJ) can be applied to widespread health threats such as pandemics to understand the inequities and injustices facing vulnerable communities in these contexts.
We utilize a case study of Florida farmworker outreach professionals to situate the perceptions and experiences of individuals working directly with farmworker communities during the pandemic within the CEJ framework. Our data for this research stem from interviews with farmworker outreach personnel. These interviews centered on how the agricultural industry has changed since March 2020, how farmworkers have been affected by these shifts, what issues they are currently facing, and what changes are still needed. We begin with a review of the literatures regarding farmworker health and CEJ.
We then turn to a discussion of the data and methods for this research. After discussing our findings, we conclude by discussing how our research contributes to the literatures on CEJ and farmworker health, as well as lessons learned for decision makers, and regulatory and health agencies.
STATEMENT OF THE PROBLEM
Florida agriculture is a multi-billion-dollar industry. Yet, the state's production was hard hit by the COVID-19 pandemic in terms of a downward shift in demand, supply chain issues, and labor shortages. As essential workers, Florida farmworkers are imperative to this economy but are faced with increased levels of risk in their jobs due to the pandemic. 6
These risks include challenges with social distancing, a lack of personal protective equipment (PPE), and job loss or uncertainty. 7 In addition, we know that farmworkers as a population experience higher incidences of preexisting conditions that may make them more vulnerable to the effects of disease, such as diabetes and high blood pressure, 8 , 9 and they are less likely to receive long-term management from health care providers for the underlying conditions they may face, other illnesses, or work-related injuries. 10
Farmworkers are particularly vulnerable to pathogenic exposure because their daily duties make it difficult for them to maintain social distancing. Since farmworkers were among the first labor groups deemed essential, they did not have the opportunity to practice social distancing by staying home, which was contradictory to government and Centers for Disease Control and Prevention mandates. In addition, sanitation measures and PPE were often lacking. Given that farmworkers live and work in rural areas, it can be exceedingly difficult for them to access medical facilities and other resources in event of a medical emergency or contracting viral diseases. 11
Despite being considered essential to the food systems and economy, “food system workers are often of low socioeconomic status, immigrant, minority, and undocumented so that they are excluded from some of the economic legal protections of workers in other industries.” 3
For Florida farmworkers, there are significant gaps in terms of affordable health care programs and access to meaningful care. In addition to barriers such as health care costs, there are language and cultural barriers, and a lack of access to transportation and technology. A large percentage of the Florida farmworker population are H-2A and immigrant workers. 12
An H-2A worker is a non-immigrant, foreign worker who is temporarily permitted to perform agricultural duties in the presence of a domestic worker shortage. 13 The health and well-being of these farmworkers is often left to the discretion of crew leaders and farm owners. Because H-2A workers are generally recruited by farm owners, the farm owner is legally responsible for providing housing, wages, and other resources. It is important to note that as soon as an H-2A worker is no longer needed, they must return to their home country.
CEJ AND INFECTIOUS DISEASE
Environmental justice underscores the ways in which social structures are intertwined with the inability to achieve environmental sustainability. Environmental justice scholars investigate the intersection between environmental and social inequalities. Today, there are myriad studies that have analyzed and researched the correlation between environmental hazards and social factors such as race and socioeconomic class.
More recently, David Pellow has provided conceptual clarity to environmental justice research through a framework he calls CEJ to further develop this field of inquiry. 14 , 15 The CEJ framework details four pillars that contribute to persistent environmental injustices. The first pillar draws on the rich history of intersectional theoretical work 16 , 17 , 18 to underscore how oppressions related to different social positionalities such as race, class, and gender can intersect to exacerbate environmental injustices.
The second pillar of CEJ involves space and multi-scalarity, where spatial factors can reinforce oppressions in multiple ways. The third pillar emphasizes the idea that certain groups are seen as “expendable” and are therefore subject to abuse, exploitation, neglect. Moreover, they are often left without a seat at decision-making tables. And finally, the fourth pillar interrogates the role of broader structural, systemic oppressions related to the execution of state power through various mechanisms. 19
We argue that these important contributions to the legacy of literature regarding environmental justice provide a framework not only for understanding patterns of exposure to environmental hazards, but also for analyzing and understanding contemporary threats such as pathogenic viruses. We draw on the work of several scholars to illustrate how the CEJ framework has utility for understanding exposure to pathogens as an environmental injustice in vulnerable communities. 20 , 21
Exposure to disease has long been thought to be an epidemiological issue, yet social justice variables are clearly a factor when it comes to likelihood of exposure and access to health care or other interventions after disease contraction. The lack of attention to infectious disease in environmental justice research can, in part, be attributed to the different ways that analysts approach understanding this issue. However, research has highlighted the correlation between environmental hazards and social indicators and health disparities in diseases such as, but not limited to: “cardiovascular disease, asthma, congenital anomalies, diabetes, and infant mortality in EJ communities.” 15
Carrillo and Ipsen 21 draw on previous work on sacrifice zones 22 , 23 , 24 to analyze case studies of meatpacking plants during the COVID-19 pandemic. Using a CEJ framework, these scholars argued that workplaces where low-wage workers and workers of color are deprioritized over continual production can become environments that pose a significant threat of exposure to infectious disease. We build upon and expand on these important contributions to investigate how pandemic events and other widespread health crises can be analyzed using the CEJ framework.
Specifically, we argue that forced environmental exposure to pathogenic threats such as viruses and bacteria, especially among vulnerable populations, can be a source of social inequity, exacerbating health disparities and environmental injustices. While pathogenic epidemiology and attention to limitations of outbreaks, infections, and spread have not been traditionally within the scope of environmental justice studies, the COVID-19 pandemic has underscored that this is an issue that is both environmental- and justice-related.
Our analysis of farmworker outreach professionals' experiences and perceptions of the COVID-19 pandemic not only adds to this burgeoning discussion of exposure to pathogens as injustice, but also highlights key recommendations to better arm farmworker outreach organizations and farmworkers to face the next inevitable pandemic.
DATA AND METHODS
The data for our analysis come from in-depth, semi-structured interviews with farmworker outreach professionals serving agricultural hubs throughout the State of Florida. Participants were identified through websites and internet searches, as well as through existing relationships with outreach organizational leaders. We developed a list of 20 organizations throughout Florida and reached out to each one requesting an interview. Of these 20, seven organizations agreed to an interview (35% of the targeted population). The IRB approval number is IRB202101388.
Potential respondents were contacted via e-mail. The interviews were all conducted by the first author via phone or Zoom to allow for safe distancing. The participants worked with farmworkers in a variety of capacities, including health and illness, safety, and legal services. The first author utilized an interview protocol to initiate questions that gave participants space to respond and provide additional context and feedback on the interview questions.
Interview questions related to the procedures that were put in place and the support that was provided to farmworkers during the pandemic, identified current needs related to resources and outreach, and addressed what needs to be done to better support farmworkers in future epidemic or pandemic events.
The interviews were recorded and transcribed, and the data were analyzed using a traditional qualitative approach that involved line-by-line, iterative coding cycles. We not only looked for themes related to the CEJ theoretical framework, but also remained open to unanticipated themes in the interview data as well. As we interviewed professionals that work with and have first-hand experience with Florida farmworkers, our results provide a broad perspective of both the direct needs of these workers in the contexts of the pandemic, as well as the needs and perspectives of organizational leaders, information on supply chain issues, and broader political circumstances surrounding the COVID-19 pandemic.
ANALYSIS
Our analysis revealed that the pathogenic threat of the COVID-19 virus posed a significant environmental injustice to Florida farmworkers in a number of ways. As we illustrate next, the findings of our research show that pandemics and other widespread health crises can be analyzed and understood using the four pillars of the CEJ framework described earlier. Specifically, we show the utility of understanding physical space in the context of forced or increased exposures for vulnerable populations working, living, and commuting in places and spaces that place them in danger of becoming exposed to pathogenic environmental threats.
Our results reveal that, in addition to existing vulnerabilities associated with farm work, race, class, and political factors such as documentation status exacerbated exposure likelihood as well as the ability to receive meaningful health care for illnesses resulting from exposure. At the onset of the COVID-19 pandemic, the term “essential workers” was coined to describe workers who “conduct a range of operations and services that are typically essential to continue critical infrastructure operations.” 25
However, the tension between expendability and “essential” status designation highlights the contradictory ways in which vulnerable populations were treated throughout the pandemic. Finally, we apply the fourth pillar of CEJ to our analysis by examining the ways in which corporate profit priorities shaped farmworker experiences in the context of pathogen exposure risk mitigation.
Physical space
We found that the physical space farmworkers lived and worked in not only placed them at high risk for exposure to the virus, but also posed challenges for effectively utilizing PPE to protect themselves. Some farmworkers were required to work indoors where social distancing was not possible and ventilation issues made exposure to the virus more likely. Interview participants described how indoor agricultural work could increase risks of exposure to viruses as well as other environmental hazards such as pesticides.
Working in outdoor spaces posed particular challenges as well. Participants described how weather conditions—a formidable issue for farmworkers in Florida—made using PPE a particular problem for farmworkers working outside. For example, one outreach professional described the issue this way: “They won't wear masks. They work outside, so it is about 100 degrees outside. They aren't going to wear a mask.”
The physical space of farmworker housing and transportation presented an environmental risk of exposure to the virus in a number of ways. In many cases, farmworkers were living in housing that was small and crowded with high numbers of workers. In addition, farmworkers are often picked up in vehicles such as vans to transport them out to agricultural production areas. In these vehicles, it was often impossible to socially distance from one another. This participant described these problems this way:
For example, everybody is being told to socially distance for safety reasons and farmworkers are sometimes in an economic situation and employment structure situation in which they share very small housing with many people, or they share transportation with many people. So, that makes it very difficult.
During the onset of the pandemic, participants described temporary housing for farmworkers where they were sleeping six or seven people to a hotel room and spreading the virus to one another in these confined circumstances. For example, a participant argued that this health crisis was overlooked or ignored by health officials who tried to just move sick farmworkers rather than provide treatment:
We are talking around 1,000 workers piled up in hotels piled up 6 people to a room, so the virus went like wildfire. So, the crew leaders contacted us, and the health department just wanted the workers to move so that they would not have that problem. They wanted the next health department to have that problem.
And finally, the quality of housing posed an environmental threat to farmworkers and their families. Because of the vulnerable nature of H-2A and undocumented workers, they feel they are not able to speak out about risky living conditions or exploitative rent costs. A participant offered this illustrative respondent: “A lot of families live in homes that would be condemned, but they pay the high rent and don't say anything.”
Intersectional environmental oppressions
As noted earlier, the CEJ framework is rooted in a tradition of intersectional theory, which emphasizes the overlapping nature of oppressions in society. Our results revealed that race, class, and political factors such as documentation status were significant factors related to the needs and experiences of farmworkers during the pandemic. Exposure to the virus and illness were major sources of concern and fear among farmworkers, as they already felt that they were vulnerable to job loss. For example, a participant argued that farmworkers were reluctant to report their illnesses because they were afraid that would lead to their deportation, as noted by this outreach worker:
So, it was horrible! Ninety percent of the workers got the virus. It was really bad. Nobody wanted to treat them, the workers didn't want to go to the hospital, they were threatened with losing their job and breach of contract for the H-2As. It was just a disaster!
This economic insecurity coupled with a dearth of information regarding best practices for staying safe led to mass confusion and worry among farmworkers, as noted by this participant:
[Referring to COVID], for them to know where to get tested if they feel sick, they don't know. They might lose their jobs. They don't know how to understand the information. They don't know where to go if they think they have it or have been exposed. There is an absolute lack of information.
In describing the obstacles to seeking medical care, information, and intervention, participants often noted a lack of cultural competency and language barriers as significant issues for farmworkers:
Not only is there a Spanish issue, but also if you speak Creole. They need speakers that speak Teke. A lot of times kids have to translate to their parents and their kids don't know the medical terms, so who knows if they are getting the information right. The fourth thing is cultural competency because a lot of times the healthcare providers don't understand their culture.
Participants noted racism and negligence in the way farmworkers were treated during the height of the pandemic, as noted by this participant:
There are incredible gaps of support. We still get calls from workers who say, “Everybody is sick here, but the owner threatened to fire us if we miss a day, and everybody is sick, and we are afraid for our lives.” No one seems to do anything. What we can provide is limited. We are there to support the families. So, what we can do is tell them to call certain people, but they are very afraid of their immigration status. It is very hard for our families and our migrant workers to navigate the COVID situation.
Overall, our results support the vast body of research that has underscored the intersectional oppressions facing farmworker communities. Moreover, our findings specifically point to the intersectional injustices stemming from pathogenic health threats.
Farmworkers as “essential workers”
The CEJ framework points to the “expendability” of certain populations and communities to explain the persistence of environmental injustices in society. We argue that, although farmworkers were identified as essential workers during the pandemic, they were often treated as disposable labor and neglected when it came to protections and safety measures afforded to other types of workers. Participants described their frustration with the lack of resources, care, and attention for the farmworker communities they served. One participant noted the irony of the term “essential worker” in the context of farmworkers in Florida:
When the pandemic first hit in April … the very first group of people that got to leave their houses after the thirty-day quarantine … was essential workers. Well, farm workers were identified as essential workers. So, you think, “Okay cool, farmworkers are identified as essential workers. Wait. Is that for them? Or is that for us? Because we need the food that they are working in.” So, it's that kind of backwards “we are recognizing you as essential.” I would say, for the first time in American history, the word “essential” was attached to farmworkers. Well, you would think that if we are going to call them essential, then we actually need to treat them as essential. So, let's make sure they get the PPE, the safety equipment, and everything like that. Well, I don't think a whole lot of legislation that ensured that the PPE made it into those communities.
Another participant poignantly described how the “essential worker” designation worked to exacerbate inequalities and injustices that had existed before the COVID-19 pandemic:
And, I would say that, in general, farmworkers have been deemed “essential.” They've continued to work and do the work that is necessary for us to continue to eat, as have food chain workers, but they have had a very difficult time getting protections in place. There's a lot of structural mechanisms that have existed long before the COVID pandemic that make it even more hazardous for farmworkers and food chain workers during a pandemic.
In addition to a lack of physical resources for this essential workforce, participants noted how they were uniquely left out of governmental relief efforts such as stimulus payments and child tax credit because of family situations or documentation status. One farmworker outreach professional described the situation this way:
In the first round [of stimulus payments], the answer was no [for farmworkers]. In the second round, they updated it. But the reason why they updated it is because the first round created such an outburst and a cry from communities saying, “Hey, not only did we call them essential, but we are not giving them the equipment they need. And we aren't even giving them the stimulus package that everyone else is getting. But of all people that deserve it, they get it.”
As mentioned earlier, farmworkers already experience significant job instability and insecurity, coupled with a lack of resources, outreach, relief payments, and other forms of support that would mitigate viral exposures and illnesses. We argue that this stands in stark contrast to their status as essential workers during pandemics and other widespread health crises.
State and corporate power
Finally, the CEJ framework highlights the structural power imbalances at the state level that can lead to the perpetuation of environmental injustices in vulnerable communities. Our results showed that systemic problems in both political and corporate structures contributed to the significant challenges faced by farmworker communities during the pandemic.
Participants pointed to corporate profit priorities to illustrate how farmworkers in the state were neglected throughout the pandemic. Participants argued that the power imbalances associated with increasing corporate consolidation of agricultural businesses intensified the injustices associated with the pandemic for farmworkers, as noted by this participant:
Also, the consolidation of power in the marketplace with regard to companies who have merged over and over again; consolidation in the marketplace is a huge problem … They basically have too much power. This threatens the rights and protections that need to be in place for dignity, basically. It allows them to get away with very unjust practices that are supported by policies that favor them because they are able to pay for the lobbying to get those policies passed.
In addition, participants noted the inextricable relationship between corporate influence and government regulatory actions regarding intervention and support during health crises, an issue especially important for vulnerable communities. One outreach professional described their frustration with the lack of positive legislative action this way: “So, some of the major challenges are corporate influence on government policies that keep the government from making policies that are better for farmworkers.”
As outreach professionals working with farmworker and agricultural communities, participants noted the challenges they faced both before and during the pandemic. They argued that corporate agri-businesses do not have a vested interest in protecting farmworker rights, protections, and safety. And corporate interests were particularly opposed to regulation and legislation designed to protect and enhance farmworkers lives, as noted by this participant:
My biggest concern is that because we are trying to change the system that makes really large profits for a few people that have a lot of power. Our survival with regard to doing this work and having team members and resources to do this work is threatened because it is not advantageous for those who have money for us to succeed. That is always a concern. How are we going to continue to fund this work?
DISCUSSION AND CONCLUSION
The results of this research underscore important contributions to the literature regarding farmworker health and the COVID-19 pandemic. We know that farmworker communities are often burdened with numerous inequalities regarding health care costs and access, higher rates of preexisting conditions, and dangerous working conditions. 26 , 27 However, we argue that by nesting our analysis within the CEJ framework, we were able to better analyze and understand the threat of exposure and infection as an environmental injustice for farmworkers.
As noted by Carrillo and Ipsen, 28 the very space that farmworkers live, work, and travel in can pose an environmental threat for workers who are forced to live in overcrowded conditions, or work in spaces that may make using PPE a significant challenge. In addition, social positionality can differentially affect how individuals are exposed or experience infectious illness.
For example, language barriers can couple with gendered issues such as a lack of childcare to compound concerns such as job loss due to nonattendance or access to meaningful medical interventions. Another CEJ pillar gives emphasis to the idea that certain populations are seen as “expendable” in the face of capitalistic production. Although farmworkers were among the first to be deemed “essential” in the wake of the pandemic, outreach professionals repeatedly described unsafe conditions, a lack of effective PPE, and neglect in the context of support and resource distribution.
In this way, we argue that our research sheds light on the discrepancy between “essential workers” and “essential positions,” when the positions are crucial for the functioning of critical infrastructure, but the individuals holding these positions are not valued or protected.
Finally, our results point to the role of state and corporate power in maintaining the structures that prioritize production over safety, especially in the context of the agricultural industry in the United States.
In light of these findings, we argue that our research makes contributions in two ways. First, this article forges a path for future analyses of pandemic events and other widespread health crises using the CEJ framework in established environmental justice and otherwise vulnerable communities. Second, our study points to important ways that policy makers and outreach professionals can preempt what experts are calling the next “inevitable” pandemic for farmworkers in Florida and other areas.
Regulatory agencies should partner with experts to devise ways to make farmworker housing, whether permanent or temporary, more conducive to social distancing and improved ventilation. Attention should also be paid to workspaces in the context of proximity to other workers, weather-appropriate PPE, and access to resources such as handwashing stations. In addition, governments and health agencies should develop fact sheets, medical intervention services, and other informational campaigns to be culturally appropriate and in a wider variety of languages, including indigenous languages.
And finally, preparations and regulations need to be put into place for vulnerable populations deemed “essential” during epidemics, pandemics, and other widespread health threats. As our results illustrate, the CEJ framework can help to identify health threats as environmental injustices before these events happen. While this case study creates inroads for understanding infectious pathogenic threats as environmental injustices in Florida farmworker communities, future research is needed to unpack this concept in other vulnerable communities and contexts.
Footnotes
AUTHORs' CONTRIBUTIONS
M.C. contributed to this research and this manuscript in the following ways: conceptualization, methodology, investigation, writing of the original draft, and review and editing. A.E.A. contributed to the conceptualization of this project and manuscript, formal analysis, methodology, supervision, visualization, and the writing of the original draft, review, and editing. T.E.S. contributed to these efforts through formal analysis, visualization, writing, review, and editing.
AUTHOR DISCLOSURE STATEMENT
No competing financial interests exist.
FUNDING INFORMATION
No funding was received for this article.