5

Systemic Barriers to H5N1 Infection Control and Prevention in High-Risk Farm Settings

The fourth session of the workshop explored community and societal barriers to access and use of personal protective equipment (PPE), health and safety approaches that center concerns of producers and farmworkers, and the needs of trusted organizations related to better supporting PPE access and uptake among workers. Anabel Rodriguez, assistant professor at Texas A&M University, moderated the session. As agricultural communities face the threats of Influenza A(H5N1), examination of broad systemic challenges to PPE adoption is critical to effective infection control, she maintained. Organizations working to address the barriers facing vulnerable farmworker populations include community health worker programs and academic extension programs.

FARMWORKER ADVOCACY ORGANIZATIONS

Amy K. Liebman, chief program officer at Migrant Clinicians Network, provided an overview of agricultural worker demographics, the regulatory landscape, and immigration considerations. Over the past decade, national milk production has remained stable but is sustained by a smaller number of farms due to an increase in large dairy operations, she explained. From 2017 to 2022, the percentage of the U.S. milk cow inventory housed on smaller dairy farms decreased from 45 to 35 percent, while the inventory on operations with 2,500 or more cows increased from 35 to 45 percent, illustrated in Figure 5-1 (USDA, 2022). She noted that the percentage of inventory at mid-sized farms has remained steady at approximately 10

percent. The expansion of large-scale dairy operations carries ramifications for various policy frameworks and farm regulations, said Liebman.

Farmworker Demographics

With the shift toward larger operations, U.S. milk production increasingly relies on improved technology and immigrant labor, Liebman remarked. She noted that dairies employing immigrant labor are estimated to produce approximately 79 percent of the nation’s milk supply (Adcock et al., 2015). In the absence of a national census or survey of dairy farmworkers, Liebman presented data from the National Agricultural Workers Survey (NAWS). Although the NAWS focuses on crop workers, dairy workers have similar demographics and therefore similar conclusions can be drawn (Fung et al., 2023). Although the agriculture workforce remains predominantly male, women are increasingly entering the industry and now comprise 32 percent of farmworkers. The workforce is young, with 42 percent of workers aged younger than 35 years. Largely a Spanish-speaking population, the majority of farmworkers are foreign-born, primarily originating in Mexico but increasingly immigrating from Central America. Liebman underscored that immigration authorization is an important issue in agriculture, given

that approximately 42 percent of farmworkers report that they lack authorization to work in the United States. On average, farmworkers have a ninth-grade education. About 21 percent of agricultural workers have total family incomes below 100 percent of the federal poverty level, with mean and median individual income ranging from $20,000–24,999. Nearly half of farmworkers report having no health insurance, and 40 percent indicated they had not visited a U.S. health care provider in the 12 months prior, said Liebman.

Liebman highlighted demographic data collected by the Upper Midwest Agricultural Safety and Health Center (UMASH) during two consecutive 5-year training and safety programs. Conducted on 19 farms averaging 21 employees, the most recent program trained approximately 360 workers and collected data from 2017 to 2021 (Vazquez et al., 2025). Almost half of the farms provided on-site housing. She noted that 41 percent of farmworkers had 8 or fewer years of education, and 32 percent had some high school education but did not complete a diploma. Spanish was the preferred language for 94 percent of workers, 74 percent of whom originated in Mexico, 12 percent were from Guatemala, and 9 percent were from Nicaragua. About one-quarter of farm employees had worked in the United States for 1 year or less, and 32 percent had worked in the dairy industry for less than a year. Liebman emphasized that just over half of workers reported receiving prior health and safety training, and 42 percent reported having been previously injured at work.

Regulatory and Policy Framework

Agricultural workers have long been excluded from labor protections afforded to other industries, said Liebman. The National Labor Relations Act of 1935 protected the right of most employees to unionize but excluded farmworkers.¹ Establishing a minimum wage and overtime pay, the Fair Labor Standards Act of 1938 brought many workers out of poverty and put child labor standards in place.² Aside from some exceptions and provisions made by individual states, agricultural workers were excluded from this legislation, she noted, with no minimum wage requirement for small farm employers, overtime exemption for all agricultural employees, and child labor permitted. When the Occupational Safety and Health Administration (OSHA) was created in 1970, few agriculture-focused standards existed. The first standard for water and sanitation was issued in 1987, following

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¹ National Labor Relations Act of 1935, Public Law 74-198, 74th Cong., 1st sess. (July 6, 1935).

² Fair Labor Standards Act of 1938, Public Law 75-718, 75th Cong., 3d sess. (June 25, 1938).

a lawsuit. Liebman underscored that OSHA can only use federal dollars to enforce regulations on farms with 11 or more workers or provide worker housing. Although smaller farms are subject to several regulations, Liebman contended that the lack of a historical regulatory framework has resulted in OSHA largely being absent from farms. She stated that farmworker exceptionalism also applies to workers’ compensation, a state-based insurance program. Liebman gave the example of Wisconsin, where state law requires most employers with three or more workers to provide workers’ compensation insurance, but the threshold is six or more workers in agriculture.

Similarly, the U.S. immigration policy framework often excludes farmworkers, said Liebman. Few visa options are available for agricultural workers, particularly in dairy. Temporary visas are available for some farmworkers in the crop industry, but dairy farms are in production year-round and thus workers require longer visas. Although visa options for dairy workers are lacking, the labor demand in this industry is high. She pointed out that the expansion of farms with 2,500 or more cows require large staffs. The lack of authorization or precarious immigration status can generate anxiety for immigrant workers, and she contended that the potential for fear to interfere with work duties constitutes an occupational hazard. Outlining numerous vulnerabilities, Liebman described how the U.S. dairy workforce faces cultural and language differences, low wages, immigration status concerns, lack of access to health care, inherent occupational health and safety risks, and lack of training and regulatory protection.

Dairy Worker Health and Safety Training

The UMASH training program yields insight on components that benefit the health and safety of workers and that aid in establishing trust, said Liebman. The organization partnered with producers and farmworkers in creating an interactive, on-the-farm training curriculum. Using participatory approaches, the program recognizes the literacy level of farmworkers. Employees complete the training during their work hours, thereby receiving compensation for their participation. Over the course of a decade, UMASH has trained over 1,000 workers across approximately 100 farms. The training has enhanced discussion of health and safety on farms by providing workers with a forum for these topics. Liebman described how the program ultimately improved the health and safety of workers. She noted that the onus of PPE responsibility largely falls on workers and, to a lesser extent, producers. In training agricultural workers on PPE and infection control, considering the audience and daily farmworker experience is key, Liebman stated. Emphasizing the importance of trust in recommendation follow-through, she said that farm safety advocates should consider numerous factors affecting the agricultural workforce, including policy

and regulatory systems, demographics, education and literacy level, and fear regarding immigration status. Liebman closed by underscoring that farmworker health and safety are public health.

PRODUCERS AND CO-OPS

Martín J. Carrasquillo-Mangual, dairy extension educator at Michigan State University Extension, discussed barriers to PPE usage on farms and effective approaches to PPE education. He emphasized that noncompliance with PPE on dairy farms rarely involves lack of concern for well-being. Farmers want to protect their herds, which constitute their livelihoods, and farmworkers want to be safe. When farmworkers are properly informed and provided with optimal access to PPE, they take a proactive approach to infection management, he asserted. However, system design often poses challenges to implementation of recommended practices. Carrasquillo-Mangual stated that in most cases, what appears to be an individual choice is actually a structural barrier.

Barriers to Effective Education

Training is a common gap affecting PPE use on farms, said Carrasquillo-Mangual. Information is not always available, accessible, or tailored to the industry. He described how much of the educational material issued from the Centers of Disease Control and Prevention (CDC) and other agencies is in the form of text-heavy—and sometimes technically complex—info-graphics, PowerPoint presentations, or bulletins that are not engaging for the audience. Dairy farmworkers are manual laborers who often learn best by doing. An infographic or poster displayed in a break room will not be as effective as a physical demonstration of safe glove use or achieving proper fit for a respirator, he highlighted. Education is best delivered directly, in the primary language spoken by the farmworkers, with terminology they understand, he added. Education level is variable in the dairy farm workforce, and complex terminology about pathogen spread and medical symptoms should be avoided in favor of easy-to-understand language. He noted that an effective approach in training farmworkers on milking procedures, animal handling, or safety practices is to demonstrate the behavior and then ask the trainees to repeat the action or explain the concept back to the trainer. Additionally, repetition of information is important, and training should be offered via periodic farm visits to offer repetition as well as any updated risk and safety information, said Carrasquillo-Mangual.

Emphasizing the importance of ensuring understanding, Carrasquillo-Mangual gave the example of a safety and biosecurity training he provided at a farm, during which he explained that workers should submerge boots

in a foot bath on the way into the milking parlor and again on the way out. However, he observed after the training that farmworkers used the foot bath only upon entering the parlor, and not when exiting. In asking farmworkers about it, he learned that they were under the impression that the foot bath was solely for protecting the cows and the parlor environment. Carrasquillo-Mangual realized that he had failed to explain that the foot baths also serve the purpose of killing microbes or pathogens that workers may come into contact with while milking that then could spread to the break room and other areas of the farm. Adding that educational efforts should consider nontraditional means of reaching dairy farmworkers—such as social media, podcasts, or other avenues that workers use for information consumption—Carrasquillo-Mangual stated that farmworkers have limited time and therefore information should be provided in formats that are easy to access and learn from.

Logistical and Environmental Barriers to PPE Use

Typically, the structure of the workday and farm environment are outside of a farmworker’s control, said Carrasquillo-Mangual. For instance, an employee may be assigned 12-hour shifts with a fast pace of milking parlor throughput that does not allow time for donning and doffing PPE for meal and snack breaks. He described how dairy workers often step aside for a drink during a busy shift and do not remove gloves, respiratory protective devices, and face shield. In contexts not conducive to following biosecurity practices—including washing hands—farmworkers often prioritize meeting work demands, he explained. Moreover, the physical farm environment often poses barriers to following PPE recommendations. Milking parlors are hot, humid environments, with ventilation typically directed at holding pens and other areas where animals are located. Therefore, the spaces in which workers operate do not always receive the full benefit of ventilation. Carrasquillo-Mangual remarked that asking workers to work 10–12 hours in full PPE in this environment is unsustainable. He recalled witnessing workers remove respiratory protective devices because they could not breathe easily, take off eye protection because it limited the visibility they needed to assess mastitis, and eschew double layers or certain types of gloves because they impaired dexterity needed to quickly perform tasks with dip cups, wands, and towels. Carrasquillo-Mangual reiterated that farmworkers do not choose the productivity expectations or environmental factors that pose barriers to PPE use compliance.

In addition to job demands and discomfort, risk perception can affect the likelihood that a farmworker will wear PPE, said Carrasquillo-Mangual. For instance, if workers assume that contracting H5N1 involves only short-term illness, they may decide that the risk of contending with viral

symptoms for a few days does not merit decreased work productivity or the discomfort of working in PPE at temperatures of 110 degrees for 12 hours at a time. He recounted that when the H5N1 outbreak started, he and his colleague filmed educational videos to inform farmworkers about CDC-recommended PPE. After wearing the PPE for 15 minutes, they experienced heat stress and fogged up goggles, despite it being a cool spring day. His colleague stated that it would be challenging to ask farmworkers to comply with these recommendations. Carrasquillo-Mangual suggested that PPE recommendations should pivot to consider the working conditions of the employees, the tasks they perform, and the types of equipment that best suit those conditions. Such an approach should then rank each type of PPE according to the level of protection it affords workers and the sustainability of wearing it for long hours in the existing working conditions, he added. Moreover, farms should provide facilities supporting health and safety measures, such as locker rooms for donning and doffing PPE and laundry facilities to enable employees to leave work clothes at the farm, said Carrasquillo-Mangual.

COMMUNITY PARTNERS

Social and Working Environment Barriers to Safety Measures

Lus Chávez, community health worker, Texas Panhandle, explored social factors affecting PPE usage and the role of trust in promoting behavior change. In her farm outreach work in Texas and eastern New Mexico, she has learned that establishing trust with farmworkers is essential. This vulnerable population is underserved, overworked, and currently wary of strangers due to the increased immigration enforcement activity nationwide, she explained, making trust all the more important. Guidance and education are more readily accepted when coming from trusted sources, said Chávez. Moreover, the establishment of trusting relationships with producers and farm owners is helpful in gaining access to farms. Chávez emphasized that due to the current levels of immigration enforcement, she and other community health workers have been denied entry on farms previously open to them, thereby affecting their ability to provide education and guidance to workers.

In addition to immigration policy, other social factors affect health and safety efforts, said Chávez. For instance, many farmworkers earn low wages and are living in poverty. She highlighted that lack of affordable housing leads many farmworkers to live in employer-provided housing, if available, or to live together in crowded homes. Sometimes as many as 10 farmworkers live in a two-bedroom house, she described, creating unsafe conditions in which infectious diseases can easily spread. Language barriers

are often present, she noted. In addition to offering education in Spanish, Chávez works to locate individuals who speak an Indigenous dialect as well as Spanish or English and enlists their help in communicating with farmworkers who speak only an Indigenous dialect. Chávez emphasized that workers have been willing to assist outreach efforts in this way because of the trusting relationships community health workers have established.

In conducting focus groups with farmworkers, Chávez has learned that working conditions often pose barriers to PPE use. For instance, many farms provide only limited supplies of PPE, so workers change their PPE infrequently. Workers often eat in the milking parlor because they are not allocated time to take a true lunch break, she noted, and they do not always remove their gloves due to inadequate supplies for replacing them. Given the nature of their jobs and the substances they come into contact with, wearing the same gloves all day poses safety risks, particularly while eating, touching one’s face, or answering a smartphone call from the manager, she underscored. Farmworkers have expressed reluctance to wear high-visibility safety apparel due to concern about drawing attention should U.S. Immigration and Customs Enforcement visit the site. Chávez noted that this concern is voiced even by those with active worker permits, as permits do not necessarily exclude workers from being profiled or detained.

The daily hardships many farmworkers face often eclipse concern for their health, said Chávez, and advocates making PPE recommendations should consider the numerous factors influencing farmworker PPE use. Engaging with farmworkers enables better understanding of their perspective on what types of PPE are comfortable, work well for their tasks, can be worn for entire shifts, and are acceptable in appearance. Chávez added that widescale changes or recommendations made at a systemic level should incorporate farmworker input and engage workers in testing out PPE.

Working Conditions and Health Precautions

Ma Elena Gutierrez, executive director at Fe y Justicia, outlined effects of workplace conditions and expectations on PPE use. Describing Fe y Justicia as a faith-based, Latinx, woman-led, grassroots organization, she stated that the organization addresses issues related to immigration, health, workers’ rights, and public safety. By focusing efforts on education, training, and connecting people with needed services, the organization engages communities across central Minnesota, meeting in people’s houses, work sites, and churches. Gutierrez stated that farm working conditions pose many barriers to PPE. Dairy workers must maintain a fast pace to achieve the high throughput of cows they are expected to milk each day. Wearing eye protection, respiratory protective devices, gloves, and aprons can slow this work, particularly when worn on top of multiple layers of clothing

during Minnesota winter weather. She said that workers who become ill are sometimes told by farm owners or supervisors to continue working. In these situations, farmworkers are fearful that taking time off could result in losing their jobs, and to persevere they often use over-the-counter medicines or medications sent by relatives in their home countries, she noted. Gutierrez strives to connect with supervisors to educate them about health measures.

DISCUSSION

Culture Influences in Personal Protective Equipment Uptake

Rodriguez asked about the influence of culture on PPE adoption in the agricultural workforce. Highlighting outdated concepts of cattle workers as hypermasculine and wearing certain clothing, Carrasquillo-Mangual stated that these ideas support a paradigm resistant to PPE uptake. Some farmworkers see themselves as strong in performing a risky job and upholding a cultural value of hard work. He remarked that workers often disengage when he discusses safety, but he maintains their attention when he describes precautions as a way that farmworkers can keep their families safe. Rodriguez commented that this approach connects the concepts of “machismo” with “familismo,” allowing farmworkers to see themselves as strong by protecting their families. She asked if cultural differences between countries of origin were apparent. Chávez replied that within the Guatemalan immigrant community, men are typically the decision-makers, and women tend to be silent and follow the determinations made by the men. Thus, women usually wait for men to approve of a new initiative before they accept it or participate, said Chávez.

Liebman highlighted the arduous journeys that many immigrants take to reach the United States. Typically, these journeys involve incredible risks and can even be deadly. Upon arriving here, immigrant farmworkers then enter an industry with many inherent risks. The will to survive is strong in this community, as is the fear of consequences should they upset their employers, she remarked. Given the risks that immigrants have taken for the opportunity to work in the United States, they may not perceive the risk of contracting a virus as very dangerous, Liebman stated, She suggested that advocates consider this context when engaging with immigrant workers. Carrasquillo-Mangual remarked that workers who have contended with such challenges and have successfully obtained jobs in the United States may be reluctant to risk losing their livelihoods by working more slowly due to wearing PPE. Many farmworkers perceive the risk of contracting H5N1 as becoming sick for a day or two and thus less consequential than the risk of losing one’s job, Carrasquillo-Mangual explained.

The Role of Employers in Personal Protective Equipment Use

Carrasquillo-Mangual observed that owners and middle managers set farm expectations; if they set a standard that workers wear PPE and lead by example in wearing it themselves, farmworkers will be much more likely to do so. Moreover, employers can evaluate workers based on adherence to safety practices rather than solely on the number of cows milked, he added. Gutierrez remarked that seeing supervisors wear PPE is more impactful if the supervisors are performing milking duties. Workers sometimes comment that only Latinos milk cows, highlighting a perceived divide between milking and other tasks on the farm. Thus, seeing supervisors perform non-milking tasks in PPE will not necessarily shift the common view that PPE slows milking pace below that expected by employers, she explained. Workers express that wearing PPE makes them too slow at their work, and they prefer not to wear PPE and accept the risk of potentially contracting a temporary illness. Gutierrez added that many farmworkers do use aprons, gloves, and boots but not other forms of PPE. Rodriguez noted that workers are in a difficult position, caught between the option of wearing so much PPE that their work slows or wearing less and potentially exposing themselves to pathogens.

Chávez recalled that during the COVID-19 pandemic, some dairies held vaccine clinics. Employers that allowed vaccine education efforts on the farm saw greater vaccination willingness in their workforce. In contrast, other dairies ordered workers to be vaccinated in the absence of education, she stated. The perceptions of those who did and did not receive education were starkly different, she described. Whereas the first group felt that vaccination protected them and enabled them to remain safe and healthy as they performed their tasks as frontline workers, Chávez said the latter group expressed that they were being unfairly and unjustly experimented on. Emphasizing the wide gap between “my employer wants to protect me” and “my protector is experimenting on me and does not care about me,” she noted that the education offered to the first group required only a small amount of effort and communication from the employer. Chávez remarked that the consequences of ordering workers to be vaccinated in the absence of education continue to persist, as these employees are now wary about the possibility of an H5N1 vaccine and distrust safety recommendations from people they believe are trying to push vaccination on them.

Liebman stated that the owners of the farms she has visited largely care about the health and safety of their workers, are willing to invest in training, and are open to participatory programs offered in the language and manner that farmworkers understand. In the UMASH programs, farm owners saw positive results, and workers felt valued, particularly given

that their participation took place during work hours. She emphasized the role of employers in paying their farmworkers to participate in safety training. The curriculum and processes were designed with employer input and consideration given to engaging both producers and farmworkers. Underscoring that every farm is unique, Liebman said that safety programs should adapt to each setting, and buy-in from management is critical to success. Similarly, Carrasquillo-Mangual remarked that most of the producers he encounters are concerned about the well-being of their workforce. He added that many milk producers are members of cooperatives, and generally these cooperatives are willing to provide PPE to members and offer them support and educational programming. Carrasquillo-Mangual contended that most producers and cooperatives encourage education and PPE access, but farmworkers are being asked to wear PPE that is not sustainable in their working environments.

Feasibility and Sustainability of Safety Recommendations

Rodriguez asked whether any practices or recommendations can increase the feasibility or sustainability of long-term PPE use. Carrasquillo-Mangual replied that recommendations should prioritize different types of PPE based on the current level of risk present at the farm and the specific types of exposure that each farm task entails. For example, farmworkers responsible for feeding calves come into close contact with the calves’ noses, and therefore respirators are appropriate for protection against exposure to air particles in exhaled cow breath. However, in a parlor setting, farmworkers are positioned at the cows’ backsides and exposure to milk droplets is common. Thus, recommendations for milk parlor workers should include wearing face shields—which simultaneously mitigate exposure from milk droplets and discourage workers from touching their faces—and removing gloves before eating or drinking, said Carrasquillo-Mangual. Acknowledging that prioritized recommendations may contradict CDC recommendations for full PPE, Liebman emphasized the importance of strong working relationships with farm owners. She remarked that all panelists described developing relationships with producers and workers prior to outbreaks, enabling farmers to trust in their industrial hygiene expertise and in their desire for practical solutions. When infections were detected, these relationships facilitated the implementation of recommendations for modifications or new steps. Liebman underscored that these trusted relationships are all the more important when guidance differs from that being issued at other levels.

Trust and Relationship Building in Safety Education

Rodriguez asked about the effects of misinformation concerning H5N1 and PPE within farmworker communities. Chávez replied that early in an outbreak, farmworkers formed their own hypothesis that sick cows had COVID-19. They did not think the cows could pass it on to humans, and they made no changes to their PPE. In surveys and door-to-door outreach, she has found little change in PPE use from pre-outbreaks to current day, despite educational efforts. Emphasizing the importance of developing trusting relationships, Chávez noted that farmworkers reach out to trusted messengers with their questions, seeing them as reliable sources of accurate information. Gutierrez observed that many farmworkers only use PPE when lots of people are ill from cold, flu, and COVID-19, and therefore her organization provides much information during the winter cold and flu season via meetings and mobile clinics. However, once the season passes and fewer people are ill, PPE use returns to pre-winter levels. Gutierrez added that although technology rapidly changes many products, PPE remains the same, and modifications that improve comfort in wearability could be helpful.

In response to a question about resources or collaborations that could strengthen education efforts, Chávez stated that resources for farmworkers in the Texas Panhandle are extremely limited, and her educational outreach activities would not be possible without grants and collaboration with organizations and universities. Remarking that education relies on the work of advocates more so than on physical supplies, she said that giving a farmworker a water bottle or a bandana when discussing heat stress is a way to make contact and open pathways for future conversations. Chávez underscored that farms in rural settings are remote, and building relationships requires effort on the part of community health workers. Gutierrez described how Fe y Justicia started a mobile clinic for outreach efforts, and partnerships with counties, clinics, and private practitioners make the mobile clinic possible. The one-on-one interactions that take place in the clinic provide opportunities for supporting agricultural workers. Even with volunteers in place, an organization cannot operate without someone to coordinate efforts, said Gutierrez, emphasizing the importance of resources such as grant funding and donations.

Liebman underscored that partnerships and resources enable community advocates to connect farmworkers with needed services, and this aids in developing trust and building relationships. She suggested that rather than approaching farmworkers with the sole focus of safety, advocates should listen and respond to the needs and concerns that workers share. For instance, a farm employee may need assistance in understanding a letter from their child’s school, and the outreach worker may be the only bilingual person they know. Many farmworkers have questions about health

care that are not related to outbreaks. When advocates understand the farmworker population and the challenges they face, they are better able to develop relationships. Moreover, outreach workers engender trust when they make referrals or provide needed services. When trusting relationships are in place, farmworkers are more likely to be receptive to messaging regarding safety and PPE, said Liebman. Rodriguez stated the importance of human connection, emphasizing that educators who deliver a few minutes of safety training without taking the time to connect are unlikely to be effective.

Gutierrez remarked that rural areas do not have the level of resources available in larger cities, and farmworkers have many concerns regarding their daily living experience. She described how a few years ago during immigration reform efforts, she met with individuals who wanted to talk about a variety of concerns including health care, obtaining valid driver’s licenses, and housing. Rather than remaining focused solely on immigration reform, her organization helped address the issues raised. For instance, she worked to support two notable 2023 legislative victories for this population: The Minnesota Driver’s License for All law eliminated the requirement to show proof of citizenship to obtain a driver’s license,³ and the state’s Earned Sick and Safe Time law requires employers to annually provide a minimum of 48 paid hours of sick leave, accrued at one hour per every 30 worked.⁴ Moreover, Fe y Justicia is advocating for health care legislation. Gutierrez highlighted that helping communities with issues that are important to them establishes credibility and builds trust.

Carrasquillo-Mangual remarked that when he visits a farm, he starts by asking questions rather than immediately dispensing information. This helps him understand the farmworkers’ reality, challenges, and perspectives. He can then incorporate this understanding into recommendations. For example, when he provides training for milkers, he mentions a step in the safety procedure and then asks them what they think the purpose of the step is. He then complements their contributions with scientific information. Carrasquillo-Mangual stated that this collaborative training that incorporates farmworkers’ perspectives helps to build relationships and trust. He also visits farms periodically and only delivers training at some of these visits. Making some visits with no specific agenda, he lets farmworkers know that he was in the area and wanted to drop by, which helps build rapport. The trust established via these visits translates into attention when he needs to deliver information about issues of concern. He added that participating in farmworker tasks, such as demonstrating the safety techniques on actual cows rather than only describing them, also builds trust.

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³ Driver’s License for All. Minnesota HF0004 (October 1, 2023), 13, 4.

⁴ Minnesota Statute § 181.9446.

Farmworkers often perceive a divide between themselves and university staff, seeing academic-affiliated professionals as having “book smarts” but lacking practical skills. Milking cows or performing other farm tasks while explaining how to implement the safety steps can overcome this perception and foster trust and credibility, said Carrasquillo-Mangual.

Chávez stated that the biggest obstacle to relationship building is time limitations. She recalled making attempts to visit a farm for 5 years before they began allowing her access. Attributing their reluctance to doubt about whether her offerings would be beneficial, she shared that she now regularly offers education at that dairy. Echoing other panelists, she emphasized the importance of listening to farmworkers and addressing their concerns rather than focusing solely on educational efforts. For instance, she asked farmworkers what they needed, and they shared their need for access to birth control. To overcome the barriers to health care access, which are often present in rural areas, Chávez found a volunteer driver, secured the donation of a gift card for gas, and transported a group of farmworkers to a local clinic to meet with providers for birth control. Chávez maintained that when people trust that you care about their needs, you become the primary contact for the employer and workers when health or safety issues arise on the farm.

Engaging and Valuing Farmworkers

Carrasquillo-Mangual cautioned that trainings designed without input from farmworkers are likely to fail. He suggested that if advocates want workers to wear safety glasses, they should ask the farmworkers what type of glasses they prefer and what would make wearing the glasses feasible as they perform their tasks. Similarly, dairy owners and workers should be engaged in policy development, said Carrasquillo-Mangual. Emphasizing that worker health and safety is public health, Liebman stated that when workers are healthier, the public is safer. Chávez highlighted the importance of seeing farmworkers as whole people who have complex lives and numerous concerns. They likely do not view PPE as a priority in their lives, and advocates should approach PPE education with the understanding that farmworkers have many other pressures and concerns. Gutierrez suggested that when people grocery shop, they should consider the hard work that goes into food production. Recalling the many years her husband spent working at a dairy, she stated that he was never able to miss a day of work, even when he was sick, due to fear of losing his job. Gutierrez commented that if we collectively consider and value the hard work that goes into producing the milk we drink and dairy foods we eat, we could generate improved PPE solutions that effectively keep farmworkers healthy and safe.