Invisible Hands, Visible Injustice

As best explained by Dr. Seth M. Holmes in Fresh Fruits, Broken Bodies: Migrant Farmworkers in the United States, the experiences of migrant laborers in the United States are deeply influenced by the interconnection of economic, political and medical systems. Through these systems, migrant laborers are trapped in cycles of exploitation and neglect, despite being essential contributors to the American economy and society. Migrating to a foreign country is not an individual decision but is influenced by economic insecurity, driven by foreign interests and lack of social mobility.

 

Economic systems play a pivotal role in shaping the lives of migrant laborers, beginning with international trade agreements like the North American Free Trade Agreement (NAFTA) in 1992. NAFTA’s influx of cheap American goods devastated Mexican agriculture, forcing many farmers out of business and compelling them to seek employment in the United States (Holmes, 2013). Once in the United States (U.S.), migrant workers find themselves at the bottom of a rigid labor hierarchy as field laborers. As of July 1, 2020, NAFTA has no longer been in effect and was replaced by the United States-Mexico-Canada Agreement (USMCA), which is supposed to keep the U.S. government accountable and guarantee workers’ rights. “Migrants work in the aspects of agriculture that are too difficult or too expensive to automate” yet are most vulnerable to exploitation such as exposure to pesticides while earning minimum wage, according to Jennifer Gordon’s “Unfair competition under the USMCA” (2023). 

 

Migrant workers, often lacking education and English-language proficiency, are relegated to the most physically demanding jobs, with little hope of advancement. Manual laborers scrape by in substandard living conditions while performing strenuous labor critical to the U.S. agricultural industry but are coerced by their immigration status. Out of fear of being deported for reporting unfit work conditions, farm workers are forced to decide between working to feed their families and a country that does not value them, or returning to their mother country to compete for lower-paying jobs. By siding with foreign interest, the transient nature of agricultural work exacerbates economic instability. Migrant laborers must frequently relocate to follow seasonal farming cycles, further limiting their access to consistent healthcare, financial resources and community support (Holmes, 2023). 

 

The transient nature of migrant work also complicates their political representation. Migrant laborers rarely have the stability needed to advocate for better labor protections or participate in political processes. They remain marginalized within the U.S. legal system, further entrenched in a cycle of vulnerability. Another consequence of their migration is the lack of consistent information on migrant workers in the United States. As they relocate within their state or cross state borders, tracking their data becomes difficult, impeding research on Mexican farm workers and their health. As Doris P. Slesinger (1992) explains in her review of migrant health, this instability also hampers research efforts, leaving significant gaps in data and policy-making aimed at improving labor conditions and health outcomes. Many of the conditions that Mexican farmworkers are predisposed to can be accredited to their living and working conditions, yet there is still a gap in research and studies about migrant workers’ health.  

 

The U.S. medical system compounds the struggles of migrant laborers through linguistic discrimination, cultural incompetence and structural racism. Seth M. Holmes’ ethnographic work (2013) provides a vivid account of how language barriers limit the patient-physician relationship. Physicians often misdiagnose or inadequately treat injuries sustained in the workplace due to communication challenges and implicit biases. Holmes describes how migrant workers who speak only Indigenous languages or nonstandard Spanish are viewed as uneducated and incapable of understanding medical advice and thus subjected to lower standards of care. Similarly, Mary Bucholtz’s “The Whiteness of Nerds: Superstandard English and Racial Markedness” (2001) analysis of linguistic racial marking between African Americans and European American students in high school explains how migrant workers who attempt to speak English but fail to meet “standard” English norms are often stigmatized as lazy or unintelligent. 

 

This discrimination extends into healthcare, where physicians may racialize patients based on their linguistic and cultural backgrounds. The inability to “code-switch” effectively—to alternate between languages or dialects depending on the context—further alienates migrant workers from receiving equitable treatment. The laborer’s lack of fluency in not only English, but the standard English rhetoric, limits the patient-physician relationship and communication, causing a lack of adequate health care. Juan Deliz et al. (2020) emphasize the importance of integrating lifeworld identities into medical education to humanize patients and address disparities. However, current curricula lack standardized methods for teaching cultural awareness, leaving physicians ill-equipped to address the unique challenges faced by migrant laborers. 

 

Without understanding the social determinants of health—including socioeconomic status, immigration status, and working conditions—healthcare providers fail to deliver adequate care. A lack of standards on what lessons are needed to educate medical students into the culturally cognizant physicians reinforces the inconsistencies in patient experience. The concept of “white public space,” as explored by Helán Page and Brooke Thomas (1994), further illustrates the systemic inequities in healthcare. Clinical settings, dominated by Euro-American practices, marginalize patients who do not conform to these standards. Migrant workers, often viewed as outsiders, are disproportionately affected by these biases, resulting in poorer health outcomes and a growing mistrust of the medical system. This is seen in Susana L. Matias et al.’s findings of “elevated risk of chronic health conditions in Latino farmworkers…who may lack access to health care” (2022).

 

As a result of past traumatic experiences, many migrant workers become accustomed to their treatment by the system and give up seeking professional healthcare. This further skews studies on people of color and adds to the physical and mental burden of navigating the American healthcare system. The American experience of migrant laborers is dictated by the interplay of economic, political and medical systems that exploit and marginalize them. Economic frameworks undervalue their labor; political systems silence their voices; and medical systems fail to provide equitable care. These interconnected structures perpetuate a cycle of vulnerability that burdens migrant workers while benefiting the U.S. population. Addressing these systemic inequities requires a multifaceted approach. Policies must prioritize economic justice for migrant laborers by ensuring fair wages and enforcing protections against exploitation. 

 

Political reform should ensure that migrant workers can safely advocate for their rights without fear of legal repercussions. In the medical field, cultural competency training and research on migrant health are essential to closing disparities in care. Only through such systemic reforms can the United States begin to honor the contributions of migrant laborers and uphold the values of equity and justice.