“We got another bill today. This time for $450 for an ultrasound.”
“I have not heard anything from the pediatrician [since we saw them in December] about a referral requested for a nutritionist for my son.”
“I got two envelopes in the mail today from health insurance. Twelve pages that I don’t understand”
“Can you help me make an appointment to replace my implant? It expires in April.”
” I don’t have anyone to bring me to my appointment because the taxi can’t bring me.”
“I can’t find my vaccination card and I need proof of it to show that I was vaccinated”
“Heard anything about the insurance yet?”
“I have gone to the ER and Urgent care several times. I am so frustrated and depressed about this because I cant get an answer about what is wrong with me. They tell me to go home and come back if I get worse. That is the problem, I shouldn’t be getting worse, I should be getting better.”
The above represent a small handful of reasons migrant workers and their family members communicated with Bridges to Health’s Community Health Worker team over the past few days. Just this week, we were in touch with more than 80 individuals. This included responding to a myriad of messages soliciting assistance and coordinating 31 appointments to ensure migrant workers and their children from across 10 counties could access health and social service appointments addressing a wide range of issues: hearing loss, HIV, post op from a hernia surgery, back pain, an overactive thyroid, congestion, rash, orthopedics, immunizations, lab work, yeast infection, pneumonia, stomach pain, and multiple appointments for WIC, eye concerns, oral health, prenatal care, and birth control. I am writing this while on hold with Vermont Health Connect, one of multiple holds in the last 90 minutes since I initiated the call on behalf of a Spanish speaking family who has been struggling since September to enroll their infant in a health insurance plan.
Migrant workers and their family members have long played a critical role in sustaining Vermont’s agricultural economy. For decades, Jamaican workers have supported seasonal agriculture and within the past two decades, dairy farms have come to rely heavily on migrant workers from Mexico and Central America. Increasingly, other seasonal and year-round businesses in Vermont are utilizing migrant workers to fill labor shortages in construction, landscaping, restaurants, and other hospitality roles. Over the past year, there has also been an increase in the number of Spanish speaking asylum-seeking families that have moved Vermont. Whether in Vermont seasonal or year round, most individuals we work with are migrating out of economic necessity and many are fleeing challenging situations in their home country. Migrant workers, often putting in 60-80 hours a week, have become a relied upon workforce sustaining a wide variety of businesses that are critical to Vermont’s agricultural landscape, tourism industry, and construction trades.
Regardless of where they live in Vermont or where they work, migrant workers and their family members face significant individual and systemic barriers to care and are disproportionately impacted by the workforce shortages within Vermont’s health and social systems, factors that when combined can severely limit timely access to care. Our team of Community Health Workers (CHWs) works hard every day against these barriers moving the needle on health equity to ensure that all living in Vermont have a more fair and just opportunity to “attain their full potential for health and well-being.“* Each day, as the many messages, calls, and emails come in from migrant workers and their family members, community based organizations, health entities, and volunteers, CHWs seek to understand the unique needs of each client, family and household serving as liaisons, cultural brokers, health educators, advocates, patient navigators, and interpreters between individuals and community-based organizations to promote health, reduce disparities, and improve service delivery.
As I think about the 80 plus individuals who reached out to us this week, I wonder what the health impact would be if we didn’t exist. Would the individual we brought to the hospital who ended up needing overnight treatment and observation for pneumonia have received the care he needed? Would the family who makes $10.50 an hour have received the assistance they needed applying for financial assistance or would they have to pay out of pocket – using earnings from 42 hours of work? Would the woman seeking an implant have ended up with an unwanted pregnancy? What would have happened to the woman in need of thyroid medication, the child needing a check up about her HIV treatment plan, and the young man with significant dental pain?