Denise Jimenez-Tapia1,2, Erica Escalera1,2 Gerardo Moreno3 , Jyoti Puvvula3 

1 David Geffen School of Medicine, UCLA; 2 Program in Medical Education-Leadership Advocacy (PRIME-LA),  Department of Family Medicine 

Background: California has 800,000 farmworkers harvesting 1/3 of US vegetables and 2/3 of fruits/nuts.1 Farmworkers experience increased occupational health hazards, limited access to healthcare (>85% being uninsured, 53% undocumented), 2 low health literacy, and poorer health outcomes.3 Despite California’s large and growing farmworker community, only 2/18 medical schools in California have programs/curriculum that trains future health care professionals in addressing farmworker health disparities.

Objectives:  To bridge the gaps in farmworker health within medical education and simultaneously improve health literacy among farmworkers. 

Design: La Cosecha is a medical student-led initiative that enriches medical training through workshops, community engagement, and interprofessional collaboration. La Cosecha has partnered with The Celebration Nation Foundation who has established trust within the Oxnard farmworker community via monthly food distributions. Health education is integrated into the food distribution sites, where participants complete pre-tests, receive health education, and then complete post-tests. Upon completion, participants receive personal protective equipment (hats, sunscreen, cooling bandanas) to mitigate occupational hazards. 

 Impact/Effectiveness: La Cosecha has educated over 39 medical students on farmworker occupational hazards, with post-tests showing increased awareness and decreased uncertainty regarding farmworker health disparities. A session on Coachella Valley Farmworker Disparities revealed a 38.7% increase in awareness on social determinants affecting farmworkers and 49.2% increase in awareness on the link between Salton Sea and farmworker respiratory disease.

 Our inaugural health education workshop in Oxnard educated 94 farmworkers on heat-related illness prevention, identification, and response through interactive, culturally sensitive classes and pamphlets. Blood pressure screenings were offered, 26 opted for screening which revealed 50% had elevated systolic blood pressure and 33% had elevated diastolic blood pressure, highlighting concerning trends. 

 La Cosecha has 2 program intervention sites (Oxnard and Coachella) where it has provided 178 farmworkers with a culturally sensitive curriculum equipping them with tools on how to prevent, identify, and respond to heat related illnesses in the fields. Post-intervention data showed a 26.4% increase in preparedness to respond to heat illness. With chronic kidney disease of unknown origin disproportionately impacting young, healthy farmworkers, La Cosecha also focused on chronic kidney disease awareness, noting a rise in awareness of rhabdomyolysis from 37.8% to 26.4% (p-value<0.01) post intervention. 

Lessons Learned/Summary: Given our growing farmworker population, it’s imperative for medical schools to expand their curriculum to include farmworker health. Understanding the multifaceted barriers, hazards, and socioeconomic determinants is crucial for comprehensive care and education. Culturally sensitive health education informed by prior farmworker research, allows for targeted education and awareness efforts. Persistent language barriers hinder access to reliable health information, while social media proves effective in raising awareness among future healthcare providers and farmworkers.