National prevalence of diabetes and barriers to care among U.S. farmworkers and associations with migrant worker status

Objectives. To quantify the prevalence of diabetes and barriers to care in U.S. migrant farmworkers (i.e., who travel from their permanent residence for seasonal farmwork).

Research Design and Methods. Age-adjusted prevalence of self-reported diabetes and barriers to care were calculated in adult U.S. farmworkers from 2008-2017 National Agricultural Workers Surveys. Results. Among 16,913 farmworkers, 30.7% reported one or more barriers to care, most often cost. Age-adjusted self-reported prevalence of diabetes was 13.51% (95% CI 10.0 – 17.1) amongst migrants and 10.8% (95% CI 9.0 – 12.6) amongst non-migrants with access to healthcare. Migrants without recent access had 83% lower odds of reporting diabetes (aOR 0.17, 95% CI 0.06 – 0.54) compared to non-migrants, likely due to poor healthcare access and/or a healthy worker effect.

Conclusion. Many migrant farmworkers face barriers to care which may lead to significant underdiagnosis of diabetes in this vulnerable population.