By: Jeramy Ashton
Disclaimer: The views expressed in this post are those of the author, and do not necessarily reflect views of the Journal, the William H. Bowen School of Law, or UA Little Rock.
Abstract
In 1865, General William T. Sherman issued a special order to allot forty acres of land to certain freed Black families in the United States. A short time later, the order was rescinded, and the land returned to White Confederate landowners. Overtime, Black persons would regain the right to land but continued to experience significant struggles, such as poor allocation of farm loans and assistance from the United States Department of Agriculture (USDA). On average it took three times longer for the USDA to process a Black farmer’s application than a white farmer’s application. In 1999, a class action lawsuit against the United States Department of Agriculture alleged the Department of racial discrimination against Black farmers between 1981 and 1996. The lawsuit reached a settlement that provided a “fast track” adjudication process and a track for higher payments to claimants who experience a lengthy review and documentation process. However, from 2006 to 2016, Black farmers were six times as likely to be foreclosed on as White farmers. Further, in 2022, an audit investigation in Mississippi revealed Black farm workers across the Mississippi Delta were being paid less than young white foreign workers who came to Delta on farm work permits.
The historical treatment of racial and ethnic groups in rural communities worsens when considering the health disparities experienced by rural populations. Rural farm workers and operators are more likely to be uninsured, lack mental health/long term care, and lack access to healthcare professionals including emergency departments. Further, at least eight rural hospitals in twenty-six states have closed since January 2010. One of the eight hospitals was in a county where seventy-two percent of residents are Black Americans. Before the declaration of the COVID-19 public health emergency, not much could be done to address the health deficiencies in rural communities as access to “Telehealth,” the provision of health-related services to patients from providers who are not at the same location, was not widely available and closely regulated. Since the unique public health emergency, the use of telehealth has skyrocketed including use in rural populations. However, populations of rural areas, particularly Black farm workers, lack the broadband or internet access required to benefit from health information and programs like telehealth. This literature review will identify how rural populations are at a higher risk of health problems and how additional access to broadband internet would combat the unique health disparities of Black farm workers.
Introduction
In 2020, over 20 million Americans did not have broadband or high-speed internet access and most of them lived in rural communities. Extending broadband to rural America is critical, not only access to healthcare but educational opportunities and improved public service. The extremely unique public health emergency allows for flexibility and increased access to telemedicine through at least July 2022, allowing additional access to medical providers from the comfort of the user’s home. While the government, insurance companies, and providers continue to explore possible ways to extend the practice of telemedicine, access to broadband internet is needed now more than ever for rural communities to solidify increased overall well-being.
The 2017 Census found that 78% of farms with new or beginning producers reported access to internet. 94.9% of new producers in 2017 were White or Caucasian. Congress will soon consider the 2023 Farm Bill which includes the Rural Broadband Provisions that would allow for increased access to high-speed internet. Access to internet provides farm workers with important information like proper pesticide related precautions that decreases the farm worker’s dermal exposure by 65%. Additionally, the 2017 Census also reported that only 62% of Black-operated farms reported access to internet with 71% of Black producers farming for eleven or more years. Not only do Black farm workers experience lingering effects of historical disadvantages but the decrease in access to essential resources such as broadband internet prohibits them from access to additional education, health, and success.
Methods
Rural Populations and Access to Broadband
According to the CDC, 15% of individuals in the United States live in rural communities. In 2019, just one year before the COVID-19 pandemic, there were only fifteen states with broadband legislation. In 2020, rural areas had 37% more residents without broadband access than their urban counterparts. The 2023 Farm Bill features “The Rural Broadband Program” that would potentially increase access to internet correlating with access to health providers. “The Rural Broadband Program provides funds for the cost of construction, improvement, and acquisition of facilities and equipment needed to provide broadband service to rural areas.” Rural populations without access to internet lack access to essential educational and health related resources. For example, agricultural contaminants, including pesticides, nitrates, and phosphorus, impact ground and surface water quality, affecting both urban and rural communities. When using contaminants like pesticides, farm workers use personal protective equipment to limit exposure and health risks. However, a 2017 Occupational and Health Safety study found that equipment was often not used correctly, significantly increasing the risk of certain cancers, birth defects, respiratory illnesses, and neurological disorders. Access to broadband internet would increase a farm worker’s access to safety precautions like the use of synthetic clothing instead of cotton, decreasing the risk of chemical exposure by at least 10%. During the COVID-19 pandemic, rural communities lacked access to educational resources on imperative information like vaccination efforts. Vaccination rates are significantly lower among rural communities with credit to a lack of educational resources. The CDC and other rural health providers collect and publish online resources specifically catering to rural communities. However, many in rural communities do not have access to such resources due to a lack of broadband access.
Health Disparities Specific to Black Farm Workers
Over the last ten years, the practice and availability of research focused on racial and ethnic groups in agriculture and health has improved. However, few concrete solutions and properly implemented strategies occurred. One author suggests the broad examination of “minority agriculture” fails to address specific racial and ethnic disparities as well as specific work tasks or areas within the field of agriculture. For example, data from the 2017 Census shows that certain ethnic groups do not often stay in one geographical area but instead frequently relocate for numerous reasons, often making it difficult to properly identify specific problems and suggest solutions. As stated earlier, Black farm workers often work for many years and during those years, generally reside in the same geographical area. The consistency and longevity have led to findings such as higher cancer morbidity and mortality rates among Black Americans living in rural communities.
The lack of internet access among Black farm workers likely adds to the finding that COVID-19 disproportionately affected Black individuals in the U.S., as vaccination rates among Black individuals trail those of other racial groups. Further, a 2021 report from the Department of Health and Human Services found that racial and ethnic populations experienced higher rates of stress and depression during the COVID-19 pandemic. The decreased access to broadband internet among rural populations and specifically Black farm workers significantly decreases access to overcoming historical barriers and inequalities.
Findings
There are several limitations in the scope of this review. Black farm workers in rural communities experience a variety of racial and ethnic, geographical, personal, and other unique health related difficulties that a vast amount of research does and does not highlight. Moreover, data about Black farm workers and their specific experience with COVID-19 was rare as the data is ongoing and the collection process either did not take place or is still in the development stage.
Further, as noted in the review, “minority farmers” are grouped together as if they experience the same geographical health concerns, racial and ethnic related susceptibilities, and overall lived experience. Inconsistency was noted as farm workers from South America were found to relocate and switch areas of work more often that their “minority” counterparts. Additionally, information was sparse on the specific areas of agriculture and farming that struggled most with health-related disparities as most literature primarily mentioned pesticide exposure without a specific area of farming.
Conclusion
The 2023 Farm Bill includes legislation that would enable access to broadband internet and in-turn provide access to communication, education, and healthcare in rural communities. Findings from the use of telemedicine during the COVID-19 Pandemic showed that rural communities overcame previous barriers of access, affordability, coverage, and education as the extended emergency access allowed them to see their medical provider via telemedicine more often. The issue of area specific illness prone to rural communities or individuals of African American descent is not directly addressed and would take time and trial to correct but would provide Black farm workers and operators with additional access to educational and health resources that are currently lacking in rural populations in the United States. A significant barrier is how one would obtain an electronic device and then use of device to access the broadband service. Although, the training and investment is worthwhile in comparison to extensive transportation, missed production deadlines, decreased pay, and costs of alternative access, the barriers remain.
About the author:
Jeramy Ashton is a third-year law student with a scholarship in Health and Human Rights. In Summer 2022, Jeramy worked with the National Agricultural Law Center and the Public Health Law Program at the CDC where he focused on legal epidemiology and health equity. Jeramy is the founding President of the Health Law & Policy Society at William H. Bowen School of Law and plans to pursue a career in Health Policy or Public Interest Litigation.