- Author: Pamela Kan-Rice
Better access to health care and safety net programs would help
Farmworkers are a crucial link in our food supply chain, a fact that came sharply into focus during the early days of the COVID-19 pandemic. To keep these essential workers healthy, there is a need for more data on farmworkers' health. A new study published by University of California scientists looks beyond work-related health concerns such as heat and pesticide exposure to the general health of the people who help plant, nurture and harvest food in California.
“The study findings confirm the high chronic-disease burden in a workforce that is considered essential but lacks adequate access to health care and safety net programs,” said Susana Matias, lead author and UC Cooperative Extension specialist in the UC Berkeley Department of Nutritional Sciences and Toxicology. “This is a concern because California needs a healthy farmworker workforce. These workers are key to putting food on our tables and should be protected and supported as any other California worker.”
After reading the study, an advocate for women farmworkers said she sees opportunities to enhance farmworkers' health by improving their working conditions by enacting policy governing work permits; childcare; pest management; unemployment benefits; access to healthy and affordable food; and safe, affordable housing.
To see a broader perspective of farmworker health, Matias analyzed data from three studies by Marc Schenker, UC Davis physician and professor emeritus. Schenker's studies examined farmworkers' general health, occupational injuries and important causes of illness and disease. Causes or so-called “social determinants” of disease include low income, food insecurity, undocumented immigration status, and poor housing conditions.
“Those social determinants are particularly negative and impact disease outcomes in the farmworker population,” Schenker said. “Too often farmworkers don't have the benefits of other working populations, including adequate health care. It is hoped that recognition of this situation can lead to addressing these deficiencies and an improvement in farmworker health.”
Irene de Barraicua, director of operations and communications for Lideres Campesinas, said the study relates to much of the work her organization does advocating for women farmworkers.
“The article and studies emphasize findings that call for higher salaries, better working conditions, more worker rights and access to healthcare,” de Barraicua said. “From these findings, we can also gather that the health of farmworkers is impacted by various stress factors related to poverty, excruciating and unsafe work conditions, and lack of or costly childcare to name a few.”
Matias found that female farmworkers were at higher risk of obesity and larger waist circumference, while male farmworkers were at higher risk of high blood pressure and high total cholesterol.
“These differences in chronic health risks between farmworker men and women suggests that clinical and public health responses might need to be sex-specific,” said Matias, who is also co-associate faculty director at the Berkeley Food Institute.
The studies were conducted with farmworkers in Mendota, Oxnard and Watsonville. Matias would like to expand the scope to assess the health of farmworkers statewide.
“Our study is not representative of other regions of the state,” Matias said. “A representative survey is urgently needed in California to better identify and quantify the health problems in this population, and to provide the services needed by these essential workers.”
“The article ‘The Chronic Disease Burden Among Latino Farmworkers in California' clearly brings to the forefront very important sociodemographic and socioeconomic ‘gaps' unique to farmworkers, an essential segment of our population and workforce,” said de Barraicua of Lideres Campesinas.
“We need to enact policy that facilitates access to health care including mental health services; easily accessible, free rural and mobile clinics; telehealth services, essentially unrestricted healthcare coverage for all,” de Barraicua said, adding that trusted community health workers who know the farmworkers' culture and speak their language are needed.
She also noted the growing population of indigenous Mexican farmworkers and face greater challenges related to language access, limited education and immigration status.
The article, co-authored by Matias, Schenker, UC Berkeley postdoctoral researcher Caitlin French and student Alexander Gomez-Lara, is published in Frontiers in Public Health.
- Author: Mike Hsu
Researchers contribute recommendations for national strategy on hunger, nutrition, health
At the first White House Conference on Hunger, Nutrition and Health convened since 1969, President Biden announced on Sept. 28 a national strategy “to end hunger in America and increase healthy eating and physical activity by 2030 so fewer Americans experience diet-related diseases.” Much of the foundational research undergirding the strategy has been informed in part by the Nutrition Policy Institute, a program of UC Agriculture and Natural Resources.
“Science is the work of many – and no one study answers all the questions – but we have a tremendous body of work that has contributed to this conference, building from all the programs and changes that were made from the last conference,” said NPI director Lorrene Ritchie.
The original Nixon-era conference produced about 1,800 recommendations – and 1,600 were eventually implemented in the subsequent years, according to Stacy Dean, U.S. Department of Agriculture Deputy Under Secretary for Food, Nutrition and Consumer Services.
A litany of far-reaching programs grew from or were propelled by the 1969 conference: the School Breakfast Program, WIC (the Special Supplemental Nutrition Program for Women, Infants and Children), SNAP (the Supplemental Nutrition Assistance Program)-Ed and CalFresh Healthy Living UC, the Expanded Food and Nutrition Education Program, and more.
This history illustrates the potential for sweeping change from this 2022 conference – which gathered about 500 experts and advocates (with 1,000 more participating online) – and from the national strategy that represents the Biden-Harris administration's “playbook.”
“Does that document have everything in it that we would like? No – but, oh my goodness, if we could accomplish all the things that they've laid out, what a transformational impact it would have,” said Ritchie, adding that she was thrilled that the highest levels of government are prioritizing hunger and nutrition-related chronic disease.
Including beverages in the conversation
In the course of gathering ideas and input from across the country, conference organizers asked Christina Hecht, NPI senior policy advisor, to author and submit NPI recommendations on encouraging the public to choose water instead of sugary drinks. Those suggestions – which range from including water in the “MyPlate” dietary guideline graphic to ensuring that every public school has a water bottle-filling station – crystallized extensive, rigorous scholarship by a broad community.
“NPI's recommendations were built on lots of work by many water researchers and advocates over the years; they're based on many years of thinking by many people,” Hecht said.
Christina and Ken Hecht, NPI policy director, also submitted recommendations as part of the Sugar-Sweetened Beverage Reduction Workgroup, which brings together experts from national, state and local organizations. Several of their key proposals, such as targeting the marketing of sugary drinks and clarifying front-of-package nutrition labels, appear as recommended steps in the national strategy document.
Other nutrition policy changes compiled by Christina Hecht – like updating the Federal Food Service Guidelines used on federal properties and in federal programs – are also reflected in the national strategy, albeit without specifically mentioning sugary drinks. Nonetheless, Hecht believes doors have been opened for future discussions that could incorporate and promote healthy beverages.
“What those doors require are continuing to develop the evidence base, continuing to translate and share the evidence base, and continuing the advocacy to bring that evidence base to the attention of decision makers,” she said.
University of California setting an example
Suzanna Martinez, an NPI-affiliated researcher who attended the White House conference, said she hopes the convening generates momentum for two bills before Congress that would help alleviate food insecurity in higher education: one that provides funding for campuses to address students' basic needs, and another that reduces barriers to SNAP (Supplemental Nutrition Assistance Program, formerly known as food stamps). The national strategy document explicitly acknowledges that “SNAP's college student eligibility restrictions are out of date given the current population who seek higher education credentials.”
Martinez, an associate professor in the Department of Epidemiology and Biostatistics at University of California San Francisco, was invited to the conference because she's part of a group driving the UC's effort to halve the number of students facing food insecurity across the system by 2030. That commitment, and UC Berkeley's work on basic needs, were highlighted by Second Gentleman Douglas Emhoff during the closing plenary session.
“The work that we're doing here in California tends to set the stage for what happens in other states,” said Martinez, who also cited California's pioneering effort to provide meals for all public school students.
NPI's ongoing work evaluating universal school meals in California and other states is just one example of how its academics and staff are refining innovative programs so they can be adopted more effectively and broadly (perhaps nationally). In fact, the White House identified “healthy school meals for all” as the top strategy for improving food access and affordability, and Ritchie applauds the administration's consistent emphasis on early interventions for healthier outcomes.
“The earlier you can create healthy habits – meaning in utero all the way through childhood – the more likely you are going to have adults who don't end up with nutrition-related chronic diseases,” she explained. “The last thing you want to do is to wait until people are really sick before they start to change their habits.”
Another overarching theme that excites Ritchie is the national strategy's “whole of government” approach to addressing a host of nutrition and hunger issues. One example is how the strategy calls for agencies not traditionally associated with food to contribute to reducing waste, such as the Department of the Treasury clarifying tax benefits for businesses that donate food.
“Throughout the document, over and over again, there are countless examples of creating synergies across government agencies and with local and state governments that can help move the needle,” Ritchie said. “It's just this kind of bold call to action that we really need.”
- Author: Mike Hsu
Nutrition Policy Institute researchers contribute to studies that inform policy changes
Marcela Gonzalez, who had wanted to be a physical therapist since she was a teenager, was in the final stage of realizing her dream.
But when she started in the PT program at the University of California San Francisco in 2021, a vexing struggle of her undergraduate years came back. Academic pressures and stomach troubles, compounded by financial worries, drained her of any energy and capacity to feed herself.
“I didn't eat; I lost a lot of weight because I just couldn't eat,” Gonzalez recalled. “I was too stressed out all the time; I was a mess.”
During her first year at UCSF, Gonzalez, for whom food has “always just been hard,” discovered that she qualified for CalFresh (California's version of the Supplemental Nutrition Assistance Program, formerly known as “food stamps”). Her participation in the program – as well as the presence of a campus food pantry – helped lift a heavy mental burden and allowed her to refocus on school.
To understand the mechanisms that connect eligible students with CalFresh benefits, which could greatly improve their lives and education, University of California researchers interviewed UC campus staff responsible for guiding undergraduate and graduate students through the application process. Their recently published study, which involved researchers at UC Agriculture and Natural Resources' Nutrition Policy Institute, illuminated several major facilitators and barriers to CalFresh enrollment.
Campus-county coordination, boosting staffing key factors
Ensuring that college students have access to CalFresh is especially crucial, given that food insecurity affects that segment of the population roughly four times the rate of the general population, according to the study's principal investigator and co-author Suzanna Martinez, an associate professor in the department of epidemiology and biostatistics at UCSF.
It's estimated that more than 40% of college students face uncertain access to healthy food – and inflation, the rising cost of attending college and increasingly unaffordable housing are likely to swell those numbers.
That's why researchers say it's critical for campus staff who work on CalFresh outreach to collaborate with the financial aid office and the county office that administers the CalFresh program locally. Through close coordination, staff members can determine if students meet the necessary exemptions and help them with the paperwork.
“When that happens, it's much easier than when a student applies without their campus Basic Needs coordinator, or when they just go to the county and apply on their own,” Martinez explained. “Maybe they don't know all of the verification documents that have to be included, or they might not know their financial aid status.”
Erin Esaryk, NPI research data analyst and first author of the study published in the Journal of Nutrition Education and Behavior, also highlighted the need for increased campus staffing to help with CalFresh enrollment, as well as more outreach by campus and county staff to student populations about the benefits.
“When there's a lot of outreach, that helps alleviate some of the stigma, to normalize the receiving of CalFresh,” Esaryk said.
Helping others worry less about food
Given her own history of travails, Gonzalez, the physical therapy student, wanted to help others at UCSF “de-stress” about food. In summer and fall 2021, she served as a “CalFresh ambassador” for her cohort of new PT students, developing presentations and guides that break down how to apply for or renew CalFresh benefits.
She became the go-to person for her classmates' questions on the logistics and details of applying for the program, and also encouraged fellow health-professional students who, like herself, did not think they would qualify.
“To take out less loans, or to not worry about food a little bit every week, is a great thing,” said Gonzalez, pointing out that subtracting food costs allows students to shave down their loans.
After helping introduce her classmates to CalFresh, she transitioned to working at the food pantry at the Parnassus campus. In addition to setting up and distributing the items, Gonzalez also posts on Instagram and TikTok (@ucsf_basicneeds) to promote the “food market,” which attracts about 100 students and campus community members every Thursday afternoon.
“You never know what you're going to get, but there's so much really good, fresh produce,” she said.
Campus food pantries deliver health benefits
Researchers are also studying how campus food pantries affect students' overall health, including easing the challenges of anxiety, depression and sleep deprivation. Another recent study published in the Journal of Nutrition Education and Behavior analyzed health-survey responses of 1,855 undergraduate and graduate students at all 10 UC campuses – before and after access to a campus food pantry.
“What we found was that students reported improvements in their perceived health and sufficient sleep,” said UCSF's Martinez, the lead author. “We also found that they reported fewer depressive symptoms, compared to before having access to the food pantry.”
By 2019, all UC campuses had established food pantries, although nationwide only about 25% of four-year colleges have one. The significant health benefits reported by UC students in this study give researchers hope that campus food pantries will see additional governmental support, in California and beyond.
“It was important to evaluate whether the food pantries were actually making a difference…if you don't have numbers or evidence, then you're not going to get funded to support future programming,” Martinez said.
Research guides state policy changes
Studies of food insecurity in the college setting have already informed policymaking aimed at smoothing the application process for CalFresh – benefits regarded by Martinez as a better long-term solution than food pantries, which constitute an emergency “short-term response” to the problem.
One example of the research's impact is a law passed last year in California that requires community colleges and California State University campuses to designate a campus-county liaison who would help students procure social services, including CalFresh. A separate law expanded the list of training programs within which students would potentially qualify for CalFresh, and another bill currently under consideration by the state Legislature would make the processing of students' CalFresh applications more consistent from county to county, through more standardized training of staff.
Meanwhile, on the research front, Esaryk, Martinez and their colleagues are completing a follow-up study on students and CalFresh enrollment, this time looking at the perspectives of county staff. And while their broader goal remains clarifying and streamlining student eligibility rules and processes at all levels, they remain focused on students and meeting their needs.
“Right now, our main mission is just to try to increase awareness of CalFresh for students and to let them know they may be eligible,” Martinez said, “and then assist them through that application process so they can actually get the benefits.”
In addition to Esaryk and Martinez, NPI director Lorrene Ritchie and Laurel Moffat of Washington State University are also authors of the CalFresh/SNAP benefits study, while co-authors of the college food pantry study are Ritchie, Gwen Chodur of UC Davis, Sevan Kaladijian of UC Irvine and Michael Grandner of the University of Arizona.
- Author: Pamela Kan-Rice
“There is much we can learn from a friend who happens to be a horse.” — Aleksandra Layland
“Training mustangs is just so much fun,” said Aubrielle, as a chestnut-colored filly named Zuri nuzzled the 4-H member from Shasta County. Six months earlier, the young wild horse was wary of being touched. Now she was sporting accessories in her styled mane that matched the teenager's turquoise jewelry.
Over the past few years, UC Cooperative Extension in Modoc County has partnered with Modoc National Forest to provide public outreach and education to support the placement and care of wild horses from Devil's Garden at the northeastern corner of California. Adopting foals reduces overpopulation of wild horses, which can harm rangeland and the health of the mustangs themselves.
This year Laura Snell, UC Cooperative Extension livestock and natural resources advisor in Modoc County, assigned weanling wild horses to 40 youth between the ages of 9 and 19 from all over the state. The mustangs were 4 to 6 months old in January when they were picked up in Alturas and taken home by California 4-H and FFA members, who feed and care for them.
“The moment when I got to touch him for the first time is probably one of the biggest parts of training as well as my progress with him,” said Morgan of Monterey County, who spent hours in the stall with Bowie trying to gain his trust.
“It was really amazing to me that I was able to touch him on day 5,” she said. “In the videos I watched leading up to getting him, most of the time it took one week to three weeks for the people in the videos to touch their wild mustangs. At that moment is when you really start to make that bond with a wild mustang.”
“The moment when I got to remove his tag was a huge part as well because at that moment you know that the mustang trusts you enough that he is letting you get that close to remove the tag,” Morgan said.
The young trainers teach the horses to wear a halter, to load and unload from a horse trailer and to navigate through obstacles. Some participants also work on tricks such as laying their horse down, walking the horse backward and walking under the horse. In June, the participants gathered in Alturas to show their progress.
“It provides them an opportunity to seek out adult mentors who are horse trainers, learn responsibility, and learn a variety of things about caring for a wild horse and learning more about themselves in the process,” said Snell.
“We find that the youth do very well with wild horses. It's really a two-way street, with the horses learning just as much as the youth are in the six months they are in training,” she added.
Sisters Kailey and Maddi in San Benito County both adopted weanling horses. Removing the tag after about three weeks was a turning point for Maddi and her horse Fiona.
“The significance of getting the tag off was we hadn't been able to get near her at all,” said Maddi. “She had some aggression toward people out of fear. So getting past that, getting to the point where she trusted me and I could get that halter on her and get close enough to get that tag off was just a huge achievement. After that, once she trusted me, she started doing really, really well and flying through her training.”
Because wildfires are part of life in California, she taught Fiona to step over flames so she won't be afraid if they need to evacuate, Maddi told KSBW reporter Brisa Colon.
“It has been amazing to be able to share this experience with another very close family,” said Aubrielle's mother Ashley Phipps. “Our daughters have gone through the entire journey together starting with visiting the corrals to pick horses together, all the way through the training process. My daughter is older than Brooklin and has been a great mentor to her, teaching Brooklin and her horse along the way. It has been such a confidence builder for my daughter! Our girls will never forget this experience!!! And I loved every moment of watching them grow through the ups and downs. This program is such a blessing.”
To qualify for the program, applicants must fill out an application which includes being enrolled in a horse program such as the 4-H Equine Project, show they have facilities and feed for the animals, designate a mentor and have their parents' approval.
The trainers and their horses competed in the Devil's Garden Colt Challenge on June 18 in Alturas, vying for awards in halter, showmanship and obstacle course with youth from 13 counties participating. Prizes totaled over $3,000.
- Author: Mike Hsu
Master Gardener volunteers partner with County of San Diego on new demonstration garden
In a garden with roughly the square footage of a two-car garage, the University of California Master Gardeners and County of San Diego staff have packed a whole lot of learning for the community.
The demonstration garden, which had its grand opening last fall, is now flourishing in its 20-by-20-foot space in a plaza at the heart of the San Diego County Operations Center. Skilled volunteers with San Diego's UC Master Gardeners, a program of UC Agriculture and Natural Resources, maintain its containers of vegetables and herbs, succulents, and native and pollinator plants.
“For such a little garden, there's a lot to look at,” said Karen Morse, a Master Gardener volunteer who helped establish the “demo garden” – a highly visible and accessible teaching tool for the many people who work and conduct business in the surrounding offices.
“We get questions from people just walking by – from the public, from county employees – all the time,” said Leah Taylor, UC Master Gardener program coordinator in San Diego County. “While we're doing what we're doing in the garden, we're a presence for people to just get a quick bite of education.”
The garden also features a “Little Free Library” of gardening books, as well as a compost bin and rain barrel for demonstration purposes. There are also signs (in English and Spanish, as well as additional languages on the garden's website) offering tips on composting/worm composting, pest management, water conservation, climate adaptation, sustainability practices, and health and nutrition. The expertise of a host of county departments and agencies inform the resources.
“The most beautiful thing about that garden is not necessarily the plants – although we love our plants – it's that it showcases almost every county department…all represented in one place and you can find how to connect with those groups, all in one place,” Taylor explained.
During planning for a broader revamp of the Operations Center grounds, the county had approached the Master Gardeners to provide guidance on a public demo garden.
“The County has a long-standing commitment to sustainability and partnership with the University of California Cooperative Extension,” said Rebeca Appel, program manager for the county's Land Use and Environment Group, which spearheaded the effort through the “Live Well San Diego” Food System Initiative. “So it was a natural approach to work with the Master Gardeners with their robust community garden program, and educational outreach in home and urban gardening throughout our region.”
The vision for the garden was shaped by county teams working with Joan Martin and Ellen Cadwallader, co-chairs of the Master Gardener committee that oversees the program's demonstration gardens across San Diego County, including those at Balboa Park and The Flower Fields in Carlsbad.
And while those gardens help raise awareness among the many visitors at those sites, Martin said the newest demo garden provides unique opportunities for ongoing community education, such as lunch-and-learns on specific gardening topics.
“This is the garden where there's really a chance for year-round education and sessions,” Martin said. “We're excited to see it get started and watch it grow.”
Morse and fellow Master Gardener Sandy Main collaborated with Appel to bring those early plans and objectives to verdant life.
“I think we ticked all the boxes of everything they wanted, initially – examples of container gardening, natives, vegetables, herbs, pollinators – and wheelchair accessible,” Morse said.
They have since passed the botanical baton to Skye Resendes, a relatively recent graduate of the Master Gardener certification program. She will coordinate a team of a dozen volunteers in the ongoing upkeep of the County Operations Center demo garden.
Resendes, who uses gardening to help her cope with the stresses of her work as a civil litigator, said she hopes the garden will not only inform the community on crucial ecological and conservation topics but also inspire more people to start their own gardens.
“The science is out there – there are huge mental health benefits to gardening,” Resendes said. “It's an absolute meditation.”
