Guide to Understanding Florida's FQHCs and 330 Expansion ...

Linguistic and cultural differences and unfamiliarity with the U.S. healthcare system create high
levels of stress and significant barriers to healthcare for many immigrants, particularly those that are
less educated. Immigrants are more likely to live in poverty and work in dangerous occupations
than the general population and are less likely to benefit from Social Security, workers
compensation, disability insurance and other safety net programs, including public and private
insurance. Undocumented immigrants live in fear of deportation which may deter them from
seeking needed healthcare services. Their inability to legally obtain a driver’s license makes
transportation to and from health centers and other needed services a challenge. Florida has a
growing number of indigenous language speakers who cannot even speak Spanish, much less
English. This makes the delivery of linguistically appropriate services an increasing challenge.
A High Percentage of Farmworkers
There are an estimated 200,000 to 250,000 farmworkers and their dependants living in Florida due
to the fact that the state has one of the longest growing seasons in the country (9 months). An
analysis of the 2000 Larson’s Enumeration Study commissioned by HRSA indicates that 60% of
Florida’s farmworkers are concentrated in 11 counties in the South and Central regions of the state;
However, 31 counties have at least 1500 farmworkers. County-by-county estimates of the number
of farmworkers in Florida can be found at www.fachc.org/state_specific_resources.htm. It is
estimated that two-thirds of Florida’s farmworkers migrate north each year following the
agricultural season up the east coast or into the Midwest, returning to Florida in late September or
early October. Farmworker livelihoods are tied to the seasons and are subject to many unpredictable
variables, including hurricanes. As a result, farmworkers’ income fluctuates significantly from
month-to- month and year-to-year. According to the National Agricultural Workers Survey
(NAWS), a random survey of the demographic and employment characteristics of the U.S. crop
labor force, the average income for a farmworker family of four is around $10,000.
Farm work demands grueling physical labor, long work hours, and frequent contact with harmful
pesticides that have been linked to a host of health problems including asthma, cancer and birth
defects. Florida has a rapidly growing nursery and greenhouse industry where workers are at high
risk for pesticide exposure because workers toil in enclosed spaces with limited ventilation. A high
percentage of greenhouse workers are women, perhaps due to their smaller hands and manual
dexterity. This trend is troublesome since children, including the unborn, are particularly vulnerable
to the effects of pesticide poisoning. Yet, pesticide poisoning is only one of the many health
conditions that farmworkers suffer from disproportionately. For more on farmworkers visit
http://www.fachc.org/mig_index.htm
A High Percentage of Homeless
According to the Florida Department of Children and Families Annual Report on Homeless
Conditions in Florida, there were an estimated 83,391 homeless individuals in Florida in 2005, up
from 76,675 in 2003. Part of the increase in homelessness may be attributed to the damage inflicted
by the hurricanes of 2004 that destroyed 20,000 homes and damaged another 45,000. Some areas
of the state saw a dramatic rise in the number of homeless individuals. For example, Escambia,
Santa Rosa and Okaloosa counties in the western Panhandle reported an increase of nearly 15,000
homeless persons and Charlotte County, the epicenter of hurricane Charlie, reported 2,800 new
Understanding Florida FQHCs Copyright 2006 Page 19 ©