Oral health is an important aspect of overall health, but many vulnerable populations such as migrant farmworkers are without access to oral healthcare. Although some non-government organizations such as faith-based organizations have attempted to fill gaps left by government and private sectors, a lack of a dental safety net creates limited access to oral health services for migrant farmworkers. Access to care is further constrained by structural factors including low wages, migration route, and high costs of care. Building off a critical medical anthropology approach in understanding oral healthcare access, I argue that limited oral health access for migrant workers in the Tampa Bay area is the result of economic constraints and not cultural beliefs or educational shortcomings. This research therefore demonstrates the social determinants of oral health, and how social disparities can become embodied in marginalized groups such as migrant farmworkers.

Objectives: Specific work processes and management structures that contribute to high rates of occupational illness and injury in agricultural industries are not well described in academic literature. This qualitative study of work organization in the U.S. fresh tomato industry investigates how work processes and management structures impact tomato workers’ occupational health. Methods: After conducting literature review and key informant interviews, semi-structured interviews and focus groups were conducted with 36 individuals with experience working in the U.S. fresh tomato industry. Interviews and focus groups were audio-recorded, transcribed, coded, and analyzed using a modified grounded theory approach. Results: These data indicate that participants endured income insecurity and hazardous supervisory practices, including wage theft, retaliation, intimidation, and humiliation, that put them at risk of preventable illness and injury. Support from workers’ organizations and health-conscious supervisory practices helped mitigate some of these occupational hazards. Conclusion: Participants’ adverse work experiences may be considered sequelae of workers’ lack of job control and positions of socioeconomic structural vulnerability. Other aspects of tomato work organization, including health-conscious supervisory practices and the involvement of workers’ organizations, indicate that modifying work organization to better safeguard health is possible. Such modifications present compelling opportunities for employers, employees, organizations, community and government leaders, and health care professionals to help create healthier occupational environments for tomato workers.

Socioeconomic and citizenship barriers prevent farmworkers from accessing public health care; thus, grassroots organization members and health care practitioners collaborate to create community health clinics that provide care for farmworkers and low-wage immigrant workers. Such community clinics are known as parallel health care systems, yet the concept's existing literature lacks comprehensive studies on the parallel systems operating within farmworker communities. To fill this research gap, I conducted nine semi-structured interviews to collect the perceptions of key community stakeholders involved in providing accessible health and financial aid to farmworker communities in Florida. I analyzed the interviews through the qualitative grounded theory method to identify which factors participants perceived as determining farmworker health outcomes, their explanations for why parallel medical systems emerge, and the differences and similarities between their answers. I found that the participants understood large-scale social structures to be influencing farmworker health outcomes. Furthermore, the participants described parallel health care systems as bridging structural gaps caused by the government's social abandonment of farmworker communities and health inequality. While the participants all similarly employed a structural framework to discuss farmworker issues, differences in perception arose during conversations of farmworker agency, the ambiguity of a "two-tiered health care," and proposed solutions. This study's findings contribute to the existing literature's observations on parallel health care systems, elaborate on the government's negative treatment of farmworkers during the COVID-19 pandemic, and generally highlight the voices of key community stakeholders currently working with farmworker communities.