Two farmworkers picking strawberries in a field. By Sophia Irinco.
Sophia Irinco is an ethnic studies major with a minor in biology and she is a 2025-26 health care ethics intern at the Markkula Center for Applied Ethics at Santa Clara University. Views are her own.
The people who sustain the nation’s food supply are susceptible to chronic disease and when they do get sick, they cannot access the care they need. Farmworkers endure long hours, are paid very little, face environmental hazards, and have limited access to basic resources. These disparities stem from systemic racism and policy inequities in both public health and healthcare, which exclude farmworkers from key labor protections and social benefits. As a result, they experience resource insecurity and increased chronic disease risk while facing significant barriers to healthcare access, highlighting an ethical responsibility to protect all farmworkers.
Who Harvests Our Food and Why is this Job Slowly Killing Them?
Without farmworkers, there is no food. Immigrants make up 70% of the nation's farmworker population, while about 40% of those immigrants are undocumented. In California, approximately 50% of farmworkers are undocumented.
Regardless of documentation status, farmworkers face barriers to basic health resources and harsh working conditions. Studies show that in California, 42% of farmworkers do not have health insurance and programs such as SNAP and full access Medicare are restricted to undocumented farmworkers. Due to cost, lack of insurance, and fewer healthcare options, farmworkers do not get the help they need. Public hospitals, community clinics, and county programs are the most common healthcare settings for farmworkers. However, in the current climate, fear of ICE has caused even fewer farmworkers than usual to seek medical care.
When farmworkers lack access to basic health resources, the resulting chronic illness and health disparities raise important ethical concerns about how essential resources and protections are distributed within society.
How Systemic Barriers Drive Chronic Disease Risk
Nationally, farmworkers are exempt from many protections under the Fair Labor Standards Act (FSLA). They are exempt from most minimum wage and hour guarantees and are also not entitled to overtime pay or mandatory breaks for rest or meals. However, California has phased in overtime protections for farmworkers, but these do not change the long hours and economic insecurity that drive chronic disease risk.
More than two-thirds of farmworkers live below 200% of the federal poverty level. As of February of 2026, AB-2646 was introduced to address the minimum wage for California farmworkers. The goal of this proposed bill is to raise the minimum wage for farmworkers to $19.50 per hour and for it to continue to rise as inflation happens. Currently, farmworkers get paid the state minimum wage of $16.90. This bill does not directly address undocumented immigrants. It specifically applies to approved agricultural employees who fall under H2-A visa workers, who come from outside of California for seasonal work, and other agricultural workers who do similar work as H2-A workers.
In addition to economic and labor inequities, environmental exposures also play a major role in farmworker health. Exposure to pesticides has been linked to pesticide poisoning and chronic diseases such as cancer and respiratory issues. Currently, as of February 2026, farmworker advocates are suing the California Department of Pesticide Regulation (DPR) for the conflicting rules for regulation of Fumigant Pesticide 1,3-dichloropropene (1,3-D). 1,3-D is known to be correlated to chronic disease such as asthma. The lawsuit claims that DPR does not clearly protect farmworkers or nearby communities, fails to warn workers about nearby pesticide use, and violates California administrative law requirements for clarity and consistency. This exposure mainly targets low-income, rural, Latino immigrant communities living or working near agricultural fields. Together, labor policies, economic inequalities, and environmental exposures demonstrate how systemic factors create conditions that increase chronic disease risk among farmworkers.
Human Dignity Beyond Food Production
Considering these systemic barriers through the lens of ethics helps us understand not just the health consequences but the moral obligations society has to farmworkers. In particular, Rawlsian justice has a focus on those who are most vulnerable and most disadvantaged. A just society should ensure that moral rights are not sacrificed for collective gain. In this case, farmworkers are being used as a means to an end, echoing Kantian ethics, which rejects treating individuals merely as instruments for others’ benefit. This “end” is the U.S. agricultural economy and agriculture companies benefiting from the labor of farmworkers.
One of Rawls’s key thought experiments is known as “the veil of ignorance,” which is used to make decisions for ethical dilemmas where you envision rational individuals choosing social rules without knowing class, race, gender, talents, and in this case, immigration status. Under this veil, you don’t know where you are placed in society, you are forced to put yourself in an undocumented immigrant fieldworker’s shoes–the most disadvantaged in this ethical situation. This framework accounts for impartiality and fairness for all people.
There are also two principles of justice to consider: equal liberty principle and difference principle. The equal liberty principle holds that everyone should have the same basic freedoms, as long as exercising those freedoms does not interfere with others’ rights. Farmworkers, regardless of immigration status, should have an equal right to labor protections, a safe work environment, and overall protection from harmful exposure. Exclusion from federal labor laws and the lack of protection by the state of California in terms of pesticide usage, limit farmworkers’ ability to exercise basic liberties, including the right to health, safety, and economic security. This requires fair wages that keep farmworkers above the federal poverty line and protection from hazardous chemicals to reduce preventable health risks.
The difference principle recognizes the justification of the situation if social and economic inequalities benefit the least advantaged and it is realistic for them to obtain better roles within the industry. The disparities in place are unjust because the economic inequalities are directly affecting farmworkers who get paid minimum wage with high exposure to dangerous pesticides and limited to no healthcare. The desperation of needing a wage to survive and provide for families keeps farmworkers from missing work and they are locked in low-paid risky jobs with no opportunity to improve economic or health outcomes.
A counterargument from agricultural industry stakeholders is that labor flexibility and wages are necessary to maintain affordable food prices. Although this argument emphasizes economic efficiency, they lack justification under a Rawlsian framework. Behind the veil of ignorance, no rational individual would accept a system in which their access to basic rights and protections depends on immigration status or economic vulnerability. Even if such a system lowers food costs for the broader population, it does so by placing disproportionate risk and harm on the least advantaged. In this case, the current structure sustains affordability for consumers while exposing farmworkers to preventable harm and instability.
It is an ethical duty for policymakers to ensure a just living wage, safe working conditions, and access to basic needs such as healthcare. Clinicians and hospitals have an obligation to provide care that is confidential and accessible. Farmworkers who avoid seeking care due to fear of ICE or cost face worsened health outcomes, which places a responsibility on healthcare systems to reduce structural barriers to treatment. This includes creating safe care environments that ensure vulnerable populations are able to seek medical attention without fear of harm. Protecting the dignity of the least advantaged is a responsibility that must be upheld—especially for those who are the backbone of the nation’s food supply.
What are the Steps Toward Protecting Farmworker Health?
Steps that need to be taken toward protecting farmworker health must be done through concrete policy actions that protect worker rights, economic security, and environmental protections. It is crucial that undocumented workers also have protections under these policies as they are the least advantaged farmworkers. First, California should expand AB-2646 to explicitly include undocumented agricultural workers, not only H-2A visa holders. Second, the Occupational Safety and Health Administration (OSHA) should establish enforceable agricultural pesticide exposure limits. Third, the California state government should create ICE free zones and fund mobile health clinics in agricultural regions. Fourth, agricultural employers should be mandated to provide employer-funded health coverage for all agricultural workers regardless of documentation status.
When viewed through a lens of justice, it becomes clear that a society that depends on farmworkers for survival also carries a responsibility to protect their health and dignity. Addressing these inequities through fair labor protections, safer environmental regulations, and expanded access to healthcare is an ethical obligation that falls on policy makers, the agricultural industry, and the healthcare industry.