Access to Phones and Use of International Numbers Among Farmworkers in North Carolina, 2023-2024

Communication barriers can hinder health promotion and healthcare services. Migrant and seasonal farmworkers face substantial challenges to healthcare access. We used a mixed-methods approach to assess access to phones and use of international numbers among agricultural workers, specifically migrant and seasonal farmworkers, and to explore potential implications for healthcare, emergency services, and public health outreach.

First, we surveyed migrant and seasonal farmworkers working in North Carolina, USA, about their ability to send text messages and make phone calls at their housing, including use of international phone numbers, in 2023. A total of 1,034 farmworkers participated in the survey, which used time-venue sampling. In 2023, we also interviewed farmworkers (n = 19) about their technology use and digital literacy skills. In 2024, as part of a statewide community assessment, we conducted listening sessions (n = 19) with farmworkers (n = 146), community health workers (n = 32), and healthcare team members (n = 34).

Among survey respondents, 19% reported being unable to consistently make phone calls at their housing, and 10% reported using a phone with a number from another country. Interviews and listening sessions revealed three themes related to farmworkers' cell phone use during the agricultural season, including use of international numbers, challenges with cell phones, and the utility of phones.

Healthcare providers, emergency services, and public health practitioners should be aware that farmworkers may face barriers to making and receiving phone calls as well as sending text messages. Healthcare systems should consider how to ensure access to care for farmworkers using phones with numbers from their country of origin. While most farmworkers have access to phones, a meaningful minority cannot consistently make a phone call to coordinate care, report an emergency, or access health promotion services.