Sources of Change in Health Care Use by Agricultural Workers in the United States, 2000 to 2020

Agricultural workers in the United States are crucial for food production yet face significant health challenges due to the conditions of their labor. Although these workers' use of U.S.-based health care services has been low historically, estimates from the first two decades of the 21st century show a sharp increase in incidence. We investigate the sources of this change by partitioning the increase into two components: one due to shifts in the composition of workers on 10 predictors of health care use, and one due to the changing impacts of these predictors on the use of U.S.-based health care. We find that 65-70% of the increase in use of health care services is accounted for by compositional shifts, especially with respect to sex, income, migrating for work, and having government-sponsored health insurance. The remaining 30-35% was due to changing impacts, particularly having access to an automobile and employer-sponsored health insurance.