Land of plenty

Where not even farm workers escape the junk-food jungle

By TRACIE WHITE

The longer you live in America, the fatter you get.

Jamie Kripke
  Genaro Rivera in his backyard with his wife, Esperanza, and daughter, Lupita.

It’s a simple fact of life, one that even farm workers like Genaro Rivera, surrounded all day by fresh fruits and vegetables, can’t seem to beat.

“You live better here in America,” says Rivera, 49, a farm laborer who immigrated from Michoacan, Mexico, 24 years ago in search of a better life, steady work and enough food to eat. “You work more here. You eat more here.”

Every night at sunset, Rivera climbs over an 8-foot-high back fence and drops into his yard at a Watsonville-area labor camp. He’s lived at the San Andreas compound for decades, working 10-hour days picking strawberries in the fields abutting his home. Like thousands of Latino farm workers, he’s been in the United States long enough to have acculturated. He has a car, a TV, a family he provides for. He’s proud of his Americanization, proud of his lifetime of work and ability to feed his family. In the village where he grew up, hunger was a way of life.

But along with the American dream has come a remote-control lifestyle and super-sized diet that has left immigrants like Rivera facing some all-American problems. Many immigrants are gaining too much weight and are facing alarming rates of obesity and the chronic diseases that come along with it: diabetes, heart disease, high blood pressure, stroke.

Often underpaid and overworked, farm workers eat at McDonald’s, Burger King, Carl’s Jr. and other fast-food restaurants where food is high-fat but low-cost. As a result, despite the long hours in the fields packing broccoli or picking strawberries, they’re getting fat just like the rest of America.

“It’s ironic really,” says Marilyn Winkleby, PhD, a professor at the Stanford Prevention Research Center who has been conducting epidemiological studies on the Latino immigrant population in the Salinas Valley for the past 20 years. “We’re seeing high obesity rates among people picking some of the healthiest foods in the U.S.”

Seated on the couch in the small, tidy living room Rivera shares with his wife, Esperanza, and 21-year-old daughter, Lupita, he relaxes at the end of the day, stretching out with his dirt-encrusted boots before him and resting his hands on his well-fed belly. He wears a cowboy hat, a grizzled beard and a sly smile that he uses to tease his daughter.

Usually Esperanza has a tortilla-and-beans dinner waiting for him. Or the family heads out to a dinner of fast food — maybe Burger King or pizza. But since Genaro was diagnosed with high blood pressure, Lupita has been trying to get her parents to cut back on the fast food and start replacing soda with water. She’s also bullied her dad into quitting smoking.

Genaro laughs when asked about the extra weight that’s come with his American life. His wife rolls her eyes. They both grab the extra girth around their waists and chuckle. They’ve grown wider around the middle than anyone ever did back home in their Mexican village. But once you’ve experienced hunger and know what it’s like not to have enough to eat, you don’t really mind a few extra pounds. They’ve still got that deep-seated fear that tomorrow there might not be enough to eat.

“I have to keep telling them they don’t have to eat everything now, today,” Lupita says. “Here, the food won’t go away.”

The problem

In America, the food doesn’t go away. It’s everywhere you look. On billboards, in TV ads, around every street corner. It’s available, it’s cheap, it’s endlessly advertised and calorie-laden. And for many immigrants, it’s a sign of success.

Jamie Kripke

It has also led to an obesity epidemic of vast proportions. 

This newest wave of immigrants has taken some time to catch up to the rest of Americans, but as their length of residency has extended, slowly but surely they’ve adjusted to the super-size-me lifestyle as well. The high-fat, high-calorie diet has begun to wreak havoc on bodies that for the most part grew up in small villages where healthy, homegrown diets and walking kept them fit.

“Part of the American dream does unfortunately lead to negative health effects,” says Christina Wee, MD, of Harvard Medical School, who co-authored a 2004 study showing that obesity is relatively rare in the foreign-born until they have been in the United States for more than 10 years. “Obesity is one of the consequences of this life of leisure. It’s a double-edged sword.”

Still, seeing these same results among farm workers, whose daily life of hard labor can hardly be referred to as a “life of leisure,” has left many scratching their heads in disbelief.

But the statistical evidence is there.

Winkleby’s most recent 2006 study shows a walloping 91 percent increase in obesity rates over the course of just 10 years among men living in labor camps in the Salinas Valley, aka the “Salad Bowl of America.” In Monterey County, men from the labor camps are usually single, she explains, working long hours, with few opportunities for aerobic exercise, and living in crowded housing with inadequate cooking facilities. So they tend to get  meals at convenient, low-cost fast-food places. The cost of the healthy food they pick is often too high for their modest budgets. Most often, the local food gets shipped out of state or even out of the country.

This alarmingly high prevalence of obesity was also found in the results of the 2000 California Agricultural Workers Health Survey, which found that 81 percent of male farm workers and 76 percent of female workers were either overweight or obese (more than 20 pounds overweight).

“The high rates of obesity reflect the high rates found across the entire low-income minority population of the United States, despite putting in long days of hard labor in the fields,” wrote David Lighthall, PhD, former executive director of the Davis, Calif., California Institute for Rural Studies in a 2001 Western Journal of Medicine article. “There is the obvious irony in the fact that this group of workers is responsible for growing and gathering much of our food supply, but their own diets and health status are poor.”

Another 2000 study by the institute, Suffering in Silence: A Report on the Health of California’s Agricultural Workers, showed that farm workers had a substantially greater incidence of high blood pressure than the rest of the U.S. population and, among male farm workers, cholesterol levels were higher as well.

The general poor health of California farm workers can be explained, in part, researchers say, by their lack of health insurance, low education levels, poor living conditions, high poverty levels and the increasing mechanization of farm work.

But the fast food advertised in mouth-watering detail on billboards that dot the highways intersecting California’s agricultural fields seem to be particularly deleterious.

When your average income level hovers at $12,000 to $14,000 a year, it just makes financial sense to buy the cheapest, most-filling food you can find. In America that means fast food.

Why it’s so hard to eat healthy food

Consider the home of retired strawberry picker 71-year-old Elena Maganan. Sandwiched between a Carl’s Jr. and a Carpet One store, eight trailers nestle nearly hidden along a mini-mall-lined stretch of Watsonville’s Green Valley Road. The trailers are tiny, worn structures decorated with old Christmas lights on top and big cactus plants out front. Mexican music rises from the family-filled trailer homes. Kids play checkers on the front steps while their parents spend long hours out in the fields picking strawberries.

Jamie Kripke

The smells of Carl’s Jr. burgers and fries fill the air. There’s a Taco Bell across the street, a Little Caesars Pizza, “home of the $5 pizza,” just down the road and a Jack in the Box, McDonald’s, Taco Bell and Wendy’s within walking distance. The ag fields are within walking distance as well.

“I hope my kids learn to cook like my mother does,” says Rosario Castillo, Maganan’s daughter, who sits inside her mother’s trailer home one summer afternoon cutting large cactus limbs into bite-size pieces. Maganan, Castillo and Castillo’s 10-year-old daughter, Jaquelin, together have filled three giant metal bowls with cactus ready for cooking. Kids next door are returning home with paper bags full of fast-food fare, but Maganan says she’s battled hard over the years to feed her family the same way she ate growing up in Mexico with fresh, home-cooked meals. But look around her. It’s not an easy battle to win.

Studies show the neighborhoods you live in influence your health. The availability of parks, for instance, or convenient markets with fresh produce contribute to differing levels of heart disease, says Winkleby, who has conducted one such study herself.

“Neighborhoods exert a pretty powerful influence on your chance of having a heart attack or stroke,” Winkleby says.

This isn’t good news for California hired farm workers who make their homes wherever they can — from employer-sponsored labor camps to abandoned cars, from tool sheds to garages, trailers, to every imaginable kind of shack, says Don Villarejo, PhD, founder of the California Institute for Rural Studies. With about 30 percent of farm workers in California undocumented, many of these homes remain hidden and poorly maintained.

The Camphora apartment complex in Salinas, for example, is a collection of low, cement-block buildings where farm workers rent individual units situated in the middle of grape fields just off Highway 101 near Soledad prison.

“It’s in poor condition,” says Tony Madrigal, an outreach worker for the Center for Community Advocacy, a nonprofit based in Salinas dedicated to improving housing conditions, health and educational programs for farm workers. He describes the apartments, which he refers to as a labor camp, as having problems with “leaky roofs, power outages, water outages, bad refrigerators and bad cooking facilities.”

The closest place to eat for the farm workers living there is a cluster of fast-food restaurants at the next highway exit.

The cure

When Esther Marshman immigrated to the United States, she was young, thin and healthy. Twenty years later, she had achieved the American dream of an easier life. No more milking the cow for breakfast on the small Mexican farm where she’d grown up, poor, one of 12 children, eating only what the family could grow on their patch of land.

But after 20 years of standing on a processing line packaging broccoli day after day, and eating 99-cent burgers at McDonald’s, she was slowly getting sick. She grew fat and, entering her 50s, was diagnosed with diabetes.

“When we came here we bought McDonald’s because it’s cheap,” says Marshman. “We didn’t know how bad it is. I was just getting fatter and fatter.”

Diabetes has scared her into changing her ways. She quit her packaging job and opened a taqueria in Salinas where she sells the food she grew up eating — whole beans, fresh-squeezed juices, cabbage, cactus, avocado. She’s lost weight and her diabetes is under control. Still, with her 60-hour work weeks, she doesn’t have time for exercise. And business is tough with the McDonald’s just across the parking lot. The fast service, low prices and free toys for kids lure customers away.

Marshman is part of a federally funded program called “Steps to a Healthier Salinas,” run by the Monterey County Health Department in collaboration with Winkleby at Stanford. The program’s goal is to go one step beyond trying to educate the 70 percent Latino population in Salinas about the risks of obesity and make changes in their living environment to encourage aerobic exercise and a healthier diet.

Health department staff members are talking to city planners and elected officials about repairing and building sidewalks and creating more recreational opportunities to encourage exercise. They’ve helped organize walking groups. And because menu changes in national chains like McDonald’s are difficult to make at the local level, they’ve gone to the mom-and-pop taquerias frequented by many farm workers. They’ve seen some positive trends toward weight loss now that they’re in the fourth year of the program, but substantial changes won’t come for 10 to 20 years, says Susan Stuart, community coordinator for the Monterey County Health Department.

“It’s particularly hard to reach the farm worker population,” says Elan Garcia, who coordinates the taqueria program.

“A lot of farm workers who eat regularly at the taquerias want these big, heavy meals loaded with calories. They’re working hard and they want a lot of food. The reality is this might be their one meal of the day. They want to get as much as they can for their money.”

Encouraging farm workers to get more exercise at the end of a long, tiring work day, or to go walking in the violence-plagued neighborhoods of east Salinas is a challenge, says Maria Garcia Jennings, clinic manager at the Alisal Health Center in east Salinas, which has seen increasing rates of obesity and diabetes among its primarily low-income Mexican-American patients, many of whom are farm workers.

“People wonder, how can farm workers be obese when they exercise all day long? They walk around, they lift, but unfortunately, while it is very hard labor physically, it’s not aerobic. It’s not going to help you lose weight,” says Jennings.

Educating farm workers about the risks of gaining too much weight has become a necessity, Jennings says. The health risks aren’t obvious to many immigrants whose No. 1 concern has been getting enough food for themselves and their children.

“These Mexican-American immigrants understand being too thin,” says Joanne Ikeda, nutritionist emeritus at the University of California-Berkeley, who has researched obesity rates in Tulare County farm worker families. “Then they come to the U.S. and make more money than they could ever earn in Mexico. Suddenly they can give their children foods they wish they had had — soft drinks, chips, donuts, fast food. Taking the family out for a dinner of fast food often feels like a sign of success.

“The idea that we should make food choices solely on our nutritional needs is ridiculous. How many people really do that?”

After 24 years in the United States, Genaro and Esperanza Rivera have begun to cut back on their family dinners at Burger King. At home, they eat many of the foods they grew up on — corn tortillas, cactus, rice soup. And, unlike many farm workers, they eat the strawberries they pick almost daily.

Their living conditions also improved considerably after a judge declared the compound “a public nuisance,” leading their landlord to upgrade it in 2002. Now the buildings are clean, neat, attractive, and the cooking facilities actually work, Lupita says. Her mom is a wonderful cook, and Lupita especially loves her homemade soups and mole.

“We used to eat at fast food a lot,” says Lupita. But since she took a nutrition class, they’ve tried to limit it. Neither of Lupita’s parents went to school past the fourth grade, but she attends the local junior college and has become her parents’ translator, health-care advisor and protector.

Her father has lost a little weight and is keeping his blood pressure under control. But when Lupita gets hungry at her part-time job at the Big Five sporting goods store, she walks across the parking lot to Jack in the Box. And the family still enjoys driving the five minutes to Burger King for a dinner of Whoppers and fries. It’s just so cheap and convenient.

“It’s not so healthy,” Lupita says. “But, well, it tastes good.”

Comments? Contact Stanford Medicine at

 Back To Contents