Transnational health protection strategies and other health-seeking behavior among undocumented and indigenous dairy workers in a rural new immigrant destination.

Latin American immigrants in new immigrant destinations (NIDs) experience numerous barriers that negatively impact their access to healthcare. Yet the wide range of health-seeking behaviors deployed in response to these barriers-particularly among those who are undocumented and indigenous-are not well understood. Further, studies of immigrant health in NIDs tend to take place in those locations, rather than using a multi-sited design. Building on NID scholarship, the transnational social protection literature, and work on structural vulnerability, this study uses a multi-sited research design to examine the health-seeking behaviors that undocumented and indigenous immigrant workers exhibit in a rural NID. Data consist of interviews conducted intermittently from 2010 to 2017 in Mexico and the U.S. with 56 individuals from indigenous villages in Veracruz who worked on dairy farms in Wisconsin and Minnesota, as well as expert interviews. We found numerous barriers to healthcare that together constituted a limited resource environment for undocumented dairy workers. This accentuated their structural vulnerability and influenced responses to health problems. Strategies among undocumented and indigenous immigrant dairy workers in a rural NID included: self-care, delaying care, relying on local ties, cross-border health consultation, cross-border health packages, and returning home for health. Furthermore, we found that women in the family or community often facilitated cross-border health activity, and that traditional folk medicine was common. We argue that these workers' health protection strategies not only serve to secure their individual status as productive workers, but on a larger scale, they play an important part in preserving the migrant labor regime in this rural NID. Further, we argue that the indigenous knowledge that is transmitted largely by women via immigrants' informal social networks is an important yet often invisible part of the carework that maintains this relatively new labor force.