Out of the Loop: (In)access to Health Care for Migrant Workers in Canada


Drawing on a survey of nearly 600 migrant farm workers in Ontario, Canada, we investigate the ways in which the liminality of temporary migrants is both conditioning and consequential in terms of health for these migrants. In particular, we demonstrate how the liminality inherent in managed temporary migration programmes creates the conditions for heightened vulnerability, which also have consequences for the health of migrant workers and their access to care. We discuss common barriers to health care access experienced by migrant workers, including employer mediation, language differences, and hours of work.

This is a preview of subscription content, access via your institution.


  1. 1.

    See Foucault et al. (1991) on this concept.

  2. 2.

    This study was funded by CERIS Ontario Metropolis Centre for Excellence in Immigration and Settlement.

  3. 3.

    The research team administered questionnaires to the migrant populations, taking issues of trust, accessibility, language and literacy into consideration. The principal investigator and coinvestigator, the university and community research assistants and International Migration Research Centre (IMRC) staff administered these questionnaires. All assistants were given appropriate training prior to survey administration. Ethical approval was granted for this research through the Wilfrid Laurier University Research Ethics Board.

  4. 4.

    FARMS is a private incorporated body comprised of growers association representatives which manages the SAWP employment, placements and transportation in Ontario. For more information, see www.farmsontario.ca

  5. 5.

    Using simple hypothesis tests, the incidence of these health problems are all different from zero with a 95 % confidence interval.

  6. 6.

    Some migrants from the Caribbean face language barriers owing to their accents and use of English or Patois vocabulary.

  7. 7.

    This relationship was determined to be statistically significant with chi-square test at .05.

  8. 8.

    For example, some 32 % of Jamaican workers reported a long-term illness as a result of illness/injury experienced while in Canada (Russell 2003).


  1. Agamben, G. (2005). State of exception. Chicago: University of Chicago Press.

    Google Scholar 

  2. Alexander, S. (2010). Humanitarian bottom league? Sweden and the right to health for undocumented migrants. European Journal of Migration and Law, 12(2), 215–240.

    Article  Google Scholar 

  3. Anderson, B. (2010). Migration, immigration controls and the fashioning of precarious workers. Work, Employment and Society, 24(2), 300–317.

    Article  Google Scholar 

  4. Arcury, T., & Quandt, S. (2007). Delivery of health services to migrant and seasonal farmworkers. Annual Review of Public Health, 28(1), 345–363.

    Article  Google Scholar 

  5. Arcury, T. A., Gesler, W. M., Preisser, J. S., Sherman, J., Spencer, J., & Perin, J. (2005). The effects of geography and spatial behavior on health care utilization among the residents of a rural region. Health services research,40(1), 135–156.

  6. Basok, T. (2002). Tortillas and tomatoes. Mexican transmigrant harvesters in Canada. Montreal: McGill-Queen’s Press.

    Google Scholar 

  7. Bechtel, G. A., Davidhizar, R., & Spurlock, W. (2000). Migrant farmworkers and their families: cultural and delivery of services in the United States. International Journal of Nursing Practice, 6(6), 300–306.

    Article  Google Scholar 

  8. Bhabha, H. K. (1994). The location of culture. New York: Routledge.

    Google Scholar 

  9. Binford, L., Carrasco Rivas, G., Arana Hernandez, S., & Santillana de Rojas, S. (2004). Rumbo a Canadá: La Migración Canadiense de Trabajadores Agrícolas Tlaxcaltecas. Mexico: SociedadCooperativa.

    Google Scholar 

  10. CIC (Citizenship and Immigration Canada). (2011). Facts and figures 2011: immigration overview, permanent and temporary residents. Ottawa: CIC. http://www.cic.gc.ca/English/resources/statistics/facts2011/index.asp.

    Google Scholar 

  11. Dunn, J. R., & Dyck, I. (2000). Social determinants of health in Canada’s immigrant population: results from the National Population Health Survey. Social Science & Medicine, 51(11), 1573–1593.

    Article  Google Scholar 

  12. Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science Medicine, 31(12), 137–163.

    Article  Google Scholar 

  13. Faraday, F. (2012). Made in Canada: how the law constructs migrant workers’ insecurity. Metcalf Foundation. Retrieved from: http://metcalffoundation.com/publications-resources/view/made-in-canada/.

  14. Foucault, M., Burchell, G., Gordon, C., & Miller, P. (Eds.). (1991). The Foucault effect: studies in governmentality. Chicago: University of Chicago Press.

    Google Scholar 

  15. Goldring, L. (2010). Temporary worker programs as precarious status: implications for citizenship, inclusion and nation-building in Canada. Canadian issues/themes canadiens. Spring 50–54.

  16. Goldring, L., & Landolt, P. (2011). Caught in the work-citizenship matrix: the lasting effects of precarious legal status on work for Toronto immigrants. Globalizations, 8(3), 325–341.

    Article  Google Scholar 

  17. Goldring, L., Berinstein, C., & Bernhard, J. K. (2009). Institutionalizing precarious migratory status in Canada. Citizenship Studies, 13(3), 239–265.

  18. Goldring, L., Berinstein, C., & Bernhard, J. K. (2007). Institutionalizing precarious immigration status in Canada. CERIS working paper no. 6. Toronto: CERIS.

    Google Scholar 

  19. Gurowitz, A. (2000). Migrant rights and activism in Malaysia: opportunities and constraints. The Journal of Asian Studies, 59(4), 863–888.

    Article  Google Scholar 

  20. Hennebry, J. (2014). Falling through the cracks: Migrant workers and the Global Social Protection Floor Initiative. Global Social Policy, 14(3), 369–388.

  21. Hennebry, J., & McLaughlin, J. (2012). The exception that proves rule: structural vulnerability, health, risks, and consequences for temporary migrant farmworkers in Canada. In P. Lenard & C. Straehle (Eds.), Legislated inequality: Canada’s Temporary Migrant Worker Program (pp. 117–138). Quebec: McGill- Queen’s University Press.

    Google Scholar 

  22. Hennebry, J. L., & Preibisch, K. (2012). A model for managed migration? Re‐examining best practices in Canada’s seasonal agricultural worker program. International Migration, 50(s1), e19–e40.

    Article  Google Scholar 

  23. Hertzman, C. (1994). The lifelong impact of childhood experiences: a population health perspective. Daedalus, 123, 167–180.

    Google Scholar 

  24. Holmes, S. (2013). Fresh fruit, broken bodies. Migrant farmworkers in the United States. Berkeley: University of California Press.

    Google Scholar 

  25. Hyndman, J. (2000). Managing displacement: Refugees and the politics of humanitarianism. Minneapolis: Minnesota University Press.

  26. IAVGO (Industrial Accidents Victims Group of Ontario) (2010). Presentation to the expert advisory panel of the occupational health and safety system review. July 2. Toronto.

  27. Kazmierkiewicz, P. (2011). Non-paper integration of migrants in Ukraine: Situation and needs assessment. Warsaw: OSCE.

  28. McGuire, S., & Georges, J. (2003). Undocumentedness and liminality as health variables. Advances in Nursing Science, 26(3), 185–195.

    Article  Google Scholar 

  29. McLaughlin, J. (2009). Migration and health: implications for development. Policy paper (2). The Canadian Foundation for the Americas Labor (FOCAL) Mobility and Development Project. Retrieved from http://www.focal.ca/pdf/Migrant%20Health%20McLaughlin%202009.pdf.

  30. McLaughlin, J. (2010). Research spotlight of migrant farmworkers in Canada. Health Research Bulletin (17). Health Canada. Retrieved from http://www.hc-sc.gc.ca/sr-sr/pubs/hpr-rpms/bull/2010-health-sante-migr/index-eng.php#a12.

  31. McLaughlin, J., & Hennebry, J. (2011). Backgrounder on health and safety for migrant farmworkers. Policy points issue (1). International Migration Research Centre (IMRC). Retrieved from http://www.wlu.ca/documents/44258/IMRC_Policy_Points_Issue_I_-_Migrant_Farmworker_Health.pdf.

  32. McLaughlin, J., & Hennebry, J. (2013). Pathways to precarity: structural vulnerabilities and lived consequences for migrant farmworkers in Canada. In L. Goldring & P. Landolt (Eds.), Producing and negotiating non-citizenship: precarious legal status in Canada (pp. 175–195). Toronto: University of Toronto Press.

    Google Scholar 

  33. McLaughlin, J., & Hennebry, J. (forthcoming). Managed into the margins: examining citizenship and human rights of migrant workers in Canada. In R. Howard Hassmann and M. Walton-Roberts (Eds.), The human right to citizenship: a slippery concept. University of Pennsylvania Press.

  34. McLaughlin, J., Hennebry, J., O’Connor, P., Furet, P., Cole, D., Pysklywec, D., Tew, M., & Haines, T. (2012). Resource document. The Migrant Health Worker Project. Retrieved from http://www.migrantworkerhealth.ca/AboutUsGeneral.html.

  35. McLaughlin, J., Hennebry, J., & Haines, T. (2014a). Paper versus practice: occupational health and safety protections and realities for temporary foreign agricultural workers in Ontario. Pistes: Interdisciplinary Journal of Work and Health.

  36. McLaughlin, J., Hennebry, J., Cole, D., Cole, G., & Williams, G. (2014b). The migrant farmworker health journey: stages and strategies. Waterloo: IMRC Policy Points, International Migration Research Centre. Retrieved from http://imrc.ca/wp-content/uploads/2013/10/IMRC-Policy-Points-VI.pdfwww.wlu.ca/imrc.

    Google Scholar 

  37. Menjívar, C. (2006). Liminal legality: Salvadoran and Guatemalan immigrants lives in the United States. American Journal of Sociology, 111(4), 999–1037.

  38. Nakache, D., & Kinoshita, P. (2010). The Canadian temporary foreign worker program: do short-term needs prevail over human rights concerns? IRPP Study (5). Retrieved from http://oppenheimer.mcgill.ca/IMG/pdf/IRPP_Study_no5.pdf.

  39. Niagara this Week (2014). HNHB LHIN funds migrant Agricultural Worker Health Services. April 3. http://www.niagarathisweek.com/news-story/4445819-hnhb-lhin-funds-migrant-agricultural-worker-health-services/.

  40. OECD-UNDESA. (2013). World migration in figures. Geneva: United National Department of Economic and Social Affairs Population Division and the Organisation for Economic Cooperation and Development.

    Google Scholar 

  41. Orkin, A., Lay, M., McLaughlin, J., Schwandt, M., & Cole, D. (2014). Medical repatriation of migrant farmworkers in Ontario: coding and descriptive analysis. Canadian Medical Association Journal (CMAJ): Open.

    Google Scholar 

  42. Otero, G., & Preibisch, K. (2009). Farmworker health and safety: challenges for British Columbia. WorkSafeBC: Vancouver. Retrieved from http://www.sfu.ca/~otero/docs/Otero-and-Preibisch-Final-Nov-2010.pdf.

    Google Scholar 

  43. Preibisch, K. (2004). Migrant agricultural workers and processes of social inclusion in rural Canada: encuentros and desencuentros. Canadian Journal of Latin American and Caribbean Studies/Revue canadienne des études latinoaméricaines et caraïbes, 29(57–58), 203–239.

    Article  Google Scholar 

  44. Preibisch, K., & Otero, G. (2014). Does citizenship status matter in Canadian agriculture? Workplace health and safety for migrant and immigrant laborers. Rural Sociology.

  45. Pysklywec, M., McLaughlin, J., Tew, M., & Haines, T. (2011). Doctors within borders: meeting the health care needs of migrant farm workers in Canada. Canadian Medical Association Journal, 183(9), 1039–1043.

    Article  Google Scholar 

  46. Quandt, S. A., Hernández-Valero, M. A., Grzywacz, J. G., Hovey, J. D., Gonzales, M., & Arcury, T. A. (2006). Workplace, household, and personal predictors of pesticide exposure for farmworkers. Environmental health perspectives, 943–952.

  47. Rodgers, G. (1989). Precarious employment in Western Europe: the state of the debate. In G. Rodgers & J. Rodgers (Eds.), Precarious jobs in labor market regulation: the growth of atypical employment in Western Europe (1–16). Belgium: International Institute of Labor Studies.

    Google Scholar 

  48. Russell, R. (2003). Jamaican workers’ participation in CSAWP and development—consequences in the workers’ rural home communities. In Canadian Migrant Agricultural Workers’ Program. Research Project. Ottawa: The North–south Institute.

    Google Scholar 

  49. Sánchez, J. (2013). Firma CNC convenio de derechos laborales. El Universal. April 9. Retrieved December 1, 2013 from http://www.eluniversal.com.mx/notas/915617.html.

  50. Sharma, A. (2006). Crossbreeding institutions, breeding struggle: Women’s empowerment, neoliberal governmentality, and state (Re)formation in India” Cultural Anthropology, 21(1), 60–95.

  51. UFCW (United Food and Commercial Workers Canada) (2013). UFCW Canada and Mexico’s CNC sign historic agreement. http://www.ufcw.ca/index.php?option=com_content&view=article&id=3389%3Aufcw-canada-and-mexicos-cnc-sign-historic-agreement&catid=6%3Adirections-newsletter&Itemid=6&lang=en.

  52. UNDP (United Nations Development Programme) (2009). Human development report 2009, overcoming barriers: human mobility and development. New York. http://hdr.undp.org/en/media/HDR_2009_EN_Complete.pdf.

  53. Verduzco, G., & Lozano, M.I. (2003). Mexican farmworkers’ participation in Canada’s seasonal agricultural labor market and development consequences in their rural home communities. In Canada’s Seasonal Agricultural Workers’ Program(CSAWP) As a model best practices in the employment of Caribbean and Mexican farm workers. Ottawa: The North–south Institute.

  54. Vosko, L. F. (2006). Precarious employment: understanding labor market insecurity in Canada. Montreal: McGill-Queen’s University Press.

    Google Scholar 

  55. White-Means, S. (1992). Health characteristics and utilization of public sector health facilities among migrant agricultural workers in Orange County, New York. Journal of Health & Social Policy, 4(1), 57–75.

    Article  Google Scholar 

  56. WHO (World Health Organization). (2010). Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: WHO. http://www.who.int/healthinfo/systems/WHO_MBHSS_2010_full_web.pdf.

    Google Scholar 

  57. World Health Organization (WHO) (2003). International migration, health and human rights. Health & Human Rights Publication Series, Issue 4. http://www.who.int/hhr/activities/en/FINAL-Migrants-English-June04.pdf.

  58. Zimmerman, C., Kiss, L., & Hossain, M. (2011). Migration and health: a framework for 21st century policy-making. PLoS Medicine, 8(5), e1001034. doi:10.1371/journal.pmed.1001034.

    Article  Google Scholar 

Download references


The authors would like to thank the Centre of Excellence for Research on Immigration and Settlement (CERIS) Ontario Metropolis Centre, which funded this work. The authors also acknowledge the contributions of Gabriel Williams and IMRC staff throughout the editing process.

Author information



Corresponding author

Correspondence to Jenna Hennebry.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hennebry, J., McLaughlin, J. & Preibisch, K. Out of the Loop: (In)access to Health Care for Migrant Workers in Canada. Int. Migration & Integration 17, 521–538 (2016). https://doi.org/10.1007/s12134-015-0417-1

Download citation


  • Health care
  • Temporary foreign workers
  • Agriculture
  • Canada