The Need
Broadband internet access and digital literacy is a “super” social determinant of health impacting the health and safety of the 73,559 migrant and seasonal agricultural workers and their families living in North Carolina. Agricultural workers experience the rurality of the digital divide while distinctively enduring a highly dangerous occupation with agricultural exceptionalism leading to structurally vulnerable housing, poverty, and reduced labor protections. The rural isolation is magnified by limited transportation, economic instability, language barriers, racial and ethnic disparities, education, and cultural differences.
Without access to the internet or cell service, agricultural workers and their families are excluded from critical support services such as emergency communications and telemedicine. In addition, the inaccessibility to online information, social connections, and education prohibits self-efficacy, participation in society, and overall emotional well-being.
Most migrant farmworkers do not have access to the internet. There are more than 1,000 migrant camps in North Carolina in rural areas with limited broadband access, making it difficult to have a one-size-fits-all internet connectivity solution. Internet connectivity is not a required service under the present migrant housing standards. Migrant agricultural worker housing is mostly located in rural areas with poor cell phone reception and without any kind of internet connectivity available.
Access to internet means access to care. Without access to the internet, agricultural workers are unable to reach healthcare providers, communicate about outbreaks, request outreach services, and stay in touch with family and loved ones.
NCFHP Approach
The NCFHP Digital Equity Team is dedicated to supporting agricultural workers in accessing telemedicine, social support, emergency communication, and educational opportunities. As the lead for digital equity within the North Carolina Farmworker Health Program, our team is committed to paving the way for digital equity among agricultural communities locally and nationally. Through the provision of internet connectivity, digital literacy initiatives, and access to technology resources, we strive to create a more inclusive and equitable digital landscape for these vital contributors to our communities.
Internet Connectivity Project (May 2020-March 2023)
Funded by CARES Act 2020 & ARPA 2021, the project aimed to bridge the digital gap among agricultural workers. Through partnerships, it provided access to telemedicine, social support, and education. Key activities included hotspot distribution, farm internet reimbursement, and forming the NC Agriculture Digital Alliance.
Project Objectives:
- Emergency Response: Hotspot Lending Program
- Medium-term Solutions: Hotspot Lending program extended, Grower Reimbursement program in collaboration with NC AgroMedicine Institute, internet hub pilot program, technology procurement.
- Digital Equity and Inclusion: Think Tank Series, NC Agriculture Digital Alliance formation.
Evaluation of Internet Connectivity Project
With support from academic partners, East Carolina University and NC State University, we were able to publish a process evaluation of the Internet Connectivity Project in the American Journal of Public Health: Digital Inclusion for Farmworkers in a Pandemic: The North Carolina Farmworker Health Program Internet Connectivity Project, 2020‒2021 | AJPH | Vol. 112 Issue 11 (aphapublications.org)
Following insights from the process evaluation, NCFHP pursued sustainable funding to continue bridging the digital divide, leading to the launch of the NCFHP Agricultural Worker Digital Equity Initiative (AWDEI) in summer 2023. AWDEI aims to advance digital equity for agricultural workers, enabling them to actively engage in society, democracy, and the economy while building upon previous projects. Supported by 2 funding sources from the Office of Digital Equity & Literacy and National Institutes of Health ComPASS, AWDEI is positioned to make significant strides in agricultural communities.
Interagency Office of Digital Equity & Literacy (July 2023-June 2025)
Overview and Scope: Aiming to bridge the digital gap for rural agricultural workers, this initiative, funded by the Office of Digital Equity and Literacy, focuses on improving broadband access and digital health skills. It involves stakeholders like workers, health professionals, ISPs, and nonprofits.
Goals and Deliverables:
- Increase broadband access.
- Integrate farmworker health themes into training.
- Ensure alignment with digital inclusion plans.
- Implement broadband access plan, promote digital health training, and collaborate with inclusion plans.
NIH ComPASS: Agricultural Workers Digital Equity Initiative (September 2023-September 2033)
Project Purpose:
AWDEI aims to improve agricultural workers’ access to affordable broadband for enhanced telehealth and reduced health disparities.
Phase 1: Project Initiation (Sept 2023 – Sept 2027)
- Establish Health Equity Research Assembly (HERA) and Agricultural Worker Advisory Board (AWAB).
- Conduct statewide community assessment and pilot studies guided by HERA and AWAB input.
Phase 2: Intervention Implementation (Sept 2027 – Sept 2031)
- Implement structural interventions through sub-awardees with support from HERA and AWAB.
- Conduct longitudinal survey to track internet access changes and robust monitoring and evaluation.
Phase 3: Dissemination and Sustainability (Sept 2031 – Sept 2033)
- Share results across audiences, review evaluation outcomes, and encourage stakeholder responsibility for worker wellbeing.
Expected Outcomes:
- Improved internet access leading to enhanced healthcare delivery.
- Better management of chronic conditions through telehealth.
- Increased communication efficiency in health record systems.