Local Perspectives on Improving Health and Wellbeing for Farmworker Families in Northern Sonoma County: Daniela Domínguez

Dra. Daniela Domínguez is an Assistant Professor at the University of San Francisco and the Chief Executive Officer at On the Margins, LLC. She is a licensed psychologist and professional clinical counselor with a special interest in liberation psychology, anti-racism, migrant justice, and gender and sexuality matters. Daniela has been instrumental in supporting the Healthcare Foundation’s Mental Health Talent Pipeline program, and recently has collaborated on a Bicultural Clinical Training Program that includes an online curriculum and knowledge-exchange (Nepantlah) for student and already-licensed therapists. On the Margins—a multi-service Bay Area organization of health professionals, artists, researchers, and consultants that “seeks to amplify community care, cultural wealth, and resilience”—is currently facilitating a two-year participatory research project with a collective of northern Sonoma County community-based organizations to develop a community-led plan for the realization of a Community Wellness Center in Cloverdale and Windsor.

How would you describe the general situation with respect to health and wellbeing for farmworker families in northern Sonoma County?

The farmworker population in northern Sonoma County is often geographically and linguistically isolated from healthcare services. In the rural areas of northern Sonoma County, social and healthcare services remain insufficient to meet the needs of an underserved farmworker population, especially those who are uninsured, underinsured, undocumented, and who speak a language other than English.

In the case of migrant farmworkers, exposure to traumatic events that may have occurred prior to migration, during migration, and post-migration can exacerbate health concerns. Unfortunately, pre-migration and migration experiences are often missed by health professionals due to inadequate understandings of migration, immigration, and racism-related stressors, which can lead to inadequate diagnosis, treatment, and care. With more culturally responsive providers, assessments, and treatment approaches, individuals, organizations, and broader systems of care may be in a better position to understand farmworkers and their families.

What are the biggest challenges or obstacles to accessing healthcare for farmworkers?

Farmworkers are impacted by persistent barriers to healthcare access given the region’s rural landscape, higher rates of poverty, and the detrimental effects of racial and immigration-related traumatic experiences. One critical challenge is that northern Sonoma County is an area with a limited supply of bilingual and multicultural professionals. Unfortunately, despite a continuing need for culturally humble practitioners to engage in work that addresses the health needs of farmworker and immigrant families, there are often limited formalized bilingual, bicultural opportunities for practitioners to receive adequate training in the areas of immigration, linguistic, and racial justice. The great news is that the Healthcare Foundation is invested in co-creating a pipeline of bilingual and multicultural providers to northern Sonoma County.

“In the case of migrant farmworkers, exposure to traumatic events that may have occurred prior to migration, during migration, and post-migration can exacerbate health concerns. Unfortunately, pre-migration and migration experiences are often missed by health professionals due to inadequate understandings of migration, immigration, and racism-related stressors, which can lead to inadequate diagnosis, treatment, and care.”

Dr. Daniela Domínguez, Assistant Professor at USF and CEO of On the Margins

What, in your opinion, are the solutions and/or some practical steps in the direction of bettering access and improving opportunities for health and wellbeing for farmworkers and their families?

Earlier research shows that a strong reliance on social networks is especially critical for Latinx and or farmworker communities in rural and Health Professional Shortage Areas (HPSA). Social support plays a critical role in sharing important health information and providing access to services and resources. One possible solution to improve access to healing services are Community Wellness Centers where farmworkers can turn to family, friends, neighbors, culture workers, healers, promotorxs and other health practitioners for support. 

In Cloverdale, the Healthcare Foundation of Northern Sonoma County, Nuestra Comunidad, La Familia Sana, and Alexander Valley Healthcare are currently using a grassroots approach led by BIPOC Cloverdale communities to envision a safe, vibrant, and green community space of belonging that aims to improve opportunities for health.

Is there anything you think the wider community (including nonprofits) of northern Sonoma County should know that might help to move things in the right direction?

Health practitioners may benefit from learning about Nepantlah, a new program being launched in August with the support of the Healthcare Foundation. Nepantlah seeks to build a virtual space where bilingual and multicultural mental health providers can share knowledge, deepen skills, and build connections with others who are working with Latinx populations, including those who are farmworkers. Nepantlah aims to cultivate a growing network of mental health providers, culture workers, and students engaged in bilingual and multicultural healing. Topics will include but are not limited to the intersection of linguistic justice and liberation, indigenous rights, decolonial praxis, Queering mental health, etc. For more information, visit https://www.nepantlah.education/.

The Healthcare Foundation’s mission is motivated by a vision of eliminating health inequities in northern Sonoma County. In recent months and years, Sonoma County farmworkers and their families have faced increased precarity and the repeated disruption of their lives as a result of forces beyond their control, from the pandemic to the impacts of climate change, with the attendant physical and mental health impacts and challenges this entails. The goal of health equity requires that we address the obstacles and challenges to their health and wellbeing. As part of the Healthcare Foundation’s effort to focus on farmworker health, we are turning to our community partners and other local stakeholders to better understand the need, the obstacles, and most importantly, the practical steps that can be taken to improve health and wellbeing for our region’s agricultural workers. We continue to collect information, engage in dialogue, and work cooperatively toward community-based solutions that can protect and enhance the wellbeing of farmworkers and their families.

Other Perspectives:

• Jocelyn Boreta, Executive Director and Co-Founder of The Botanical Bus (2 min read)
• Sue Labbe, Chief Executive Officer of Alliance Medical Center (2 min read)
• Corazón Healdsburg’s Promotora Staff (2 min read)
• Jade Weymouth, Executive Director of La Familia Sana (2 min read)
• Bertha Diaz, Community Health Worker / Promotora and Financial Services Specialist at Alexander Valley Healthcare (1 min read)
• Alma Bowen, Founder and Executive Director of Nuestra Comunidad (1 min read)