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Community, Health, and Family

Lessons Learned on Immigration Enforcement on Dairy Worker Health from the Rapid Community Assessment of H5N1 Avian Influenza Knowledge, Attitudes, and Practices among Dairy Workers in California, Colorado, Minnesota, New York, Vermont, and Washington Nicandro Mandujano Acevedo*, Nicandro Mandujano Acevedo, Lisbeth Gall,

INTRODUCTION
Beginning in early 2024, H5N1 spread rapidly through dairy herds in the US. A total of 70 human cases were identified in 13 states, with 65 of these cases occurring in individuals working on poultry or dairy farms. Simultaneously to the efforts by outreach programs and health centers to respond to this public health emergency, immigration enforcement across the country began to be intensified. The National Center for Farmworker Health’s (NCFH), in collaboration with a national advisory council and the Centers for Disease Control and Prevention (CDC), developed a community based participatory project to assess and understand H5N1 knowledge, attitudes, and behaviors among dairy workers as well as their demographic make-up and access to health care. 

 
METHODS
In-person surveys were conducted in partnership with local farmworker-serving organizations at dairy workers’ homes, in their workplaces, and at local community sites from March to September 2025. Qualitative interviews with dairy workers and industry experts were conducted virtually and in-person. Surveys and interviews took place with individuals located in states with current or past infected dairy herds and in states with no known infections of dairy herds for comparison purposes. Interviews participants came from California, Colorado, Iowa, Michigan, Minnesota, New Mexico, New York, Texas, Vermont, Washington, and Wisconsin. 

 
RESULTS
A total of 708 dairy workers participated in surveys, and 20 dairy workers, farmworker-serving organization staff, and industry experts participated in qualitative interviews. The majority of survey participants were male (86%), aged 26-54 (66%), and born in Mexico (79%). When asked about current challenges faced by the dairy worker community interview participants from all groups identified federal immigration policies as a critical issue. The current political landscape, characterized by indiscriminate law enforcement and immigration raids, has made dairy farms even more challenging to access and work with. They all stated the additional stress and anxiety workers have been experiencing due to law enforcement. 

 
DISCUSSION
This project provides a portrait of dairy workers and their navigation of the US health care system. It highlights the added stress and barriers this community faces to access care during a public health emergency when the justice system remains unchecked. Findings highlight the importance of community trust building among employers, workers, community organizations, and government agencies and how this is essential to address critical issues faced by dairy workers and rural communities at large to improve their wellbeing.