Services provided:

(a) Visits to homes.

(c) Visits to schools, day-care centers, total

21

(n) Referrals for medical or dental care, total:

Chairman, Migrant Health Subcommittee,
New Senate Office Building, Washington, D.C.

DEAR SENATOR WILLIAMS: Unmet health needs experienced by migrants have been recorded in detail, and are probably no different in Washington State than in any other area. A list of those needs would include, but not be limited to, the following: Medical care; dental care; family planning; immunizations; nutrition education; food preparation instruction.

These and other conditions are brought on, or contributed to, by: Too many communicable diseases; poor housing and sanitation; inadequate education; low income; language barriers; continual mobility; poor personal hygiene.

Each of these thirteen factors works to the disadvantage of the migrant and his family. Some are beyond the scope of the Migrant Health Act, but others, medical and dental care, case finding and disease prevention by public health nurses, and housing and basic sanitation techniques, are being attacked in Washington.

We view this only as a beginning. There are many migrants in Washington who have not yet been reached by any special services; and it is important that those areas with migrant health projects expand their activities.

The following is a list of health districts in Washington where significant numbers of migrants are employed.

Reference to the above table of peak populations will indicate that the presently operating programs serve only a minority of the migrants. We estimate that the stay of migrant agricultural workers and their families amounts to some 110,000 person-months each year in the state as a whole, but only about 12,000 personmonths in Whatcom, Skagit and Pierce Counties, places where migrant programs at a fair level of intensity have been carried out. The present funding under the Migrant Health Act in these three counties, serving about one-ninth of the migrant need, is $118,496. To provide services at this intensity to the rest of the State would require then, as a rough estimate, some $1,060,000. To fill the total need, however, could require much more. The most intensive project in the state, the Puyallup-Stuck Valley Project, is funded at $40,324 to serve needs of migrants present for 1,600 person-months. To serve migrant needs in the state at this level would require about $2.8 million, and even then it is worth noting that the Puyallup-Stuck Valley migrants, mostly Indians, are eligible for considerable service elsewhere under other legislation.

The extent of need may be grasped by noting we forecast, very roughly, that some 246 children will be born to migrant families while they are in Washington during the 1968 season; and that of these, a dozen will die during the first year, eight from preventable causes. About ninety-five adult migrants will also die.

The "poor health" syndrome of migrants is extremely difficult to meet. One of the most frustrating aspects of the picture is mobility. The health problems of a moving population are compounded by a here-today-gone-tomorrow culture which makes any service impossible to complete. The factor of mobility will be altered in the next few years as changes occur in agricultural economics and farm mechanization. In the meantime, we feel we must continue and expand our efforts to serve the migrant workers and their dependents who come to Washington.