Our Vision – Healthy Kansans living in safe and sustainable environments .

1. www.kdheks.gov Our Vision – Healthy Kansans living in safe and sustainable environments.

2. Kansas’ Low German Mennonites:Meeting the Challenge of an Emerging Farmworker Population KS Statewide Farmworker Health Program Kansas Department of Health and Environment Tina Guenther-Regional Case Manager Cyndi Treaster-Program Director Our Vision – Healthy Kansans living in safe and sustainable environments.

3. Miguel’s Story: A Multicultural Exchange Our Vision – Healthy Kansans living in safe and sustainable environments.

4. Low Germans in Kansas While a few Low German Mennonites from Mexico report working in Kansas as early as the late 1970’s and early 1980’s, large numbers began arriving in the late 1990’s. Our Vision – Healthy Kansans living in safe and sustainable environments.

5. Low Germans in Kansas In 1998, KSFHP registered 141 LG Mennonites from Mexico, representing 7 percent of the total farmworkers served. In 2004, 1452 LG Mennonites from Mexico were registered representing 43 percent of the total farmworkers served. Our Vision – Healthy Kansans living in safe and sustainable environments.

6. KSFHP Populations Served 2089 2449 3377 Our Vision – Healthy Kansans living in safe and sustainable environments.

7. 2009 Kansas Farmworker Profile Of 4443 farmworkers & dependents identified: • 62% Latinos, 36% Low German • 96% need interpreting • 91% were under 150% of poverty Our Vision – Healthy Kansans living in safe and sustainable environments.

8. 2009 Kansas Farmworker Profile Continued • 51% were male, 49% were female • 51% were 19 years/under, 49% over 19 • 79% were uninsured • 55% were seasonal, 45% were migrant Our Vision – Healthy Kansans living in safe and sustainable environments.

9. Early Research : Low Germans Mennonites from Mexico Migration North: Mennonites from Mexico: An Orientation to the Mexican Mennonite Culture & Way of Life, Mennonite Central Committee, Winnipeg, Manitoba. 1995 Kanadier Mennonites: Gaining An Understanding of Their Health and Illness. Beliefs. Kulig, Judith C,RN, DNSc, et al. University of Alberta, Canada 2002 ... Our Vision – Healthy Kansans living in safe and sustainable environments.

10. Who are these Farmworkers?: Health Survey Team 2003 • Contacted Mennonite Central Committee and Mennonite Church USA, Western District Conference • Older Mennonite Support Group (grants, culture and language) • Canadian born team of three sent to Western Kansas (interviews and focus groups) Our Vision – Healthy Kansans living in safe and sustainable environments.

11. Characteristics of the LG Mennonites in Kansas (2003) • Originate from colonies in Mexico • Highly mobile population • Speak a form of Plautdietsch or Low German • Do not emphasize formal education • Low literacy, but often highly skilled Our Vision – Healthy Kansans living in safe and sustainable environments.

12. Characteristics of the LG Mennonites in Kansas (2003) • Religious identity is primary • Separation from the modern world • Most conservative (90%) believe ministers are responsible for Bible interpretation and its application to everyday life. • Agriculture as a way of life-Bible Our Vision – Healthy Kansans living in safe and sustainable environments.

13. 2 Timothy 3:14 • 14But as for you, continue in what you have learned and have become convinced of, because you know those from whom you learned it,

14. Characteristics of the LG Mennonites in Kansas(2003) • Adhere to rigid gender roles within a patriarchal culture • Tend to have large families, fertility is influenced by religious beliefs • Little experience with modern health care services • Issues with depression and anxiety Our Vision – Healthy Kansans living in safe and sustainable environments.

15. 2003 KSFHP Health Survey Our Vision – Healthy Kansans living in safe and sustainable environments.

16. 2003 Health Survey Results Our Vision – Healthy Kansans living in safe and sustainable environments.

17. How Will We Serve the LGM’s? • A temporary intern with KSFHP had experience with health promoter programs at the border and recommended KSFHP consider the model. My thought “like looking for a needle in a haystack!”

18. KSFHP Health Promoters and Friends Tina Guenther, Lena Dyck, Sara Friesen, Helen Loewen, Lisa Froese Our Vision – Healthy Kansans living in safe and sustainable environments.

19. KSFHP Health Promoters • Are trusted and respected community members (culture and language) • Provide informal community based health-related services (health education, case management, interpretation, etc.) • Establish vital links between health providers and persons in the community Our Vision – Healthy Kansans living in safe and sustainable environments.

20. Agriculture as a way of life in Mexico Our Vision – Healthy Kansans living in safe and sustainable environments.

21. Our Vision – Healthy Kansans living in safe and sustainable environments.

22. Cuauhtemoc, Mexico (Chihuahua) Our Vision – Healthy Kansans living in safe and sustainable environments.

23. Our Vision – Healthy Kansans living in safe and sustainable environments.

24. Large Agriculturally Based Families Our Vision – Healthy Kansans living in safe and sustainable environments.

25. Passport Pictures Our Vision – Healthy Kansans living in safe and sustainable environments.

26. Migrating Between U.S. and Mexico Our Vision – Healthy Kansans living in safe and sustainable environments.

27. Our Vision – Healthy Kansans living in safe and sustainable environments.

28. Settled in Seminole Texas Our Vision – Healthy Kansans living in safe and sustainable environments.

29. Sugar Beets in Kansas 1974 Our Vision – Healthy Kansans living in safe and sustainable environments.

30. One Foot in Two Worlds Our Vision – Healthy Kansans living in safe and sustainable environments.

31. Developing Innovative Practices • KSFHP has utilized a variety of methods to reach the LGM (and all) populations of farmworkers who come to Kansas to work and sometimes settle in our state.

32. Harvest of Health Curriculum Ernte der Gesundheit - Low German1-Wie Finde Hilfe in Kansas (wma)2-Vorbeugende Dedienung und Reinlichkeit (wma)3-Nahrung und Nahrungs Unterstuetzung (wma)4-Bedrueckt Fuehlen (wma)5-Alcohol Misbrauchen und Rauchen (wma)6-Familie Plannen (wma)7-Hantavirus (wma)8-Fragen ueber Einwanderung (wma)9-Sicherkeit auf dem Farm (wma) • This information was developed for migrant and seasonal farmworkers in Kansas.Harvest of the Health visual booklet.  click here (pdf) 2.69mb • Harvest of Health - English1-How Do I Find Assistance in Kansas (wma)2-Preventive Services and Hygiene (wma)3-Nutrition and Nutrition Assistance (wma)4-Depression (wma)5-Alcohol Abuse and Smoking (wma)6-Family Planning (wma)7-Hantavirus English (wma)8-FAQs About Immigration English (wma)9-Occupational and Farm Safety (wma) http://www.kdheks.gov/olrh/FWAudioEd.htm Our Vision – Healthy Kansans living in safe and sustainable environments.

33. KSFHP Calendars 2009 2011 2008 2010 Our Vision – Healthy Kansans living in safe and sustainable environments.

34. Community Outreach LGM Health Fair in Western KS Our Vision – Healthy Kansans living in safe and sustainable environments.

35. Chronic Disease Self-Management & Health Promotion Groups • Kansas Optimizing Health (based on the Stanford's Chronic Disease Self-. Management Program) • Diabetes & Cardiovascular Disease Self-Management Guide from the Gateway Community Health Center “La Clinica” Our Vision – Healthy Kansans living in safe and sustainable environments.

36. Focus Groups Questions • What are the biggest health problems you and your family face?  • How are your healthcare needs being met?  • What are the problems you have when trying to get health care?  • How has your health changed since being on the Farmworker Health Program?  • How are you using the program?  • How are you using the Medical benefits? • How are you using the Dental benefits? • How are you using the Pharmacy benefits?  Our Vision – Healthy Kansans living in safe and sustainable environments.

37. Focus Groups Questions • What works well with Farmworker Health Program or what do you like about the program? • What doesn’t work well with Farmworker Health Program or what don’t you like about the program? What recommendations would you make?  • Each year we try to do things to help our families get or stay healthy. What are some of the things that you learned from KSFHP program activities?   • Each year we showcase a health issue through our calendar. What did you learn from this calendar? Our Vision – Healthy Kansans living in safe and sustainable environments.

38. KSFHP Health Survey 2009 Our Vision – Healthy Kansans living in safe and sustainable environments.

39. KSFHP Health Survey 2009

40. Impact of Time in the U.S.? Our Vision – Healthy Kansans living in safe and sustainable environments.

41. Questions? Tina Guenther, KS Statewide Farmworker Health Program (UMMAM) 712 A St. John St Garden City, KS 67846 (620) 952-1470 tguenther@ummam.org www.kdheks/gov/olrh Cyndi Treaster, KS Statewide Farmworker Health Program (KDHE) 1000 SW Jackson, Ste 340 Topeka, KS 66612 (785) 296-8113 ctreaster@kdheks.gov www.kdheks/gov/olrh Our Vision – Healthy Kansans living in safe and sustainable environments.