Background: Known by some as the "invisible" people because of their precarious work and low social status, migratory and seasonal farmworkers (MSFW) are a critical and underappreciated component to the agriculture industry in the United States. Despite advances in knowledge about the health needs of this population, identifying geographies of high-risk remains a challenging task for community health workers and farmworker advocacy organizations.Methods: Using patient encounter data (2011-2015) from regional Community and Migrant Health Centers (C/MHC), this study investigates the geography of farmworker chronic disease (diabetes, obesity, hypertension) and associated risk factors (anxiety, stress, depression, tobacco use) in Northeastern Colorado through the lens of Geographic Information Science (GIS).Results: Spatial scan statistics (SaTScan) identified disease cluster hot spots in 151 zip codes and chronic disease risk factor clusters in 44 zip codes. Additionally, 13487 farmworkers or 82% of the total population is found in zip codes designated as chronic disease hot spots, while 10,115 or 62% of the population reside in zip codes identified as risk factor hot spots. GIS-based Network Analysis determined that 1,269 farmworkers lived greater than 30 minutes from a C/MHC, or 7.7% of the total population in the study area (n = 16,419).Conclusions: The findings of this study confirm the need for geospatial analytics in farmworker population healthcare management. These methods, combined with multiple contextual and methodological perspectives, will inform appropriate outreach, research, and policy strategies, and further, serve to address the unique geographic challenges facing MSFW's in Northeastern Colorado.
Keywords: Migratory and seasonal farmworkers; chronic disease; geographic information science; healthcare accessibility; medical geography.