They Feed Colorado. But Who’s Caring for Them?: Insights from the Project Protect Preventative Healthcare Survey

Colorado’s agricultural workers wake before sunrise to harvest produce, care for livestock, and sustain our state’s food system. Yet when it comes to their health, many are left without support. The 2024 Preventative Healthcare Survey by Project Protect Food Systems Workers documents widespread gaps in access to basic medical care among rural, Spanish-speaking, and immigrant workers across the state. 

The survey provides the most comprehensive picture of Colorado’s agricultural workforce, which is typically grouped with other Mountain West states in national surveys or completely excluded from data collection efforts. The 2024 Preventative Healthcare Survey includes responses from 595 current and former agricultural workers across six rural regions, gathered through multilingual, in-person outreach by trusted leaders of the Project Protect Promotora Network. The findings confirm what Project Protect has seen in the field for years: too many essential workers are struggling to get the care they need.

Survey Findings at a Glance

The survey data paints a troubling picture of health inequities:

• 65% of respondents had no health insurance.
• Only 22% reported receiving health insurance from their employer.
• About 41% said their employer would pay them while recuperating from a workplace injury, while more than one in three said no, and nearly a quarter did not know.
• Just 30% reported access to paid sick leave.
• More than half didn’t know about hospital financial assistance programs.

Chronic conditions like diabetes, high blood pressure, cardiovascular disease, and dental pain were reported across many households. Mental health concerns and long-term physical pain also featured prominently. For many families, even basic services like checkups or vaccines felt out of reach. These are preventable gaps with serious long-term consequences, especially as many rural areas across Colorado face persistent shortages of healthcare providers.

Agricultural workers are often excluded from employer-provided benefits and public health programs due to immigration status, seasonal work arrangements, or geographic isolation. Many live in Health Professional Shortage Areas and must sometimes travel more than 100 miles to reach a provider. Even when clinics are available, workers face linguistic barriers, limited appointment availability, and fear of retaliation if they take time off. The lack of clear information and culturally appropriate services means that workers frequently delay care, sometimes until it’s too late.

A Call to Invest in Health Equity

The Project Protect Promotora Network closes these gaps in healthcare access through culturally and linguistically tailored outreach by trusted community leaders. Project Protect Promotoras have deep ties to agricultural workers through shared experiences and trust built over the past five years. In the 2024 survey, Project Protect didn’t just collect data; promotoras sat down face-to-face with workers, heard their concerns, and ensured their voices informed the analysis. But this work depends on continued funding. Outreach, translation, transportation, and care coordination all require resources. With larger donations, Project Protect can expand its programs to new regions, increase staffing, and offer specialized care for mental health, chronic disease, and maternal health needs that are often ignored in this population.

The findings of the 2024 Preventative Healthcare Survey are a clear call for action. The results demonstrate that the essential agricultural workers who form the backbone of our food system remain underinsured, underserved, and overlooked by mainstream health systems. These workers experience higher rates of chronic disease and lower access to care, all while supporting the state’s economy.

Community health clinics and nonprofits like Project Protect are stepping in to fill the gaps. But we can’t do it alone. As funding for public health programs faces uncertainty, community-driven organizations need strong backing from individuals, foundations, and businesses who believe in health equity. This is not just a public health issue; it’s a matter of justice. Agricultural workers deserve the same dignity, access, and protection as anyone else. Their labor keeps our families fed. Supporting their health is not charity, it’s a responsibility.

Project Protect invites everyone—donors, partners, and community members—to be part of this effort. Together, we can build a healthier, more just Colorado.

By Tessa Doolittle

If you have questions about this project or want to support our work, please contact Hunter Knapp at hunter@projectprotectfoodsystems.org.

Funding for the survey was provided by the Health Disparities and Community Grant Program. The views expressed do not necessarily reflect the official policies of, nor does the mention of, imply endorsement by, the Colorado Department of Public Health and Environment.