Dr. Joaquin Alfredo-Angel Rubalcaba, lead author on study of the FFP: “We do show that mothers are getting healthier... Their health, in terms of gestational diabetes and hypertension, [is] improving.”

Jon Esformes, CEO of Pacific Tomato Growers and first grower to join the FFP: "At the end of the day, when someone shows up to do a job, they want to go to the job, do their job, earn their money, know that they’re safe and go home."

A few weeks ago, we shared some remarkable news from the Fair Food Program with you: a multi-state, peer-reviewed public health study found that mothers working on Fair Food Program farms gave birth to healthier infants than their counterparts on non-FFP farms — a powerful reminder that when workers are protected, entire families thrive.

This landmark research — published by Duke University Press in the widely respected journal Demography — is the first to demonstrate that a Worker-driven Social Responsibility program can generate population-level public health gains by guaranteeing fundamental human rights on the job. Its findings suggest that the protections embedded in the Fair Food Program — and similar worker-driven models — can reach far beyond the workplace, functioning as targeted public health interventions in communities long exposed to extreme labor exploitation. 

Today, we are proud to share a feature-length article that takes a deeper look at this study, tracing how the Fair Food Program’s worker-drafted human rights standards, backed by multi-layered monitoring and enforcement mechanisms, translate into something profoundly human: healthier families and stronger communities. The feature comes courtesy of The Packer, the nation’s leading produce industry news outlet, which has for years documented the evolution and expansion of the Presidential Medal-winning Fair Food Program.

Written by The Packer’s Produce Editor Christina Herrick, the article brings forward new insights from the study’s lead author, who explains that beyond the reduction in low-birth-weight births, the program is also linked to decreases in diabetes and hypertension. These conditions, long prevalent among farmworkers, are closely tied to birth outcomes but also carry serious, lifelong consequences of their own — underscoring how the same protections that support healthier pregnancies are improving overall health in farmworker communities. The story also features reflections from Laura Safer Espinoza, Executive Director of the Fair Food Standards Council, and Jon Esformes, CEO of Pacific Tomato Growers and the first grower to join the FFP back in 2010. At a glance, the piece offers a deeper understanding of the FFP’s win/win impact, showing how its protections safeguard workers’ health while helping participating growers recruit and retain employees by becoming employers of choice.

We're excited to share the article in full with you below. If you'd like to read the article on The Packer's website, click here.

New Research Links Better Pay and Safer Conditions to Healthier Babies

A peer-reviewed study finds that infants born to farmworkers on Fair Food Program farms are 10% less likely to be born at a low birth weight.

A peer-reviewed study published in the journal Demography has found a direct link between participation in the Fair Food Program and improved birth outcomes for farmworkers. Infants born to farmworker mothers on Fair Food Program-certified farms were 10% less likely to be born at a low birth weight.

Low birth weight, the Fair Food Program notes, is closely linked to perinatal mortality, cognitive development, chronic disease risk and more.

Joaquin Alfredo-Angel Rubalcaba, the study’s lead author and an associate professor of public policy at the University of North Carolina at Chapel Hill, says low birth weight is a good marker to track, as it’s a sensitive indicator of the “health spillover” for both mothers and infants.

“We do show that mothers are getting healthier,” he says. “Their health, in terms of gestational diabetes and hypertension, [is] improving.”

Quantifying the Health Spillover

Birth weight, which has already been measured and validated through public health research, would also be a way to quantify how the Fair Food Program influenced maternal and infant health outcomes.

“It’s not just the income; it’s all of these other things that go along with that,” Rubalcaba says, noting that improved working conditions create a positive health spillover that extends beyond the individual.

“When you’re healthy, you don’t have to worry about your child being malnourished,” he says. “When you don’t have to worry about the things that we take for granted on a day-to-day basis, you’re able to focus on the things that make you productive.”

Rubalcaba says this spillover effect continues beyond just a nuclear family and into communities.

“The community is thriving as a result of the efforts, at least, in my opinion, in my survey of the data, and the fact that we were able to see a result in publicly available data, in the birth records data, was pretty remarkable,” he says.

Moving Beyond the Paycheck

While the data is remarkable, the three drivers of these health outcomes — safer conditions, higher wages and reduced stress — manifest in personal ways for the workers.

Wage premiums and stricter enforcement against wage theft for farms in the Fair Food Program raised worker incomes by 24%. Legal protections against sexual harassment, forced labor and verbal abuse helped decrease maternal stress levels. The program’s focus on safety standards also helped to reduce physical strain and environmental hazards.

Laura Safer Espinoza, a retired New York State Supreme Court justice and executive director of the Fair Food Standards Council, says the study’s outcome highlights the strong correlation between improvements in overall working environments and increased birth rates.

Safer Espinoza says more than $50 million has been distributed to workers on Fair Food Program farms. What’s more remarkable, she says, is that retailers and brands have pledged to support this program.

“They have agreed to commit their market power and put those purchasing practices to work to incentivize good practices at the bottom of the food supply chain,” she says.

More Than Just Better Pay

Safer Espinoza points to other successes within the program that speak to the broader themes of family. These include requiring workers to be paid at call time, which she says resulted in later starts.

“For the first time, workers who were called to the field at a later time were able to eat breakfast with their children. They were able to walk their children to school,” she says.

As researchers surveyed workers in Immokalee, Fla., about the benefits of the Fair Food Program, it wasn’t only better pay; it was more family time, says Safer Espinoza.

“Families reported that their children were healthier and happier, and parents were delighted to be able to have that precious time with their children in the morning,” she says. “And that’s simply because the law was being enforced.”

Safer Espinoza says this study shows tangible benefits when women working on Fair Food Program farms earn more through increased pay or the elimination of wage theft. She says eliminating sexual harassment and verbal abuse reduces stress and tension, too.

“When mothers can work and expectant mothers can work in an environment where it is safer, where they are treated with more respect, where they don’t have to be fearful and stressed every day, this is the proof that it makes a huge difference,” she says.

And she says the study’s results aren’t necessarily an expected outcome that she and the Fair Food Standards Council members thought would happen on participating farms. She says the survey’s results show a greater impact on the Fair Food Program. 

“We were not necessarily thinking, ‘This will increase birth rate and be transformational across generations in the way that it obviously is and has been proven to be,” she says. “It will make a huge difference for the children who are born to workers on Fair Food Program farms. They’ll be healthier and have better futures, and that’s something that I don’t think was necessarily contemplated when we set out, but it is a very beautiful result of this collaboration.”

A New Standard for Growers

Jon Esformes, CEO of Sunripe Certified Brands and the first grower to join the Fair Food Program, says he’s proud of how his company has become an employer of choice thanks to the positive culture created on his family’s farm. He says a couple of years ago, when he was on a panel about labor shortage with then-Agriculture Secretary Tom Vilsack, he had to say that he had no trouble recruiting and retaining workers as an employer of choice.

“That spoke to over a decade of bridge building and creating what we call a safe and fair work environment where everybody understands their rights, everybody feels safe and making complaints, everybody feels like the company is open to evolution, and that’s been the history of the relationship with the coalition,” he says.

And that’s truly what workers want, Esformes says.

“At the end of the day, when someone shows up to do a job, they want to go to the job, do their job, earn their money, know that they’re safe and go home,” he says.

And this study, Esformes says, helps highlight the intangible benefits from creating this type of workplace culture quantitatively.

“People tend to be evidence-based and need that evidence to convince them to keep doing something,” he says. “We didn’t need that for ourselves. For us, we knew what was happening. But in the meantime, it’s good for the general population to have a greater understanding of the efficacy of this type of program and its impact on the community.”