Heat-related illness symptoms and mental health in Florida farmworkers

Background Farmworkers face disproportionate occupational heat exposure and high rates of heat-related illness (HRI), and emerging evidence suggests associations between heat exposure and adverse mental health outcomes. Objective This exploratory pilot study aimed to (1) characterize the burden of depression, anxiety, and climate change psychological distress among Florida farmworkers relative to national benchmarks, (2) explore cross-sectional associations between HRI symptoms and mental health outcomes, and (3) examine cross-sectional associations between perceived impacts of Florida Senate Bill 1718 (S.B. 1718) and mental health outcomes. Methods In July 2024, 53 adult farmworkers (58% female, 42% male) were recruited through the Farmworker Association of Florida (FWAF) in Apopka and Pierson, Florida. Community health workers verbally administered the PHQ-9, GAD-7, CCPD scale, an eight-symptom HRI checklist, and two investigator-developed items on S.B. 1718. Workday heat index was derived from the Florida Automated Weather Network. Analyses included descriptive statistics, Fisher’s exact tests, and linear and logistic regression adjusted for age, sex, and agricultural tenure. Results Moderate-to-severe anxiety, depression, and climate change psychological distress were observed in 21, 25, and 34% of participants, respectively, exceeding U.S. adult and Hispanic-adult benchmarks. Cross-sectional associations were observed between the number of same-day HRI symptoms and each mental health outcome (all p 0.05 unadjusted). Participants reporting feeling discouraged from seeking hospital care due to S.B. 1718 had higher mean PHQ-9 scores than those who did not (6.59 vs. 3.00; p = 0.008). Confidence intervals around regression estimates were wide, reflecting sparse-data instability rather than precise effect sizes. Significance This study addresses an empirical gap at the intersection of occupational heat exposure, immigration policy, and mental health among farmworkers in the southeastern United States. The findings identify mental health as an under recognized dimension of farmworker occupational health and point to the need for integrated approaches that link heat-safety protections, routine mental health screening in community-based settings, and attention to the policy environments that shape healthcare access. Larger, longitudinal studies are needed to confirm these associations and to guide the scale and design of such integrated responses.