By Thomas Fuller, The New York Times | November 23, 2016

SALINAS, Calif. — As Americans gather around Thanksgiving tables, chances are that the healthier parts of their menus — the tossed salads, broccoli casseroles or steaming bowls of roasted brussels sprouts — were grown here in the Salinas Valley.

A long strip of deep and fertile soil pinched by sharply rising mountains, the valley has more than doubled its output of produce in recent decades and now grows well over half of America’s leaf lettuce.

Yet one place the valley’s bounty of antioxidants does not often appear is on the tables of the migrant workers who harvest it.

Public health officials here describe a crisis of poverty and malnutrition among the tens of thousands of farmworkers and their families who tend to the fields of lettuce, broccoli, celery, cauliflower and spinach, among many other crops, in an area called the salad bowl of the nation.

More than a third of the children in the Salinas City Elementary School District are homeless; overall diabetes rates are rising and projected to soar; and 85 percent of farmworkers in the valley are overweight or obese, partly because unhealthy food is less costly, said Marc B. Schenker, a professor at the University of California, Davis, who studies the health of farmworkers.

“The people who grow our food can’t afford to eat it, and they are sicker because of it,” said Joel Diringer, a public health specialist and advocate for farmworkers. “It’s an incredible irony that those who work in the fields all day long don’t have access to the fresh produce that they harvest.”

For decades, the fields of the Salinas Valley have been a revolving door of migrants, from the Okies of John Steinbeck’s writings to the Latin American immigrants who tend the fields today. Ninety-one percent of farmworkers in California are foreign born, primarily from Mexico, according to the United States Department of Labor.

While the valley’s vegetables are reaching an ever-growing number of American households, public health officials say there are no signs of improvement in the living conditions and diets of farmworkers.

The popularity of sugary drinks and cultural preferences for filling but high-calorie foods like tacos and tamales contribute to the obesity of farmworkers and their families, public health officials say. Because an estimated half of agricultural workers in the Salinas Valley are in the country illegally, many do not have health insurance and go without treatment until symptoms become acute.

The combination of high rents and low incomes — wages typically fall in the range of $10 to $15 an hour — leaves farmworkers with minimal and often inadequate money for food and is a contributor to the housing crisis in Salinas.

Homelessness has risen so steadily in recent years that the Salinas City Elementary School District now has a liaison for students without permanent housing.

Cheryl Camany, the school district’s homeless liaison, listed the types of dwellings where some farmworkers slept: “Tents, encampments, abandoned buildings,” she said. “They could be living in a toolshed, a chicken coop.”

Poverty and neglect among farmworkers is by no means new. Steinbeck, the valley’s most famous native son, wrote in the 1930s about the “curious attitude toward a group that makes our agriculture successful.”

“The migrants are needed, and they are hated,” he wrote, a sentiment that residents here feel has been revived with the election of Donald J. Trump as president and his promises to deport undocumented workers.

At a diabetes and nutrition awareness class held at a nursery school in King City, overweight women from farmworker families were given a barrage of statistics on the dangers of poor diets, especially those excessive in sugar.

“Two in five Americans will develop diabetes,” Lisa Rico, the instructor, told the class in Spanish. “But for us it’s one in two.”

The class was run by the Natividad Medical Foundation, a nonprofit that is part of Natividad Medical Center, a large hospital in Salinas.

Ms. Rico read to the class the findings of a survey of 1,200 young people in Monterey County, which includes Salinas: 72 percent of children under 10 years old and 83 percent of teenagers said they drank at least one soda a day; adolescents drank 4.5 times as many sugary drinks as water.

A study published in March by the U.C.L.A. Center for Health Policy Research reported that 57 percent of residents in Monterey County had diabetes or prediabetes, just slightly above the California average of 55 percent.

But Dr. Dana Kent, the medical director for health promotion and education at the Natividad Medical Foundation, said estimates among farmworkers might be low, especially among those who are undocumented and fearful to obtain medical services.

“We get a sense that there are a lot of people out there who are undiagnosed,” Dr. Kent said.

On a recent afternoon, workers from Mexico and El Salvador harvested heads of iceberg lettuce in a field in Gonzales, a city in the heart of the Salinas Valley. The workers moved so quickly — slicing, trimming the outer leaves and putting the heads of lettuce into plastic bags — that they looked like actors in a film played at an accelerated speed.

Angelica Beltran, the supervisor, said her workers typically ate six to eight tacos while at work and had two or three sodas during their shift.

“No one drinks diet soda,” she said. “It doesn’t taste good.”

Despite the frenetic pace of the work, farmworkers suffer from what Melissa Kendrick, the head of the Food Bank for Monterey County, calls the “obesity paradox of the poor.”

“They are fat, yes, but they are malnourished because all they are eating is garbage,” she said.

The consumption of cheap, starchy food has been a major contributor to the epidemic of obesity across America. But the rates among farmworkers here are significantly higher: 85 percent are overweight or obese compared with 69 percent nationally.

Some farmworkers in the Salinas Valley sleep next to the vegetables they cannot afford to buy.

In a row of dusty, barracks-style apartments straddled by railway tracks and vast fields of broccoli, Maria Hernandez, 60, pays $520 a month for two tiny rooms, each about 18 feet across. Her extended family are Mexican immigrants who have spent their lives farming and picking strawberries, celery and other crops. She became aware of the need to eat healthily when both her mother and her sister were diagnosed with diabetes.

“Although we are surrounded by it, we don’t eat it because it’s expensive,” said Antonia Tejada, Ms. Hernandez’s daughter, who works the night shift at McDonald’s. “We will buy a big bag of beans instead of a little thing of broccoli for $2 that won’t feed even one person.”

Only an hour south of Silicon Valley, the Salinas Valley is a rural setting with urban prices.

Israel de Jesus, who works as an interpreter at the Natividad Medical Center in Salinas, crowded into a home that rented for $1,600 a month when he was doing farm work.

“There’s no way to save money because of the bills and the rent,” Mr. de Jesus said. “But you have to save money so you can make it through the winter.”

Even when vegetables and other healthy foods are available or affordable, farmworkers sometimes opt for the satisfaction of comfort food.

Brigita Gonzalez rises every day at 3:30 a.m. to prepare food for her husband, who leaves for the fields an hour later. When she made him a salad once to accompany his tacos, he returned in the evening with the salad unfinished.

Ms. Gonzalez says her husband was needled by co-workers for eating a salad: “Everybody was like, ‘What are you eating?’”

Ms. Kendrick of the food bank said demand was strong for healthy foods, cultural preferences notwithstanding. The food bank gives out about five million meals a year and is raising money to build a large food warehouse on a six-acre plot.

Ms. Kendrick, who previously worked in Silicon Valley, said she was motivated by the idea that malnutrition and hunger were fixable in a country with so much wealth.

“I’ve spent time in India, the Middle East, Southeast Asia — third world countries where poverty is everywhere,” she said. “It’s shocking when it’s in your home state.”