Food miles are often the sole criteria by which agricultural sustainability is assessed. Social justice is an alternative measure. Social justice is comprised of a number of component parts of which health is but one. Little appears to be known of the health status of farm workers. This study describes the selfreported health status of farm workers in four countries employed in producing fresh vegetables for UK supermarkets. The study had five objectives: i. To assess the health and well being of farm workers in UK vegetable production. ii. To compare the health of UK farm workers with farm workers from other countries supplying similar products to the UK market. iii. To explore the potential impact of pesticides on farm worker health, both at the policy and farm level. iv. To identify major causes of poor health (where it occurs) and identify its determinants. v.Consider the ethical implications of supplying to the UK horticulture market from production in developing countries. Over 2500 completed questionnaires were collected from farmers and farm workers in the UK, Spain, Kenya, and Uggnda between 2006 and 2007. Pesticide data was collected from a number of farms in the UK, Kenya and Uganda but not from Spain. Workers employed on Kenyan export farms scored significantly higher than both the population norm and workers from the three other participating countries. There was no relationship between the self-reported health of a worker and the environmental impact rating of pesticides used on a given farm. The farm worker health scores have important implications for policy makers as ethical purchasing decisions will need to offset the food miles of a given vegetable by the social benefits such as health that devolve from purchasing vegetables from developing countries. Ethical purchasing decisions might be shaped in the future by the concept of buying from wherever improves the health status of producers rather than wherever is nearest.