Self-reported stress symptoms in farmers

The Intersection of Gender and Occupational Roles in Agriculture: Stress, Resilience, and Alcohol Behaviors of US Farmers

OBJECTIVES

The purposes of this study were to explore behavioral and mental health outcomes among a sample of farmers living in the United States and to compare differences between male and female farmers.

METHODS

An online cross-sectional survey was distributed within the farming community by researchers, farming consultants, and community partners. χ 2 and analysis or variance analyses were used to explore relationships between variables of interest.

RESULTS

Female survey respondents reported significantly higher perceived stress and significantly lower resilience than their male counterparts. A significant interaction effect was observed between gender and farm roles on alcohol consumption patterns, with female farm owners and managers reporting binge drinking behavior most frequently.

CONCLUSIONS

This study identified distinct differences between respondents in terms of stress, resilience, and alcohol consumption patterns, based on both gender and occupational roles.

Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study

Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PERSPECTIVE: This study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.

One Welfare: Assessing the Effects of Drought and the COVID-19 Pandemic on Farmers' Well-Being and Their Perception of Goats' Welfare

Considering the interconnections between human well-being, animal welfare, and the environment, this study aimed to investigate the impacts of drought and the COVID-19 pandemic on small-scale goat farmers' well-being and their perception of goats' welfare following the One Welfare framework. Using a telephone survey, close-ended questions, and Likert scales, we assessed the impacts of drought and the COVID-19 pandemic on human well-being and animal welfare in the Coquimbo region of Chile. The DASS-21 questionnaire was used to evaluate farmers' mental health. Goat farmers perceived the scarcity of water and food for animals as factors that negatively affected animal productivity and welfare and caused an increase in farmers' stress levels. Farmers who had not been visited by a veterinarian showed higher levels of stress than those who received one visit during the year (M = 10 vs. 2, p = 0.025). Additionally, farmers who perceived better welfare of their animals showed lower levels of depression (rs = -0.17, p = 0.048), anxiety (rs = -0.21, p = 0.016), and stress (rs = -0.33, p < 0.001). These findings emphasize the importance of addressing farmers' mental health and veterinary support as crucial aspects to ensure both goat welfare and farm productivity.

A cross-sectional study of alcohol, opioid use, and anxiety in agriculturally based occupations

PURPOSE

Although there are many studies that have examined substance use and mental health concerns in rural areas, there is a paucity of research related to the prevalence of substance use and mental well-being in agriculturally based occupations. This study aimed to determine the prevalence of alcohol and opioid misuse and anxiety among adults in agriculturally based occupations in the rural Midwest and to determine the risk factors for alcohol misuse.

METHODS

Data were collected via mailed surveys with 1,791 surveys returned. Participants completed the Alcohol Use Disorder Identification Test, the Drug Abuse Screening Test-1, the Generalized Anxiety Disorder Screener, and reported demographic data. Multivariable logistic regression was used to examine factors associated with alcohol misuse.

RESULTS

Younger age, male, not married, agriculturally based workers were significantly associated with alcohol misuse. For opioid use, the highest prevalence rate (10%) was found among direct agricultural workers who were not married and in the age group 19-39. The highest anxiety prevalence rate was found in participants aged 19-39 (15.5%) who also scored in the highest level of alcohol misuse with a prevalence rate of 27.9%.

CONCLUSIONS

Future research is suggested in the areas of gender identity and anxiety in agricultural populations and agriculturally based occupations as protective factors for opioid misuse.

Occupational stress among farm and ranch operators in the midwestern United States

BACKGROUND

This study used surveillance data from 2018 and 2020 to test the stability of work-related strain symptoms (high stress, sleep deprivation, exhaustion) with demographic factors, work characteristics, and musculoskeletal symptoms among farm and ranch operators in seven midwestern states of the United States.

METHODS

Cross-sectional surveys were conducted among farm and ranch operators in 2018 (n = 4423) and 2020 (n = 3492). Operators were asked whether, in the past 12 months, they experienced extended work periods that resulted in high stress levels, sleep deprivation, exhaustion/fatigue, or other work-related strain symptoms. Covariates included personal and demographic factors, work characteristics, number of injuries, work-related health conditions, and exposures on the operation. Summary statistics were tabulated for explanatory and outcome variables. The classification (decision) tree approach was used to assess what variables would best separate operators with and without reported strain symptoms, based on a set of explanatory variables. Regularized regression was used to generate effect estimates between the work strain variables and explanatory variables.

RESULTS

High stress level, sleep deprivation, and exhaustion were reported more frequently in 2018 than 2020. The classification tree reproduced the 2018 model using 2020 data with approximately 80% accuracy. The mean number of reported MSD symptoms increased slightly from 1.23 in 2018 to 1.41 in 2020. Older age, more time spent in farm work, higher gross farm income (GFI), and MSD symptoms in six body regions (ankles/feet, knees, lower back, neck, shoulders, wrists/hands) were associated with all three work strain symptoms.

CONCLUSIONS

Musculoskeletal pain and discomfort was a strong predictor for stress, sleep deprivation, and exhaustion among farmers and ranchers. This finding indicates that reducing MSD pain and discomfort is beneficial for both physical and mental health.

What Impacts Perceived Stress among Canadian Farmers? A Mixed-Methods Analysis

Globally, farmers report high levels of occupational stress. The purpose of this study was to identify and explore factors associated with perceived stress among Canadian farmers. A sequential explanatory mixed-methods design was used. An online cross-sectional national survey of Canadian farmers (n = 1132) was conducted in 2015-2016 to collect data on mental health, demographic, lifestyle, and farming characteristics; stress was measured using the Perceived Stress Scale. A multivariable linear regression model was used to investigate the factors associated with perceived stress score. Qualitative interviews (n = 75) were conducted in 2017-2018 with farmers and agricultural sector workers in Ontario, Canada, to explore the lived experience of stress. The qualitative interview data were analyzed via thematic analysis and then used to explain and provide depth to the quantitative results. Financial stress (highest category-a lot: (B = 2.30; CI: 1.59, 3.00)), woman gender (B = 0.55; CI: 0.12, 0.99), pig farming (B = 1.07; CI: 0.45, 1.69), and perceived lack of support from family (B = 1.18; CI: 0.39, 1.98) and industry (B = 1.15; CI: 0.16-2.14) were positively associated with higher perceived stress scores, as were depression and anxiety (as part of an interaction). Resilience had a small negative association with perceived stress (B = -0.04; CI: -0.06, -0.03). Results from the qualitative analysis showed that the uncertainty around financial stress increased perceived stress. Women farmers described the unique demands and challenges they face that contributed to their overall stress. Results from this study can inform the development of mental health resources and research aimed at decreasing stress among Canadian farmers.

"Farmers Aren't into the Emotions and Things, Right?": A Qualitative Exploration of Motivations and Barriers for Mental Health Help-Seeking among Canadian Farmers

Working in agriculture has been associated with an increased prevalence of psychological distress and mental health concerns. Farmers are also less likely than non-farmers to seek-help for their mental health. Previous research examining help-seeking among farmers has focused predominantly on male farmers, and has not included many of the Canadian agricultural commodity groups or provinces. The goal of this study was to explore perceptions of farmer help-seeking for mental health amongst farmers and people who work with farmers. The study objectives were to characterize the motivations and barriers to help-seeking behaviours. Semi-structured interviews were conducted with 75 farmers and individuals who work with farmers in Ontario, Canada, between 2017 and 2018. Interviews were conducted in person, and by telephone when needed. Topics of discussion included farming stresses and their impacts; personal well-being; agricultural crises and mental health help-seeking; use of mental health supports; motivators and barriers to help-seeking; and perceived ideals for mental health supports. Thematic analysis was conducted collaboratively by three authors using inductive and deductive coding. Our analysis resulted in five themes around help-seeking motivations and barriers: 1) Accessibility of mental health supports and services; 2) Stigma around mental health in the agricultural community; 3) Anonymity and/or lack of anonymity in seeking support; 4) Farm credibility; and 5) Recommendations for implementing mental health services for the agricultural community. This study provides insights around how farming culture and the accessibility and delivery of services may influence help-seeking for mental health, and proposes strategies to break down barriers to help-seeking in this population.

Stress, anxiety, depression, and resilience in Canadian farmers

PURPOSE

To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers.

METHODS

An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016.

RESULTS

1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities.

CONCLUSIONS

These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

Farmer Burnout in Canada

While farmers in several countries worldwide are reported to be at higher risk for poor mental health outcomes like chronic stress, depression, and anxiety, there is a paucity of research on burnout in farmers. This cross-sectional study used an online survey administered between September 2015 and February 2016 to investigate burnout (as measured by the Maslach Burnout Inventory-General Survey (MBI-GS)) amongst farmers in Canada. The specific objectives were to measure the three components of burnout (exhaustion, cynicism, and professional efficacy), and to explore potential associated risk factors, as well as to determine the prevalence of the different burnout profiles (engaged, ineffective, overextended, disengaged, and burnout). MBI-GS results were obtained from 1075 farmers. Approximately 70% of the study sample identified as male and 30% as female, and participants were from a variety of farming commodities. Scores for exhaustion, cynicism, and professional efficacy were all higher than international norms. While 43% of participants were classified as engaged, 44% were classified in the ineffective, overextended, or disengaged profiles (i.e., intermediate profiles on the engagement - burnout continuum), and 12% were classified in the burnout profile. Risk factor results highlighted the positive effects of farmer support from spouse/romantic partner, friends, and industry. Overall, the results from this study demonstrate cause for concern with respect to farmer burnout, suggest potential avenues for intervention, and serve as a call to action to better support farmers in Canada.

Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review

Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.

Exploring the Drivers of Irrigator Mental Health in the Murray–Darling Basin, Australia

There has been little work conducted on how landholders’ farm management approaches and financial capital (specifically (i) farm method such as organic farming and (ii) financial profitability) may impact mental health. In particular, there is emerging evidence that an increase in natural farm capital and environmental conditions may improve farmers’ wellbeing. We used a 2015–2016 survey, which randomly sampled 1000 irrigators from the southern Murray–Darling Basin, to model the drivers of irrigators’ psychological distress. Results highlight that worsening financial capital (namely, lower farmland value, higher farm debt, lower percentage of off-farm income, lower productivity change over the past five years, and lower net farm income) was the most statistically significant factor associated with increased irrigator distress. In addition, there was some evidence that being a certified organic irrigator was also associated with lower psychological distress; however, it was only weakly significant in our overall model, with the most significance within the horticultural industry model. Contrary to expectations, drought and water scarcity were not the main drivers of psychological distress in the time-period studied, with their influence seemingly through reducing financial capital as a whole.

Who and How: Exploring the Preferred Senders and Channels of Mental Health Information for Wisconsin Farmers

Unfavorable economic and environmental conditions have fueled the development of mental health resources and services for farmers. However, it is unclear who farmers want mental health information from (senders) and how they want mental health information delivered (channels). A self-administered questionnaire was used to determine the preferred senders of mental health information and the preferred channels of mental health information. Farmers were most receptive to receiving mental health information from medical providers, spouses/family members, and friends. Among the channels of information, respondents were interested in receiving mental health information from farm newspapers/magazines and one-on-one in person. Our findings have pragmatic implications for agricultural safety and health and public health organizations working to disseminate mental health information to farmers. Receptiveness to specific senders and channels of information among farmers should inform resource dispersion and future intervention.

Farm-Related Concerns and Mental Health Status Among Norwegian Farmers

The agricultural sector in Norway has undergone structural changes over the past 50 years. The objective of this study was to analyze the distribution of concerns about farm economy, work time, and mental complaints among Norwegian farmers. In a sample of single principal owner-operators (n = 2,676), we calculated the unadjusted and adjusted odd ratios (ORs) for concerns about the farm economy, concerns for insufficient time to complete work, and high symptom load of mental complaints. Structural equation modeling (SEM) was used to explore the associations between farm characteristics, concerns, and mental health. Farmers had a high probability for an increased symptom load of mental complaints. The level of farm income was more strongly associated with economic concerns and mental health concerns when a major part of total household income resulted from farming. The high workload required in farming combined with off-farm supplemental employment was additionally associated with higher levels of time concerns and mental complaints. Norwegian farmers have a relatively high workload both in farming and in off-farm work but are able to make sustainable plans for their individual workload needs. The high individual workload in both these arenas poses a challenge, but was not associated with a greater probability for a high symptom load of mental complaints.

Stress and cognitive function in Latino farmworkers

BACKGROUND

Job stress has been associated with cognitive function, but the relationship is often overlooked when considering occupational health and safety issues of farmworkers. This study examined the relationship between stress and change in stress with change in cognitive function in a representative sample of 123 Latino farmworkers.

METHODS

A prospective study design was used in which stress and cognitive function data were collected at baseline and at 3-month follow-up. Linear regression models were used for analyses. Potential confounders included baseline gender, age, education, number of years worked in U.S. agriculture, ever smoking status, self-rated health, and depressive symptoms.

RESULTS

Baseline stress was significantly correlated with baseline cognitive function (r = -0.27; P < 0.001). Adjusting for confounders, increased baseline stress was associated with greater decline in cognitive function (P = 0.024). Short-term changes in stress were not associated with cognitive change in this cohort.

CONCLUSIONS

Stress at work is an important risk factor for poor cognitive function. This analysis suggests several implications for the provision of health care and for the organization of work for farmworkers.

Farmers' suicides in the Vidarbha region of Maharashtra, India: a qualitative exploration of their causes

Background:

To explore the various perceived reasons for farmers’ suicides in the Vidarbha region of Maharashtra, their common factors, and to suggest solutions.

Methods:

The present formative research was undertaken in the 23 villages surrounding the Anji Primary Health Centre, located in the Vidarbha region of Maharashtra, India. A triangulation of free list and pile sort exercises was used. The data was analyzed by Anthropac 4.98.1/X software. This was followed by a semi-structured focus group discussion. To increase the validity of the results, these findings were presented to the participants and later they were circulated to the 26 farmers’ clubs in the villages for comment and discussion during their monthly, village based meetings.

Results:

Farmers perceived debt, addiction, environmental problems, poor prices for farm produce, stress and family responsibilities, government apathy, poor irrigation, increased cost of cultivation, private money lenders, use of chemical fertilizers and crop failure as the reasons for farmers’ suicides. Participants suggested solutions such as self-reliance and capacity building among farmers, a monitoring and support system for vulnerable farmers, support and counseling services, a village-level, transparent system for the disbursement of relief packages.

Conclusions:

Farmers’ suicides in Vidarbha are caused by the complex interplay of social, political and environmental constraints. Hence, a comprehensive intervention to ensure self reliance and capacity building among farmers in modern farming techniques , monitoring and support system for vulnerable farmers, a village-level, transparent system for disbursement of relief packages is required to prevent farmer suicides in the near future. Apart from this, there is a need to strengthen the National Mental Health Program at primary health care level to offer support and counseling to vulnerable farmers in rural area.

Coping with Drought

The slow-onset disasters, like drought, consistently deplete farmers’ resources at a faster rate than they can be replenished. Drought has been a recurring phenomenon in the southern regions of Iran and it has repeatedly been a leading cause of declining production and great human suffering. In view of the fact that poor and small farmers are more vulnerable, it is expected that they would be the main victims of such conditions. Investigation of rural poor strategies in drought conditions and assessing the impact of the governmental interventions to mitigate the drought consequences, especially on the poor state, constituted the main objectives of this study. Case study was the research method and an in-depth interview was used as the main technique of data collection. Findings revealed that farmers’ attitude towards drought was mostly metaphysical rather than physical and environmental. Poor farmers were harshly affected by the drought. It hurt them not only because of their attitude or belief, but also because of their low socio-economical position. Moreover, governmental interventions worsen the poor farmers’ situation because they treated all the farmers’ homogeneously. Much of governmental supportive services were benefited by non-poor farmers. On the contrary, the poor farmers’ who were in dire need, benefited the least. Therefore, governmental interventions fail to support the poor farmers, because it considers all stratums similar and it only focuses on productive policies. Some recommendations are pre-sented at the end of the article based on research findings.

Policies, programs, and regulations to support the transition to sustainable agriculture in Canada

The development of political strategies in Canada to support the transition from conventional to sustainable agriculture has been limited by the absence of a comprehensive conceptual framework for identifying the most critical policies, programs, and regulations. In this paper, we propose a framework that uses an efficiency/substitution/redesign spectrum to categorize both sustainable fanning systems and government activities. The framework is then used to identify a diverse range of short, medium, and longterm strategies to be pursued by governments in Canada to support the transition. Strategies discussed include research, diffusion, and training; market development; and safety net programs and tax provisions. Finally, the implications and implementation of the redesign concept for food production, processing, and distribution are outlined.

The psychosocial and socioeconomic consequences of bovine spongiform encephalopathy (BSE): a community impact study

The detection of the first indigenous case of bovine spongiform encephalopathy (BSE) in Canada on May 20, 2003, had significant consequences for the livestock industry. As a result, borders were closed by several trade partners, particularly the United States. The outbreak led to direct and indirect economic impacts to the "cattle" industry exceeding $6 billion. As a consequence of a number of risk management interventions implemented by the Canadian Food Inspection Agency (CFIA) and provincial agencies, the BSE outbreak appears to have been largely contained. The initial results from our study of the socioeconomic and psychosocial impact of BSE on the health and well-being of rural and farm families living in Canada, a topic that remains largely unexamined are presented. Our analysis of the outbreak raises a number of questions concerning the resulting consequences for farmers, their families, and their communities, including considerations from a social determinants' of health perspective. In particular, our preliminary findings reveal that 5 years following the detection of the first indigenous case of BSE in Canada, ongoing uncertainty and stress resulting from unrecoverable financial losses continue to weigh heavily on the health and well-being of farmers, their families, and survival and sustainability of agricultural communities.

Suicide mortality and agricultural rationalization in post-war Europe

BACKGROUND

The relationship between agricultural rationalization and suicide mortality has been little researched. On the basis of the hypothesis that agricultural rationalization leads to more suicide, this study investigated whether a general relationship could be found between structural change in agriculture and suicide mortality in post-war Europe.

METHOD

Due to the expected small size of the effect, the data were deliberately collected so as to maximize the variation in the independent variable. Annual national-level data on suicide mortality, the percentage of the work force in agricultural employment, and the unemployment level were collected from those countries and 10-year periods where the structural changes (reductions in employment) in agriculture between 1950 and 1995 had been most and least pronounced. In order to avoid confounders, the annual changes in the variables' values were correlated with each other, adding a control for the level of unemployment, and allowing for lagged effects.

RESULTS

The annual changes in the levels of agricultural employment and those of suicide mortality did not covary at all. Controlling for unemployment levels did not change this, nor could any lagged effects be found.

CONCLUSIONS

At the most general level, no causal relation between agricultural rationalization and suicide mortality was detected. This lack of a universal relation does not, however, preclude the possibility of the relationship existing given certain socio-historical circumstances.

Tideswell health survey: a population survey of the health needs and service utilization of a farming community

OBJECTIVES

In the UK, there have been no epidemiological studies focusing on the general health status of rural communities, despite the prevalence of rural deprivation and the widely acknowledged link between poverty and ill health. The primary objective of this study was to test the null hypothesis that no differences existed between the health status of the farming and non-farming populations registered with one general practice, in order to inform a local health needs assessment. The secondary objective was to test the suitability of the research method as a model for a wider study.

STUDY DESIGN

A postal questionnaire survey was undertaken with the total farming population (n = 248) registered with Tideswell general practice, and matched with an equivalent random sample of non-farmers (n = 248) from the remainder of the practice list. The main outcome measures were income, general health status, quality of life (EQ5D), musculoskeletal problems, mental health status and service utilization.

RESULTS

Significant differences were found between the two groups. Farmers were identified as having health needs that were greater than those found in the local non-farming sample. In addition, the observed EQ5D value for farmers was found to be significantly lower than that found in social classes IV and V (0.78 vs 0.82) and the UK mean.

CONCLUSIONS

This modest controlled study is the first of its kind in the UK. Health inequalities and inequities were identified that may be generalizable to other UK hill farmers. However, a larger, wider epidemiological study across different types of farming groups is now required to gain a fuller understanding of the health status of this indigenous rural population. The methodology employed in this study was successful and could serve as a model for such a study.

Farming and mental health problems and mental illness

BACKGROUND

Farmers experience one of the highest rates of suicide of any industry and there is growing evidence that those involved in farming are at higher risk of developing mental health problems. This article provides an overview of the literature examining mental health issues experienced by farming populations in the United Kingdom, Europe, Australia, Canada and the United States and identifies areas for further research.

METHOD

A literature review (Medline, Science Direct, Ingenta, Proquest and PsychINFO) was carried out using the words 'farmers', 'agriculture', 'depression', 'mental health', 'mental illness', 'stress', and 'suicide', as well as a review of relevant papers and publications known to the authors. (Papers not written in English and those published prior to 1985 were excluded.)

RESULTS

Fifty-two papers were identified with the majority focusing on stress and coping styles in farmers (24). A number of studies also focused on neuropsychological functioning and agricultural chemical use (7), depression (7), suicide (9), general mental health (4) and injury and mental health (1). This body of research studied male farmers, female farmers, farm workers, farming families, and young people living on farms. Research to date indicates that farmers, farm workers and their respective families face an array of stressors related to the physical environment, structure of farming families and the economic difficulties and uncertainties associated with farming which may be detrimental to their mental health.

CONCLUSION

Whilst suicide rates in some groups of farmers are higher than the general population, conclusive data do not exist to indicate whether farmers and farming families experience higher rates of mental health problems compared with the non-farming community. It is clear, however, that farming is associated with a unique set of characteristics that is potentially hazardous to mental health and requires further research.

Wisdom from the drought: Recommendations from a consultative conference

OBJECTIVE

Drought is a serious and recurring problem for rural and remote Australia. This paper reports the proceedings of a consultative conference concerning the mental health effects of drought held at the Centre for Rural and Remote Mental Health, Orange, in December 2003. The conference objective was to record the collective experience of government and non-government agencies dealing with the effects of drought in rural areas and to collate information for the development of a mental health strategy for future drought.

DESIGN

Participants were recruited in consultation with rural mental health organisations. Questions about mental health service strategies to minimise and respond to the mental health impact of the drought were posed to participants. Qualitative data were collected using a Nominal Group Technique.

SETTING

The Centre for Rural and Remote Mental Health, Bloomfield Hospital, Orange, New South Wales.

PARTICIPANTS

Twenty-three professionals participated, including representatives from New South Wales Health, Mental Health, and Agriculture; the Department of Community Services, and Rural Financial Counsellors.

MAIN OUTCOME MEASURE

Qualitative analysis of participant responses.

RESULTS

Three general strategies emerged as the most beneficial in minimising adverse mental health outcomes in times of drought: community-building and education about the physical, financial and mental health effects of drought; co-operation between and co-ordination of agencies in delivering mental health and other drought support; and continuity and planning of improved mental health services.

CONCLUSIONS

Drought has a serious effect on the mental health of communities. It is important to plan a response beyond the end of the drought, bringing together different government and non-government agencies to build community capacity to address common mental health needs.

Chronic disease risk in central New York dairy farmers: results from a large health survey 1989-1999

BACKGROUND

The agricultural workplace presents a variety of health and safety hazards; it is unknown whether farm work may be a risk factor for certain chronic diseases.

METHODS

The health survey data from a large rural population in central New York were used from two studies (1989, 1999) to assess both 1999 prevalence and 10-year incidence of self-reported diabetes, heart disease, hypercholesterolemia, and hypertension among farm (predominantly dairy) and non-farm residents. The 1999 asthma prevalence was also assessed.

RESULTS

Multiple logistic regression models for 1999 prevalence found statistically significant protective effects of farming for hypertension (OR=0.83, P=0.0105) and hypercholesterolemia (OR=0.853, P=0.0522). Non-significant results were seen for heart disease (OR=0.67, P=0.128) and diabetes (OR=0.856, P=0.1358). The model for 1999 asthma prevalence showed a significantly elevated risk for farming (OR=1.542, P=0.0004). Logistic models created for the 10-year incidence of hypertension, hypercholesterolemia, diabetes, and heart disease did not show a significant effect for farming.

CONCLUSIONS

The protective effect of farming observed for the 1999 prevalence of hypertension and hypercholesterolemia was not seen for the 10-year incidence of these diseases.

Suicide in Australian farming, 1988-1997

OBJECTIVES

To identify and describe suicide data for occupational classifications relating to farm managers and agricultural labourers for Australia for the period 1988 to 1997, and to relate resultant suicide rates to farmers' terms of trade.

METHOD

Descriptive and linear regression analysis of aggregated mortality data.

RESULTS

In the period 1988 to 1997, 921 suicides were identified. The majority of these suicides were farm managers (67.4%). Farm manager suicides occurred predominantly in older age groups (55 + years). In comparison agricultural labourer suicides were younger, with the majority of suicides occurring in the 15-39 years age group. The most common methods for both groups were firearms (particularly hunting rifles and shot guns), hanging and motor vehicle exhaust gas. These methods accounted for approximately 81% of all male farm suicides. Firearms accounted for 51% of male farm suicide, in comparison to 23% for the wider Australian male population for the same period. Estimated age standardized rates per 100 000 for male farm managers for the 10-year period ranged from 24.8 to 51.4. For male agricultural labourers these rates ranged from 23.5 to 41.9. Analyses also revealed a negative correlation (r = -0.75, p < 0.01) between farm manager suicide rates and farmers' terms of trade.

CONCLUSION

Male farm manager and agricultural labourer suicide rates are higher than male national rates and rates in the wider rural population, particularly in the later years of the period investigated. Firearms prefigure as the most common method of suicide, despite decreases in this method in the wider rural population. Establishing more accurate denominator data for the farming community is a priority, as is preventative action that accounts for unique aspects of farm life.

Safe handling of agricultural pesticides in Minnesota: results of a county-wide educational intervention

Safe pesticide handling in a group of Minnesota farmers, aged 40 years and older, was influenced through the use of a multifaceted, countywide educational intervention. Two intervention counties and two control counties were involved in this effort. The intervention consisted of mailed pesticide information to farm households, educational programs on pesticides for county physicians, elementary school training modules on pesticides and the use of safe pesticide handling displays in key business areas by agricultural extension agents. Five hundred eight farmers were identified as pesticide users (186 in the intervention counties and 322 in the control counties). The use of gloves and other protective clothing while handling pesticides increased in the intervention group. Improvement was greater in those who had used protective equipment the least before the intervention. From these results, it appears that a broad-based educational intervention might have a modest impact in how farmers protect themselves when using pesticides.

Stress in farmers: a survey of farmers in England and Wales

OBJECTIVES

To investigate potential sources of stress for farmers in England and Wales

METHOD

A postal questionnaire was sent to a randomly selected group of 800 members of the National Farmers' Union and 200 members of the Farmers' Union of Wales.

RESULTS

500 questionnaires (51%) were returned completed between October 1995 and March 1996. Farmers had problems with record keeping and paperwork (62%), difficulty understanding forms (56%), and problems arising from the effects of new legislation and regulations (49%). Nearly a quarter (23%) reported financial problems and most worried about money (79%). Very few were socially isolated, with over 90% having at least one confidant. 70% worked > 10 hours a day, and 31% had health problems which interfered with their work, including more than a quarter of those < 50. 16% of the sheep farmers reported symptoms which they attributed to organophosphate poisoning. The farmers most vulnerable to financial and other problems were those with small farms and mixed farming operations. Farmers in Wales also seemed more vulnerable than those in England, but a lower response rate from members of the Farmers' Union of Wales means this difference should be interpreted cautiously.

CONCLUSION

The survey confirms findings from several regional studies that many farmers are experiencing considerable stress from various causes. Local and national initiatives to assist farmers, including outreach programmes, should be encouraged. Policy makers should be aware of the potential impact of legislation, particularly on the more vulnerable groups.

A study of suicide in farmers in England and Wales

The proportional mortality ratio for suicide is higher in farmers than in the general population. The reasons for this are likely to be complex, but may include easy availability of firearms, stress related to work, financial difficulties, and family problems. A psychological autopsy study of suicide in 84 farmers who died between 1991-1994 is presented and some preliminary findings are discussed.