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Watanabe-Galloway S, Chasek C, Yoder AM, Bell JE. Substance use disorders in the farming population: Scoping review. J Rural Health 2022; 38:129-150. [PMID: 33955045 DOI: 10.1111/jrh.12575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this scoping review is to summarize the current knowledge base in order to make recommendations for prevention and treatment of substance use disorders among the farming populations. METHODS We conducted a scoping review of peer-reviewed articles published between January 1989 and September 2019. The search yielded 3,426 citations and the final review was conducted on 42 articles. The full review was conducted by 4 authors to extract information about the target population, data collection methods, and main results. FINDINGS There were 21 articles on farmers and 21 articles on farmworkers. The majority of the articles were about alcohol. Overall, farmers had higher prevalence of risky alcohol consumption patterns than nonfarmers. The prevalence of risky alcohol consumption was also high among farmworkers compared to the general population. Risk factors for risky alcohol consumption included male gender, lower socioeconomic status, and psychological problems (eg, depression). Recommendations for prevention and intervention of alcohol disorders included policy development and implementation to curb alcohol access by taxation, screening of alcohol-related problems, and alternative means of recreation instead of alcohol consumption. CONCLUSIONS This review confirmed that alcohol-related problems are prevalent among farmers and farmworkers. More population-based research is called for to understand the additional risk factors of alcohol disorders and the prevalence of other substance-related disorders. Also, interventions should be tailored to the unique culture of farmers and farmworkers.
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Affiliation(s)
- Shinobu Watanabe-Galloway
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Christine Chasek
- Department of Counseling and School Psychology, University of Nebraska at Kearney, Kearney, Nebraska, USA
| | - Aaron M Yoder
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jesse E Bell
- Department of Environmental, Agricultural & Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Fávero JL, Meucci RD, Faria NMX, Fiori NS, Fassa AG. Alcohol consumption among tobacco farmers: prevalence and associated factors. CIENCIA & SAUDE COLETIVA 2018; 23:871-882. [PMID: 29538567 DOI: 10.1590/1413-81232018233.13102016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 06/22/2016] [Indexed: 11/22/2022] Open
Abstract
RESULTS This study aims to describe the prevalence of heavy drinking, high-risk alcohol consumption and associated factors among tobacco farmers. A cross-sectional study was carried out with 2,469 tobacco farmers over 18 years old in 2011. High-risk alcohol consumption was considered the intake of three or more standard doses per day for men or two or more for women. Heavy drinking was considered the intake of four or more standard doses per day for men and three or more for women. Hierarchical multivariate analysis was performed to investigate the association with socioeconomic, behavioral, and occupational variables. : The prevalence of high-risk and heavy drinking was of 4.7% and 1.09% among women and 30.8% and 4.8% among men, respectively. The factors associated with high-risk drinking for men and women were the percentage of income tobacco accounted for (PR 1.3 and 0.4), being an employee (PR 1.3 and 3.1), and use of pesticides (PR 1.5 and 2.1), respectively. Heavy drinking among men was associated with losing the crop (PR 1.6), attending religious activities (PR 0.3), and hours working in agriculture (PR 0.6). Occupational factors were associated wit high-risk alcohol consumption among men. The associated factors vary according to the pattern of consumption assessed.
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Affiliation(s)
- Juliana Lopes Fávero
- Núcleo de Vigilância Epidemiológica Hospitalar, Hospital Universitário Cassiano Antônio de Moraes. Av. Marechal Campos 1355, Santos Dumont. 29042-715 Vitória ES Brasil.
| | | | | | - Nadia Spada Fiori
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Anaclaudia Gastal Fassa
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
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Brew B, Inder K, Allen J, Thomas M, Kelly B. The health and wellbeing of Australian farmers: a longitudinal cohort study. BMC Public Health 2016; 16:988. [PMID: 27634298 PMCID: PMC5025556 DOI: 10.1186/s12889-016-3664-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 09/12/2016] [Indexed: 11/13/2022] Open
Abstract
Background Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. Methods The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. Results Farmers who lived remotely reported worse mental health (β −0.33, 95 % CI −0.53, −0.13) and wellbeing (β −0.21(95 % CI −0.35, −0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. Conclusions Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3664-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bronwyn Brew
- Bathurst Rural Clinical School, Western Sydney University, Bathurst Base Hospital, Howick St, Bathurst, NSW, Australia. .,Centre for Rural and Remote Mental Health, University of Newcastle, Forest Road, Orange, NSW, Australia. .,Medical Epidemiology and Biostatistics Department, Karolinska Institute, Stockholm, SE-171 77, Sweden.
| | - Kerry Inder
- Centre for Rural and Remote Mental Health, University of Newcastle, Forest Road, Orange, NSW, Australia.,School of Nursing and Midwifery, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Joanne Allen
- Massey University, Private Bag 11222, Palmerston North, New Zealand.,Centre for Brain and Mental Health Research, and School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
| | - Matthew Thomas
- School of Psychology, Charles Sturt University, Panorama Drive, Bathurst, NSW, Australia
| | - Brian Kelly
- Centre for Brain and Mental Health Research, and School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW, Australia
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Davis-Lameloise N, Philpot B, Janus ED, Versace VL, Laatikainen T, Vartiainen EA, Dunbar JA. Occupational differences, cardiovascular risk factors and lifestyle habits in South Eastern rural Australia. BMC Public Health 2013; 13:1090. [PMID: 24266886 PMCID: PMC3866476 DOI: 10.1186/1471-2458-13-1090] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 11/20/2013] [Indexed: 12/31/2022] Open
Abstract
Background In rural and remote Australia, cardiovascular mortality and morbidity rates are higher than metropolitan rates. This study analysed cardiovascular and other chronic disease risk factors and related health behaviours by occupational status, to determine whether agricultural workers have higher cardiovascular disease (CVD) risk than other rural workers. Methods Cross-sectional surveys in three rural regions of South Eastern Australia (2004-2006). A stratified random sample of 1001 men and women aged 25-74 from electoral rolls were categorised by occupation into agricultural workers (men = 214, women = 79), technicians (men = 123), managers (men = 148, women = 272) and ‘home duties’ (women = 165). Data were collected from self-administered questionnaire, physical measurements and laboratory tests. Cardiovascular disease (CVD) and coronary heart disease (CHD) risk were assessed by Framingham 5 years risk calculation. Results Amongst men, agricultural workers had higher occupational physical activity levels, healthier more traditional diet, lower alcohol consumption, lower fasting plasma glucose, the lowest proportion of daily smokers and lower age-adjusted 5 year CVD and CHD risk scores. Amongst women, managers were younger with higher HDL cholesterol, lower systolic blood pressure, less hypertension, lower waist circumference, less self-reported diabetes and better 5 year CVD and CHD risk scores. Agricultural workers did not have higher cardiovascular disease risk than other occupational groups. Conclusions Previous studies have suggested that farmers have higher risks of cardiovascular disease but this is because the risk has been compared with non-rural populations. In this study, the comparison has been made with other rural occupations. Cardiovascular risk reduction programs are justified for all. Programs tailored only for agricultural workers are unwarranted.
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Affiliation(s)
| | | | | | | | | | | | - James A Dunbar
- Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, PO Box 423, Warrnambool, VIC 3280, Australia.
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Inder KJ, Handley TE, Fitzgerald M, Lewin TJ, Coleman C, Perkins D, Kelly BJ. Individual and district-level predictors of alcohol use: cross sectional findings from a rural mental health survey in Australia. BMC Public Health 2012; 12:586. [PMID: 22853803 PMCID: PMC3491021 DOI: 10.1186/1471-2458-12-586] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 06/25/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Excessive alcohol use is a significant problem in rural and remote Australia. The factors contributing to patterns of alcohol use have not been adequately explained, yet the geographic variation in rates suggests a potential contribution of district-level factors, such as socio-economic disadvantage, rates of population change, environmental adversity, and remoteness from services/population centres. This paper aims to investigate individual-level and district-level predictors of alcohol use in a sample of rural adults. METHODS Using baseline survey data (N = 1,981) from the population-based Australian Rural Mental Health Study of community dwelling residents randomly selected from the Australia electoral roll, hierarchal logistic regression models were fitted for three outcomes: 1) at-risk alcohol use, indicated by Alcohol Use Disorders Identification Test scores ≥8; 2) high alcohol consumption (> 40 drinks per month); and 3) lifetime consequences of alcohol use. Predictor variables included demographic factors, pre-dispositional factors, recent difficulties and support, mental health, rural exposure and district-level contextual factors. RESULTS Gender, age, marital status, and personality made the largest contribution to at-risk alcohol use. Five or more adverse life events in the past 12 months were also independently associated with at-risk alcohol use (Adjusted Odds Ratio [AOR] 3.3, 99%CI 1.2, 8.9). When these individual-level factors were controlled for, at-risk alcohol use was associated with having spent a lower proportion of time living in a rural district (AOR 1.7, 99%CI 1.3, 2.9). Higher alcohol consumption per month was associated with higher district-level socio-economic ranking, indicating less disadvantage (AOR 1.2, 99%CI 1.02, 1.4). Rural exposure and district-level contextual factors were not significantly associated with lifetime consequences of alcohol use. CONCLUSIONS Although recent attention has been directed towards the potential adverse health effects of district or community level adversity across rural regions, our study found relatively few district-level factors contributing to at-risk alcohol consumption after controlling for individual-level factors. Population-based prevention strategies may be most beneficial in rural areas with a higher socio-economic ranking, while individual attention should be focused towards rural residents with multiple recent adverse life events, and people who have spent less time residing in a rural area.
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Affiliation(s)
- Kerry J Inder
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Tonelle E Handley
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia
| | - Michael Fitzgerald
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Centre for Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW, Australia
| | - Terry J Lewin
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia
| | - Clare Coleman
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW, Australia
| | - David Perkins
- Department of Rural Health, Broken Hill, University of Sydney, Sydney, NSW, Australia
| | - Brian J Kelly
- Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle, NSW, Australia
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW, Australia
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