The health and wellbeing of Australian farmers: a longitudinal cohort study

Abstract

BackgroundIsolation, 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.MethodsThe 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.ResultsFarmers 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.ConclusionsRemoteness 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 materialThe online version of this article (doi:10.1186/s12889-016-3664-y) contains supplementary material, which is available to authorized users.

Between the Social and Economic Dimensions of Sustainability in Rural Areas—In Search of Farmers’ Quality of Life

“…Talking about urban-rural differences, it is worth noting that, naturally, in rural areas there are longer distances between objects, including important institutions. Thus, remoteness is perceived as a factor lowering quality of life [164], because it can limit access to different institutions. However, in our research, a rise in distance from a set of institutions was correlated with a rise in the latent variable living conditions, which in consequence improved the mental comfort variable.…”

“…This means that the good current economic situation is usually burdened with sacrifices in personal life. On the other hand, scholars have underlined that the bad economic situation of farmers, combined with other stress-generating factors (such as fluctuating weather, long work hours, lack of information, isolation, remoteness) result in the low level of farmers' mental comfort [164,168,169].…”

Environmental factors and suicide in Australian farmers: A qualitative study

“…Remote farmers self-reported worse mental health and wellbeing than remote non-farm workers regardless of recent adverse life events, financial hardship or climatic adversity. 41 This compared to regional farmers, who did not differ from regional non-farm workers on either indice. 41 Geographical isolation, combined with loneliness, withdrawal and the intrinsic isolation of farming as an occupation 3,23 as well as sociocultural norms and attitudes 28,40,41 may therefore be relevant to increased rates of farmer suicide.…”

“…The need for control and self-reliance has been reported as a stronger barrier for farmers than non-farmers in seeking support for mental health problems in the same state. 40 In NSW, Brew et al (2016) 41 reported that all farmers, regardless of rurality, were half as likely to visit a GP or mental health professional in the last 12 months compared to non-farm workers, but that remote farmers were more likely to be more isolated and have less access (structural barriers) to care. Farmers are more than three times as likely to die by suicide in QLD than in NSW.…”

“…This physical isolation may compound barriers to service utilisation within the sociocultural environment, making help seeking even less likely. A longitudinal cohort study in rural NSW 41 found that remoteness was a significant factor. Remote farmers self-reported worse mental health and wellbeing than remote non-farm workers regardless of recent adverse life events, financial hardship or climatic adversity.…”