International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators

Toward a Public Health Approach to Farmer Suicide Prevention: The Potential Power of Systems Change

OBJECTIVE

Suicide among farmers has, over the past 20 years, garnered attention from scholars around the world. The purpose of this paper is twofold. First, this paper will present a framework for considering farmer suicide that builds upon the Interpersonal-Psychological Theory of Suicidal Behavior and extends our current explanations of suicide to include a multilevel, multifactorial focus on individual, interpersonal, community and systemic factors at the root of stressors contributing to suicide among farmers. Secondly, a blueprint for farmer suicide prevention, leveraging the Water of Systems Change Model, is proposed.

METHOD

In the spirit of conveying multi-layered influence on farmer suicide while highlighting relevant levels for prevention a parsimonious, prevention-based model of farmer suicide is presented.

RESULTS

The Water of Systems Change (WSC) model incorporates research to bring attention to the community, organizational, and societal conditions that keep a problem, such as farmer suicide, from being eradicated.

CONCLUSION

Suicide is a societal issue that requires a multi-level response. Farmer suicide is a particular concern, as farmers provide for and support all of us. It is incumbent upon public health and the community-at-large to improve our policies, systems, and contexts to create an environment in which farmers are also provided for and supported.

Mental Health Among LGBTQ+ Farmers in the United States

OBJECTIVES

The objective of the current study is to describe mental health among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people who work in agriculture in the U.S.

METHODS

This study uses a survey of LGBTQ+ adults who work in agriculture in the U.S. (N = 148), including questions about LGBTQ+ identity, farming background, depression symptoms (PHQ-8) and diagnosis, anxiety symptoms (GAD-7) and diagnosis, suicide risk, and stress. Data were analyzed using SPSS, including descriptive statistics, chi-square tests, and Mann-Whitney U tests.

RESULTS

Over one-third (36.1%) had probable depression (PHQ-8 ≥ 10), and 71.9% were experiencing mild to severe depression symptoms. Nearly half (46.2%) had probable anxiety disorder (GAD-7 ≥ 8), and 69.7% experienced mild to severe anxiety symptoms. Over half (51.7%) were at significant risk for suicide. Greater proportions of men had probable anxiety disorder, probable depression, and suicide risk compared to non-men. Greater proportions gay participants had probable depression, as did beef producers. Perceived stress was higher for men, lesbian and gay participants, transgender participants, and those in beef production. Resilient coping was highest among participants who were genderqueer or genderfluid, bisexual, and those in field crop production.

CONCLUSION

LGBTQ+ farmers in the current sample experienced depression and anxiety at higher rates than general farming or general LGBTQ+ samples, although suicide risk was lower than for general LGBTQ+ samples. Future research should explore how working in agriculture may be protective against suicide risk for LGBTQ+ farmers, as well as how specific farm stressors are related to LGBTQ+ farmer mental health.

Farming Activities and Risk of Inflammatory Bowel Disease: A French Nationwide Population-based Cohort Study

BACKGROUND AND AIMS

Epidemiological data regarding inflammatory bowel disease [IBD] are lacking, in particular for occupationally exposed populations. We investigated whether, among the entire French farm manager [FM] workforce, certain agricultural activities are more strongly associated with IBD than others.

METHODS

Nationwide, population-based, insurance claims and electronic health records from all FMs who worked at least once over the period 2002-2016 were used [n = 1 088 561, 69% males]. The outcome measure was the association between 26 farming activities and the risk of IBD, Crohn's disease [CD], and ulcerative colitis [UC], measured as hazard ratios [HRs], after adjusting for age, sex, pre-existing medical comorbidities, and farm location. The time to first chronic disease declaration was used as the underlying time scale. A model was generated for every activity and disease, using a reference group comprising all FMs who abstained from the specified activity from 2002 to 2016.

RESULTS

There were 1752 IBD cases, with 704 CD [40.2%] and 1048 UC [59.8%] cases, respectively. Elevated HRs were observed for fruit arboriculture [HR from 1.17 to 1.52] and dairy farming [HR from 1.22 to 1.46] for all IBD, in crop farming for CD only (HR = 1.26, 95% confidence interval [CI]: 1.06-1.49), and in shellfish farming [HR from 2.12 to 2.51] for both CD and IBD.

CONCLUSIONS

Further research regarding specific farming activities and exposures likely to modify the microbiota [eg, pesticides, pathogens] is required to identify potential occupational risk factors [agricultural exposome] for IBD. Exposure to Mycobacterium avium subspecies paratuberculosis, Cryptosporidium, environmental toxins, micro/nanoplastics, and pesticides represents promising research avenues.

Qualitative social and human science research focusing on actors in and around dairy farming- An invited review

Qualitative research related to humans, dairy cows, calves and farming has been published by scientists from a variety of disciplines in many journals targeting dairy science audiences. We aimed to investigate how scientific communities other than those working in dairy science describe, analyze and discuss dairy farming, because we found it important to bring this research to the attention of dairy scientists. In total, 117 articles were identified as involving one or more qualitative research methods in relation to dairy cattle. The review brought out a wealth of perspectives, new insights and discussions related to dairy cattle, farmers, farming and the sector, and in relation to societal issues and food and ecological landscapes. A broad range of qualitative research methods were used, and the literature targeted issues at the animal, farm, societal, food system and landscape level. Some raised critical questions about existing structures, highlighted unfairness in the industry, or pointed to new potential futures and contemporary agendas. We expect that it will be inspirational and stimulating for researchers to review new sources of literature and suggest a closer interdisciplinary collaboration among researchers from different disciplines for the future development of research involving dairy cattle. Further, it could be relevant and even necessary to engage in such interaction to avoid increasing polarization around future development of the sector, for example related to climate change or how industrialization seems to push inequity or ignore the agency of animals themselves. Exploring perspectives of farming from different angles could enrich the outcomes of future dairy research.

Farmers' Mental Health: The Mediating Role of Chronic Fatigue

The agricultural environment is known to be particularly harmful to farmers' psychological health. To better understand how its impact is modulated, this study mainly focuses on the mediating role of chronic fatigue between A) loneliness at work, autonomy, workload, government regulations and policies and financial hardship, and B) life satisfaction, positive affect and psychological distress. The study is based on a sample of 453 Canadian dairy farmers. Structural equation modeling analyses confirmed the mediating role of chronic fatigue in the relationships between the factors studied, with the exception of financial hardship. Implications for research and the psychological burden affecting agricultural workers are discussed.

Farming activity and risk of treated thyroid disorders: Insights from the TRACTOR project, a nationwide cohort study

BACKGROUND

Epidemiological data regarding thyroid diseases are lacking, in particular for occupationally exposed populations.

OBJECTIVES

To compare the risk of hypothyroidism and hyperthyroidism between farming activities within the complete population of French farm managers (FMs).

METHODS

Digital health data from retrospective administrative databases, including insurance claims and electronic health/medical records, was employed. This cohort data spanned the entirety of French farm managers (FMs) who had undertaken work at least once from 2002 to 2016. Survival analysis with the time to initial medication reimbursement as timescale was used to examine the association (hazard ratio, HR) between 26 specific farming activities and both treated hypothyroidism and hyperthyroidism. A distinct model was developed for each farming activity, comparing FMs who had never engaged in the specific farming activity between 2002 and 2016 with those who had. All analyses were adjusted for potential confounders (e.g., age), and sensitivity analyses were conducted.

RESULTS

Among 1088561 FMs (mean age 46.6 [SD 14.1]; 31% females), there were 31834 hypothyroidism cases (75% females) and 620 hyperthyroidism cases (67% females), respectively. The highest risks were observed for cattle activities for both hyperthyroidism (HR ranging from 1.75 to 2.42) and hypothyroidism (HR ranging from 1.41 to 1.44). For hypothyroidism, higher risks were also observed for several animal farming activities (pig, poultry, and rabbit), as well as fruit arboriculture (HR = 1.22 [1.14-1.31]). The lowest risks were observed for activities involving horses. Sex differences in the risk of hypothyroidism were observed for eight activities, with the risk being higher for males (HR = 1.09 [1.01-1.20]) than females in viticulture (HR = 0.97 [0.93-1.00]). The risk of hyperthyroidism was two times higher for male dairy farmers than females.

DISCUSSION

Our findings offer a comprehensive overview of thyroid disease risks within the FM community. Thyroid ailments might not stem from a single cause but likely arise from the combined effects of various causal agents and triggering factors (agricultural exposome). Further investigation into distinct farming activities-especially those involving cattle-is essential to pinpoint potential risk factors that could enhance thyroid disease monitoring in agriculture.

Survey of farm, parlour and milking management, parlour technologies, SCC control strategies and farmer demographics on Irish dairy farms

BACKGROUND

This cross-sectional study describes a survey designed to fill knowledge gaps regarding farm management practices, parlour management practices and implemented technologies, milking management practices, somatic cell count (SCC) control strategies, farmer demographics and attitudes around SCC management on a sample of Irish dairy farms.

RESULTS

We categorized 376 complete responses by herd size quartile and calving pattern. The average respondent herd was 131 cows with most (82.2%) operating a seasonal calving system. The median monthly bulk tank somatic cell count for seasonal calving systems was 137,000 cells/ml (range 20,000 - 1,269,000 cells/ml), 170,000 cells/ml for split-calving systems (range 46,000 - 644,000 cells/ml) and 186,000 cells/ml for 'other' herds (range 20,000 - 664,000 cells/ml). The most common parlour types were swing-over herringbones (59.1%) and herringbones with recording jars (22.2%). The average number of units across herringbone parlours was 15, 49 in rotary parlours and two boxes on automatic milking system (AMS) farms. The most common parlour technologies were in-parlour feeding systems (84.5%), automatic washers on the bulk tank (72.8%), automatic cluster removers (57.9%), and entrance or exit gates controlled from the parlour pit (52.2%). Veterinary professionals, farming colleagues and processor milk quality advisors were the most commonly utilised sources of advice for SCC management (by 76.9%, 50.0% and 39.2% of respondents respectively).

CONCLUSIONS

In this study, we successfully utilised a national survey to quantify farm management practices, parlour management practices and technology adoption levels, milking management practices, SCC control strategies and farmer demographics on 376 dairy farms in the Republic of Ireland. Rotary and AMS parlours had the most parlour technologies of any parlour type. Technology add-ons were generally less prevalent on farms with smaller herds. Despite finding areas for improvement with regard to frequency of liner changes, glove-wearing practices and engagement with bacteriology of milk samples, we also found evidence of high levels of documentation of mastitis treatments and high use of post-milking teat disinfection. We discovered that Irish dairy farmers are relatively content in their careers but face pressures regarding changes to the legislation around prudent antimicrobial use in their herds.

Cohort profile: The FarmMERGE project-Merging human and animal databases to investigate the relationship between farmer and livestock health and welfare. The HUNT Study

Stockmanship is an important determinant for good animal welfare and health. The goal of the FarmMERGE project is to investigate the associations between farmer health and work environment, and the health, productivity and welfare of their livestock. We merged several livestock industry databases with a major total population-based health study in Norway (The Trøndelag Health Study 2017-2019 (HUNT4)). This paper describes the project's collection and merging of data, and the cohort of farmers and farms that were identified as a result of our registry merge. There were 56,042 participants of HUNT4 (Nord-Trøndelag County participants only, participation rate: 54.0%). We merged a list of HUNT4 participants whose self-reported main occupation was "farmer" (n = 2,407) with agricultural databases containing production and health data from sheep, swine, dairy and beef cattle from 2017-2020. The Central Coordinating Register for Legal Entities was used as an intermediary step to achieve a link between the farmer and farming enterprise data. We identified 816 farmers (89.5% male, mean age 51.3 years) who had roles in 771 farming enterprises with documented animal production. The cohort included 675 unique farmer-farm combinations in cattle production, 139 in sheep, and 125 in swine. We linked at least one HUNT4 participant to approximately 63% of the dairy farms, 53% of the beef cattle farms, 30% of the sheep farms, and 38% of the swine farms in Nord-Trøndelag County in the 2017-2019 period. Using existing databases may be an efficient way of collecting large amounts of data for research, and using total population-based human health surveys may decrease response bias. However, the quality of the resulting research data will depend on the quality of the databases used, and thorough knowledge of the databases is required.

Indicators of occupational pesticide exposure are associated with psychiatric symptoms

In southeastern Spain, intensive and highly productive agriculture under plastic also poses a risk to human health, as evidenced by reports on acute pesticide poisoning and its effects on mental health. However, knowledge of chronic exposures and their relationship to psychiatric disorders is still limited. This study analyzed the relationship between occupational exposure to pesticides and psychiatric disorders in farmers from Almería. A cross-sectional study was conducted amongst a coastal population in Almería, where over 32,800 ha of land are dedicated to intensive agriculture in plastic greenhouses. A total of 409 people participated in the study: 203 farmers and 206 control subjects. The highest risk of psychiatric disorders was observed in farmers living in areas of high exposure to pesticides, working in greenhouses (intensive agriculture), without protective goggles and without wearing masks. This study supports previous evidence of an elevated risk of psychiatric disorders among farm workers exposed to pesticides.

Lifestyle parameters of Japanese agricultural and non-agricultural workers aged 60 years or older and less than 60 years: A cross-sectional observational study

OBJECTIVES

Improving the lifestyle of occupational workers is essential for extending healthy life expectancy. We investigated various lifestyle-related items in a rural Japanese population and compared them between agricultural and non-agricultural workers.

METHODS

This cross-sectional study was conducted as a part of the "Iwaki Health Promotion Project." Lifestyle-related items such as sleep, work hours, nutrition, health-related quality of life, and proportion of time spent performing each daily activity were compared between agricultural and non-agricultural workers in the ≥60 years (n = 251) and <60 years (n = 560) age groups.

RESULTS

Agricultural workers had significantly lower Pittsburgh Sleep Quality Index total scores than non-agricultural workers in the <60 years group. The proportion of participants with more than 5 weekly working days was high among agricultural workers in both groups. Additionally, the proportion of people who worked more than 8 h per day was high among agricultural workers in both age groups. Energy intake per day was high among agricultural workers in the <60 years group. In both age groups, agricultural workers slept and woke up approximately 40 min earlier than did non-agricultural workers.

CONCLUSIONS

Agricultural workers have better sleep habits but work longer than non-agricultural workers, with some differences in energy intake and proportion of time spent on each daily activity. These differences should be considered when planning lifestyle intervention programs for agricultural workers.

Exploring the occupational experiences of livestock farmers during drought: A narrative inquiry

INTRODUCTION

For much of the 21st century, Australia has endured the most prolonged and severe drought since records began. This drought has been found to have negative and long-lasting consequences upon both the physical and mental well-being of farmers and their families. To date, however, no research has examined the experience of drought from an occupational perspective.

OBJECTIVE

This study aims to explore the way in which drought impacts upon the lived experience of the farming role and the way in which the occupational identity of farmers influences the meanings attributed, and response to, drought.

METHODS

Narrative inquiry and thematic analysis were used to explore the experiences of drought among six farming men and four farming women from Northern Queensland.

FINDINGS

Four inter-related themes were identified. These being: 'Becoming a farmer - Rites of passage on entry to the farming role'; 'Farmers as guardians over the land'; 'Drought as siege' and; 'Leisure occupations as temporary bridges to a world beyond drought'. Each of these themes offer insights into the way in which drought comes to be understood by farmers and, in turn, experienced and responded to.

CONCLUSION

By better understanding the occupational experiences of farmers during drought, resources can be more effectively targeted towards promoting occupational balance and well-being. Interventions aimed at reframing the way in which the farming role is conceptualised from a young age and supporting occupations beyond farming as bridges to the outside world may be effective in achieving positive outcomes during drought.

Measuring Mental Health Service Preferences Amongst Illinois Dairy Producers

OBJECTIVES

To mitigate mental health concerns of farmers, research is needed to investigate strategies that encourage help-seeking behavior in this population. This study attempts to identify those help-seeking strategies. Six mental health service options were examined.

METHODS

A survey, implementing a best-worst scaling choice experiment, was disseminated to members of the Illinois Milk Producers Association. Two methods of analysis were conducted. The first, a count-based method, employs a simple count-based approach to measure the relative preferences for the six mental health service options in question. The second is more complex and employs a latent-class logit regression model to measure individual preferences.

RESULTS

The mental-health service options, ranked in order from most preferred to least preferred were: 1) speak to family and friends, 2) keep it to myself, 3) utilize programs offered by agricultural organizations, 4) search online for self-help resources, 5) talk to a mental health professional, and 6) use "tele-health" support services.

CONCLUSION

This study examined an important gap in the literature concerning help-seeking preferences of dairy farmers. It is the first to utilize a choice experiment approach to assess help-seeking preferences among this understudied population. Results provide important empirical evidence to support distinct categories of farmers who may be weighing options regarding how to best address their mental health concerns.

Factors Influencing Farmers' Use of Adaptive and Maladaptive Coping Strategies

OBJECTIVES

Chronic stress is associated with a variety of negative outcomes for farmers in the United States (U.S) and worldwide, who face near-constant exposure to internal (e.g. family conflict) and external (e.g. weather) stressors. Research indicates that farmers' stress may be reduced by engaging in adaptive coping strategies and avoiding maladaptive coping strategies. However, little is known about what predicts their coping strategy use. Informed by the transactional theory of stress and coping, the present manuscript seeks to identify factors associated with U.S. farmers' use of adaptive and maladaptive coping strategies.

METHODS

U.S. farmers (N = 135) completed survey assessments of factors theorized to be associated with coping strategy choice (maladaptive beliefs about farm stress management, farm stress management self-efficacy, age, and sex) as well as measures of adaptive and maladaptive coping.

RESULTS

Farm stress management self-efficacy was a significant, positive predictor of adaptive coping, and maladaptive beliefs about farm stress management were a significant, positive predictor of maladaptive coping. Maladaptive beliefs about farm stress management and farm stress management self-efficacy interacted to predict maladaptive coping, such that the positive relationship between maladaptive beliefs about farm stress management and maladaptive coping was significant at higher levels of self-efficacy. Sex was unrelated to coping strategies, and age was negatively associated with maladaptive coping strategies but unassociated with adaptive coping strategies.

CONCLUSION

The findings point to the utility of increasing farm stress self-management self-efficacy to increase farmers' adaptive coping and reducing maladaptive beliefs about farm stress management to reduce maladaptive coping. Efforts to promote adaptive coping by increasing self-efficacy should also target maladaptive beliefs farmers hold toward stress management, because increasing self-efficacy may also increase the likelihood of maladaptive coping when maladaptive beliefs are present.

Overage labor, intergenerational financial support, and depression among older rural residents: evidence from China

Background

Depression is a major factor affecting the happiness of older rural residents. With the increasing aging of the Chinese population, overage labor is becoming more prevalent in rural areas of China. This study aimed to assess whether, and if so, how, overage labor affects depression status in older rural residents.

Methods

Using data from the China Health and Retirement Longitudinal Study, this study explored the association between overage labor and depression among older rural residents by using ordinary least squares and moderated mediation models.

Results

The results show that overage labor significantly reduced levels of depression in older rural residents. This result remained robust after using propensity score matching and double machine learning. Furthermore, the improvement of older rural residents' depression via overage labor is mainly achieved through work income, but this mediating effect is negatively moderated by intergenerational financial support. This implies that in traditional Chinese rural society, intergenerational financial support from children plays an important role in reducing depression among older rural residents.

Conclusion

Our findings have potential policy implications for China and other developing countries in terms of addressing issues related to aging and depression in older adults.

Agricultural activities and risk of treatment for depressive disorders among the entire French agricultural workforce: the TRACTOR project, a nationwide retrospective cohort study

Background

Although depression is a major issue among farming population, to date, there have been few studies on specific agricultural activities. We aimed to investigate whether, among the entire French farm manager (FM) workforce, certain agricultural activities are more strongly associated with depression than others.

Methods

This nationwide retrospective cohort study used data from an administrative health database available to the TRACTOR project. This database pertains to the entire French agricultural workforce (overseas workers not included). Data were analyzed from January 2021 to December 2022. All FMs that worked at least once over the period 2002-2016 were included. The outcome measure was the association between 26 agricultural activities and the risk of depression measured as hazard ratios (HRs) after adjusting for age, sex, and pre-existing medical comorbidities. The time to first depression insurance declaration, or first antidepressant prescription claim was used as the underlying timescale. For each activity, the reference/control group included all FMs that never performed the considered activity between 2002 and 2016, while the exposed group included FMs that performed the considered activity at least once from 2002 to 2016. Four sensitivity analyses were conducted to test hypotheses, and to address potential sources of bias.

Findings

There were 84,507 (7.76%; 28.2 cases per 1000 person-years) depression cases among 1,088,561 FMs (mean age 46.6 [SD 14.1]). Compared to other activities, dairy farming (HR = 1.37, 95% confidence interval: 1.32-1.42), cow farming (HR = 1.53 [1.47-1.59]), poultry and rabbit farming (HR = 1.37 [1.27-1.50]), and mixed farming (HR = 1.30 [1.24-1.36]) were more strongly associated with depression. Sex differences were observed, with most of the time, risks higher for females than for males.

Interpretation

Agricultural activities at risk of depression among the entire French agricultural workforce were identified. These findings do represent a crucial first step on the road to implement effective preventive measures against depression to determine where additional resources should be allocated to screen for depression, along with intervention.

Funding

MIAI@Grenoble Alpes, and Mutualité Sociale Agricole.

Computerized Cognitive Behavioral Therapy for Anxiety and Depression in Farming Communities: Mixed Methods Feasibility Study of Participant Use and Acceptability

BACKGROUND

Farmers have higher rates of depression than nonfarmers and higher rates of suicide than the general population. Several barriers to help seeking have been identified in farmers, which may be overcome by offering web-based mental health support. Computerized cognitive behavioral therapy (cCBT) is an effective intervention used to prevent and treat mild to moderate depression but has not been evaluated in the farming community.

OBJECTIVE

This study explored the feasibility of delivering a cCBT course tailored to farmers using a mixed methods approach.

METHODS

Farmers (aged ≥18 years) with no, minimal, or moderately severe depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score <20) were recruited using web-based and offline advertisements and given access to a cCBT course consisting of 5 core modules and automated and personalized email support. Depression (PHQ-9), anxiety (General Anxiety Disorder-7), and social functioning (Work and Social Adjustment Scale) were measured at baseline and the 8-week follow-up. Wilcoxon signed rank tests assessed changes in scores for all outcome measures over time. Telephone interviews focusing on participant use and satisfaction with the course were analyzed using thematic analysis.

RESULTS

Overall, 56 participants were recruited; 27 (48%) through social media. Overall, 62% (35/56) of participants logged into the course. At baseline, almost half of the participants reported experiencing minimal depressive symptoms (25/56, 45%) and mild anxiety (25/56, 45%), and just over half (30/56, 54%) reported mild to moderate functional impairment. Posttreatment data were available for 27% (15/56) of participants (41/56, 73% attrition rate). On average, participants experienced fewer depressive symptoms (P=.38) and less functional impairment (P=.26) at the 8-week follow-up; these results were not statistically significant. Participants experienced significantly fewer symptoms of anxiety at the 8-week follow-up (P=.02). Most participants (13/14, 93%) found the course helpful and easy to access (10/13, 77%) and the email support helpful (12/14, 86%). Qualitative interviews identified heavy workloads and mental health stigma within the farming community as barriers to help seeking. Participants thought that web-based support would be helpful, being convenient and anonymous. There were concerns that older farmers and those with limited internet connections may have difficulty accessing the course. Improvements regarding the layout and content of the course were suggested. Dedicated support from someone with farming knowledge was recommended to improve retention.

CONCLUSIONS

cCBT may be a convenient way of supporting mental health within farming communities. However, challenges in recruiting and retaining farmers may indicate that cCBT supported only by email may not be an acceptable mode of mental health care delivery for many; however, it was valued by respondents. Involving farming organizations in planning, recruitment, and support may address these issues. Mental health awareness campaigns targeting farming communities may also help reduce stigma and improve recruitment and retention.

Behaviour change interventions for responsible antimicrobial use on farms

BACKGROUND

In the coming years, major governance changes in the form of policy directives and regulations will catalyse major top-down change with respect to animal health on European farms in an effort to combat the OneHealth threat of antimicrobial resistance. This top-down approach must be met with bottom-up strategies to ensure target actors (namely, farmers and vets) are supported and motivated to change their practices, thus, avoiding unintended consequences of forced change. Although much behavioural research has explored the factors influencing antimicrobial practices on farms, a gap exists translating these findings into evidence-based behaviour change interventions that can be put into practice. The current study aims to fill this gap. It provides insights into identifying, understanding, and changing the behaviours of farmers and veterinarians with respect to the responsible use of antimicrobials in farming.

RESULTS

Through an inter-disciplinary and multi-actor approach, the study combines scientific knowledge from the behavioural sciences and animal health sciences, coupled with tacit knowledge from a co-design, participatory approach to recommend seven behaviour change interventions that can help to support good practices amongst farmers and vets, with respect to animal health, and reduce the use of antimicrobials on farms. The behaviour change interventions include message framing; OneHealth awareness campaign; specialised communications training; on-farm visual prompts and tools; social support strategies (for both farmers and vets); and antimicrobial use monitoring. The study details each intervention with respect to their evidence base and scientific concept, grounded in behavioural science, along with stakeholder feedback on design and delivery of the interventions.

CONCLUSIONS

These behaviour change interventions can be taken, adapted, and put into practice by the agri-food community to support good animal health practices and responsible antimicrobial use on farms.

Beyond Age and Cause: A Multidimensional Characterization of Fatal Farm Injuries in Ireland

The study seeks to enhance understanding of the complex nature of fatal farm injuries and thereby support the development of targeted safety messages or interventions. The research analyses fatal farm injuries surveillance data collected by the Health and Safety Authority (Ireland) for the period 2004-2018. Utilizing Non-Linear Canonical Correlation Analysis (NLCCA) to identify similarities and differences between 274 fatal injuries, multiple interactions and correlations between two sets of variables were identified. The analysis identified two major patterns of injury. The first relates to older farmers (60+) who were killed due to being struck by an object in motion, i.e. a tractor or machine. These injuries occurred mainly during the summer or winter between 13:00 and 18:00 in the Southern-Eastern regions. The second pattern also relates to older farmers, however these fatalities are associated with beef production and the primary cause of injury was being kicked or crushed by livestock. These injuries commonly occur in the Border, Midland, and Western regions where fatalities are prevalent during spring and outside of normal working hours. Assessing interactions between variables demonstrates to whom, how, when, and where fatal injuries affect different groups within the farm population. These findings provide regulators and farm safety stakeholders with key insights into background characteristics of fatal injuries including type of enterprise, time of day, season, and regional location that should be used to develop safety awareness, training, and targeted interventions to at-risk populations.

A thematic analysis of the personal factors influencing mental health help-seeking in farmers

PURPOSE

It is crucial to understand the micro-level personal factors that impact farmer mental health help-seeking, given that farmers are at increased risk of suicide yet show reduced mental health help-seeking behaviors.

METHODS

Ten farmers, 10 farmers' partners, and 8 general practitioners (ie, family physicians) from Australia completed qualitative semi-structured interviews. Braun and Clarke's method of thematic analysis was used to analyze the data.

FINDINGS

The analysis resulted in 4 themes: "mental health literacy," "stigma of mental illness and help-seeking," "support, the partners' role in help-seeking," and "the intersectionality between being a farmer, age, and gender." Farmers' knowledge and understanding of mental health and treatments was varied. Stigma was reported to be reducing, but still present toward both mental illness and mental health help-seeking. Support from a partner was reported to facilitate help-seeking if delivered tactfully. Lastly, being older and male were reported to negatively impact farmer mental health help-seeking.

CONCLUSION

The findings contribute to understanding farmer mental health help-seeking and could inform quantitative research and the development and implementation of interventions to promote mental health help-seeking in this group.

The Role of Social Work in Confronting the Farmer Suicide Crisis: Best Practice Recommendations and a Call to Action

Although estimates of prevalence vary, suicide rates among farmers are high and pose an important challenge for mental health policy and practice. The lack of mental health resources in many rural communities is a significant barrier to improving farmer mental health outcomes. The current paper will review (1) current findings related to the psychosocial functioning of agriculturalists including rates of suicide and common mental health concerns within this population; (2) describe stressors and risk factors associated with mental health symptoms in rural and agricultural communities; and (3) discuss barriers associated with accessing mental health treatment. This article also includes recommendations for increasing the cultural competence of social work practitioners working with rural communities. Finally, existing research on using technology and workforce development approaches for increasing access to mental health in rural communities is presented and recommendations for future research are explored.

The impact of work organisation on the work life of people on pasture-based dairy farms

The seasonal workload combined with increased dairy herd sizes and a declining workforce have created social sustainability challenges for pasture-based dairy farms. Effective work organisation can build productive capacity that may have a positive impact on this scenario. Our objective was to develop a framework to characterise and examine the effect of work organisation on the working situations of the people involved in a sample of 55 pasture-based dairy farms in Ireland. We conceptualised that effective work organisation on a dairy farm could be considered as a system that is efficient from a labour input perspective, resulting in a profitable farming system with outcomes of good operator well-being, health and safety, and quality of life. A literature review established efficiency & productivity, flexibility and standardisation as our three characteristics of work organisation. Using data from an existing labour time-use study completed from the 1st February to 30th June 2019, we aimed to test the veracity of these work organisation characteristics in the Irish pasture-based dairy system. Two proxy indicators were selected to represent each of the three work organisation characteristics, and each of the 55 farms were categorised into quartiles based on their ranking for these six indicators (1 = most effective quartile to 4 = least effective quartile). The most and least effective quartiles of farms for work organisation showed similar levels of farm labour input and labour efficiency. Farmers in the most effective work organisation quartile were working 51.2 h/week from February to June compared with 70.0 h/week for farmers in the least effective quartile, which was attributed to later start times, earlier finish times, and more time at non-farm activity. Farms achieving effective work organisation had a labour-efficient system with relatively low farmer working hours. Extension of the work organisation concept to other farms could improve their labour situation and aid in alleviating some of the key quality of life challenges faced by dairy farmers.

From co-design to co-production: Approaches, enablers, and constraints in developing a public health, capacity-building solution

INTRODUCTION

Investigating how co-designed knowledge can be translated to co-produce a public health capacity-building solution for difficult-to-engage population groups drawing on the co-production experience of a prevention-focused, capacity-building mental health solution targeting primary producers.

DESIGN

A qualitative study undertaken in rural and regional Victoria involving members of the design working group including project team (7px), digital design team (5px), marketing team (3px), and funding partner representatives. The study design involved reflective practice to collect data to identify the phases of co-production and assess the design working group members' experiences. The analysis involved inductive coding using Braun and Clarke's thematic analysis.

OBJECTIVE

Identifying major points of divergence and/or convergence; enablers and/or constraints; and ways to better navigate and strengthen the co-production process.

FINDING

Given members of the design working group, diverse skills sets divergence was experienced in all co-production phases. Divergence was also experienced between the project team and the funding partner given the uniqueness of working conditions and requirements of workers in the primary production industry. The project team applied an iterative development process to project management; encouraging iterative cycles to create/test/revise among the teams, and with the funding partner, until each was satisfied with the end result (convergence).

DISCUSSION & CONCLUSION

When developing a co-created public health prevention campaign it is critical that the project team focuses on relationship building among the members of the design working group and ensures adequate resourcing, development of shared understanding of project goals and target audience, ongoing communication, and a commitment to working iteratively.

Barriers to and Facilitators of Engaging With and Adhering to Guided Internet-Based Interventions for Depression Prevention and Reduction of Pain-Related Disability in Green Professions: Mixed Methods Study

BACKGROUND

Internet-based interventions (IBIs) are effective for the prevention and treatment of mental disorders and are valuable additions for improving routine care. However, the uptake of and adherence to IBIs are often limited. To increase the actual use of IBIs, it is important to identify factors for engaging with and adhering to IBIs.

OBJECTIVE

We qualitatively evaluated barriers and facilitators regarding a portfolio of guided IBIs in green professions (farmers, gardeners, and foresters).

METHODS

Interview participants were selected from 2 randomized controlled trials for either the prevention of depression (Prevention of Depression in Agriculturists [PROD-A]) or the reduction of pain interference (Preventive Acceptance and Commitment Therapy for Chronic Pain in Agriculturists [PACT-A]) in green professions. The intervention group in PROD-A (N=180) participated in an IBI program, receiving access to 1 of 6 symptom-tailored IBIs. The intervention group in PACT-A (N=44) received access to an IBI for chronic pain. Overall, 41 semistructured qualitative interviews were conducted and transcribed verbatim. Barriers and facilitators were identified via inductive qualitative content analysis, with 2 independent coders reaching almost perfect intercoder reliability (Cohen κ=0.92). A quantitative follow-up survey (30/41, 73%) was conducted to validate the results. Subgroup analyses were performed based on intervention characteristics.

RESULTS

We identified 42 barriers and 26 facilitators, which we assigned to 4 superordinate categories related to the intervention (20 barriers; 17 facilitators), work (4 barriers; 1 facilitator), individual (13 barriers; 8 facilitators), and technical (5 barriers; 0 facilitators) aspects. Key barriers (identified by at least 50% of the interviewees) were time-consuming work life (29/40, 73%) and time-consuming private life (23/40, 58%). Similarly, the most frequently identified facilitators included presence of motivation, curiosity, interest and perseverance (30/40, 75%), flexible time management at work (25/40, 63%), and support from family and friends (20/40, 50%). Although agreement with barriers in the quantitative follow-up survey was rather low (mean 24%, SD 11%), agreement with facilitators was substantially higher (mean 80%, SD 13%). Differences in agreement rates were found particularly between intervention completers and noncompleters. Completers agreed significantly more often that perceived IBI success; being motivated, curious, interested, and perseverant; and having a persisting level of psychological strain have been facilitating. Noncompleters agreed more often with experiencing the e-coach contact as insufficient and technical problems as hindering for intervention completion.

CONCLUSIONS

Based on these results, strategies such as customization of modules for more flexible and adaptive use; video chat options with the e-coach; options to facilitate social support by family, friends, or other participants; or using prompts to facilitate training completion can be derived. These approaches could be evaluated in further quantitative research designs in terms of their potential to enhance intervention use in this occupational group.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00014000, https://tinyurl.com/3bukfr48; German Clinical Trials Register DRKS0001461, https://tinyurl.com/ebsn4sns.

Well-being at work and Finnish dairy farmers─from job demands and loneliness towards burnout

OBJECTIVES

Novel information about the relationships between farmers' job demands, lack of resource, burnout, and ill health is reported based on testing the so-called "health impairment process" of the Job Demands─Resources Model (JD-R) on a representative sample of Finnish dairy farmers. The aim was to find out whether two different job demand factors; workload, societal demands and lack of resource; loneliness, were related to the indicators of ill health via burnout.

METHODS

The data is based on a postal survey of 400 Finnish dairy farms. Altogether 265 questionnaires were received from 188 farms and included in the analysis. The response rate was 47 per cent among sample farms. Structural equation modelling (SEM) was used to analyze the relationships between the variables. Explanatory factor analysis was used to group the job demand and lack of resource variables.

RESULTS

We identified two job demand factors, which we labelled workload and societal demands and one lacking job resource, loneliness. Our theoretical model was supported in that two of the factors, namely workload and loneliness, were related to ill health indirectly via burnout. In addition, workload was directly connected with ill health. Societal job demands were not significantly related to burnout, or to ill health.

CONCLUSION

Our results suggest that farmers could benefit from means to reduce workload, especially the physical load. This topic needs further research as the restructuring process has increased farm enterprise sizes. There is a need to develop tools and projects to alleviate loneliness among farmers. Lack of social support, high workload, ill health, and burnout among farmers may have serious direct and indirect negative consequences for the sustainability of farming.

Safer tomorrow: Irish dairy farmers' self-perception of their farm safety practices

INTRODUCTION

Encouraging safe work practices (SWPs) is challenging in agriculture. Group-based social learning has effectively promoted SWPs and health behaviors in other occupations, and could be applied in agriculture (e.g., through farmer discussion groups (DGs)). In Ireland, dairy DG members are more likely to adopt novel technologies and practices, a relationship that might extend to SWPs. The extent of SWP adoption among Irish dairy farmers is unknown. This paper evaluates a 2018 baseline study of SWP implementation, conducted as part of a dairy DG-based intervention study.

METHOD

A paper-based survey of SWP implementation and safety self-perception was distributed to 1,220 farmers from 84 dairy DGs. For eight SWPs, associated with high-risk farm hazards (livestock, slurry, machinery, or tractors), farmers were asked how frequently they implemented these practices in the previous year, and how frequently they intended to do so next year (0: never, 1: rarely, 2: sometimes, 3: most of the time, 4: all of the time).

RESULTS

Surveys were completed by 460 farmers. For the previous year, three SWPs, related to slurry, machinery, and tractor hazards, scored a median frequency of four. Four SWPs, related to livestock, slurry, and machinery hazards, scored a median frequency of three. The lowest median score (two) was for tractor exit behavior. Median intention scores matched or exceeded past frequency for all SWPs, while 73% intended to increase implementation of at least one SWP. Most (96%) considered themselves a "safe farmer."

CONCLUSIONS

Farmers generally perceived themselves to be safe at work, which is reflected in their SWP implementation. Most farmers intended to increase SWP implementation, suggesting awareness of safety shortcomings and a desire to farm more safely.

PRACTICAL APPLICATIONS

This study can inform farm safety promotion initiatives. The disconnect between farmers' safety self-perception and SWP implementation merits further research.

Participant perspectives of an online co-design process to develop a prevention-focused mental health and well-being platform for primary producers

OBJECTIVE

To explore participant experiences of an online co-design process to develop a web-based preventative mental health and well-being intervention targeting primary producers in rural Australia.

SETTING

Rural Victoria, Australia.

PARTICIPANTS

Participants from a primary producer background, including horticulture, fisheries, animal cultivation and farm consultancy, were eligible for the study if they had participated in both the co-design and beta testing processes for a primary producer platform.

DESIGN

A qualitative study using semi-structured phone-based interviews was undertaken. A reflexive inductive approach to data analysis was employed to develop themes.

RESULTS

Eleven participants were interviewed, with an average age of 51 years, of which 7 were female. Five main themes were developed. These included: (1) participant diversity, (2) impact of online delivery on co-design participation, (3) experiences of the co-design process, (4) maintaining a shared vision and goals and (5) acting on the co-design recommendations. Use of online methods was a clear enabler to engage participants who were geographically dispersed and offers an alternative to more conventional approaches to co-design using face-to-face methods. Some aspects of participant engagement may need a greater focus when conducted online compared with face-to-face.

CONCLUSIONS

Using an online co-design method to develop a preventative mental health and well-being web-based platform for primary producers was novel. Findings address a gap in the literature around the experience of participants engaging in a co-design process and identify opportunities to improve participant engagement and experience with the online format.

Farmer Mental Health Interventions: A Systematic Review

The prevalence of mental health disorders and suicide amongst agricultural producers is a global problem. Community leaders, researchers, policymakers, and clinicians have mobilized to develop programs to address this issue. This study reviewed a wide range of mental health interventions targeting farmer mental health spanning over 50 years and examined their reported effectiveness and constraints. A total of ninety-two articles on farmer mental health were included in a final systematic review. Most articles were written concerning mental health literacy and peer and paraprofessional support interventions in the United States and Australia. Among the 56 studies reporting empirical evaluative data, 21 were mixed-method, 20 quantitative, 11 qualitative, and 5 literature synthesis. Non-experimental, self-reported, and qualitative data suggest efficacy of mental health literacy programs, peer and paraprofessional support, and community-based and agroecological interventions. However, most interventions were not subject to rigorous evaluation and only one intervention was evaluated using a control condition. The heterogeneity of existing studies and paucity of rigorous evaluation proscribes firm conclusions related to program-type efficacy. This review demonstrates that there is still a need for a stronger and broader evidence base in the field of farmer mental health interventions, which should focus on both holistic, multi-component programs and targeted approaches.

Animal Welfare and Farmers' Satisfaction in Small-Scale Dairy Farms in the Eastern Alps: A "One Welfare" Approach

The multidimensional concept of animal welfare includes physical health, good emotional state, and appropriate behavior of the animals. The most recent methods for its assessment are inspired by the Welfare Quality, a project compiling animal-, resource-, and management-based measures. Recently, animal welfare assessment has also considered the human factor in a so-called “One Welfare” approach. The One Welfare framework highlights the interconnections between animal welfare, human well-being, and the environment. The concept seems to fit particularly well to mountain areas where the relationship between human, animals, and the environment is stronger. In such disadvantaged areas, farmers' well-being plays a key role in maintaining livestock farming profitably and sustainably. This study aims to investigate the relationship between farmers' satisfaction, animal welfare outcomes, and overall farm performance in 69 small-scale dairy farms in the Eastern Alps. Animal welfare assessment consisted of animal-based measures and was performed using the methodology proposed by the European Food Safety Authority for this type of farm. Moreover, the farmers were interviewed to retrieve data on farm characteristics and on their level of satisfaction toward workload, land organization, relationship with the agricultural/non-agricultural community, and the future of local agriculture. The results show that good animal welfare can be obtained in a mountain farming system. Clinical indicators show a low prevalence of diseases and of very lean cows as opposed to integument alterations. The workload is not perceived as a problem in traditional farms (i.e., tie-stall and with no participation in quality-certification schemes). Animal welfare is higher in those farms where farmers have a positive engagement with both the agricultural and non-agricultural community and where farmers are satisfied with their land organization. A One Welfare approach could be applied on a larger scale to fully understand the links between animal and human well-being in mountain areas.

Are guided internet-based interventions for the indicated prevention of depression in green professions effective in the long run? Longitudinal analysis of the 6- and 12-month follow-up of a pragmatic randomized controlled trial (PROD-A)

OBJECTIVE

Evidence of long-term stability for positive mental health effects of internet-based interventions (IBIs) for depression prevention is still scarce. We evaluate long-term effectiveness of a depression prevention program in green professions (i.e. agriculture, horticulture, forestry).

METHODS

This pragmatic RCT (n = 360) compares a tailored IBI program to enhanced treatment as usual (TAU+) in green professions with at least subthreshold depression (PHQ ≥ 5). Intervention group (IG) received one of six IBIs shown previously to efficaciously reduce depressive symptoms. We report 6- and 12-month follow-up measures for depression, mental health and intervention-related outcomes. Intention-to-treat and per-protocol regression analyses were conducted for each measurement point and complemented by latent growth modeling.

RESULTS

After 6 months, depression severity (β = -0.30, 95%-CI: -0.52; -0.07), insomnia (β = -0.22, 95%-CI: -0.41; -0.02), pain-associated disability (β = -0.26, 95%-CI: -0.48; -0.04) and quality of life (β = 0.29, 95%-CI: 0.13; 0.45) in IG were superior to TAU+. Onset of possible depression was not reduced. After 12 months, no intervention effects were found. Longitudinal modeling confirmed group effects attenuating over 12 months for most outcomes. After 12 months, 55.56% of IG had completed at least 80% of their IBI.

CONCLUSIONS

Stability of intervention effects along with intervention adherence was restricted. Measures enhancing long-term effectiveness of IBIs for depression health promotion are indicated in green professions.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Agricultural Cooperatives in Mental Health: Farmers' Perspectives on Potential Influence

Agricultural cooperatives are formed to promote farmers' economic, social, and legislative interests. Their role in influencing mental health is less known. We characterized farmers' experiences with cooperatives and identified the potential impact of cooperatives in promoting mental health. Semi-structured interviews were conducted in Wisconsin with 12 participants, including farmers, cooperative professionals, and agricultural extension educators. Participants were asked about stress among farmers; cooperative structures and services provided to farmers, and farmers' interactions with the cooperatives; and the role cooperatives play in reducing stress among farmers. Three main themes were developed: stress farmers were experiencing, available resources from cooperatives, and the role of cooperatives in promoting farmers' mental health. Stress farmers were experiencing was elucidated through the subthemes: increased stress, depression, and suicide and stressors involving finances, occupational pressure, relationships, isolation, and loneliness. Available resources from cooperatives were described in subthemes: cooperative characteristics, services, and engagement activities. The role of cooperatives in promoting farmers' mental health was discussed through subthemes: responder, community, facilitator, and divergent views on whether co-ops can protect farmers' mental health. Cooperatives provide members market stability, services, and opportunities for decision-making, social interaction, and civic engagement. These resources create a community where farmers feel a sense of belonging and retain a level of control. As rural communities continue to struggle with mental health resource shortages, identifying and evaluating community-based resources such as those offered by the cooperatives is imperative.

Elements of Social Sustainability among Austrian Hay Milk Farmers: Between Satisfaction and Stress

Proponents of hay milk farming claim several benefits on an ecological and economic level, while little about the social aspects has been studied so far. The present study serves as a first exploration of certain aspects of social sustainability from the perspective of hay milk farmers. The results of an online survey of 284 Austrian hay milk farmers are presented. The statistical analyses included Fisher’s exact tests (contingency tables), Kendall’s rank correlations and a two-step cluster analysis. The sampled farms show positive attitudes toward the work in agriculture (e.g., contribution to the cultural landscape) and are mainly satisfied regarding several job aspects (e.g., occupational diversity), but to a great extent dissatisfied with others (e.g., social recognition, time resources). The critical stressors are the agricultural policy, the economic situation, too little time for partnership or family life as well as bureaucracy and work overload. Multiple medium associations between aspects of well-being are revealed. Obvious and meaningful relationships between farm characteristics and aspects of well-being are scarce. The cluster analysis does little to help explain the characteristics of well-being within the patterns of farms. It therefore seems that the perception of the investigated aspects of well-being on hay milk farms is mostly formed individually and is only associated with the farms’ characteristics to a certain degree.

Weather, Workload and Money: Determining and Evaluating Sources of Stress for Farmers in Ireland

The demands of modern farming can place substantial stress upon the farmer, adversely impacting their wellbeing. This study identifies both the prevalence of stress and assesses the demographic, farm, and social characteristics that impact the incidence of stress. We report the results of a survey of a nationally representative sample of farm enterprises in Ireland undertaken in association with the Teagasc National Farm Survey (NFS) in 2018, which saw 736 questionnaires completed by farm operators. Frequency analysis is used to report the primary sources and prevalence of stress. A probit model is developed identifying and quantifying the factors that impact the incidence of stress. There were 57% of farmers who reported experiencing stress resulting from their farm work. Key sources of stress included "poor weather", (47%), "workload" (32%) and "financial" concerns (28%). The results of the probit model establish that the effect of age on the incidence of stress is significant, positive, and non-linear, indicating as farmers get older they are more likely to experience stress but at a declining rate. Operating a sheep farm system, as opposed to any other type of farm system, reduces the probability of stress. Working off-farm also reduces the probability of stress by 0.097, other things being equal. The findings highlight variance in the levels of stress reported by farmers by age and farm system, and consequently, the need to develop targeted supports that take consideration of differences within the population of farmers and farm enterprises.

Suicidality among South Brazilian tobacco growers

OBJECTIVE

To assess prevalence of suicidal ideation and suicide attempt among South Brazilian tobacco growers and to analyze the associated factors related to the suicidal ideation.

METHODS

A cross-sectional study was conducted in 2011 with a random sample of 2469 tobacco growers in São Lourenço do Sul/RS. Suicidal ideation was characterized by the question "Has the thought of ending your life been on your mind?". Suicide attempt was assessed by the question "Have you ever tried to kill yourself?". Investigation of factors associated with suicidal ideation was done by means of Poisson regression.

RESULTS

Prevalence of suicidal ideation and suicide attempt was 2.5 % and 1.2 % respectively. In the adjusted analysis, suicidal ideation was associated with being female, older age, moderate participation in religious activities and difficulty in paying debts. Those who worked in activities that required inadequate postures (hunched over or other forced positions), as well as farmers who performed 6-9 pesticide-related tasks demonstrated greater risk of suicidal ideation. Regarding health conditions, medical diagnosis of asthma, chronic low back pain, number of lifetime green tobacco sickness episodes and lifetime pesticide poisoning were positively associated with suicidal ideation.

CONCLUSION

Suicidal thoughts and attempts are relevant mental health problems among tobacco growers. Reducing pesticide use, as well as exposure to nicotine and improving socio-economic conditions, can reduce suicidal ideation and improve the mental health of exposed workers.

"That's Me I am the Farmer of the Land": Exploring Identities, Masculinities, and Health Among Male Farmers' in Ireland

Compared to other occupational groups, farmers in Ireland experience a disproportionate burden of health problems, which impact farmers’ livelihoods and farming sustainability. Internationally, farmers’ poor health outcomes are associated with intersecting economic, environmental, socio-cultural, and occupation-specific factors linked to changes in agricultural governance. This qualitative study explored the challenges and stressors facing farmers in Ireland and how changes in farming governance have impacted farmers’ identities, masculinities and health. Eleven focus groups (n = 26 female, n = 35 male, age-range 20s–70s) were conducted with both male farmers (n = 3 focus groups; n = 13) and key informants (n = 8 focus groups; n = 48, 22 male, 26 female). Utilizing Thematic Content Analysis, transcripts were coded independently by the first and second author using open and comparative coding techniques, with emerging themes grouped into primary and subthemes. Theme memos and conceptual maps tracked evolving relationships between themes. The analysis identified three broad themes. “Wrestling with challenges to autonomy and control within farming” examines the impact of tighter regulatory frameworks associated with changes to farming governance and unpacks other challenges associated with scale and succession. “Farming masculinities and health” explores how farming masculinities were closely aligned with farming practices and health practices and were framed relationally. “Isolation and the demise of rural communities” considers the impact of reduced social interaction on loneliness among farmers, particularly among more “at risk” single and older farmers. Findings provide unique insights into contemporary challenges and stressors facing farmers and have important implications for informing the design and roll-out of a national farmers’ health training program.

Farm Suicides in Wisconsin, 2017–2018: Preliminary Findings and a Call for Future Research

Studies across the last few decades have consistently found farmers and farmworkers at an elevated risk of death by suicide compared to other occupational groups in the United States. Still, there is currently no comprehensive national surveillance system for agricultural-related injuries or suicides. For this study, we analyzed Wisconsin death certificate data from 2017 and 2018 to identify the burden of suicide among farmers and farmworkers. In 2017 and 2018, 44 farm-related suicides were identified, or 14.3 per 100,000 farmers and farmworkers. The median age of victims was 51.5 ± 20, and six (13.6%) were female. As these suicide cases were cross-checked, we found that none were identifiable solely from previously published news media or obituaries, indicating: (1) a clear need for a multi-sourced suicide data approach and inter-agency collaborations for future research, and (2) the need for a deeper investigation into the reporting of farm-related suicides. These data are necessary for informing state and local level policy, resource prioritization, and the evaluation of intervention efforts.

Neighborhood farm density, types of agriculture, and depressive symptoms among older farmers: a cross-sectional study

BACKGROUND

Farmers may have an increased risk for poor mental health. In connection with this, factors specific to the neighborhood environment such as farm density and the type of agriculture, might be important for mental wellbeing. In this study we aimed to clarify the cross-level interaction on depressive symptoms between farm density at the neighborhood level by type of agriculture and the longest occupation of individuals (farmer or non-farmer).

METHODS

Data came from the 2016 wave of the Japan Gerontological Evaluation Study (JAGES) that were linked to governmental agricultural data. Information was analyzed from 147,549 respondents aged 65 years or older, residing in 1024 neighborhoods in 39 municipalities. We calculated farm (crop or animal husbandry) density at the neighborhood level, dividing the number of agricultural management entities by the population. Three-level (individual, neighborhood, and municipality) Poisson regression analysis was used to calculate the prevalence rate ratios of depressive symptoms.

RESULTS

The prevalence of depressive symptoms was higher among individuals whose longest occupation was farmer compared to non-farmer. The estimated probability of depressive symptoms by a cross-level interaction analysis showed that among farmers of both genders, those who were residing in neighborhoods where the farm density was low had a higher prevalence of depressive symptoms, regardless of the type of agriculture. The slope of the relationship between depressive symptoms and animal husbandry farm density varied by occupation, with a higher prevalence of depressive symptoms observed in male farmers compared to male non-farmers.

CONCLUSIONS

The high prevalence of depressive symptoms among farmers in neighborhoods with a low farm density may reflect a scarcity of formal and informal social support in such communities. The health effects of the neighborhood environment on farmers, such as farm density, which may vary by the type of agriculture, should be further researched.

Farmer Mental Health in the US Midwest: Key Informant Perspectives

In this study, we seek to illuminate: (1) the ways farm service providers and mental health professionals understand the drivers of farm stress, (2) the strategies, challenges, and opportunities farm service providers and mental health professionals identify for supporting the mental health needs of farm families, and; (3) opportunities for future research and outreach to improve the mental health of farmers in the U.S. Midwest region. We obtained qualitative data from a series of semi-structured key informant interviews with 19 subject matter experts, using content analysis to identify themes across four domains: main challenges, unique impacts by subpopulation, coping strategies, and interventions and recommendations. The key informants we interviewed identified a variety of acute and chronic stressors, including several that are structural, rather than individual and interpersonal, and which lie outside of the control of farmers themselves. They also highlighted diversity within farm populations by socio-demographic and farm characteristics as well as positive and negative coping strategies, with negative being more common. For interventions and recommendations, they stressed the importance of education on mental health, improving access to care, and addressing root causes of stress. While farmer stress is well-documented, less is known about the perspectives of farm service professionals and mental health providers who care for them. The insights from this study add important information on how to best support the immediate and long-term mental health needs of farmers and farm families in the U.S. Midwest and beyond.

Assessing Farm Stress and Community Supports in a U.S.-Mexico Border County

Imperial County, California, is a high-need, medically underserved area that has some of the worst overall health outcomes of all California counties. Given this and the high depression and anxiety rates in agricultural occupations, Imperial County farmers and ranchers may be at an increased risk of stress and poor mental health outcomes. An exploratory mixed methods assessment was used to collect information from 24 farmers and ranchers in Imperial County. Survey topics included questions about farm or ranch operations, farm-related stress, mental health, community support, and health behaviors. The results indicate that most respondents perceive unpredictable factors, such as government regulations, as the most impactful stressors related to their farm or ranch operations. Additionally, depression symptomatology scores were positively correlated with respondents' ability to obtain credit. Efforts to understand farm-related stress and how community support can help Imperial County farmers and ranchers mediate adverse physical and mental health effects through formal and informal networks are considered.

Effectiveness of guided internet-based interventions in the indicated prevention of depression in green professions (PROD-A): Results of a pragmatic randomized controlled trial

BACKGROUND

Major Depressive Disorder (MDD) has a major impact on public health. Reduction of depression burden in general population is of greatest importance and might be achieved by implementation of depression prevention measures into routine care. We evaluate an online prevention measure as part of a national project aiming to reduce depression in the occupational group of green professions.

METHODS

This two-armed pragmatic RCT (n = 360) evaluates the effectiveness of a tailored internet-based intervention (IMI) program compared to enhanced treatment as usual. The IMI program entailed access to one of six guided IMIs each focusing on different symptom areas (depressive mood with optional comorbid diabetes, perceived stress, insomnia, panic and agoraphobia and harmful alcohol consumption). Eligible were entrepreneurs, spouses, family members and pensioners in green professions with adequate insurance status and at least subthreshold depression (PHQ≥5). Primary outcome was depressive symptom severity (QIDS-SR16) at 9-weeks post-treatment (T1). Various secondary outcomes were assessed at T1.

RESULTS

A small effect of depression reduction (d=-0.28, 95%-CI: -0.50 to -0.07) was found at T1 favouring the IMI program (β=-0.22, 95%-CI: -0.41 to -0.02, p=.033). Categorical analysis indicated a reduced risk of potential MDD with NNTB=28.11. Adherence to the IMI program at T1 was exceptionally low.

LIMITATIONS

Results are limited to green professions and representativeness might be restricted by self-selection of participants.

CONCLUSION

Depression burden in green professions can be reduced by this online prevention measure. Yet, short-term effectiveness is restricted by low adherence rates.

TRIAL REGISTRATION

German Clinical Trial Registration: DRKS00014000. Registered: 09 April 2018.

Mortality from suicide among agricultural, fishery, forestry and hunting workers in Italy and the contribution of work-related factors

OBJECTIVES

Excess risk of suicide has been reported among workers in agriculture, fishery, forestry and hunting (AFFH). However, there is still uncertainty in the quantification of the risk and in the contribution of work-related factors. We aimed to quantify the suicide mortality risk among these workers in Italy.

METHODS

We carried out a historical cohort study based on record linkage between the 2011 Italian census and the mortality archives for years 2012-2017. The mortality rate ratio (MRR) was used as a measure of risk. MRR was estimated through quasi-Poisson regression models using workers in other sectors as reference category. Models were adjusted for age, citizenship, marital status, area of residence, education, employment status and hours worked per week.

RESULTS

The cohort included 1 004 655 workers employed in the AFFH sector and 15 269 181 workers in other sectors. During the 6-year follow-up, 559 deaths from suicide (500 men and 59 women) occurred among AFFH workers and 5917 (4935 men and 982 women) among workers in other sectors. The MRR for suicide was 1.36 (95% CI 1.19 to 1.55) among men and 1.18 (95% CI 0.87 to 1.60) among women. The excess risk was remarkably high for casual and fixed-term contract workers (3.01, 95% CI 1.50 to 6.04).

CONCLUSIONS

Male workers in AFFH are at high risk of suicide mortality, and casual and fixed-term contract workers are at exceedingly high risk. Our study also suggests a higher risk among single, highly educated and long-hours workers. Female workers in AFFH do not have an appreciably increased risk.

Poor mental health of livestock farmers in Africa: a mixed methods case study from Ghana

Background

Agriculture represents the mainstay of African economies and livestock products are essential to the human population’s nutritional needs. However, in many developing countries, including Ghana, livestock production fails to meet demand due to population growth and negative effects of climate change. One of the challenges to production is livestock loss affecting farmers. However, despite stressful events experienced, livestock farmers’ mental health is poorly documented. This study aims to identify the root causes of livestock losses and their influence on pastoralists’ mental health.

Methods

We conducted a mixed methods study in two districts in the Northern and Southern Belts of Ghana. Using the Depression Anxiety and Stress Scale–21 and guided interviews, we collected quantitative and qualitative data from 287 livestock farmers and 24 key-informants respectively. Mental health scores were categorized using standard guidelines. We evaluated the factors that explained variations in mental wellbeing using general linear models (α = 0.05).

Results

About 85% (240/287) of the livestock farmers lost cattle within 1 year. Of these, 91% lost cattle to animal diseases, 50% to theft and 27% to pasture shortages. Qualitative findings reveal that due to poor access to veterinary services, farmers treat livestock diseases themselves with drugs from unregulated sources and often sell diseased cows for meat to recover losses. Findings showed that 60% of livestock farmers had poor mental health. Of those, 72% were depressed, 66% anxious and 59% stressed. Mental wellbeing was negatively associated with the number of adverse events experienced, proportion of livestock lost to most of the major loss factors, emotional attachment to livestock and self-reported physical illnesses in farmers, but positively associated with increasing herd size [F (8,278) = 14.18, p < 0.001, R² = 0.29].

Conclusions

Livestock diseases are the leading cause of losses to livestock farmers, whose mental wellbeing is negatively affected by these losses. Although an adaptive strategy by farmers to compensate for poor veterinary services, the arbitrary use of veterinary drugs and sale of diseased cattle pose health risks to the public. Further research to evaluate the performance of veterinary services in Ghana, mental health problems and risk to human health due to potential high-risk meat entering the food chain, is needed.

Gender Differences in Depressive Symptoms and Work Environment Factors among Dairy Farmers in Japan

Dairy farmers are more likely than nonfarmers to experience high demands and are at risk of mental health problems. However, there is scarce evidence on the current state of psychological health and related factors among dairy farmers, and the knowledge of potential gender differences is limited. This study aimed to examine the prevalence of depressive symptoms assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and its association with work environment characteristics and to identify gender differences. Data were collected from 273 dairy farmer participants (169 males and 104 females) in Japan. Females were more likely to be depressed, and young and middle-aged women appeared to be at risk of depression. For both genders, a demanding work environment was related to depression. There were some gender differences; for example, worries about the harmful effects of pesticides on health and the balancing of family roles and work roles were related to depression in men, while worries about one's financial situation and the health status of livestock were associated with depression in women. Females benefited from support through direct interaction, while males benefited from involvement in social activities. These findings will contribute to the development of a gender-specific approach to promote psychological health in the dairy farming community.

Characterizing the attitudes and motivations of Ontario dairy producers toward udder health

Considerable research has focused on identifying risk factors for intramammary infections, yet mastitis remains a pervasive disease on dairy farms. Increasingly, researchers are appreciating the role of dairy producer mindset in determining management style and thus udder health status of the herd. The objective of this study was to explore the attitudes and motivations of Ontario dairy farmers toward udder health in herds with varying bulk milk somatic cell count (BMSCC). In December 2011, 5 focus groups were conducted across Ontario, Canada, with independent groups of dairy producers representing low, medium, and high BMSCC herds. Groups were established based on producer's weighted BMSCC levels as recorded over the summer of 2011. A semi-structured interview guide was followed to discuss topics relating to udder health. Thematic analysis was performed on the interview transcripts. Generally, producers noted management techniques (specifically culling infected cows and monitoring BMSCC), a perceived wealth of information on mastitis control, and a proactive whole-herd management approach engender the perception of control over mastitis. Producers in the low BMSCC group were confident in their level of knowledge and control of mastitis in their herds, whereas high BMSCC producers generally felt lower levels of control. Several areas were identified by producers that counteract this perception, contributing to perceived low levels of control over mastitis. Participants identified that at certain times they do not understand the cause of BMSCC on their farm. This attitude was especially prominent in the high BMSCC group. Other times, producers cited improper sample handling, seasonal issues, perceived milk culture shortcomings, and low herd size as factors that limited their control over mastitis in their herds. Though producers generally have high levels of self-efficacy beliefs when it comes to udder health management, the perception still exists that, under certain situations, mastitis is uncontrollable. This highlights the fact that educational and extension efforts need to focus on ensuring that producers employ proven mastitis diagnostic, prevention, and treatment practices in a systematic manner, with realistic expectations.

Farmer Discussion Groups Create Space for Peer Learning about Safety and Health

Objectives: Occupational safety and health (OSH) interventions emphasizing regulation or education have had limited success in reducing agricultural accidents and fatalities. There is a growing interest in sociocultural approaches to OSH promotion amongst farmers, such as peer learning groups (PLGs). The level of OSH engagement within farmer PLGs (e.g. dairy discussion groups (DDGs)) is unknown. This study evaluates Irish DDG engagement with OSH in 2016 to better understand how DDGs contribute to OSH promotion.Methods: A mixed-mode (online, postal, and telephone) retrospective survey of 121 DDG representatives (i.e. chairperson or long-term member) assessed voluntary OSH engagement in 2016, including the location, frequency, duration, and content of OSH discussions.Results: Representatives of 96 DDGs participated in the survey and met the survey criteria. Most DDGs discussed OSH to some extent in 2016 (96%), including sharing personal experiences of accidents and illnesses (89%) and close calls (82%). For 76 DDGs, at least one meeting in 2016 addressed specific hazard and risk management topics. Groups were diverse with respect to discussion frequency, duration, and topics discussed.Conclusion: Farmers actively engaged with OSH in most DDGs surveyed, suggesting dairy farmers value OSH discussions. The findings illustrate the role of DDGs in OSH promotion, as a space for farmer-led, peer-to-peer knowledge-sharing. Farm advisory (extension) services and OSH professionals can strengthen OSH engagement through tailored resources that reflect contemporary OSH knowledge and popular discussion approaches (e.g. experience-sharing).

Suicide and Types of Agriculture: A Time-Series Analysis in Japan

OBJECTIVE

In recent years, rural areas have reported higher suicide rates than urban areas worldwide. Although agricultural activity is a key characteristic of many rural areas, rurality may also have heterogeneous qualities based on the type of agriculture pursued. However, to date, no study has examined potential linkages between suicide rate and types of agriculture.

METHOD

In this study, we used 1983-2007 annual time-series data of the standardized mortality ratio (SMR) of suicide and product-specific agricultural outputs in Japanese municipalities to shed light on this phenomenon. We conducted a multilevel linear regression analysis, taking into account a hierarchical structure of the time-series data, limiting our analysis to municipalities where agricultural land use was high.

RESULTS

Our multilevel analysis showed that the animal husbandry output was positively associated with suicide SMR in both women and men, with a stronger relationship among women, whereas no association was observed in agricultural crop output. Temporal analysis showed that the association could be observed consistently throughout the period between 1983 and 2007.

CONCLUSIONS

This study raises the possibility that the industrial and cultural characteristics of communities that rely on animal husbandry may be associated with an increased risk of suicide.

Using a Neural Network Analysis to Assess Stressors in the Farming Community

In the 1980s and 1990s, with decreasing numbers of full-time farmers and adverse economic conditions, chronic stress was common in farmers, and remains so today. A neural network was implemented to conduct an in-depth analysis of stress risk factors. Two Colorado farm samples (1992-1997) were combined (n = 1501) and divided into training and test samples. The outcome, stress, was measured using seven stress-related items from the Center for Epidemiologic Studies-Depression Scale. The initial model contained 32 predictors. Mean squared error and model fit parameters were used to identify the best fitting model in the training data. Upon testing for reproducibility, the test data mirrored the training data results with 20 predictors. The results highlight the importance of health, debt, and pesticide-related illness in increasing the risk of stress. Farmers whose primary occupation was farming had lower stress levels than those who worked off the farm. Neural networks reflect how the brain processes signals from its environment and algorithms allow the neurons "to learn". This approach handled correlated data and gave greater insight into stress than previous approaches. It revealed how important providing health care access and reducing farm injuries are to reducing farm stress.