Health-related quality of life within agriculture in England and Wales: results from a EQ-5D-3L self-report questionnaire

Health-related quality of life assessed by EQ-5D-5L and its determinants among Chinese adults

Background

Due to the rising standard of living and advances in public health and medical care in recent years in China, the health-related quality of life (HRQoL) has been increasingly acknowledged as an important part of health management of adults. This study aimed to analyze the HRQoL of Chinese adults and identify the influencing factors, proposing specific recommendations for improvement.

Methods

A cross-sectional study was conducted among 1,291 selected adults from four provinces spanning different regions in China aged ≥18 years from July 2021 and January 2022. The EuroQol-5D-5L (EQ-5D-5L) was used to conduct the HRQoL survey, and a general questionnaire was administered to collect demographic characteristics, general information, and health behaviors of participants. The health utility value was measured, and one-way analysis of variance was performed. The Tobit regression model was employed to analyze the factors influencing the HRQoL of Chinese adults.

Results

The mean health utility values and visual analog scale scores for adults were 0.9400 ± 0.1197 and 84.09 ± 14.392, respectively. Notably, 60.3% of respondents reported no difficulties in any of the five dimensions of EQ-5D. However, a substantial proportion faced challenges in anxiety/depression (27%) and pain/discomfort (26.2%). Tobit regression model revealed that age, marital status, educational level, diet, sleep, mental state, mood, and chronic diseases significantly impact the HRQoL of Chinese adults.

Conclusion

The HRQoL among Chinese adults is generally satisfactory, but pay particular attention on areas such as pain, psychological anxiety, chronic diseases, and negative emotions is needed. The factors such as stress associated with marriage and the demands of high-skilled occupations might influence the overall health of the population. According to our findings, public health strategies to improve HRQoL should be developed to promote relatively healthy environments and lifestyles for older adults. Moreover, proactive measures are crucial for mitigating the potential health impacts associated with marital stress and high-skilled employment.

Factors Associated with Elderly Health-Related Quality of Life in Tibet: A Cross-Sectional Study from a Health Ecological Perspective

Background

Aging and its consequences are receiving considerable global attention in developed and developing countries. The health-related quality of life (HRQoL) of elderly individuals is crucial for public health and social welfare. Despite advances in understanding the health status of the elderly population in Tibet, a region located on China's southwest border, a significant research gap remains regarding their HRQoL.

Methods

We conducted a cross-sectional study in Tibet, China, in 2018, which thoroughly examined HRQoL and its determinants in individuals aged 60 and above. The EQ-5D-VAS instrument, consisting of two standardized scales (EQ-5D-3L and EQ-VAS), was utilized to measure HRQoL. We based the selection of potential determinants on a novel health ecological model encompassing various environmental and personal factors. We employed the Least Absolute Shrinkage and Selection Operator regression to systematically pinpoint key predictive factors for dimensionality reduction. The Tobit regression analysis further elucidated the relationship between these factors and the EQ-VAS and EQ-5D-index scores.

Results

Our study encompassed 1604 elderly participants. They presented varying severity levels across all five dimensions of the EQ-5D-3L. The most commonly observed issue was pain/discomfort, with a prevalence of 40.27%. The average EQ-VAS score was 56.15 (SD=21.15), and the mean EQ-5D-index score was 0.78 (SD=0.25). Our multivariate analysis revealed that determinants such as age, sex, number of chronic illnesses, vision problems, hearing problems, physical activity, employment status, social participation, place of residence, and insurance type were significantly associated with HRQoL.

Conclusion

The HRQoL of Tibet's elderly population presents significant concerns, especially given the region's challenging natural conditions. This underscores the urgent need for focused policy interventions at the socio-economic strata to extend vital support and aid.

Anxiety and Associated Stressors Among Farm Women in England and Wales

OBJECTIVES

The findings presented here derive from a wider study that sought to establish a baseline understanding of mental health and wellbeing among the agricultural community in England and Wales. This paper focuses on selected questions that investigated levels of anxiety and associated stress factors among farm women, a group which has been relatively neglected within previous research on farming mental health in the United Kingdom.

METHODS

A questionnaire survey was widely distributed to members of the agricultural community in England and Wales (n = 15,296) in both paper and online formats. The survey included a number of standardised instruments to assess mental health and wellbeing, including the Generalised Anxiety Disorder-7 scale (GAD-7). Focusing on a sub-sample of female respondents (n = 3487), this paper details the findings from the GAD-7, alongside those from a selection of other questions investigating sources of stress, loneliness and perceived business viability.

RESULTS

A significant proportion of female respondents were experiencing anxiety at the time of survey completion, with 23.3% reaching the threshold for clinically relevant anxiety based on their GAD-7 scores (medium or severe anxiety, scores≥10). A further 34.6% were classified as experiencing mild anxiety (scores 5-9) whilst 42.1% were not suffering from anxiety (scores 0-4). Medium/severe anxiety was identified as being associated with a number of stress factors, feelings of loneliness and pessimistic perceptions of farm business viability. There were important age-based differences, with working-aged women identified as more likely to suffer from anxiety, loneliness and certain stressors than older women.

CONCLUSION

The findings reported here indicate concerning levels of anxiety among farming women and this should be seen as a call to action. There are clear associations between anxiety and a range of stressors and, although we cannot ascertain causality, these point to issues that demand attention in efforts to improve mental health within this social group. The factors contributing to anxiety are, however, multiple and complex and farm women may be affected by particular gender-based challenges that have not yet been explicitly explored in relation to mental health. Further research is needed to investigate and understand these issues in greater depth.

Farmers Supporting Farmers: Livestock Auctions as Spaces to Reconstruct Occupational Community and Counter Mental Health Issues

Social isolation within agricultural communities is prevalent within the United Kingdom (UK). Along with other social and economic determinants, social isolation is considered to be a contributing factor towards the high rates of mental health issues experienced among people working in agriculture. The livestock auction mart is one of the remaining spaces upon which many livestock farmers rely for consistent social interaction and to experience community, both determinants proven to improve physical and mental health. However, the importance of the social contribution of livestock auction marts to farmer wellbeing appears rarely in associated literature. The aims of this study, therefore, were i) to determine levels of isolation experienced by livestock farmers who attend auction marts and ii) to identify the role of the mart as a system of social support, with an emphasis on the informal support system attendees provide for one another. Findings from 90 qualitative interviews demonstrate that the auction mart is an important social site where occupational community and identity can be produced and reproduced for all attending stakeholders, positively impacting upon mental health and wellbeing. The strength of the occupational community among livestock farmers should be considered as a key element among a basket of options approach in the development of support interventions, and as a pathway to negotiating barriers to both help-seeking behaviors and reaching the hard-to-reach.

The wellbeing paradox in Hungarian local sustainable agriculture: a health psychology approach

BACKGROUND

The literature suggests that farmers' work involves a number of operational difficulties. Although alternative food networks address the majority of their problems, they can potentially generate new hardships. The aim of this study is to examine the situational and engagement-related work difficulties associated with the everyday world of Community Supported Agriculture (CSA) farmers.

METHODS

This study used the health psychology approach, namely interpretive phenomenology, to understand the social determinants of farmers' working lives in CSA and to explore mental health challenges within the practices of local sustainable farming. To collect data, semi-structured, in-person interviews were conducted with CSA farmers in Hungary.

RESULTS

Our study shows that new modes of consumer-producer connectivity create novel situations and issues which farmers are forced to address. Three personal experiential themes emerge from the data to describe CSA farmers' work difficulties: (1) Conflicted autonomy; (2) The pressure of boxes; (3) Social overload. The difficulties for CSA farmers seem to be rooted in the economic characteristics of alternative agriculture where farmers organize food production for the satisfaction of consumer needs. In addition, structural conditions require several different CSA farmer roles, which could even be conflicting.

CONCLUSION

This study provides participants' perspectives on the health and wellbeing costs of sustainable farming. Newer producer-consumer connections require both time and experience and involve extra effort or skills, but farmers often lack these abilities. The results show how perceptions of work processes relate to the general framework of CSA, which necessitates a distinct strategy for farm management.

The impact of COVID-19 on farmers' mental health: a case study of the UK

OBJECTIVES

In this paper, we use a UK case study to explore how the COVID-19 pandemic affected the mental health (emotional, psychological, social wellbeing) of farmers. We outline the drivers of poor farming mental health, the manifold impacts of the pandemic at a time of policy and environmental change, and identify lessons that can be learned to develop resilience in farming communities against future shocks.

METHODS

We undertook a survey answered by 207 farmers across the UK, focusing on drivers of poor mental health and the effect of the COVID-19 pandemic. We also conducted 22 in-depth interviews with individuals in England, Scotland and Wales who provide mental health support to farmers. These explored how and why the COVID-19 pandemic affected the mental health of farmers. These interviews were supplemented by 93 survey responses from a similar group of support providers (UK-wide).

RESULTS

We found that the pandemic exacerbated underlying drivers of poor mental health and wellbeing in farming communities. 67% of farmers surveyed reported feeling more stressed, 63% felt more anxious, 38% felt more depressed, and 12% felt more suicidal. The primary drivers of poor mental health identified by farmers during the pandemic were decreased social contact, issues with the general public on private land, and moving online for social events. Support providers also highlighted relationship and financial issues, illness, and government inspections as drivers of poor mental health. Some farmers, conversely, outlined positive impacts of the pandemic.

CONCLUSION

The COVID-19 pandemic is just one of many potential stressors associated with poor farming mental health and its impacts are likely to be long lasting and delayed. Multiple stressors affecting farmers at the same time can create a tipping point. Therefore, there is a need for long-term support and ongoing evaluation of the drivers of poor mental health in farming families.