2011 Rural Health Summit presentation

1. 1-800-365-1656/kirk.ballin@va.eastersealsucp.com
Addressing health and safety issues related to individuals and families engaged in agricultural
related activities is more complex than it is with other residents of rural communities. Clinicians
may encounter issues similar to other clients/patients, but the unique situational context of a
farmer can amplify or compound the health issues of that farmer.
 Cultural Context
1. Work and way of life/identity are inseparably intertwined. More than just a job. For
many famers, being a farmer is a 24/7 existence.
2. Independent; self-reliant; trustworthy; a bit suspicious of outside interests
3. Getting the work done when it needs to be done is a priority. (story reference)
4. How a farmer views the world is first and foremost framed by his/her relationship with
everything that impacts upon whatever he/she is producing. Things that seem minor or
mundane to you or me can be significant to a farmer. e.g. talking about the weather
isn’t just small talk.
 Environmental Factors
1. The weather. Whether it’s sunny or rainy from one day to the next can have a huge
impact on a farmer’s day to day life and the success or failure of his/her endeavors, e.g.
mowing, drying, and baling hay.
2. Geography. The nature of the terrain and accessibility to the production areas of a farm
can be very demanding and even dangerous. Hilly, muddy, rocky, etc. Whether walking
or navigating with machinery, e.g. if you have arthritis in your joints, navigating
challenging terrains becomes even more difficult and painful.
3. Exposure to harmful substances and conditions: pesticides; herbicides; dust; fumes;
sound; too much sun; cold; wind; viruses; waste products
4. Livestock. Large or small, each brings its own set of unique challenges and demands (ref.
survey)
5. Working in confined or high places; twisting, jumping, lifting, climbing
6. Most farms are not regulated by safety standards or inspections for much of their
operations.
 Machinery/Tools

2. 1. Obvious dangers of working with big machines. Two of the most common for small
farmers: PTO; rollovers. Other issues: vibration; sound; fumes; stress on joints and
back; old machinery
2. Tool usage. Often tools are stressful on joints. Not ergonomically correct. Power
tools are often used without ear or eye protection.
3. Medications and machinery
 Financial Stresses
1. Most equity tied up in the farm, often in equipment, feed and seed
2. Income very vulnerable to weather, markets (local, national, international), timing,
availability of labor, fuel
3. Poor healthcare coverage; very often underinsured;
4. Natural or other disasters
5. Often have to take jobs off the farm to make it, and/or be dependent on other
family members’ income.
 Personal/Family Issues
1. Personal issues, especially if related to family problems, may have impact on work and
thereby on risk factors.
2. Delay seeking out healthcare (work demands, accessibility, tough-it-out mentality)
3. Obesity issues related to diet and a “hardworking sedentary lifestyle” (ref. survey). Co-
morbidity.
4. Less likely to seek behavioral health care (stigmas, availability, time). Related incidences
of depression and suicides.
5. Live and work in a somewhat circumscribed world, especially if they don’t belong to a
church or other community based organization.
 Migrant and Seasonal Farm Workers
1. Particularly vulnerable population because of nature of migrant lifestyle, and thereby
access to good, consistent healthcare
2. Cultural and language issues unique to this population, thereby decreasing
awareness/understanding of health and safety issues
3. Potential for exploitation and being put in riskier situations and healthcare needs being
ignored
Virginia Agricultural Health & Safety Survey:
http://bsesrv214.bse.vt.edu/Grisso/Papers/Virginia_Survey.pdf