Background
The physical health of farmers
The mental health of farmers
The Australian Rural Mental Health Study (ARMHS)
Methods
Recruitment
Definition of the study group
Variables and outcomes
Socio-demographic characteristics
Vulnerabilities and rural mediating factors
Physical health outcomes
Mental health and wellbeing outcomes
Service use
Statistical methods
Results
Baseline | 1 year | 3 years | 5 years | |
---|---|---|---|---|
N = 1284 | N = 782 | N = 528 | N = 460 | |
Demographics | ||||
Age (mean, SD) | 48.3 (11.9) | 50.7 (11.2) | 51.8 (10.4) | 53.9 (10.5) |
Gender, female (n, %) | 733 (57 %) | 460 (59 %) | 317 (60 %) | 274 (60 %) |
Married/defacto (n, %) | 1019 (79 %) | 628 (80.7 %) | 435 (82.4 %) | 373 (82.5 %) |
Completed highschool (n, %) | 1000 (80.3 %) | 619 (82.4 %) | 435 (84.5 %) | 376 (84.9 %) |
Financial hardship (n, %)* | 289 (29 %) | 191 (25 %) | 116 (22 %) | 102 (22.5 %) |
ARIA + (mean, SD) | 4.47 (3.35) | 4.34 (3.27) | 4.44 (3.40) | 4.26 (3.22) |
Main Outcomes | ||||
Self-Report Physical Health (mean, SD)* | 3.45 (0.96) | 3.24 (0.91) | 3.24 (0.91) | 3.27 (0.91) |
Self-Report Mental Health (mean, SD) | 3.60 (0.99) | 3.54 (0.93) | 3.57 (0.93) | 3.48 (0.97) |
Wellbeing Index (mean, SD) | 0.06 (0.69) | 0.03 (0.63) | 0.06 (0.62) | 0.01 (0.64) |
Characteristics of farmers, employed farm residents and other rural workers at baseline
Other rural workers | Farm Residentsa | Farmersb | |
---|---|---|---|
N | 850 | 253 | 181 |
Age (mean, SD) | 47.6 (11.5) | 47.0 (12.0) | 52.8 (12.6)** |
Gender Female (n, %) | 495 (58.2 ) | 167 (66.0)* | 68 (37.6)** |
Married/defacto (n, %) | 628 (74.0) | 207 (81.8)** | 155 (86.6)** |
Completed High school (n, %) | 667 (81.2) | 201 (81.3) | 128 (74.4)* |
Financial Hardship (n, %) | 181 (27.3) | 66 (29.8) | 47 (36.4)* |
Years Rural (mean, SD) | 35.66 (16.2) | 34.27 (16.52) | 44.21 (15.94)** |
ARIA+ (mean, SD) | 4.25 (3.35) | 3.96 (2.76) | 6.12 (3.61)** |
SEIFA (mean, SD) | 945.6 (34.5) | 934.5 (36.83)** | 921.69 (30.45)** |
Vulnerabilities | |||
Number of Adverse Life Events (mean, SD) | 1.52 (1.53) | 1.49 (1.48) | 1.67 (1.64) |
Neuroticism (mean, SD) | 2.08 (1.92) | 1.93 (1.74) | 1.91 (1.78) |
Community and Personal Support (mean, SD) | −0.06 (0.67) | 0.10 (0.63)** | 0.06 (0.65)* |
Rural Modifying factors | |||
Drought stress (mean, SD) | 1.20 (0.40) | 1.40 (0.49)** | 1.65 (0.48)** |
Infrastructure and Services Perception (mean, SD) | 2.40 (0.95) | 2.43 (0.93) | 2.71 (0.95)** |
Sense of Place (mean, SD) | 34.35 (6.19) | 36.89 (6.15)** | 38.27 (6.91)** |
Longitudinal analysis. Physical and mental health outcomes of farmers compared to non-farm workers
Farmers (estimated marginal means) | Non-farm workers (estimated marginal means) | Unadjusted GEE Farmer v Non-farm Worker | TOTAL effecta GEE Farmer v Non-Farm Worker | p Interactionb | ||
---|---|---|---|---|---|---|
ASGC regional (inner or outer) N = 2112 | ASGC remote (remote or very remote) N = 824 | |||||
Self-report Physical Health N = 3035 | 3.21 (SE 0.06) | 3.35 (SE 0.02) | β = −0.14 (−0.27, −0.02)* | β = 0.03 (−0.13, 0.19) | β = −0.19 (−0.39, 0.01) p = 0.06 | 0.02 |
Harmful Alcohol Use N = 2750 | 4.16 (SE 0.28) | 4.40 (SE 0.13) | β = −0.24 (−0.85, 0.38) | β = −0.44 (−1.11, 0.24) | NS | |
Current Smoker N = 2732 | 9 % (SE 2 %) | 13 % (SE 1 %) | OR 0.64 (0.37, 3.09) | OR 0.63 (0.35, 3.71) | NS | |
Overweight BMI ≥ 25 N = 1920 | 71 % (SE 4 %) | 68 % (SE 1.5 %) | OR 1.19 (0.81, 1.72) | OR 0.77 (0.51, 1.17) | NS | |
Adequate Exercise N = 965c | 15 % (SE 3 %) | 19 % (SE 1.4 %) | OR 0.72 (0.42, 1.22) | 0.78 (0.44, 1.38) | NS | |
Chronic Illness N = 2990 | 14 % (SE 2 %) | 12 % (SE 0.8 %) | OR 1.15 (0.80, 1.66) | OR 0.66 (0.44, 0.98)* | NS | |
Injury in the last 12 months N = 2992 | 18 % (SE 2 %) | 17 % (0.8 %) | OR 1.07 (0.78, 1.46) | OR 1.05 (0.76, 1.45) | NS | |
Number of visits to a GP in the last 12 months N = 2693 | 1.46 (SE 0.08) | 1.60 (0.04) | β = −0.09 (−0.21, 0.03) | β = −0.13 (−0.25, −0.01)* | NS |
Farmers (estimated marginal means) | Non-farm workers (estimated marginal means) | Unadjusted GEE Farmer v Non-farm Worker | TOTAL effecta GEE Farmer v Non-Farm Worker | p Interactionb | ||
---|---|---|---|---|---|---|
ASGC regional (inner or outer) N = 2112 | ASGC remote (remote or very remote) N = 824 | |||||
Wellbeing Index N = 3036 | −0.07 (SE 0.05) | 0.04 (SE 0.02) | β = −0.12 (−0.21, −0.02)* | β = −0.01 (−0.14, 0.13) | β = −0.21 (−0.35, −0.06)** | 0.01 |
Self-report Mental Health N = 3034 | 3.42 (SE 0.06) | 3.57 (SE 0.03) | β = −0.16 (−0.29, −0.02)* | β = 0.03 (−0.17, 0.23) | β = −0.33 (−0.53, −0.13)** | <0.01 |
Psychological distress N = 3032 | 14.6 (SE 0.33) | 14.4 (SE 0.14) | β = 0.01 (−0.04, 0.06) | β = 0.03 (−0.02, 0.09) | NS | |
Current depression N = 2743 | 2.65 (SE 0.22) | 2.91 (SE 0.10) | β = −0.25 (−0.74, 0.24) | β = −0.11 (−0.65, 0.43) | NS | |
Sought help from a Mental Health professional in last 12 months N = 2760 | 9 % (SE 2 %) | 16% (SE 1 %) | OR 0.52 (0.32, 0.83)** | OR 0.59 (0.35, 0.97)* | NS |