Transcript Vermont AgrAbility v2 reed.ppt

Issues in Aging
Among Farmers
University of Kentucky
Deborah Reed
Lori Garkovich
Mary Kay Rayens
Susan Westneat
Steve Browning
University of Minnesota
Jan McCulloch
Clemson University
Charles Privette
NIOSH grant # R01 OH04157-01A1
Objectives for this session
Understand the normal aging process
Define “health” from a farmer perspective
Examine the health status of older farmers
Describe injury patterns of older farmers
Describe the sociocultural context of farm
work
 Examine work organization and adaptations
 Identify methods to assist older farmers
and their families





2/62
What makes farmers so old?
 Exodus of young people
 “retiring” from a nonfarm career into
farming
 shift from part-time farming to fulltime farming.
 Gale (2002) estimates that “about
25,000 operators in the 65-and-older
age group entered farming each year
from 1978 to 1992.”
3/62
“Normal” Aging






Decreased respiratory capacity – 20’s
Presbyopia – 40’s
Compromised joints – 50’s
Skin changes – 60’s
Decreased distal sensation – 70’s
Temperature tolerance – 80’s
4/62
As age advances . . .
 Prolonged recovery
 Morbidity and mortality increases
 Co-morbidities increase
5/62
Sample
Sustained Work Indicators of Farmers Over 50
 Farmers and their spouses over age
50 (N=1,423)
 African American farmers in South
Carolina
 Predominantly white farmers in
Kentucky
 Recruited through household survey,
KY FFHHSP, KY African-American
ROPS Survey, SCASS
6/62
Method
 4 survey waves




10/02-3/03
10/03-2/04
6/04- 7/04
3/05- 4/05
1423
1124
992
962
 Mailed and/or telephone surveys
 67.6% response rate
7/62
Summary Demographics
Characteristic
Gender
Race
Wave 1
Wave 2
Wave 3
Total
N
%
N
%
N
%
N
%
Male
714
51.5
481
50.2
494
51.7
1689
51.2
Female
673
48.5
477
49.8
462
48.3
1612
48.3
White
1090
79.0
777
81.5
764
80.3
2631
80.1
Black
273
19.8
164
17.2
175
18.4
612
18.6
Other
17
1.2
13
1.3
12
1.3
42
1.3
Yes
1260
91.1
879
91.9
873
91.5
3012
91.4
No
123
8.9
78
8.2
81
8.5
282
8.6
Currently married
8/62
Summary Demographics (continued)
Characteristic
Wave 1
Wave 2
Wave 3
Total
N
%
N
%
N
%
N
%
1190
85.8
841
87.8
831
86.9
2862
86.7
197
14.2
117
12.2
125
13.1
439
13.3
50-59
353
26.3
211
23.0
191
20.9
755
23.8
60-69
579
43.2
413
45.0
395
43.1
1387
43.7
70 and older
409
30.5
294
32.0
330
36.0
1033
32.5
State of residence
Kentucky
South Carolina
Age in years
9/62
Older Farmers . . .
 Slowing reflexes
 Physical wasting
 Accelerated hearing
loss
 Arthritis
 Cataracts
 Skin cancer
10/62
Self-rated health
Characteristic
Wave 1
Wave 2
Wave 3
N
N
N
%
%
%
Total
N
%
Health status
Excellent/very good
468
33.9 451 47.1
362
38.0 1281 38.9
Good/fair
803
58.1 430 44.9
527
55.4 1760 53.5
Poor
110
7.9
76
7.9
63
6.6
249
7.6
11/62
Self-rated Health by Age Groups
< 65
N=749
65 - 69
N=267
70+
N=407
Total Sample
N=1,423
Excellent
12.0
7.1
5.7
9.3
Very good
28.4
25.1
17.5
24.7
Good
36.7
33.3
35.2
35.7
Fair
16.8
28.1
29.8
22.7
Poor
6.1
6.4
11.8
7.8
12/62
Perspectives on Health Status
How would you best
define good health?
Under 65
N=749
65 - 69
N=267
70+
N=407
Total
Sample
N=1,423
Absence of pain
14.5
15.3
10.9
13.7
Ability to work
39.1
40.0
41.8
40.0
Absence of major disease
25.4
25.5
23.4
24.9
Not having to take
medications
17.0
16.5
18.1
17.2
Some other definition
3.9
2.8
5.9
4.2
13/62
Prevalence of health problems affecting at least 10% of male respondents
60
Percent of respondents with each health problem
55.6
50
46.9
40
29.2
30
26.8
24.6
20
17.1
16.1
14.9
12.1
10
0
Arthritis
Hypertension
Back
Hearing
*Calculated as a percentage of male respondents only
Cataracts
Other vision
Prostate*
Diabetes
Heart
14/62
Prevalence of health problems affecting at least 10% of female respondents
60.00%
50.00%
48.42%
41.83%
40.00%
30.00%
22.92%
20.00%
21.92%
11.75% 11.60%
10.46% 10.46%
10.00%
st
eo
po
ro
si
s
es
et
O
er
v
th
O
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ia
b
is
io
n
ts
ar
ac
C
at
ri n
g
Ba
ck
H
ea
er
te
H
yp
Ar
th
ri t
i
s
ns
io
n
0.00%
15/62
Comparisons of number of health problems
by demographic characteristics
3.5
Average number of health problems
3
*
*
2.5
2
1.5
1
0.5
0
<65 years >= 65 years
*Comparison significant at p < .05
Male
Female
White
Minority
16/62
Activity Deficits – part 1
Male
Sitting 2 hours
12.35%
Female
16.80%
Standing/being on feet 2
hours
29.70%
27.94%
Walking up 10 steps
without resting
10.28%
8.32%
Difficulty walking for 1/4
mile
0.00%
16.93%
17.21%
5.00%
10.00%
15.00%
20.00%
25.00%
30.00%
35.00%
17/62
Activity Deficits – part 2
Male
Carrying 10 lbs.
Pick up penny
Female
13.44%
5.67%
9.88%
9.31%
Reaching up over
head
17.62%
17.00%
43.28%
39.35%
Stooping, kneeling
0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
18/62
Take Prescription Meds Daily
%
Frequency
N
Male
70.9%
350
494
Female
79.6%
403
506
Total
sample
75.3%
753
1,000
19/62
Types of Meds Taken
%
Frequency
Heart
17.0
129
Diabetes
14.0
107
Respiratory
2.5
19
Arthritis
17.9
135
Blood Pressure
59.8
450
Glaucoma
1.7
13
Thyroid
9.3
70
20/62
Depression – CESD Scores
 20 items measuring depressive
symptoms
Possible score range from 0-60
12% scored above 16 (at risk) with half
of those above 23 (probable
depression)
Compares somewhat favorably to
general elderly population (14-44%)
21/62
“How do you see yourself?”
Examples of Questions Asked
 I’ve always felt I could make of my life
pretty much what I wanted to make of it.
 Once I make up my mind to do something,
I stay with it until the job is completely
done.
 Very seldom have I been disappointed by
the results of my hard work.
 It’s important for me to be able to do
things the way I want to do them rather
than the way other people want me to do
them.
22/62
John Henryism Scale
 Self-efficacy scale
 12 items 4 pt Likert
 (completely true → completely false)
 Lower score = higher self-efficacy
 Sample did extremely well
 Mean score 19.25 / 48
 Males scored better than females (p=.03) but
both in high end
23/62
Injury
24/62
Results: Injury rates
by wave and gender
Wave
Male
(1689)
Female
(1612)
Overall
Rate*
1
16.2
3.7
9.5
2
15.4
4.4
9.3
3
14.3
3.7
8.6
* Adjusted for age distribution
25/62
Farm Injury Rate Among Older Male Farmers by Age and
Wave of Survey. Analysis based on 1689 (observations)
of Older Male Farmers from Kentucky and South Carolina.
25
20
15
Wave 1
Wave 2
Wave 3
10
5
0
50-59
60-69
70 and +
Age in Years
26/62
Farm Injury Rate Among Older Female Farmers by Age and
Wave of Survey. Analysis based on 1612 (observations) of
Older Females from Kentucky and South Carolina.
25
20
15
Wave 1
Wave 2
Wave 3
10
5
0
50-59
60-69
70 and +
Age in Years
27/62
Distribution of Farm Injury for
Males (n=282 injuries)
n=49
17.4%
n=179
63.5%
n=13
4.6%
n=20
7.1%
n=19
6.7%
Cuts
Chemicals
Burns
Broken Bones
Amputations
Sprains
n=2
.7%
28/62
Distribution of Farm Injury
for Older Female Farmers
n=5
8.2%
n=37
60.7%
N = 61 Injuries
n=7
11.5%
n=3
4.9%
Cuts
Chemicals
Burns
Broken Bones
n=6
9.8%
Amputations
Sprains
n=3
4.92%
29/62
Preliminary Bivariate Association
With Farm Injury
Characteristic
N (farm injury)
Rate
OR
95% CI
White
233
8.9
Black
62
10.1
1.16
0.85-1.57
Other
6
14.3
1.72
0.64-4.31
50-59
89
11.7
1.40
1.01-1.92
60-69
119
8.6
0.99
0.73-1.33
90
8.7
Race
Age
70 & older
30/62
Preliminary Bivariate Association
(continued)
Characteristic
N
(farm injury)
Rate
OR
95% CI
242
14.3
4.25
3.15-5.74
61
3.8
More time
46
16.4
2.94
1.85-4.66
Same time
189
9.6
1.58
1.11-2.26
Half as much
23
8.3
1.35
0.77-2.34
Much less
44
6.3
Gender
Male
Female
Work Status
31/62
Percent injured within the last 12 months, by type and source
Percent of respondents injured, by injury type
14
Farm-related
Not farm-related
12
10
8
6
4
2
0
Cut (stiches)
Burn
*Includes sprains, strains, etc.
Broken bone
Type of Injury
Chemical reaction Digit/extremity loss
Other injury*
32/62
Work
33/62
Characteristics of the farm
respondents and the farm
operation
Under
65
N=749
65 – 69
3.5
3.9
4.5
3.9
Crops
32.6
36.5
32.7
33.4
Both
63.9
59.6
62.8
62.8
Hay
65.8
66.7
64.4
65.6
Cattle and calves
61.4
57.3
62.9
61.1
Tobacco
49.7
50.2
51.6
50.3
N=267
70+
Total
Sample
N=407 N=1,423
General type of farm
Livestock
Proportion of farms with the
following crops or livestock
34/62
Farm Work Status Compared to
Last Year
< 65
N=749
65 - 69
N=267
70+
N=407
Total
Sample
N=1,423
More time
13.9
8.6
4.2
10.2
About the same
57.2
59.1
55.4
57.1
8.2
9.0
9.2
8.6
20.6
23.4
31.2
24.1
Half as much
time
Much less time
35/62
Performance of Farm Tasks Over Time
In past 5 years
< 65
N=748
65-69
N=267
70+
N=407
Since April 2002
< 65
N=748
65-69
N=267
Total Sample
N=1,423
70+
N=407
In
past 5
years
Since
April
2002
Crop Production Activities
Till ground (plow,
disc)
43.3
44.9
41.8
35.1
33.7
30.7
43.1
33.6
Plant crops
47.4
43.8
36.6
36.3
34.5
26.8
43.6
33.2
Apply pesticides,
herbicides,
insecticides
44.5
41.1
39.1
34.8
33.3
29.2
42.4
33.0
Bale hay or straw
42.5
37.8
38.6
33.9
32.6
31.4
40.5
33.0
Hand harvest crop
35.0
27.3
26.3
22.8
21.3
16.2
31.1
20.7
Transport crops
30.6
25.5
21.1
23.6
19.9
17.0
26.9
21.0
Operate a combine
9.2
8.6
5.4
5.2
6.0
3.4
8.0
4.8
Chop silage
4.8
5.2
5.2
2.3
3.7
3.4
5.0
2.9
36/62
In past 5 years
< 65
N=748
65-69
N=267
70+
N=407
Since April 2002
< 65
N=748
65-69
N=267
Total Sample
N=1,423
70+
N=407
In past
5
years
Since
April
2002
Animal Production Activities
Feed animals
63.0
53.9
52.8
56.2
49.1
44.7
58.4
51.6
Mow fields
51.8
50.9
53.8
43.5
47.2
47.9
52.2
45.5
Herd animals
42.5
36.7
36.9
38.2
31.8
31.0
39.8
34.9
Transport animals
38.9
31.5
29.2
33.2
28.8
24.1
34.7
29.8
Other veterinarian
work
31.5
25.8
23.6
27.4
23.6
17.9
28.2
24.0
Castrate animals
23.8
25.5
21.9
18.0
20.2
17.7
23.5
18.3
4.9
3.4
3.4
2.3
2.2
1.2
4.2
2.0
Milk animals
37/62
In past 5 years
< 65
N=748
65-69
N=267
70+
N=407
Since April 2002
< 65
N=748
65-69
N=267
Total Sample
N=1,423
70+
N=407
In
past 5
years
Since
April
2002
Other General Farm Activities
Run farm errands
74.9
67.4
63.1
71.2
64.0
57.5
70.1
65.9
Repair farm
equipment/tools
47.1
49.8
50.4
45.7
45.7
44.5
48.6
45.3
Climbed higher
than 8 feet
43.9
43.8
39.1
40.0
37.8
34.9
42.5
37.9
Operated farm
equipment on
highways
41.4
38.2
36.6
39.9
32.6
32.2
39.4
36.3
Farm Management Tasks
Paid farm bills
75.2
73.4
68.3
72.2
66.3
62.9
72.9
68.4
Done farm
bookkeeping
66.1
56.2
55.5
64.8
52.4
51.1
61.2
58.5
Order farm
supplies
60.7
55.8
55.4
56.9
50.2
50.4
58.2
53.8
Purchased major
farm supplies or
equipment
44.6
43.1
43.5
37.1
34.1
33.4
44.0
35.5
Comparisons of number of farm tasks in last 5 years and last 12 monthsa
by demographic characteristics
Average number of farm tasks done
14
12
10
a
a
8
6
4
2
0
<65 years >= 65 years
Male
Female
White
Minority
*Comparisons were made between the levels of the demographic variable for a fixed time; bars
with the same letter are not significantly different (p > .05)
a Solid
bars give tasks done in the last 5 years; hashed bars refer to tasks in last year
39/62
Retired from farming?
Amount of Farming
< 65
N=749
65 - 69
N=267
70+
N=407
Total
Sample
N=1,423
Completely retired
15.3
20.7
30.6
20.7
Partially retired
37.6
54.4
51.5
44.7
Not retired
47.1
24.9
17.9
34.6
40/62
Adaptations to Continue Farming
< 65
N=749
65 - 69
N=267
70+
N=407
Total
N=1,423
Likely
47.1
61.0
64.3
54.6
Not likely at all
52.9
39.0
35.8
45.4
Likely
33.6
31.0
25.1
30.8
Not likely at all
66.4
69.1
74.8
69.3
Likely
30.6
41.3
43.6
36.2
Not likely at all
69.4
58.7
56.5
63.8
Likely
39.1
51.4
55.5
46.0
Not likely at all
60.9
48.6
44.5
54.0
In next 5 years, how likely will you:
Stop farming completely
Change type of farming (e.g.
crops instead of livestock)
Transfer farm management to
another person(s)
Have someone else take over
farm tasks
Adaptations to continue
farming
Under
65
N=749
65 - 69
70+
N=267 N=407
Total
Sample
N=1,423
In the past 5 years, have you
done any of the following to
make your farm work easier?
Bought newer equipment to make
a farm task easier to do
59.8
50.6
45.0
53.8
Reduced the scale of my operation
31.9
33.0
34.2
32.7
Stopped raising or producing a
particular crop or animal
25.5
20.0
26.3
24.7
Had someone else take over a
farm task
17.1
23.6
29.2
21.8
Leased out or sold land
19.0
16.4
25.8
20.4
Purchased a computer for farm use
24.6
14.2
7.4
17.7
Changed from primarily crop
production to livestock production
15.4
15.7
16.2
15.7
Changed from primarily livestock
production to crop production
5.9
5.6
6.9
6.1
42/62
Farm Work Satisfaction
< 65
N=749
65 - 69
N=267
70+
N=407
Total
Sample
N=1,423
A great deal
56.9
56.9
67.1
59.8
Some
31.2
30.8
23.5
28.9
Very little
7.2
6.7
5.0
6.5
None
4.7
5.5
4.4
4.8
43/62
“Cutting Back”
Transitioning from farmer to retiree
… learning from focus groups …
44/62
Objective
Identify the
processes, barriers,
and facilitative factors
included in the decision of farmers age
50 and over to retire from farm work
45/62
Farming – Cradle to Grave
 Most rapidly aging
occupation in
America
 Family structured
 Historical and
cultural context
46/62
FACTORS THAT INFLUENCE THE
DECISION TO CONTINUE FARMING
 Social factors
 Type of farm enterprise
 Household composition
 Economic status
 Structural factors




Opportunities for labor substitution
Availability of hired labor
Degree of mechanization
Ownership
47/62
WORK AND ITS MEANING
 To be a farmer is to be
a manager, owner,
employee and laborer –
all simultaneously.
 To be a farmer is to
“carry on the family
tradition”
 To be a farmer is to
become part of the land
itself
48/62
SAMPLE (N = 67)
Couples Females
Males
TOTAL
Black
8 (16)
6
6
28
White
14 (28)
6
5
39
Total
22 (44)
12
11
67
Selected counties in Kentucky and South Carolina
49/62
PRIMARY CONCEPTS
 Farm management and decision
making
 Physical farm labor
 Use of technology in farm practices
 Health
 Attachment to land
50/62
Summary of Findings
 Technology and production modifications
allowed farmers to remain in physical labor
on the farm but decrease the amount of time
(“cutting back”)
 Attachment to land: major factor in
sustained work of older farmers and spouses
 Intend to remain active until health forces
them to retire
51/62
Summary of Findings (continued)
 Farming and farm work is a part of the
self-identity
 When planning occurs for retirement it is
most often in the context of the land,
not personal wellbeing.
52/62
Persistence of Work
 Self-defined as “retired” or had “cut back”
 “I’m retired from the physical part….still do
all the management. I drive the tractor. I do
the silage and rake the hay. But all I really
do is manage the dairy.”
‘Retired’ farmer
 I help my neighbors and son when they
need it. I still do some custom work [ hay].
We do some research plots for seed.
 Definition of work: “If you love it, it’s not
work.”
53/62
Meaning of Work
 Defines health
 “I can’t think of a time I wouldn’t be raising
cows unless I was dead or disabled.”
 “We don’t really want to be retired because,
truth is, you haven’t got long.”
 “As long as I can climb onto a tractor I will.
If you stop, you set still and die.”
 Defines self
 “farming is a habit, a way of life. We
don’t know anything else to do.”
54/62
FINDINGS (continued)
 Over half of farmers had also held off
farm jobs
 Retired from off farm jobs; increased
farm work
 Felt farm work reduced their overall
stress and relaxed them from their off
farm job strain
 “It would be hard to quit farming. It
would be depressing. I might end up
being a statistic [suicide].”
55/62
CONCLUSIONS
 Farmers rarely
retire completely
from farming
 Modify work organization and environment
 Family members have evolving roles
 Health status not as important as
attachment to land
 Under such conditions, farmers may place
themselves and family members at risk for
illness and injury
56/62
Application to Field Practice
 Provide counsel on
risk reduction
 Develop farm work
guidelines for
seniors
 Assess the whole
picture
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IMPLICATIONS
 Need to be aware of physical and
psychosocial factors that influence farmers’
decisions to remain active in farm work
 Ask specifics about any farm work- including
management
 Older farmers and their spouses should be
assessed for “work fitness”
 Older farmers should be guided to make
management and ergonomic changes in their
farm operations to optimize their health
 Families should be counseled on role
transference to minimize stress
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Heritage, History, Home, Health
“How can you explain to someone, ‘ this
used to be a washed out gulley. I put in
that waterway’ or ‘that land used to be
so tired but look at it now’. How can you
explain what this feeling means. It’s our
life, our history, our home.”
- SC farmer
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Persistence
“My Doctor,
after I cut my
leg off, he
said just to
sell the farm
and retire.
I was so mad, I’m not going to sell
what we worked so hard for! This is
what I do. This is who I am, I’ll find a
way to do it. I have to.” DB, age 70
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Why do you continue to farm?
“It’s in the blood. We’ve always liked it.
It’s part of who we are.”
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Pack and Go
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