Issues in Aging Among Farmers

University of KentuckyDeborah Reed Lori Garkovich Mary Kay Rayens Susan WestneatSteve 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

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What makes farmers so old?

Exodus of young people “retiring” from a nonfarm career into

farming shift from part-time farming to full-

time farming. Gale (2002) estimates that “about

25,000 operators in the 65-and-older age group entered farming each year from 1978 to 1992.”

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“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

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As age advances . . .

Prolonged recovery Morbidity and mortality increases Co-morbidities increase

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SampleSustained 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

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Method

4 survey waves 10/02-3/03 1423 10/03-2/04 1124 6/04- 7/04 992 3/05- 4/05 962

Mailed and/or telephone surveys 67.6% response rate

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Summary Demographics

Characteristic Wave 1 Wave 2 Wave 3 Total

N % N % N % N %

Gender 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

Race 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

Currently married

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

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Summary Demographics (continued)

Characteristic Wave 1 Wave 2 Wave 3 Total

N % N % N % N %

State of residence

Kentucky 1190 85.8 841 87.8 831 86.9 2862 86.7

South Carolina 197 14.2 117 12.2 125 13.1 439 13.3

Age in years

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

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Older Farmers . . .

Slowing reflexes Physical wasting Accelerated hearing

loss Arthritis Cataracts Skin cancer

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Self-rated health

Characteristic Wave 1 Wave 2 Wave 3 Total

N % N % N % 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

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Self-rated Health by Age Groups

< 65N=749

65 - 69N=267

70+N=407

Total SampleN=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

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Perspectives on Health Status

How would you best define good health?

Under 65N=749

65 - 69N=267

70+N=407

Total SampleN=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

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55.6

46.9

29.2

26.8

12.1

24.6

17.116.1

14.9

0

10

20

30

40

50

60

Arthritis Hypertension Back Hearing Cataracts Other vision Prostate* Diabetes Heart

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*Calculated as a percentage of male respondents only

Prevalence of health problems affecting at least 10% of male respondents

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Prevalence of health problems affecting at least 10% of female respondents

48.42%41.83%

22.92%

10.46%10.46%

21.92%

11.75% 11.60%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Arthriti

s

Hyper

tens

ionBac

k

Hearin

g

Catar

acts

Other

visio

n

Diabet

es

Osteop

oros

is

0

0.5

1

1.5

2

2.5

3

3.5

<65 years >= 65 years Male Female White Minority

Comparisons of number of health problems by demographic characteristics

* *

*Comparison significant at p < .05

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Activity Deficits – part 1

17.21%

8.32%

27.94%

12.35%

16.93%

10.28%

29.70%

16.80%

0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00%

Difficulty walking for 1/4mile

Walking up 10 stepswithout resting

Standing/being on feet 2hours

Sitting 2 hours

Male Female

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Activity Deficits – part 2

39.35%

17.00%

9.31%

5.67%

43.28%

17.62%

9.88%

13.44%

0.00% 10.00% 20.00% 30.00% 40.00% 50.00%

Stooping, kneeling

Reaching up overhead

Pick up penny

Carrying 10 lbs.

Male Female

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Take Prescription Meds Daily

% Frequency N

Male 70.9% 350 494

Female 79.6% 403 506

Total sample

75.3% 753 1,000

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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

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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%)

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“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.

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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

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Injury

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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

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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.

0

5

10

15

20

25

50-59 60-69 70 and +

Wave 1Wave 2Wave 3

Age in Years

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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.

0

5

10

15

20

25

50-59 60-69 70 and +

Wave 1Wave 2Wave 3

Age in Years

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Distribution of Farm Injury for Males (n=282 injuries)

Cuts

Chemicals

Burns

Broken Bones

Amputations

Sprains

n=4917.4%

n=134.6%

n=207.1%

n=196.7%

n=2.7%

n=17963.5%

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Distribution of Farm Injury for Older Female Farmers

Cuts

Chemicals

Burns

Broken Bones

Amputations

Sprains

n=58.2%

n=711.5%

n=34.9%

n=69.8%

n=34.92%

n=3760.7%

N = 61 Injuries

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Preliminary Bivariate Association With Farm Injury

Characteristic N (farm injury) Rate OR 95% CI

Race

White 233 8.9

Black 62 10.1 1.16 0.85-1.57

Other 6 14.3 1.72 0.64-4.31

Age

50-59 89 11.7 1.40 1.01-1.92

60-69 119 8.6 0.99 0.73-1.33

70 & older 90 8.7

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Preliminary Bivariate Association (continued)Characteristic N

(farm injury)Rate OR 95% CI

Gender

Male 242 14.3 4.25 3.15-5.74

Female 61 3.8

Work Status

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

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0

2

4

6

8

10

12

14

Cut (stiches) Burn Broken bone Chemical reaction Digit/extremity loss Other injury*

Farm-related

Not farm-related

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ePercent injured within the last 12 months, by type and source

Type of Injury*Includes sprains, strains, etc. 32/62

Work

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Characteristics of the farm respondents and the farm operation

Under 65

N=749

65 – 69

N=267

70+

N=407

Total SampleN=1,423

General type of farm

Livestock 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

Proportion of farms with the following crops or livestock

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

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Farm Work Status Compared to Last Year

< 65N=749

65 - 69N=267

70+N=407

Total SampleN=1,423

More time 13.9 8.6 4.2 10.2

About the same 57.2 59.1 55.4 57.1

Half as much time

8.2 9.0 9.2 8.6

Much less time 20.6 23.4 31.2 24.1

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Performance of Farm Tasks Over Time

In past 5 years Since April 2002 Total SampleN=1,423

< 65N=748

65-69N=267

70+N=407

< 65N=748

65-69N=267

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

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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

Milk animals 4.9 3.4 3.4 2.3 2.2 1.2 4.2 2.0

In past 5 years Since April 2002 Total SampleN=1,423

< 65N=748

65-69N=267

70+N=407

< 65N=748

65-69N=267

70+N=407

In past 5

years

Since April 2002

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In past 5 years Since April 2002 Total SampleN=1,423

< 65N=748

65-69N=267

70+N=407

< 65N=748

65-69N=267

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

*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)

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a Solid bars give tasks done in the last 5 years; hashed bars refer to tasks in last year

aa

0

2

4

6

8

10

12

14

<65 years >= 65 years Male Female White Minority

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Retired from farming?

Amount of Farming< 65

N=74965 - 69N=267

70+N=407

Total SampleN=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

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Adaptations to Continue Farming

In next 5 years, how likely will you: < 65N=749

65 - 69N=267

70+N=407

TotalN=1,423

Stop farming completely

Likely 47.1 61.0 64.3 54.6

Not likely at all 52.9 39.0 35.8 45.4

Change type of farming (e.g. crops instead of livestock)

Likely 33.6 31.0 25.1 30.8

Not likely at all 66.4 69.1 74.8 69.3

Transfer farm management to another person(s)

Likely 30.6 41.3 43.6 36.2

Not likely at all 69.4 58.7 56.5 63.8

Have someone else take over farm tasks

Likely 39.1 51.4 55.5 46.0

Not likely at all 60.9 48.6 44.5 54.0

Adaptations to continue farming

Under 65

N=749

65 - 69N=267

70+N=407

Total SampleN=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

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Farm Work Satisfaction

< 65N=749

65 - 69N=267

70+N=407

Total SampleN=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

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“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

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Farming – Cradle to Grave

Most rapidly aging occupation in America

Family structured

Historical and cultural context

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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

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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

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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

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PRIMARY CONCEPTS

Farm management and decision making

Physical farm labor Use of technology in farm practices Health Attachment to land

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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

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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.

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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.”

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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.”

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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].”

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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

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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 myleg off, he said just to sell the farm and retire. I was so mad, I’m not going to sellwhat we worked so hard for! This iswhat 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.” 61/62

Pack and Go

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