The health and wellbeing of Australian farmers: a longitudinal cohort study
Open accessAbstract
BACKGROUND: Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. METHODS: The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. RESULTS: Farmers who lived remotely reported worse mental health (β -0.33, 95 % CI -0.53, -0.13) and wellbeing (β -0.21(95 % CI -0.35, -0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. CONCLUSIONS: Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Farmers were in general only half as likely as non-farmers to consult a general practitioner or mental health professional.
“Indeed, farmers were in general only half as likely as non-farmers to consult a general practitioner or mental health professional, according to an Australian study [33].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
SAUNDERS, J. B., AASLAND, O. G., BABOR, T. F., DE LA FUENTE, J. R., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb02093.x · Cited by 13,482 · cited 1× · see citing works
“Harmful alcohol use in the last 6 months (baseline) or 12 months (1,3 and 5 year waves) was measured using the Alcohol Use Disorder Identification Test (AUDIT-10), maximum total score of 40 [39].”
MethodKESSLER, R. C., ANDREWS, G., COLPE, L. J., HIRIPI, E., MROCZEK, D. K., NORMAND, S.-L. T., WALTERS, E. E., & ZASLAVSKY, A. M. (2002) · Psychological Medicine · doi:10.1017/s0033291702006074 · Cited by 10,327 · see citing works
Suicide Prevention Strategies: A Systematic Review
Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., Hegerl, U., Lonnqvist, J., Malone, K., Marusic, A., et al. (2005) · JAMA · doi:10.1001/jama.294.16.2064 · Cited by 2,852 · see citing works
Brugha, T. S., & Cragg, D. (1990) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1990.tb01360.x · Cited by 883 · see citing works
Validation of an Environmental Distress Scale
Higginbotham, N. H., Connor, L. H., Albrecht, G. A., Freeman, S., & Agho, K. (2006) · EcoHealth · doi:10.1007/s10393-006-0069-x · Cited by 247 · see citing works
Grégoire, A. (2002) · Occupational Medicine · doi:10.1093/occmed/52.8.471 · Cited by 241 · see citing works
Climate Change and Farmers’ Mental Health: Risks and Responses
Berry, H. L., Hogan, A., Owen, J., Rickwood, D., & Fragar, L. (2011) · Asia Pacific Journal of Public Health · doi:10.1177/1010539510392556 · Cited by 236 · see citing works
Help-Seeking by Rural Residents for Mental Health Problems: The Importance of Agrarian Values
Judd, F., Jackson, H., Komiti, A., Murray, G., Fraser, C., Grieve, A., & Gomez, R. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1111/j.1440-1614.2006.01882.x · Cited by 219 · cited 2× · see citing works
“Stoicism and a tendency to selfreliance could be considered to be both a protective mechanism to mental health problems or a barrier to finding help when it is needed [29].”
BackgroundAlston, M., & Kent, J. (2008) · Journal of Sociology · doi:10.1177/1440783308089166 · Cited by 213 · see citing works
HOW DEFINITION OF MENTAL HEALTH PROBLEMS CAN INFLUENCE HELP SEEKING IN RURAL AND REMOTE COMMUNITIES
Fuller, J., Edwards, J., Procter, N., & Moss, J. (2000) · Australian Journal of Rural Health · doi:10.1046/j.1440-1584.2000.00303.x · Cited by 197 · see citing works
Understanding suicide in Australian farmers
Judd, F., Jackson, H., Fraser, C., Murray, G., Robins, G., & Komiti, A. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0007-1 · Cited by 192 · cited 4× · see citing works
“This is consistent with other Australian and international research which mainly use the K10 and similar tests [19, 25, 27].”
BackgroundResultInfluentialBetter access to mental health care and the failure of the Medicare principle of universality
Meadows, G. N., Enticott, J., Inder, B., Russell, G. M., & Gurr, R. (2015) · The Medical Journal of Australia · doi:10.5694/mja14.00330 · Cited by 162 · see citing works
Suicide in Australian Farming, 1988–1997
Page, A. N., & Fragar, L. J. (2002) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2002.00975.x · Cited by 148 · see citing works
Rapid change, climate adversity and the next ‘big dry’: Older farmers' mental health
Polain, J. D., Berry, H. L., & Hoskin, J. O. (2011) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2011.01219.x · Cited by 123 · see citing works
Trend in suicide in England and Wales, 1982-96.
Kelly, S., & Bunting, J. (1998) · PubMed · Cited by 123 · see citing works
Trends in suicide in England and Wales, 1982-96.
Kelly, S., & Bunting, J. (1998) · PubMed · Cited by 119 · see citing works
Determinants of mental health and well-being within rural and remote communities
Kelly, B. J., Lewin, T. J., Stain, H. J., Coleman, C., Fitzgerald, M., Perkins, D. A., Carr, V. J., Fragar, L., Fuller, J. D., Lyle, D. M., et al. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0305-0 · Cited by 115 · see citing works
Self-citationThe psychological impact of chronic environmental adversity: Responding to prolonged drought
Stain, H. J., Kelly, B. J., Carr, V. J., Lewin, T. J., Fitzgerald, M., & Fragar, L. (2011) · Social Science & Medicine · doi:10.1016/j.socscimed.2011.09.016 · Cited by 109 · see citing works
Self-citationMental health and well‐being within rural communities: The Australian Rural Mental Health Study
Kelly, B. J., Stain, H. J., Coleman, C., Perkins, D. A., Fragar, L., Fuller, J. D., Lewin, T. J., Lyle, D. M., Carr, V. J., Wilson, J. M., et al. (2010) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2009.01118.x · Cited by 101 · see citing works
Self-citationWho is down on the farm? Social aspects of Australian agriculture in the 21st century
Alston, M. (2004) · Agriculture and Human Values · doi:10.1023/b:ahum.0000014019.84085.59 · Cited by 95 · see citing works
Social networks and mental health among a farming population
Stain, H. J., Kelly, B., Lewin, T. J., Higginbotham, N., Beard, J. R., & Hourihan, F. (2008) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-008-0374-5 · Cited by 94 · cited 4× · see citing works
“This is consistent with other Australian and international research which mainly use the K10 and similar tests [19, 25, 27].”
BackgroundResultInfluentialSelf-citationIschemic heart disease mortality in Iowa farmers. The influence of life-style
Pomrehn, P. R. (1982) · JAMA · doi:10.1001/jama.248.9.1073 · Cited by 85 · see citing works
Stress and help‐seeking for drought‐stricken citrus growers in the Riverland of South Australia
Staniford, A. D., Dollard, M. F., & Guérin, B. (2009) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2009.01059.x · Cited by 81 · see citing works
Suicide in the farming community: methods used and contact with health services: Table 1
Booth, N. J., Briscoe, M., & Powell, R. J. (2000) · Occupational and Environmental Medicine · doi:10.1136/oem.57.9.642 · Cited by 80 · see citing works
Psychological impact of foot-and-mouth disease on farmers
Peck, D. F., Grant, S., McArthur, W., & Godden, D. (2002) · Journal of Mental Health · doi:10.1080/09638230020023877 · Cited by 78 · see citing works
Mental health of British farmers
Thomas, H. V., Lewis, G., Thomas, D. R., Salmon, R. L., Chalmers, R. M., Coleman, T. J., Kench, S. M., Morgan-Capner, P., Meadows, D., Sillis, M., et al. (2003) · Occupational and Environmental Medicine · doi:10.1136/oem.60.3.181 · Cited by 77 · see citing works
Suicides on farms in South Australia, 1997-2001
Miller, K., & Burns, C. M. (2008) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2008.01011.x · Cited by 65 · see citing works
Handley, T. E., KAY‐LAMBKIN, F. J., Inder, K., Lewin, T. J., Attia, J., Fuller, J. D., Perkins, D. A., Coleman, C., Weaver, N., & Kelly, B. J. (2014) · BMC Psychiatry · doi:10.1186/s12888-014-0249-0 · Cited by 60 · see citing works
Self-citationMental health of farmers in Southern Queensland: Issues and support
Hossain, D., Eley, R. M., Coutts, J., & Gorman, D. (2008) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2008.01014.x · Cited by 58 · see citing works
Alcohol Consumption, Obesity, and Psychological Distress in Farming Communities—An Australian Study
Brumby, S. A., Kennedy, A. J., & Chandrasekara, A. (2013) · The Journal of Rural Health · doi:10.1111/jrh.12001 · Cited by 57 · see citing works
Distress among rural residents: Does employment and occupation make a difference?
Fragar, L., Stain, H. J., Perkins, D. A., Kelly, B. J., Fuller, J. D., Coleman, C., Lewin, T. J., & Wilson, J. M. (2010) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2009.01119.x · Cited by 52 · see citing works
Self-citationA prospective study of morbidity and mortality rates among farmers and rural and urban nonfarmers
Stiernström, E.-L., Holmberg, S., Thelin, A. G., et al. (2001) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(00)00287-0 · Cited by 51 · see citing works
Mortality among Farmers in Iceland
Rafnsson, V., & Gunnarsdóttir, H. K. (1989) · International Journal of Epidemiology · doi:10.1093/ije/18.1.146 · Cited by 44 · see citing works
Mortality patterns of Australian male farmers and farm managers
Fragar, L., Depczynski, J., & Lower, T. (2011) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2011.01209.x · Cited by 44 · see citing works
Mortality of farmers and farmers' wives in England and Wales 1979-80, 1982-90.
Inskip, H. M., Coggon, D., Winter, P. D., & Pannett, B. (1996) · Occupational and Environmental Medicine · doi:10.1136/oem.53.11.730 · Cited by 40 · see citing works
Hayes, D., Greenlund, K. J., Denny, C. H., Neyer, J. R., Croft, J. B., & Keenan, N. L. (2011) · Europe PMC (PubMed Central) · Cited by 38 · see citing works
Davis‐Lameloise, N., Philpot, B., Janus, E. D., Versace, V. L., Laatikainen, T. K., Vartiainen, E. A., & Dunbar, J. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-1090 · Cited by 31 · see citing works
Farmers and Retirement: A Longitudinal Cohort Study
Thelin, A. G., & Holmberg, S. (2010) · Journal of Agromedicine · doi:10.1080/10599240903389623 · Cited by 23 · see citing works
The Household, Income and Labour Dynamics in Australia (HILDA) Survey: An Introduction
Watson, N., & Wooden, M. (2002) · Cited by 22 · see citing works
Perceval, M., Fuller, J. D., & Holley, A.-M. (2011) · International Journal of Mental Health · doi:10.2753/imh0020-7411400205 · Cited by 22 · see citing works
Butterworth, P., Handley, T. E., Lewin, T. J., Reddy, P., & Kelly, B. J. (2014) · Journal of Public Health · doi:10.1007/s10389-014-0640-9 · Cited by 14 · see citing works
Self-citationPatterns of alcohol use for farm and non‐farm residents in New South Wales
Eather, J., Fragar, L., Depczynski, J., et al. (2011) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2011.01191.x · Cited by 5 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [44]Glymour MM Greenland S Rothman K Greenland S Lash T Causal Diagrams Modern Epidemiology 2008 3 Philadelphia Lippincott Williams & Wilkins
Cited by
Sorted by citations
Key Risk Factors Affecting Farmers’ Mental Health: A Systematic Review
Daghagh Yazd, S., Wheeler, S. A., & Zuo, A. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234849 · Cited by 393 · see citing works
Climate change and mental health research methods, gaps, and priorities: a scoping review
Hwong, A. R., Wang, M., Khan, H., Chagwedera, D. N., Grzenda, A., Doty, B., Benton, T., Alpert, J., Clarke, D., & Compton, W. M. (2022) · The Lancet Planetary Health · doi:10.1016/s2542-5196(22)00012-2 · Cited by 154 · see citing works
Farmer Mental Health Interventions: A Systematic Review
Younker, T., & Radunovich, H. L. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19010244 · Cited by 115 · see citing works
Vayro, C., Brownlow, C., Ireland, M., & March, S. (2020) · Sociologia Ruralis · doi:10.1111/soru.12274 · Cited by 87 · see citing works
What farmers want from mental health and wellbeing-focused websites and online interventions
Gunn, K. M., Barrett, A., Hughes-Barton, D., Turnbull, D., Short, C. E., Brumby, S., Skaczkowski, G., & Dollman, J. (2021) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2021.06.016 · Cited by 56 · see citing works
Gunn, K. M., Skaczkowski, G., Dollman, J., Vincent, A. D., Brumby, S., Short, C. E., & Turnbull, D. (2023) · Journal of Agromedicine · doi:10.1080/1059924x.2022.2156642 · Cited by 20 · see citing works
Braun, L., Terhorst, Y., Titzler, I., Freund, J., Thielecke, J., Ebert, D. D., & Baumeister, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192113858 · Cited by 17 · see citing works
“Indeed, farmers were in general only half as likely as non-farmers to consult a general practitioner or mental health professional, according to an Australian study [33].”
BackgroundBraun, L., Freund, J., Thielecke, J., Baumeister, H., Ebert, D. D., & Titzler, I. (2022) · JMIR Mental Health · doi:10.2196/39122 · Cited by 11 · see citing works
Bowyer, H. L., Pegler, R., & Williams, C. (2023) · JMIR Formative Research · doi:10.2196/42573 · Cited by 6 · see citing works
Riethmuller, M. L., McEvoy, P. M., & Newnham, E. A. (2025) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2025.103657 · Cited by 4 · see citing works
Riethmuller, M. L., Newnham, E. A., & McEvoy, P. M. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117381 · Cited by 4 · see citing works
Rice, K., Handley, T., Austin, E., Rock, A. J., Kiem, A. S., Patrick, R., West, C., Coffey, Y., Kennedy, A., & Usher, K. (2026) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2026.104254 · Cited by 1 · see citing works
- Authors
- Brew, B., Inder, K., Allen, J., Thomas, M., & Kelly, B.
- Affiliations
- Karolinska Institutet (SE)
- Centre for Rural and Remote Mental Health (AU)
- Massey University (NZ)
- Charles Sturt University (AU)
- University of Newcastle Australia (AU)
- Corresponding author
- Brew, Bronwyn
- Venue
- BMC Public Health
- Published
- 2016-09-15
- Volume
- 16
- Issue
- 1
- Pages
- 988-988
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC5025556
- OpenAlex
- W2520360803
- Cited by
- 171
- References
- 43
- Citations by year
- 2026: 10 · 2025: 26 · 2024: 42 · 2023: 22 · 2022: 21 · 2021: 17 · 2020: 19 · 2019: 10 · 2018: 4
- FWCI
- 5.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Charles Sturt University Research Output (CRO) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
- Funders
- National Health and Medical Research Council (401241)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Agriculture and Farm Safety
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Life Sciences › Agricultural and Biological Sciences › General Agricultural and Biological Sciences › Rural development and sustainability
- Keywords
- farmers, mental health, well-being, remoteness, rural mental health, help-seeking barriers, health care utilization, chronic disease, financial hardship, rural New South Wales
- MeSH terms
- Farmers, Adult, Australia, Mental Disorders, Female, Humans, Life Change Events, Longitudinal Studies, Male, Mental Health, Middle Aged, Patient Acceptance of Health Care, Rural Population, Droughts, Diagnostic Self Evaluation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
