Cited by 393Agriculture and Farm SafetyMental Health Treatment and AccessCOVID-19 and Mental Health

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Key Risk Factors Affecting Farmers’ Mental Health: A Systematic Review

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Daghagh Yazd, Sahar, Wheeler, Sarah Ann, Zuo, Alec·2019·International Journal of Environmental Research and Public Health

DOI 10.3390/ijerph16234849PMC PMC6926562

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Abstract

Recently, concern has increased globally over farmers’ mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers’ mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers’ mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers’ mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers’ mental health, and information on how to reduce help-seeking barriers amongst farmers.

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Figure 1 Schematic for identifying studies.CC BY · PubMed Central

Figure 2 Number of farmers’ mental health studies published by country.CC BY · PubMed Central

Figure 3 Number of farmers’ mental health studies from 1979 to April 2019.CC BY · PubMed Central

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Drought‐related stress among farmers: findings from the Australian Rural Mental Health Study
Austin, E. K., Handley, T., Kiem, A. S., Rich, J. L., Lewin, T. J., Askland, H. H., Askarimarnani, S. S., Perkins, D. A., & Kelly, B. J. (2018) · Medical Journal of Australia · doi:10.5694/mja17.01200 · Cited by 129 · cited 1×
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Stress and Burnout Among Finnish Dairy Farmers
Kallioniemi, M., Simola, A. J. K., Kaseva, J., & Kymäläinen, H. (2016) · Journal of Agromedicine · doi:10.1080/1059924x.2016.1178611 · Cited by 123 · cited 5×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
BackgroundMethodInfluential
Neurocognitive, Mental Health, and Glucose Disorders in Farmers Exposed to Organophosphorus Pesticides
Malekırad, A. A., Faghih, M., Mirabdollahi, M., Kiani, M., Fathi, A., & Abdollahi, M. R. (2013) · Archives of Industrial Hygiene and Toxicology · doi:10.2478/10004-1254-64-2013-2296 · Cited by 120
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Anxiety and depression following cumulative low-level exposure to organophosphate pesticides
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Background
Symptoms of psychological distress and suicidal ideation among banana workers with a history of poisoning by organophosphate or n-methyl carbamate pesticides
Wesseling, C., de Joode, B. V. W., Keifer, M., London, L., Mergler, D., & Stallones, L. F. (2010) · Occupational and Environmental Medicine · doi:10.1136/oem.2009.047266 · Cited by 109 · cited 3×
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BackgroundMethod
Depression and Pesticide Exposures in Female Spouses of Licensed Pesticide Applicators in the Agricultural Health Study Cohort
Beseler, C. L., Stallones, L. F., Hoppin, J. A., Alavanja, M. C. R., Blair, A. E., Keefe, T. J., & Kamel, F. (2006) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000235938.70212.dd · Cited by 108 · cited 2×
“[51] found an increase in the risk of depression among women with a history of”
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Male farmers with mental health disorders: A scoping review
Roy, P., Tremblay, G., Oliffe, J. L., Jbilou, J., & Robertson, S. (2013) · Australian Journal of Rural Health · doi:10.1111/ajr.12008 · Cited by 104
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Background
Stressors and Symptoms Predictive of Distress in Farmers
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From stress to distress: Conceptualizing the British family farming patriarchal way of life
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Background
Anxiety and Depression Symptoms Among Farmers: The HUNT Study, Norway
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BackgroundInfluential
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 1×
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Stress among Farm Women: Work and Family as Interacting Systems
Berkowitz, A. D., & Perkins, H. W. (1984) · Journal of Marriage and the Family · doi:10.2307/351874 · Cited by 93 · cited 2×
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A Cohort Study of Pesticide Poisoning and Depression in Colorado Farm Residents
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Test-retest reliability of the hopelessness scale and its items in a university population
Holden, R. R., & Fekken, G. C. (1988) · Journal of Clinical Psychology · doi:10.1002/1097-4679(198801)44:1 · Cited by 91
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Exposure to pesticides and mental disorders in a rural population of Southern Brazil
Campos, Ÿ., da Silva, V. D. S. P., Sarpa, M., & Otero, U. B. (2016) · NeuroToxicology · doi:10.1016/j.neuro.2016.06.002 · Cited by 90
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BackgroundInfluential
Working in Australia's heat: health promotion concerns for health and productivity
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Depressive Symptoms in Farm Women: Effects of Health Status and Farming Lifestyle Characteristics, Behaviors, and Beliefs
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Neuropsychiatric Disorders in Farmers Associated with Organophosphorus Pesticide Exposure in a Rural Village of Northwest México
Serrano‐Medina, A., Ugalde-Lizárraga, A., Bojorquez-Cuevas, M. S., Garnica-Ruiz, J., González-Corral, M. A., García-Ledezma, A., Pineda-García, G., & Cornejo‐Bravo, J. M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16050689 · Cited by 86 · cited 1×
“[126] on 140 agricultural workers with organophosphorus pesticide exposure in Mexico showed that 25% of them had major depression with suicidal attitudes, 24% had anxiety, 24% had combined depression–anxiety, and 22% of them had major depression and no psychiatric diagnosis disorder.”
Background
Pathways to Suicide in Australian Farmers: A Life Chart Analysis
Kunde, L., Kõlves, K., Kelly, B. J., Reddy, P., & Leo, D. D. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14040352 · Cited by 85
Stress Factors Contributing to Depression Among Latino Migrant Farmworkers in Nebraska
Ramos, A. K., Su, D., Lander, L. I., & Rivera, R. (2015) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-015-0201-5 · Cited by 82 · cited 2×
“Other barriers included farmer self-reliance, social image/stigma, negative perceptions of health professionals’ efficacy and high treatment fees [9,20].”
Background
Exposure to organophosphate (OP) pesticides and health conditions in agricultural and non-agricultural workers from Maule, Chile
Muñoz-Quezada, M. T., Lucero, B. A., Iglesias, V., Lévy, K., Muñoz, M. P., Achú, E., Cornejo, C., Concha, C., Brito, A. M., & Villalobos, M. (2016) · International Journal of Environmental Health Research · doi:10.1080/09603123.2016.1268679 · Cited by 80
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 · cited 1×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
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
Economic Hardship and Depression Among Women in Latino Farmworker Families
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“The most reported risk factors for farmers respectively were daily pesticides exposure [110,189], financial problems [37,129], unpredictable climate [139,143], and past injuries [52,66].”
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A Sunburnt Country: The Economic and Financial Impact of Drought on Rural and Regional Families in Australia in an Era of Climate Change
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Electroencephalogram, cognitive state, psychological disorders, clinical symptom, and oxidative stress in horticulture farmers exposed to organophosphate pesticides
Bayrami, M., Hashemi, T., Malekırad, A. A., Ashayeri, H., Faraji, F., & Abdollahi, M. R. (2011) · Toxicology and Industrial Health · doi:10.1177/0748233711407243 · Cited by 74 · cited 1×
“Mini-Mental State Examination (MMSE) [74] 9 5%”
“Watching the bank balance build up then blow away and the rain clouds do the same”: A thematic analysis of South Australian farmers’ sources of stress during drought
Gunn, K. M., Jarrett, C. E., Kettler, L. J., Dollman, J., & Turnbull, D. A. (2016) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2016.05.005 · Cited by 74 · cited 1×
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Method
Stress in farmers: a survey of farmers in England and Wales
Simkin, S., Hawton, K., Fagg, J., & Malmberg, A. (1998) · Occupational and Environmental Medicine · doi:10.1136/oem.55.11.729 · Cited by 73
Pesticide poisoning and neurobehavioral function among farm workers in Jiangsu, People's Republic of China
Zhang, X., Wu, M., Yao, H., Yang, Y., Cui, M., Tu, Z.-B., Stallones, L. F., & Xiang, H. (2015) · Cortex · doi:10.1016/j.cortex.2015.09.006 · Cited by 73
Farmers' stress and coping in a time of drought
Fennell, K., Kettler, L. J., Skaczkowski, G., & Turnbull, D. A. (2012) · Rural and Remote Health · doi:10.22605/rrh2071 · Cited by 72 · cited 1×
“However, a few studies found otherwise [13,172].”
A clinical neurological, neurophysiological, and neuropsychological study of sheep farmers and dippers exposed to organophosphate pesticides
JAMAL, G. A., Hansen, S., Pilkington, A., Buchanan, D., Gillham, R. A., Abdel-Azis, M., Julu, P. O. O., Al-Rawas, S. F., Hurley, F. W., & BALLANTYNE, J. P. (2002) · Occupational and Environmental Medicine · doi:10.1136/oem.59.7.434 · Cited by 72
Drought and Distress in Southeastern Australia
Hanigan, I. C., Schirmer, J., & Niyonsenga, T. (2018) · EcoHealth · doi:10.1007/s10393-018-1339-0 · Cited by 72 · cited 1×
“[147] showed significant associations between distress and drought duration in young rural women regardless of whether they were in farming occupations or not.”
Background
Understanding the impacts of water scarcity and socio-economic demographics on farmer mental health in the Murray-Darling Basin
Yazd, S. D., Wheeler, S. A., & Zuo, A. (2019) · Ecological Economics · doi:10.1016/j.ecolecon.2019.106564 · Cited by 72
Self-citation
Economies, ethics and emotions: Farmer distress within the moral economy of agribusiness
Bryant, L., & Garnham, B. (2014) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2014.03.006 · Cited by 71
Psychosocial Consequences of Agricultural Transformation: The Farm Crisis and Depression1
Belyea, M. J., & Lobao, L. (1990) · Rural Sociology · doi:10.1111/j.1549-0831.1990.tb00673.x · Cited by 71
Why Do You Ride?: A Characterization of Mountain Bikers, Their Engagement Methods, and Perceived Links to Mental Health and Well-Being
Roberts, L., Jones, G., & Brooks, R. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.01642 · Cited by 71 · cited 1×
“indoor, which might be encouraged to improve individuals’ (not specifically farmers) mental health and vitamin D status [194,195], but these aspects were not the specific focus of this study and they are left for future research.”
Background
Psychiatric symptomatology among Mexican American farmworkers
Vega, W. A., Warheit, G. J., & Palacio, R. (1985) · Social Science & Medicine · doi:10.1016/0277-9536(85)90309-0 · Cited by 68 · cited 1×
“Health Option Survey (HOS) [8]/Farm Stress Survey (FSS) [79] 2 1%”
Background
Farmers' Suicide in India: Implications for Public Mental Health
Das, A. (2009) · International Journal of Social Psychiatry · doi:10.1177/0020764009103645 · Cited by 67
Mental 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 66 · cited 2×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Cholinesterase Depression and Its Association with Pesticide Exposure across the Agricultural Season among Latino Farmworkers in North Carolina
Quandt, S. A., Chen, H., Grzywacz, J. G., Vallejos, Q. M., Galvan, L., & Arcury, T. A. (2010) · Environmental Health Perspectives · doi:10.1289/ehp.0901492 · Cited by 66
Impact of a foot and mouth disease crisis on post-traumatic stress symptoms in farmers
Olff, M., Koeter, M. W. J., Haaften, E. H. V., Kersten, P. H., & Gersons, B. P. R. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.186.2.165 · Cited by 66 · cited 3×
“Brief Symptom Inventory Scale [60]/15-item impact of Event Scale [61]/19 item Inventory Scale [62]/48 item Stress Scale [31]/Depression-Anxiety-Stress Scale [63]/Geriatric Depression Screening Scale [64]/Wechsler Adult Intelligence Scale [65]/Farming Family Stressor scale [7]/Beck Depression Scale (BDS) [66]/12-item S…”
BackgroundMethod
Stress in New Zealand farmers
Firth, H. M., Williams, S., Herbison, P., & McGee, R. O. (2006) · Stress and Health · doi:10.1002/smi.1119 · Cited by 65
Exposure to pesticide as a risk factor for depression: A population-based longitudinal study in Korea
Koh, S. B., Kim, T. H., Min, S., Lee, K., Kang, D. R., & Choi, J. R. (2017) · NeuroToxicology · doi:10.1016/j.neuro.2017.07.005 · Cited by 65 · cited 2×
“[81] revealed that the association with depression was stronger amongst farmers with past pesticide poisoning episodes than amongst those with no such reported experiences.”
BackgroundMethod
Pesticide Exposure and Depression Among Agricultural Workers in France
Weisskopf, M. G., Moisan, F., Tzourio, C., Rathouz, P. J., & Elbaz, A. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kwt089 · Cited by 64 · cited 1×
“Questionnaires based on the Midtown Manhattan study [48]/the Warheit study [49]/the Raitasalo study [50]/the Karasek and Theorells study/asked questions such as: “has a DOCTOR ever told you that you had been diagnosed with depression requiring medication?” [51]/ “how would you rate your level of depression in the last…”
Method
The Farm Crisis: Patterns and Impacts of Financial Distress Among Iowa Farm Families.
Bultena, G. L. (1986) · Rural Sociology · Cited by 63
Water torture: Unravelling the psychological distress of irrigators in Australia
Wheeler, S. A., Zuo, A., & Loch, A. J. (2018) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2018.08.006 · Cited by 61 · cited 2×
“[26] found that some irrigators in particular industries have higher mental health problems than dryland farmers in the Murray-Darling Basin.”
BackgroundSelf-citation
COPING WITH THE OCCUPATIONAL STRESSORS OF POLICE WORK: A STUDY OF SCOTTISH OFFICERS
Biggam, F. H., Power, K., & Macdonald, R. R. (1997) · Stress Medicine · doi:10.1002/(sici)1099-1700(199704)13:2 · Cited by 60
Depressive symptoms and severity of acute occupational pesticide poisoning among male farmers
Kim, J.-Y., Ko, Y., & Lee, W. J. (2013) · Occupational and Environmental Medicine · doi:10.1136/oemed-2012-101005 · Cited by 59 · cited 1×
“Brief Symptom Inventory Scale [60]/15-item impact of Event Scale [61]/19 item Inventory Scale [62]/48 item Stress Scale [31]/Depression-Anxiety-Stress Scale [63]/Geriatric Depression Screening Scale [64]/Wechsler Adult Intelligence Scale [65]/Farming Family Stressor scale [7]/Beck Depression Scale (BDS) [66]/12-item S…”
Method
Comparative assessment of migrant farm worker health in conventional and organic horticultural systems in the United Kingdom
Cross, P., Edwards, R. T., Hounsome, B., & Edwards‐Jones, G. (2007) · The Science of The Total Environment · doi:10.1016/j.scitotenv.2007.10.048 · Cited by 57
Knowledge, attitude and practices of pesticide use and acetylcholinesterase depression among farm workers in Nepal
Atreya, K., Sitaula, B. K., Overgaard, H. J., Bajracharya, R. M., & Sharma, S. (2012) · International Journal of Environmental Health Research · doi:10.1080/09603123.2011.650154 · Cited by 57 · cited 2×
“Clinical Test [70]/Medical Symptom Validity Test [71]/Mini International Neuropsychiatric Interview Diagnostic Test (MINI) [19] 12 7%”
Cognitive impairment in agricultural workers and nearby residents exposed to pesticides in the Coquimbo Region of Chile
Corral, S. A., de Angel, V., Salas, N., Zúñiga-Venegas, L. A., Gaspar, P. A., & Pancetti, F. C. (2017) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2017.05.003 · Cited by 57
The Mental Health of the Organic Farmer: Psychosocial and Contextual Actors
Brigance, C., Más, F. S., Sánchez, V., & Handal, A. J. (2018) · Workplace Health & Safety · doi:10.1177/2165079918783211 · Cited by 54 · cited 1×
“[185] indicated that some of the risk factors that affect the mental health of organic farmers—e.”
Background
Acute health effects of organophosphorus pesticides on Tanzanian small-scale coffee growers
Ngowi, A. V., Maeda, D. N., Partanen, T. J., Sanga, M. P., & Mbise, G. (2001) · Journal of Exposure Science & Environmental Epidemiology · doi:10.1038/sj.jea.7500172 · Cited by 53
Development of the Farm Stress Survey: Factorial Structure, Reliability, and Validity
Eberhardt, B. J., & Pooyan, A. (1990) · Educational and Psychological Measurement · doi:10.1177/0013164490502018 · Cited by 53 · cited 3×
“Health Option Survey (HOS) [8]/Farm Stress Survey (FSS) [79] 2 1%”
Background
The Farm Crisis and Mental Health: A Longitudinal Study of the 1980s1
Ortega, S. T., Johnson, D. R., Beeson, P. G., & Craft, B. J. G. (1994) · Rural Sociology · doi:10.1111/j.1549-0831.1994.tb00550.x · Cited by 52
Stress, Place, and Allostatic Load Among Mexican Immigrant Farmworkers in Oregon
McClure, H. H., Snodgrass, J. J., Martínez, C. R., Squires, E. C., Jiménez, R. A., Isiordia, L. E., Eddy, J. M., McDade, T. W., & Small, J. (2015) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-014-0066-z · Cited by 52 · cited 1×
“It has also been found that there are more mental impairments observed with aging farmers [96,97,100,129,180].”
Background
Functional disability and social conflict increase risk of depression in older adulthood among Bolivian forager-farmers
Stieglitz, J., Schniter, E., von Rueden, C., Kaplan, H., & Gurven, M. (2015) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/gbu080 · Cited by 52 · cited 1×
“[158] stated that those farmers who diagnosed with depression had a significantly higher total disability score.”
Background
Contemporary Feminist Analysis of Australian Farm Women in the Context of Climate Changes
Alston, M., Clarke, J., & Whittenbury, K. (2018) · Social Sciences · doi:10.3390/socsci7020016 · Cited by 52
Psychological distance of climate change and mental health risks assessment of smallholder farmers in Northern Ghana: Is habituation a threat to climate change
Acharibasam, J. W., & Anuga, S. W. (2018) · Climate Risk Management · doi:10.1016/j.crm.2018.04.002 · Cited by 52
Health Symptoms Associated with Pesticides Exposure among Flower and Onion Pesticide Applicators in Arusha Region
Mwabulambo, S. G., Mrema, E. J., Ngowi, A. V., & Mamuya, S. (2018) · Annals of Global Health · doi:10.29024/aogh.2303 · Cited by 52
Stress in Dairy Farming and the Adoption of New Technology.
Alpass, F., Flett, R. A., Humphries, S., Massey, C. L., Morriss, S. D., & Long, N. R. (2004) · International Journal of Stress Management · doi:10.1037/1072-5245.11.3.270 · Cited by 51 · cited 6×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
BackgroundMethodInfluential
Identifying Stressors and Coping Strategies in Two-Generation Farm Families
Weigel, R. R., & Weigel, D. J. (1987) · Family Relations · doi:10.2307/584487 · Cited by 49 · cited 1×
“Overall, our review suggested that female farmers experience more psychological distress than male farmers [14,16,21,30,50,59,62,77,80,170,171].”
Background
Beyond discourses of drought: The micro-politics of the wine industry and farmer distress
Bryant, L., & Garnham, B. (2013) · Journal of Rural Studies · doi:10.1016/j.jrurstud.2013.03.002 · Cited by 49 · cited 1×
“, through reducing the number of paid farm employees, working longer hours), diversify/change production or decide to exit [134].”
Background
Farm-related injury mortality in New Mexico, 1980–1991
Crandall, C. S., Fullerton, L., Olson, L. M., Sklar, D. P., & Zumwalt, R. E. (1997) · Accident Analysis & Prevention · doi:10.1016/s0001-4575(96)00066-8 · Cited by 48
Working conditions and depressive symptoms in the 2003 decennial health survey: the role of the occupational category
Cohidon, C., Santin, G., Imbernon, E., & Goldberg, M. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0157-7 · Cited by 48
Local and global factors in work stress—the Australian dairy farming examplar
Wallis, A., & Dollard, M. F. (2008) · Cited by 48
Untitled work
(2007) · PubMed · Cited by 47
Associations of Poor Housing with Mental Health Among North Carolina Latino Migrant Farmworkers
Mora, D. C., Quandt, S. A., Chen, H., & Arcury, T. A. (2016) · Journal of Agromedicine · doi:10.1080/1059924x.2016.1211053 · Cited by 47 · cited 1×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Farm-Related Concerns and Mental Health Status Among Norwegian Farmers
Logstein, B. (2016) · Journal of Agromedicine · doi:10.1080/1059924x.2016.1211055 · Cited by 47 · cited 4×
“Also, loss of self-esteem, withdrawal from social activity, relationship breakdown, forgetfulness, loss of temper, relaxation problems, feeling blue, and substance abuse have been reported [9,13,35,36].”
BackgroundMethodInfluential
Modifiable risk factors for depressed mood among farmers
Onwuameze, O. E., Paradiso, S., Peek-Asa, C., Donham, K. J., & Rautiainen, R. H. (2013) · Annals of Clinical Psychiatry · doi:10.1177/104012371302500202 · Cited by 45 · cited 3×
“The most reported risk factors for farmers respectively were daily pesticides exposure [110,189], financial problems [37,129], unpredictable climate [139,143], and past injuries [52,66].”
BackgroundMethod
Cardiovascular risk factors and psychological distress in Australian farming communities
Brumby, S. A., Chandrasekara, A., McCoombe, S. G., Kremer, P. J., & Lewandowski, P. A. (2012) · Australian Journal of Rural Health · doi:10.1111/j.1440-1584.2012.01273.x · Cited by 45 · cited 1×
“, neck, shoulder, and back pain [73]; obesity; metabolic syndrome; abdominal adiposity; and cardiovascular disease [153,154]) tend to have higher self-reported psychiatric impairment.”
Background
Mental disorders and suicide attempt in rural China
Liu, B.-P., Qin, P., Liu, Y., Yuan, L., Gu, L., & Jia, C.-X. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2017.12.087 · Cited by 45 · cited 1×
“Most importantly, mental disorders have been identified as one of the key risk factors for suicide attempts among farmers [34].”
Background
Stress and Sociocultural Factors Related to Health Status Among US–Mexico Border Farmworkers
Carvajal, S. C., Kibor, C., McClelland, D. J., Ingram, M., de Zapien, J. G., Torres, E., Redondo, F., Rodriguez, K., Rubio-Goldsmith, R., Meister, J. S., et al. (2013) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-013-9853-1 · Cited by 43 · cited 1×
“Brief Symptom Inventory Scale [60]/15-item impact of Event Scale [61]/19 item Inventory Scale [62]/48 item Stress Scale [31]/Depression-Anxiety-Stress Scale [63]/Geriatric Depression Screening Scale [64]/Wechsler Adult Intelligence Scale [65]/Farming Family Stressor scale [7]/Beck Depression Scale (BDS) [66]/12-item S…”
Method
Farmer suicides: a qualitative study from Australia
Perceval, M., Kõlves, K., Reddy, P., & Leo, D. D. (2017) · Occupational Medicine · doi:10.1093/occmed/kqx055 · Cited by 43
Predictors of Depressive Symptoms in Older Rural Couples: The Impact of Work, Stress and Health
Rayens, M. K., & Reed, D. B. (2013) · The Journal of Rural Health · doi:10.1111/jrh.12028 · Cited by 42 · cited 1×
“It has also been found that there are more mental impairments observed with aging farmers [96,97,100,129,180].”
Background
Mental health among Latina farmworkers and other employed Latinas in North Carolina.
Arcury, T. A., Sandberg, J. C., Talton, J. W., Laurienti, P. J., Daniel, S. S., & Quandt, S. A. (2018) · Rural Mental Health · doi:10.1037/rmh0000091 · Cited by 42
Poor sleep quality is associated with obesity and depression in farmers
Hawes, N. J., Wiggins, A. T., Reed, D. B., & Hardin‐Fanning, F. (2019) · Public Health Nursing · doi:10.1111/phn.12587 · Cited by 42 · cited 2×
“Lack of access to mental health services in rural areas was another major burden to the delivery of appropriate mental health services [20,33,155].”
Background
Effect of subjective economic status on psychological distress among farmers and non-farmers of rural China
Feng, D., Ji, L., & Xu, L. (2015) · Australian Journal of Rural Health · doi:10.1111/ajr.12187 · Cited by 41 · cited 1×
“[105] reported farmers have a lower prevalence of mental illness than the general population, although were more likely to report thinking that life was not worth living.”
Background
Causes and effects of stress on farmers: a qualitative study
Raine, G. (1999) · Health Education Journal · doi:10.1177/001789699905800307 · Cited by 41 · cited 1×
“Furthermore, machinery breakdown [67], hearing loud machines [14], time pressure [79], and governmental regulations [6] were other identified risk factors.”
Background
Occupational Injuries Among Agricultural Workers 51 to 61 Years Old: A National Study
Zwerling, C., Sprince, N. L., Wallace, R. B., Davis, C., Whitten, P. S., & Heeringa, S. G. (1995) · Journal of Agricultural Safety and Health · doi:10.13031/2013.19469 · Cited by 40
Pesticide exposure, tobacco use, poor self-perceived health and presence of chronic disease are determinants of depressive symptoms among coffee growers from Southeast Brazil
Conti, C. L., Barbosa, W. M., Simão, J. B. P., & da Silva, A. M. Á. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.11.063 · Cited by 40
What’s up with the self-employed? A cross-national perspective on the self-employed’s work-related mental well-being
Gevaert, J., Moortel, D. D., Wilkens, M., & Vanroelen, C. (2018) · SSM - Population Health · doi:10.1016/j.ssmph.2018.04.001 · Cited by 40 · cited 3×
“Overall, younger farmers experienced higher levels of stress-related symptoms [62,85,88,179].”
BackgroundMethod
An Informal Look at Farm Stress
Walker, J. L., Walker, L. S., & MacLennan, P. M. (1986) · Psychological Reports · doi:10.2466/pr0.1986.59.2.427 · Cited by 38 · cited 3×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
BackgroundMethod
Fracked: Coal seam gas extraction and farmers’ mental health
Morgan, M. I., Hine, D. W., Bhullar, N., Dunstan, D. A., & Bartik, W. J. (2016) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2016.04.012 · Cited by 37 · cited 1×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Interpersonal and social correlates of depressive symptoms among Latinas in farmworker families living in North Carolina
Roblyer, M. I. Z., Grzywacz, J. G., Suerken, C. K., Trejo, G., Ip, E. H., Arcury, T. A., & Quandt, S. A. (2015) · Women & Health · doi:10.1080/03630242.2015.1086464 · Cited by 36
Pesticide-related health problems and diseases among farmers in the United Arab Emirates
Beshwari, M. M. M., Bener, A., Ameen, A., Almehdi, A. M., Ouda, H. Z., & Pasha, M. A. H. (1999) · International Journal of Environmental Health Research · doi:10.1080/09603129973182 · Cited by 34
Safety practices and depression among farm residents
Stallones, L. F., & Beseler, C. L. (2004) · Annals of Epidemiology · doi:10.1016/j.annepidem.2003.11.004 · Cited by 34
Development and validation of a work stressor scale for Australian farming families
McShane, C. J., Quirk, F. H., & Swinbourne, A. L. (2015) · Australian Journal of Rural Health · doi:10.1111/ajr.12261 · Cited by 34 · cited 3×
“Brief Symptom Inventory Scale [60]/15-item impact of Event Scale [61]/19 item Inventory Scale [62]/48 item Stress Scale [31]/Depression-Anxiety-Stress Scale [63]/Geriatric Depression Screening Scale [64]/Wechsler Adult Intelligence Scale [65]/Farming Family Stressor scale [7]/Beck Depression Scale (BDS) [66]/12-item S…”
BackgroundMethod
Agricultural stressors: identification, causes and perceived effects among Nigerian crop farmers
Olowogbon, T. S., Yoder, A. M., Fakayode, S. B., & Falola, A. O. (2018) · Journal of Agromedicine · doi:10.1080/1059924x.2018.1538915 · Cited by 33 · cited 2×
“Other agricultural stressors which have been identified to be common in developing countries include poor agricultural extension services/contact, poor road infrastructure, unfavourable market prices, poor access to market information, and poor access to credit facilities [36].”
Background
Correlates of Psychosomatic Stress Symptoms among Farm Women: A Research Note on Farm and Family Functioning
Berkowitz, A. D., & Perkins, H. W. (1985) · Journal of Human Stress · doi:10.1080/0097840x.1985.9936742 · Cited by 32 · cited 1×
“Berkowitz and Perkins [173] found that farm women who are in conflict with their husbands about farm roles, or are unhappy with their marriages, are more likely to report stress related health symptoms.”
Background
Psychosocial Work Environment Among Employed Swedish Dairy and Pig Farmworkers
Kolstrup, C. L., Lundqvist, P., & Pinzke, S. (2008) · Journal of Agromedicine · doi:10.1080/10599240801986157 · Cited by 31 · cited 1×
“Higher mental disorder levels and poorer vitality have been reported for animal farmers [90,91] and dairy farmers [90,92], compared to non-farmers.”
Background
Does Farming Have an Effect on Health Status? A Comparison Study in West Greece
Demos, K., Sazakli, E., Jelastopulu, E., Charokopos, N., Ellul, J., & Leotsinidis, M. (2013) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph10030776 · Cited by 31
Pesticide exposure and screen-positive neuropsychiatric disease in British sheep farmers
Povey, A. C., McNamee, R., Alhamwi, H., Stocks, S. J., Watkins, G., Burns, A. S., & Agius, R. M. (2014) · Environmental Research · doi:10.1016/j.envres.2014.09.008 · Cited by 30
The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS)
Yin, H., Xu, G., Tian, H., Yang, G., Wardenaar, K. J., & Schoevers, R. A. (2017) · Psychological Medicine · doi:10.1017/s0033291717001878 · Cited by 30
Gender Differences in Depression Symptoms Among Rice Farmers in Thailand
Hanklang, S., Kaewboonchoo, O., Morioka, I., & Suwan-ampai, P. (2015) · Asia Pacific Journal of Public Health · doi:10.1177/1010539515620631 · Cited by 29 · cited 4×
“In addition, a lack of family support and listening to loud machines were also predictors of poor female mental health [14].”
BackgroundInfluential
Generating toxic landscapes: impact on well-being of cotton farmers in Telangana, India
Kannuri, N. K., & Jadhav, S. (2018) · Anthropology and Medicine · doi:10.1080/13648470.2017.1317398 · Cited by 29
Examining Nervios Among Immigrant Male Farmworkers in the MICASA Study: Sociodemographics, Housing Conditions and Psychosocial Factors
O’Connor, K., Stoecklin‐Marois, M. T., & Schenker, M. B. (2013) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-013-9859-8 · Cited by 28 · cited 1×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Farmers’ perceptions of coexistence between agriculture and a large scale coal seam gas development
Huth, N. I., Cocks, B., Dalgliesh, N. P., Poulton, P. L., Marinoni, O., & Garcia, J. N. (2017) · Agriculture and Human Values · doi:10.1007/s10460-017-9801-0 · Cited by 28 · cited 2×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Trait Mindfulness Helps Explain the Relationships Between Job Stress, Physiological Reactivity, and Self-Perceived Health
Eddy, P. J., Wertheim, E. H., Hale, M. W., & Wright, B. J. (2018) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001493 · Cited by 28
Prevalence of Chronic Diseases and Occupational Injuries and their Influence on the Health-Related Quality of Life Among Farmers Working in Small-Farm Enterprises
Rostamabadi, A., Jahangiri, M., Mansourabadi, B. N., Javid, M., Ghorbani, M., & Banaee, S. (2019) · Journal of Agromedicine · doi:10.1080/1059924x.2019.1592047 · Cited by 28 · cited 2×
“[161] reported that musculoskeletal disorders, cuts, and fractures accounted for the most frequent injuries amongst farmer affecting their mental health.”
Background
Work Ability Index (WAI) and Its Health‐related Determinants among Iranian Farmers Working in Small Farm Enterprises
Rostamabadi, A., Mazloumi, A., & Foroushani, A. R. (2014) · Journal of Occupational Health · doi:10.1539/joh.13-0171-oa · Cited by 27 · cited 1×
“Several other risk factors and symptoms predictive of psychological distress in farmers have been identified by researchers, such as government policies [5,17,18,22,67,77], isolation [9,17,18,37,163], heavy workload [7,37], role conflict [7,16], time pressure [7,67,79], poor housing conditions [11,22,32,66], foot and…”
Background
Musculoskeletal pain, depression, and stress among Latino manual laborers in North Carolina
Tribble, A. G., Summers, P., Chen, H., Quandt, S. A., & Arcury, T. A. (2015) · Archives of Environmental & Occupational Health · doi:10.1080/19338244.2015.1100104 · Cited by 27 · cited 3×
“Farm Stressor Inventory [30]/Personality Assessment Inventory (PAI) [19]/Edinburgh Farming Stress Inventory (EFSI) [21]/Beck Depression Inventory (BDI) [72]/Welke’s Farm Ranch Stress Inventory [28]/Migrant Farmworker Stress Inventory [73] 11 6%”
Background
Predictors of mental complaints among Norwegian male farmers
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“Overall, our review suggested that female farmers experience more psychological distress than male farmers [14,16,21,30,50,59,62,77,80,170,171].”
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Method
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See all 393

Authors: Daghagh Yazd, S., Wheeler, S. A., & Zuo, A.
Affiliations: Centre for Global Food and Resources, Faculty of Professions, University of Adelaide, Adelaide, SA 5000, Australia
The University of Adelaide (AU)
Corresponding author: Wheeler, Sarah Ann
ORCID: Daghagh Yazd, Sahar
Wheeler, Sarah Ann
Zuo, Alec
Venue: International Journal of Environmental Research and Public Health
Publisher: MDPI AG
Published: 2019-12-02
Volume: 16
Issue: 23
Pages: 4849
ISSN: 1660-4601 (ISSN-L)
DOI: 10.3390/ijerph16234849
PMC: PMC6926562
OpenAlex: W2990842690
Cited by: 393
References: 186
Citations by year: 2026: 58 · 2025: 80 · 2024: 81 · 2023: 63 · 2022: 51 · 2021: 40 · 2020: 20
FWCI: 2.47
Type: journal article
Language: en
Open access: gold
dx.doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (vor)
Locations: International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
Funders: Australian Research Council (FT140100773)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Agriculture and Farm Safety
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords: farmer mental health, risk factors, pesticide exposure, financial hardship, climate variability, drought, physical health, occupational injuries, farm workers, mental illness, help-seeking barriers, climate change impacts
MeSH terms: Farmers, Adult, Agriculture, Mental Disorders, Female, Health Status, Humans, Male, Middle Aged, Risk Factors, Stress, Psychological

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Key Risk Factors Affecting Farmers’ Mental Health: A Systematic Review

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