Academic journal article
By Kilpatrick, Sue; Willis, Karen; Johns, Susan; Peek, Karla
Rural Society , Vol. 22, No. 1
Abstract: While links between rurality and health are clearly established, there continues to be interest in the resources that can make a difference to rural, often underserved, small communities. This research investigated how collective features of communities of place and industry communities of common purpose, influence farmer and fisher strategies to maintain good physical and mental health in the face of difficult climatic and economic factors. Centred on five farming and fishing sites in Australia, the research found it was not the health services in the sites, but the differences in the resources and capacity of non-health service community and industry groups and organisations that influenced the health and wellbeing behavioural choices of the farmers and fishers. Community groups and industry associations facilitated local access to programmes and their credibility persuaded people to participate. They cross the boundary between health services and farmer and fisher communities and are preferred, soft entry points to health information and support that can reduce the impact of occupational stress.
Keywords: farmer health, fisher health, rural communities, communities of common purpose, boundary crossers
Although farmers and fishers around the world have always been exposed to the vagaries of climate and global economic forces, in recent years there have been particular pressures due to the global financial crisis and a series of severe climatic and natural disaster impacts. There has been an accumulation of factors which had a particularly severe effect on rural Australia, collectively described in this research as 'difficult times'. They include reduced demand for agricultural products, lower prices, climate variability and the effects of long-term drought. 'Difficult times' affect physical health and psychological wellbeing (Alston & Kent, 2008; Clark, Brinkley, Lamont, & Laughlin, 2000; Wallis & Dollard, 2008).
Occupation and rurality are important determinants of physical and mental health. Occupational stress has been suggested as explaining the link between occupation and health, through a sense of lack of control and high work demands (Karasek, 1979) or perceived low rewards, job insecurity and other psychosocial factors (Siegrist, 2004; Siegrist, Benach, Goldblatt, & McKnight, 2009). Labour intensification, or working harder without increasing hours, has been suggested to negatively affect workers' health. The concept of a fixed amount of health capital (Blaxter, 2010) that is drawn down over a working life has been used to explain why workers in occupations which place heavy demands on mind and body, such as farming or seafaring, suffer poor health after a time in the occupation (Bloor, 2011). Occupational quality influences social integration and sense of control, which have been shown to impact on health behaviours and outcomes in rural areas (Wickrama, Lorenz, Conger, Matthews, & Elder, 1997).
Rural culture which favours stoicism, along with gender, influences health beliefs and behaviours in both positive and negative ways (Fragar, Henderson, Morton, & Pollock, 2007; King, Lane, MacDougall, & Greenhill, 2009). Many male farmers' definitions of rurality and masculinity, constructed around notions of being tough and uncompromising and the custodian of the family land, lead them to think they have failed their families and communities in these difficult times (Alston, 2012). Increased government regulation, and a widening of the schism between urban and rural Australians can also be expected to impact on the mental health of farmers and fishers. Rurality is associated with less positive health behaviours in Australia (Australian Institute of Health and Welfare, 2008).
There is a large body of research that indicates a positive link between social cohesion or connectedness and improved health outcomes for rural people (Caldwell & Boyd, 2009; Harvey, 2007; Hegney et al. …