Societal factors of Primary Stroke among Vietnamese Farmers

Cerebrovascular disease (stroke) is increasingly recognized as a public health problem in Vietnam, where a market-based economic reform has been taken place during the past two decades. This study examined the underlying societal and economic factors that are associated or contributed to stroke risk among farmers in Vietnam. The study was conducted in Kien Giang, a Mekong delta province with a population of 1.6 million, among whom 75% are farmers or living in rural areas. Between June and August 2007, in-depth interviews and participant observation were conducted in 10 farmers who had a stroke, and 10 family members of the patients. The study identified 4 themes related to the underlying risk factors of stroke: mode of production, exploitation, poverty, and unhealthy lifestyles. The patients and their relatives consistently reported that their rice cultivation was dependent on personal loan with high interest, and this placed the farmers in constant stress to repay the loan by working long hours in rice fields with harsh condition. The stress led them to harmful lifestyles such as heavy smoking, alcohol intake and poor nutrition, which are major risk factors of stroke. Moreover, due to poverty and limited income, medical attention among these farmers was almost always inadequate. These results suggest that the production mode and social conditions under which farmers lived their lives are the major factors increasing their risk of stroke and cardiovascular diseases. This study has provided an insightful perspective for thinking of a novel approach to prevent stroke among farmers in Vietnam.