Farm elders define health as the ability to work

Purpose: Thirty percent of America's 2.2 million farms are operated by persons over age 65. The purpose was to determine how older farmers best define health and to assess which demographic, farm work, and physical and mental health status indicators predict health definition. Research on defining health published to date has relied heavily on qualitative methods. Methods: Data were collected during the baseline wave of data collection (2002-2003) in a longitudinal study of family farmers residing in Kentucky and South Carolina (n=1,288). Computer assisted telephone surveys and mailed surveys were used to collect data. Predictors of health were determined using a generalized estimating equation model to account for dependence between spouses. Focus groups of a subset of survey participants (n=127) further explored the meaning of health. Findings: Average age of participants was 65.3; 51% were male; 79% were White; 91% were married. Nearly 42% defined health as ‘the ability to work' compared to definitions of absence of major disease, absence of pain, or not having to take medication. Predictors of health definition included race, number of farm tasks, taking medications, and limitations to farm work due to health. Work was reported as essential to good physical and mental health by group participants. Conclusions: Health behaviors are centered in the individual's perception of health. Understanding the defining attributes of health can support better approaches to health care and health promotion, particularly among rural subcultures like farmers, who have their identity rooted in their work and whose occupation is extremely hazardous.