A Systematic Review of Health-Related Quality-of-Life Measurement in Patients With Complicated Urinary Tract Infections.

Farming continues to be one of the most dangerous professions in the United States (US). The national fatal injury rate in agriculture is six times higher than the national average for all workers and when focusing on the Northeastern US, the rate of nonfatal injuries in agriculture is 11 times greater than the average of all occupations in this region. While significant advancements in safety have made farming less dangerous, there are still thousands of non-fatal and fatal injuries on farms every year, and likely many more as underreporting is common in this industry. In 2011, Leigh et al. estimated 73.7% and 81.9% of injury or illness cases on crop farms and animal farms, respectively, were not reported. While the impact of agricultural injury is commonly accounted for by number killed, number injured, or medical expenses, such injuries have shown to expand beyond the individual and have ripple effects in rural communities. This supports a socio-ecological framework in which farmers are directly linked to their surroundings and those around them. Kilanowski describes the socio-ecological model in the context of agricultural public health with the individual at the center including their closest interactions and relationships nested within four systems of influences: 1) work, school, church, and neighborhood; 2) community and social networks; 3) societal, religious, cultural values; and 4) time, historical context, and policy. This system states “health is affected by the interactions between the characteristics of the individual, the community, and the environment that includes the physical, social, and political components.” Injury is not the only dangerous outcome on farms. Agricultural workers are also at risk for chronic health issues. Difficult physical labor, exposure to chemicals, ad lack of access to health services put farmers and farmworkers at risk for chronic pain and health issues. In addition to injury and physical health concerns, farmers have been known to experience depression, isolation, and poor mental health, with this being a major focus of research and policy in recent years. From examining 2021 data, Sussel et al. found that the suicide rate amongst male agricultural workers was 49.9 per 100,000 Full-Time Equivalent (FTE) compared to the average of 32 per 100,000 FTE. Farming, Fishing, and Forestry as an occupational group had the second highest suicide rate across all occupations in 2021. The unpredictable nature of farming, influenced by weather, fluctuating markets, changing regulations, labor shifts, among other factors, contribute to significant stress for farmers. As the agricultural landscape in the US changes due to mechanization, we must also consider societal changes that affect the industry. Although technology has allowed farms to scale, 2022 data indicate the vast majority (84%) of farms in the Northeast are still small operations that gross less than $100,000 a year. This can be attributed to financial and physical barriers such as land inaccessibility, labor shortages, and land development. Studies have suggested small- to mid-sized farms with limited resources and a lack of safety trainings are at higher risk for occupational injury.