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Agricultural Hazards ReductionThrough Stress ManagementPamela Dee Elkind PhD a , John E. Carlson PhD b &Barbara Schnabel MA ba Center for Farm Health and Safety , EasternWashington University , Cheney, WA, 99004, USAb Social Survey Research Unit, College ofAgriculture , University of Idaho , Moscow, ID,83843, USAPublished online: 11 Oct 2008.

To cite this article: Pamela Dee Elkind PhD , John E. Carlson PhD & Barbara SchnabelMA (1998) Agricultural Hazards Reduction Through Stress Management, Journal ofAgromedicine, 5:2, 23-32, DOI: 10.1300/J096v05n02_05

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Agricultural Hazards ReductionThrough Stress Management

Pamela Dee Elkind, PhDJohn E. Carlson, PhDBarbara Schnabel, MA

ABSTRACT. This paper describes a community based program toreduce farm hazards through recognition and training about the roleof stress in farm health and safety. Through data from focus groupsand a questionnaire administered at the 1993 Agricultural Expositionin Spokane, Washington it was hypothesized that occupational stres-sors are perceived by farmers to be significantly related to farminjuries. Farm-related stressors include economic pressures such asdebt burden, weather, undependable farm labor, government regula-tion, and market variability and costs. A workshop to aid farmerswas developed and conducted in EasternWashington state to providefarmers with information about how stressors may be affecting themand to introduce and encourage interventions that alleviate stress as apotential source of farm injury. A summary of the workshop presen-tations and a brief analysis of the effectiveness of this interventionprogram follow. Evaluation data from workshop participants andfrom random samples of Eastern Washington farmers are analyzed. Thereported results demonstrate stress reduction in workshop participants.[Article copies available for a fee from The Haworth Document DeliveryService: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com]

KEYWORDS. Farm stress, farm safety, stress management, oc-cupational stress

Pamela Dee Elkind is Sociologist and Director, Center for Farm Health andSafety, Eastern Washington University, Cheney, WA 99004.

John E. Carlson is Rural Sociologist and Director, and Barbara Schnabel isSurvey Manager, Social Survey Research Unit, College of Agriculture, Universi-ty of Idaho, Moscow, ID 83843.

Journal of Agromedicine, Vol. 5(2) 1998E 1998 by The Haworth Press, Inc. All rights reserved. 23

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JOURNAL OF AGROMEDICINE24

BACKGROUND

The Center for Farm Health and Safety is in the Department of Sociolo-gy at Eastern Washington University (EWU), Cheney, Washington, andwas founded in 1989. Its principal purposes are to conduct research anddesign interventions relevant to rural health issues. During the past fouryears the Center has managed aW. K. Kellogg funded ‘‘Community-basedprogram to reduce farm hazards through recognition and training about therole of stress in farm safety and health.’’ The activities of the programhave centered on developing a videotape and workbook for use in stressmanagement workshops, and delivering workshops in rural areas. Localsponsoring organizations designated facilitators who were trained to reachEastern Washington farmers with this workshop. The project has an advi-sory board consisting of local/regional individuals involved in agribusi-ness and farming operations.The program was a natural consequence of the Center’s work. Several

years prior to the establishment of the Center at EWU, we were invited bythe University of Iowa to conduct the eastern Washington state portion ofresearch that was to become the National Coalition for Agricultural Safetyand Health (N-CASH) survey.1 The N-CASH study was the basis for aBush administration briefing and the EWU Center director was a keynotespeaker at the Surgeon General’s conference on Farm Health and Safety.The results of the Eastern Washington survey showed that farmers appearto be knowledgeable concerning the dangers of their occupation but stilltend to engage in unsafe practices.2 The question which emerged and hasnot yet been adequately answered is; ‘‘Why do they continue to engage inunsafe practices?’’Seeking additional insight into the factors related to high farm injury

rates, the Center has conducted several research activities, each addressingthe question: ‘‘If a farmer knows that a practice is unsafe or unhealthy,why does he or she still perform these unsafe practices?’’ In 1992 a seriesof focus groups were conducted with local individuals engaged in agri-businesses. Participants in these groups concluded that occupational stressprevents farmers from taking appropriate safety precautions even whenthey are aware of the dangers of their practices.3To further understand the impact of occupational stress via specific

stressors, a stress survey was conducted at the Spokane Agricultural Ex-position in 1993. The survey, completed by 215 Exposition attendees,ranked the perceived impact of stressors on Washington farmers.4 A num-ber of earlier studies had reported that several variables, mostly economicwere the major form of stressors.5,6Given the consistency with which stress had been related to farm safety

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Elkind, Carlson, and Schnabel 25

by area farmers, a project proposal was submitted to the W. K. KelloggFoundation to address the following goals:

a. introduce to the agricultural community in three eastern Washingtoncounties user-friendly techniques to help reduce stress, and thus pro-mote health and safety;

b. encourage networking and coalition-building as a means of reduc-ing stress in order to promote health and safety;

c. involve the agricultural community in health and safety promotionthrough stress management techniques; and

d. train community members to present stress reduction workshops,and to have these community members train other local citizens todo the same.

Specific strategies designed to accomplish these goals were incorporatedinto the development of a multi-focused, interactive farm stress workshop.The Center’s proposal became one of 11, 3-year national demonstrationprojects funded in 1993 by the W. K. Kellogg Foundation.The initial year of the project was devoted to the development of the

stress reduction program. A professionally-produced videotape was devel-oped including live testimony from individuals who had experienced seri-ous injury or personal loss due to a farm accident which had occurredwhile stressed. A Farm Stress Workbook was also developed includingexercises for recognizing and coping with stress, with the expectation thatthese exercises would serve as the basis for group discussions. At the endof the workbook, a ‘‘contract’’ was presented for the individual to outlinethe steps he or she would take to reduce the impact of stressors in his/herlife. An in-depth survey was designed by the external evaluator from theUniversity of Idaho in conjunction with the advisory board. The purposeof the survey was to measure the impact of the workshop on participantsand to evaluate the success of the project.During 1993-94, the primary focus of the project was the implementa-

tion of the stress workshops. The program was initially tested at the 1994Ag Expo in Spokane and 25 workshops were subsequently held at localagribusiness and agricultural organization meetings. Community trainerswere selected and trained by Center staff members to administer the work-shop.

PARTICIPANT PROCEDURES

The adult Farm Stress Workshop took approximately one hour to com-plete. After the purpose of the workshop was explained to the participants,

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they were asked to complete the demographic portion of an evaluationquestionnaire. The questionnaire included questions about their farm op-erations, education level, age, family income, experiences with farm-re-lated injury, personal and significant others’ attitudes and perceptions ofcontrol over safety practices. The participants then watched a video.Following the introductory portion of the video, participants completed

a farm stress inventory. After the video presentation concerning stressoridentification, participants completed activity sheets about coping strate-gies. Workbook discussion followed describing strategies for establishingsupport networks, learning problem solving skills, and engaging in thoughtstopping techniques to reduce stress. The three stress reduction techniquesare defined as follows: Networking is a way to take action and a way toconnect with people or resources that can be of assistance. Networking isalso knowing the right person to contact so you can obtain the informa-tion you need. Problem solving is a process of breaking down a largeproblem into more manageable tasks. The four steps to problem solvingare (1) define the problem, (2) find alternatives, (3) choose an alternative,(4) implement a solution. Thought stopping involves concentrating on theunwanted thoughts and, after a short time, suddenly stopping and empty-ing your mind. Thought stopping clears your mind of the unwantedthoughts and worries that distract you from work, sleep, and leisure. Abrief video introduced networking, problem solving, and thought stop-ping, the three coping strategies. Participants completed a questionnairewhich assessed the degree to which they intend to use coping strategiesfollowing their workshop presentation. The signing of a self-contract to trycoping mechanisms completed their participation.Workshops were conducted in 1994 with farmers in Spokane, Lincoln,

and Whitman counties (see Table 1 for additional information about thesamples). Farmers who had participated in the 1994 workshops and hadcompleted the questionnaire were contacted again in 1995. The follow-upquestionnaire contained many questions identical to the questions in the1994 questionnaire.In 1994 a questionnaire similar to the one handed out at the 1994

workshops was mailed to a random sample of 982 farmers in Spokane,Lincoln and Whitman counties. The random samples were drawn fromlists of farmers obtained from the Agricultural Stabilization and Conserva-tion Service in each county. In 1996, questionnaires were mailed to thefarmers who had responded to the 1994 survey. The random sample pro-vided a basis for comparing workshop participants with the general popu-lation of farmers in the area.Additional workshops were conducted in 1995 with farmers in Spo-

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Elkind, Carlson, and Schnabel 27

TABLE 1. Sample Characteristics.

1994 Workshops 1995 Workshops Random Sample

Workshop Follow-up Workshop Follow-up Initial mailing Follow-up

Total in Sample 325 270 237 174 982 546

Non-farmers, ineligible* 90 122 63 78 436 206

Farmer responses 235 148 174 96 546 340

Response rate** 63% 65% 64% 67%

*Ineligible included those retired, no longer farming, deceased or moved from the area.

**Response rate was calculated using the following formula:

Response Rate = Valid ResponsesTotal Sample Ineligibles

100

kane, Adams, Lincoln, Whitman and Yakima counties. In 1996, a follow-up questionnaire was mailed to the farmers who participated in the 1995workshops.The following section presents selected characteristics of the workshop

participants and random sample of farmers.

BACKGROUND CHARACTERISTICS

The 1994 and 1995 workshop participants’ average age was a littleyounger (49.9) than the average for respondents from the random sample(52.1). Educational levels for respondents and their spouses were roughlyequivalent for the three groups (Table 2).Seventy-two percent of the 1994 workshop participants and 57% of the

1995 workshop participants were a part of a family farm corporation,whereas 51% of the random sample were part of a family farm corpora-tion. Respondents from the random sample were more likely to farm alonethan 1994 workshop participants (49% compared with 29%). The percent-age of workshop participants who farmed with relatives was higher (73%of the 1994 participants and 74% of the 1995 participants) than for respon-dents from the random sample (44%). It is possible that persons farmingwith others have more time to belong to organizations where workshopswere held. The majority of respondents from all three groups were maleyet there was a higher percentage (15% and 17%) of female respondents inthe 1994 and 1995 workshops than in the random sample (6%).The majority (53%) of respondents from the random sample had a gross

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household income in 1992 of more than $100,000 (Table 3). The grosshousehold income for almost half the respondents from the 1994 work-shop (48%) was $30,000 to $99,999 and for the 1995 workshop (51%)was $30,000 to $74,999.The following analysis evaluates the influence of the workshops on the

reduction of stress from factors related to the farm operation.

FARM STRESS ANALYSIS

Farmers were given a list of 28 items that potentially could cause stressin managing farm operations and were asked to indicate the level to which

TABLE 2. Characteristics of Workshop Participants and Random Sample ofFarmers: Level of Education.

Workshop Random Workshop1994 Sample 1995

Education (n = 224) (n = 507) (n = 166)

Respondent Spouse Respondent Spouse Respondent Spouse

Elementary school 0* 0 0 1 4 0Some high school 2 1 2 3 5 2High school graduate 15 20 23 23 13 20Vocational training 11 13 10 9 13 9Some college 26 28 29 28 27 26College graduate 37 29 30 27 32 36Advanced college degree 9 9 6 9 6 7

*Reported as percents

TABLE 3. Characteristics of Workshop Participants and Random Sample ofFarmers: Gross Household Income Before Taxes and Expenses in 1992.

Workshop Random WorkshopIncome 1994 Sample 1995

(n = 228) (n = 518) (n = 174)

LESS THAN $19,999 10* 4 7$20,000 TO $29,999 14 7 12$30,000 TO $49,999 28 11 34$50,000 TO $74,999 10 12 17$75,000 TO $99,999 10 13 9$100,000 TO $249,999 19 37 17$250,000 TO $499,999 7 13 3$500,000 OR MORE 2 3 1

*Reported as percents

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Elkind, Carlson, and Schnabel 29

each item was stressful to them in their farm operation. These items havebeen previously developed with farmer input and have been used in earlierfarm research.4 All survey instruments were pre-tested prior to their beingfinalized. The response categories were ‘‘No Stress,’’ ‘‘Slight Stress,’’‘‘Moderate Stress,’’ ‘‘Serious Stress,’’ or ‘‘Not Applicable.’’ By subjectingthe list of stressors to factor analysis six groups emerged. They were:stressors related to farm management, health stressors, stress factors notcontrolled by the farmer, financial stressors, stressors associated with gov-ernment policies or programs, and stressors specific to the farm (Appen-dix). The means for each scale are presented for the three sample groups inTable 4.A higher scale mean for the farm management scale indicated that

farmers felt more stress when determining the most profitable ranch andfarm enterprises, getting enough information to make decisions, keepingrecords, and establishing long range farm operation goals. The 1994 and1995 workshop respondents had higher scale means than those from therandom sample or the follow-up surveys. Workshop participants felt morestress in the area of farm management than the random sample. The

TABLE 4. Farm Stress Scale Means.

RandomWorkshop Workshop ’94 Workshop Workshop ’95 Random Sample

Scale 1994 Follow-up 1995 Follow-up Sample Follow-up

Farm 2.316 2.181 2.286 2.068** 2.022 1.992management

Health 2.506 1.905*** 2.598 1.836*** 1.952 2.009

Control 2.994 2.820*** 2.776 2.571* 2.743 2.706

Finances 2.727 2.210*** 2.647 1.913*** 2.114 2.093

Government 2.781 2.622 2.622 2.426* 2.517 2.531

Farm 2.482 2.382 2.343 2.216*** 2.254 2.274problems

NOTE: Means are based on the following scores: No stress = 1; Slight stress = 2; Moderate stress = 3; and Seriousstress = 4.

A difference of means test for dependent samples was done on each workshop group and the random sample. Theasterisks associated with the follow-up scores indicate the statistical level of significance according to the following probabili-ties:

P < .05P < .01P < .001

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follow-up survey showed a reduction in stress for this scale which wassignificant for the 1995 workshop respondents.A higher scale mean for the health scale indicated farmers felt more

stress when confronted with major illness or accident, alcohol or drug use,a death in the family, lack of health care providers, transfer of the farm tothe next generation, family conflicts, and responsibility for dependentrelatives. Participants of the 1994 and 1995 workshops showed the great-est reduction in health related stress on the follow-up surveys.The control scale was comprised of factors not completely within the

farmer’s control such as weather, poor crops or machinery breakdown.The control scale means were closest for the 1995 workshop participantsbut the differences between the workshop and follow-up scores were stillstatistically significant. The control scale means were higher for eachgroup than the farm management, health, finances, government or farmproblems scales means. This would indicate that factors perceived to beoutside the farmer’s control cause more stress than factors within thefarmer’s control.The finances scale was made up of items concerning high interest rates

on debt, off-farm employment, inability to obtain credit or farmer’s debtload. Respondents from the 1994 workshop had a higher finances scalemean than respondents from the other groups. Reductions in financialstress were the second largest for respondents from the 1994 and the 1995workshops.The government scale was comprised of items related to the uncertainty

of foreign or national markets, government regulations or policy shifts,transporting of crops and the cost of machinery or production. Govern-ment scale means from all samples were among the highest, indicating thatgovernment issues tend to generate relatively high levels of stress amongfarmers.The farm problems scale included problems that were specific to the

farm operation such as soil erosion, inability to hire and keep good labor-ers, use of dangerous chemicals, use of dangerous machinery, or the deathof a valuable animal. Respondents from both workshops had the secondlowest farm problems scale means. Farm management scale means werethe lowest for both groups. Differences due to the workshops was notsignificant in 1994.Overall, the stress scale means dropped for both the 1994 and 1995

workshop participants who responded to the follow-up questionnaire forall six scales. Stress scale means for random sample follow-up respon-dents were only slightly different between the two time periods. Thissuggests that less stress was perceived by farmers after the workshop.

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Elkind, Carlson, and Schnabel 31

SUMMARY AND CONCLUSIONS

Their were consistent findings in the six stress scales following theworkshops. It is possible that the workshops had a positive influence onthe farmers ability to handle the stressors of his/her farming operation. Thegreatest reductions in stress in the 1994 workshops were in the health,control, and finances scales. In the 1995 workshops the greatest differ-ences were in the health, finances and farm problems scales. In 1995differences in the farm management scale, the control scale and the gov-ernment scale were also statistically significant.Workshop attendees were younger and had lower income levels than

the random sample. It is possible these farmers would have higher stresslevels in their farming operations than older farmers with higher incomes.Workshop attendees also were slightly higher in education level than therandom sample.In general, results suggest that positive results can be achieved by

presenting a workshop focusing on reducing the influence of stressfulsituations in a farmer’s life. The presentation of stress reducing techniquescan play a positive role in reducing stress and increasing the health andsafety of farm operations.

REFERENCES

1. Elkind P. Correspondence between knowledge, attitudes and behavior infarm health and safety practices. Journal of Safety 1993; 24:171-179.

2. Meyers M, et al. Papers and Proceedings of the Surgeon General’s Confer-ence on Agricultural Safety and Health. U.S. Department of Health and HumanServices. NTIS PB 93-114890. September 1992.

3. Elkind P. Attitudes and risk behavior. In Meyers, et al. (eds) Papers and Pro-ceedings of the Surgeon General’s Conference on Agricultural Safety and Health.U.S. Department of Health and Human Services. NTIS PB 93-114890. September1992.

4. Elkind P. Farm stressors: The hazards of agrarian life. AAEM 1994; 1:23-27.

5. Weigel RR. Helping farmers handle stress. Journal of Extension 1980;18:37-40.

6. Walker LS, Walker JL. Stressors and symptoms: Predictive of distress in-formers. Family Relations 1987; 36:374-378.

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APPENDIX

QUESTIONS USED TO DEVELOP FARM STRESS SCALES

MANAGEMENT SCALE

1. Determining the most profitable ranch and farm enterprises.2. Having enough information to make important decisions.3. Too much or too little time spent on record keeping.4. Difficulty in establishing long range farm operation goals.

HEALTH SCALE

1. Major illness or accident (yourself or others).2. Alcohol and other drug use, abuse or addiction (yourself or others).3. Death in family.4. Lack of health care providers.5. Transfer of farm from one generation to next.6. Family conflicts.7. Responsibility for dependent relatives (young or elderly).

CONTROL SCALE

1. Weather.2. Poor crops.3. Machinery breakdown.

FINANCES SCALE

1. High interest rates on debt.2. Off-farm employment to make ends meet.3. Inability to obtain credit.4. Debt load.

GOVERNMENT SCALE

1. Uncertainty of foreign/national markets.2. Government regulations or policy shift.3. Transporting of crops (roads and rail).4. Cost of machinery or production.

FARM PROBLEMS SCALE

1. Soil erosion.2. Inability to hire and keep good laborers.3. Use of dangerous chemicals.4. Use of dangerous machinery.5. Death of a valuable animal.

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