Dr Rebecca Orr - Farmer Health

Rural Road to Health

Dr Rebecca Orr is an academic GP from Northern Ireland who focuses on farmers' health. She is also the Chair of the Agri Rural Health Forum in Northern Ireland.

Episode Summary:

00.45 Rebecca tells us about her professional background and how she became interested in rural health and farmers health

04.00 What is the role of women in farming and the health of rural communities?

06.50 What is the NI Agri-rural health forum? What work do they do?

21.20 Why are you researching farmers' health? How important has it been to include farmers in the research process?

34.45 What were some of the key findings of her research?

39.25 What should clinicians be thinking about when they are caring for farmers and their families?

47.00 What are your top three tips for people thinking about going into a rural health career?

Key Messages:

Even though about 86% of those in farming are men, women have always played a huge role in farming.

The NI Agri-rural health forum started in 2021. They have a role to bring everyone around the table to talk about health, they bring together agriculture, public health, voluntary sector, government and commercial organisations.

Key aims of the Agri-rural forum are to share information between the different stakeholders. The forum holds panels, workshops, developing a network to help partnerships flourish.

Researchers have come to speak to the Agri-rural health forum, this has provided inspiration for other activities.

Decided to focus on blood pressure and cardiac health. Teamed up with the British Heart Foundation to develop tailored health materials for farmers. “You might know your tire pressure, but do you know your blood pressure”.

Developed a 5 year plan for what they would like to work on next. One of the next topics is respiratory health and occupational lung disease in farmers.

One of the challenges was to find a way to bring different partners together who may have different interests and targets, building trust is a big part of this process.

There is a gap in knowledge about farmers' health in the UK and Northern Ireland, especially linking it to primary care. How does the change in farming practices affect farmers’ health?

There is a divergence in mortality among farmers compared to the general population.

They got farmers involved in the research study. The question is: what factors influence the behaviour of farmers at risk of cardiometabolic disease? The farmers informed the choice of the research methods and they were involved in the development of the survey. They used the COM-B framework, farmers understood this framework and got behind it.

Farmers analysed the questionnaire, edited it together and they took ownership of the research protocol with the research team.

It has been important to give feedback regularly to the farmers (participants) on the progress of the research and the insights that were gained. It is important to involve them in the discussions around how the data and insights are interpreted.

Farmers were asked to rate their top priorities, they responded with farm and family health and then personal health were their priority. When asked what the priority of their peers is they answered farm financial health.

Key findings so far:

- Risk taking, one farmer said “we are actually gamblers”. Does that feed into their choices around health?

- Optimism - that thing will work out

- Sense of responsibility - they take responsibility for optimised farm health

- Self-sufficient - feeling that they have to figure things out for themselves

- Seasonality

- Planning

Advice for clinicians:

• Farmer clinic - don’t need an appointment, they can just turn up

• Be straight talking - if there is a risk they want to know about it in clear language

• Farmers experience life and death and are aware of the fragility of life and some of the physiology

• Trust - the clinician being seen as part of the community

• Ask about their work - will help you build a management plan

• Farmers are heavily influenced by family, think about the whole family context.

• Make the consultation count

Top three tips:

1. Keep an open mind, rural health is full of variety.

2. Chat to everybody, especially those who are not directly involved in healthcare.

3. Have a flexible plan for the future, “if the plan is flexible you are always on plan”.

Dr Rebecca Orr X: @rebecca0rr

Email: [e-mail]

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