“They Can’t Possibly Understand What I’m Going Through”: Female Farmers’ Perspectives on Barriers to Care in Georgia
Abstract
:1. Introduction
2. Methods
2.1. Participant Recruitment
2.2. Data Collection
2.3. Data Analysis and Interpretation
3. Results
3.1. Participant Demographics
3.2. Health Outcomes
3.3. Barriers to Help-Seeking
3.4. Formal Healthcare Challenges
3.4.1. Time Constraints
3.4.2. Cost of Accessing Care
3.4.3. Provider Disconnection and Cultural Competence
3.5. Stigma
3.5.1. Community Stigma
3.5.2. Self-Stigma
3.6. Cultural Norms
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Participant | Date | Generation | Race/Ethnicity | Farm Role | Commodity | # of Workers |
---|---|---|---|---|---|---|
1 | 6 September 2023 | 4th | White | Full-Time Owner/Manager | Dairy Cattle | 6 |
2 | 18 September 2023 | 5th | White | Part-Time Owner/Agriculture Education | Beef Cattle, Hay | 4 (combination of part and full-time) |
3 | 18 September 2023 | 4th | White | Full-Time Owner/Manager | Poultry | 4 (combination of part and full-time) |
4 | 4 October 2023 | 5th | White | Full-Time Owner/Manager | Diversified Livestock, Poultry | 150 |
5 | 4 October 2023 | 3rd | White | Full-Time Owner/Manager | Citrus, Strawberries, Sunflowers | 4–10 (combination of part and full-time) |
6 | 25 October 2023 | 3rd | White | Full-Time Owner/Manager | Ornamental Crops, Cut Flowers | 3–15 (combination of part and full-time) |
7 | 14 November 2023 | 2nd | Latina | Full-Time Owner/Manager | Certified Organic Vegetable Farm | 13 (5 cooperative owners, 8 part-time workers) |
8 | 14 November 2023 | 2nd | White | Full-Time Owner/Manager | Certified Organic Vegetable Farm | 13 (5 cooperative owners, 8 part-time workers) |
9 | 6 December 2023 | 1st | White | Full-Time Owner/Manager | Fruit, Vegetables, Flowers | 2 full time (unspecified seasonal help) |
10 | 6 December 2023 | 1st | White | Full-Time Owner/Manager | Diverse Produce, Cut Flowers, Herbs | 8 (5 full-time, 3 part-time) |
11 | 11 December 2023 | 1st | White | Full-Time Owner/Manager | Beef Cattle | 5 (2 full-time, 3 part-time) |
12 | 13 December 2023 | 2nd | White | Full-Time Owner/Manager | Beef Cattle, Pork, Row Crops | 4–10 (combination of part and full-time) |
13 | 15 December 2023 | 2nd | African American | Part-Time Owner/Manager | Forestry, Herbs, Fruit and Vegetables, Aquaculture | 1 full-time (family assistance and unspecified volunteers) |
14 | 8 January 2024 | 3rd | White | Full-Time Owner/Manager | Dairy Cattle | 5 (1 full-time, 4 part-time) |
15 | 6 February 2024 | 2nd | White | Part-Time Owner/Manager | Beef Cattle | 2 full-time |
16 | 28 February 2024 | 3rd | African American | Full-Time Owner/Manager | Vegetables, Fruit, Herbs | 1 full time (unspecified volunteers and day labor) |
Theme | Concepts | Quotes |
---|---|---|
Formal Healthcare Challenges | Time Constraints | “I mean, I think the time, like the time demands of farming make it hard to weave self-care in, especially in the height of the season. Like it’s just- it’s hard to take a half day off or a whole day off if, you know, the team’s got a really hard day and you’ve got a lot to do”. [Participant 8, Certified Organic Vegetable Farmer] |
Lack of Insurance and Cost of Accessing Care | “And there’s just so much red tape with everything, you know, that even just keeping up with the paperwork, there’s a program that provides free health insurance to farmers through [Organization Name]. But like I checked one box wrong. So now there’s a denial letter and I have to reapply. And it’s just like you give up because it’s so exhausting”. [Participant 16, Fruit and Vegetable Farmer] | |
Provider Disconnection and Cultural Competence | “…when you can help that animal. To be like ‘oh, sorry, I’m going to the dentist’. That’s like leaving if your kid busted their head open on the sidewalk. You’re going to stop and take your kid where it needs to go… And if farmers are already experiencing financial distress, and then you tell them ‘well we’re going to charge you a cancellation fee’. Well, I’m never going to make the appointment”. [Participant 14, Dairy Cattle Farmer] | |
“It’s just extremely complicated to talk to someone who doesn’t understand. Like, I’m better off talking to my friend that farms down the road because, you know, if I lose a calf, then I feel really bad because, you know, you feel really guilty, really guilty. And he’s like, ‘well, you did—You did all you could’. Like that makes me feel better for him to say that. But if a therapist that doesn’t understand, is like ‘you did all you could’ you know, it just doesn’t—It doesn’t—It’s not the same”. [Participant 15, Beef Cattle Farmer] | ||
“I just had my physical yesterday and they ask you ‘‘have you been depressed or have you lost interest in doing things that you used to love to do?’ They ask you that when you first go in—and I sat there and I was like, you know, they don’t even look at you when they’re asking that… They don’t—it’s just a form they’re checking off”. [Participant 5, Citrus Farmer] | ||
Stigma | Community Stigma | “There’s still a stigma, particularly in rural areas. Even people who want to seek treatment often are afraid to, even within our churches we are often told to suck it up, lean on God, suck it up. It doesn’t matter if you can really handle it or not… people will say, God doesn’t give you more than you can handle. Oh, yes, he does. He absolutely does”. [Participant 6, Ornamental Crop Farmer] |
There was a thing we were trying to put on through the chamber for the Cattlemen’s Association that we were having to choose the topic. Do we want to do the topic on mental health or do we want to do like lifesaving things you can do on the farm, like having tourniquets and stuff? Immediately there was no talking about the mental health. Nobody wanted to go there. [Participant 11, Beef Cattle Farmer] | ||
Self-Stigma | “I think there’s um, I think they feel shame that they need medicine, you know, or don’t want any type of medical, any type of medicine to help them deal with anxiety or stress”. [Participant 2, Beef Cattle and Hay Farmer] | |
Cultural Norms | Prioritization of Work | “I think sometimes we don’t take care of ourselves and go to the doctor or the dentist or whatever like we should, because we are spending all of our time working. And, you know, we really don’t leave the farm much because we’re—we’re working so much. I think that’s an issue for us and probably for other farmers, too”. [Participant 9, Fruit and Vegetable Farmer] |
Restrictive Emotionality | “He wouldn’t have sought help for that (mental health). ‘Ain’t no way, I can get through this’. You know, and he kind of reflected that on me. No, you can’t cry and you can’t do this. You can’t do that, you know? So at his funeral, I didn’t shed a tear. You know, I went in another room (and) fell apart”. [Participant 5, Citrus Farmer] | |
Pride | “Farmers are very proud types, so being vulnerable enough to go. Um that would probably be one. They don’t want to exhibit that something’s wrong with them. And they don’t want a doctor to tell them that they can’t do (something), because if the doctor tells them they can’t do (something), they’re going to find a way anyway”. [Participant 14, Dairy Cattle Farmer] | |
“Down [highway number] to church, to the gas station to get his coffee in the morning… But you tell a farmer they can’t—they’ll find a way. So they don’t want to hear that from a doctor, so they typically won’t go”. [Participant 14, Dairy Cattle Farmer] |
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Hopkins, N.; Griffeth, L.L.; Reece, C.; Proctor, C. “They Can’t Possibly Understand What I’m Going Through”: Female Farmers’ Perspectives on Barriers to Care in Georgia. Int. J. Environ. Res. Public Health 2024, 21, 1130. https://doi.org/10.3390/ijerph21091130
Hopkins N, Griffeth LL, Reece C, Proctor C. “They Can’t Possibly Understand What I’m Going Through”: Female Farmers’ Perspectives on Barriers to Care in Georgia. International Journal of Environmental Research and Public Health. 2024; 21(9):1130. https://doi.org/10.3390/ijerph21091130
Chicago/Turabian StyleHopkins, Noah, Lauren Ledbetter Griffeth, Chase Reece, and Christina Proctor. 2024. "“They Can’t Possibly Understand What I’m Going Through”: Female Farmers’ Perspectives on Barriers to Care in Georgia" International Journal of Environmental Research and Public Health 21, no. 9: 1130. https://doi.org/10.3390/ijerph21091130