Syson-Nibbs L, Saul C, Cox P
Farm Out Health Project, Newholme Hospital, High Peak and Dales Primary Care Trust, Baslow Road, Bakewell DE45 1AD, UK.
Public Health. 2006 Mar;120(3):221-8. doi: 10.1016/j.puhe.2005.09.005. Epub 2005 Dec 19.
In the UK, there have been no epidemiological studies focusing on the general health status of rural communities, despite the prevalence of rural deprivation and the widely acknowledged link between poverty and ill health. The primary objective of this study was to test the null hypothesis that no differences existed between the health status of the farming and non-farming populations registered with one general practice, in order to inform a local health needs assessment. The secondary objective was to test the suitability of the research method as a model for a wider study.
A postal questionnaire survey was undertaken with the total farming population (n = 248) registered with Tideswell general practice, and matched with an equivalent random sample of non-farmers (n = 248) from the remainder of the practice list. The main outcome measures were income, general health status, quality of life (EQ5D), musculoskeletal problems, mental health status and service utilization.
Significant differences were found between the two groups. Farmers were identified as having health needs that were greater than those found in the local non-farming sample. In addition, the observed EQ5D value for farmers was found to be significantly lower than that found in social classes IV and V (0.78 vs 0.82) and the UK mean.
This modest controlled study is the first of its kind in the UK. Health inequalities and inequities were identified that may be generalizable to other UK hill farmers. However, a larger, wider epidemiological study across different types of farming groups is now required to gain a fuller understanding of the health status of this indigenous rural population. The methodology employed in this study was successful and could serve as a model for such a study.
在英国，尽管农村贫困现象普遍存在，且贫困与健康不佳之间的联系已得到广泛认可，但尚未有针对农村社区总体健康状况的流行病学研究。本研究的主要目的是检验零假设，即登记在一家全科诊所的务农人口和非务农人口的健康状况不存在差异，以便为当地的健康需求评估提供信息。次要目的是检验该研究方法作为更广泛研究模型的适用性。
对登记在蒂兹韦尔全科诊所的全体务农人口（n = 248）进行了邮寄问卷调查，并与该诊所名单上其余人员中随机抽取的同等数量的非务农人员样本（n = 248）进行匹配。主要观察指标包括收入、总体健康状况、生活质量（EQ5D）、肌肉骨骼问题、心理健康状况和服务利用情况。
两组之间存在显著差异。务农人员被确定存在比当地非务农样本更大的健康需求。此外，务农人员的EQ5D观察值显著低于社会阶层IV和V的观察值（0.78对0.82）以及英国平均水平。
这项适度的对照研究在英国尚属首次。研究发现了健康不平等现象，这些现象可能适用于其他英国山区农民。然而，现在需要开展一项针对不同类型务农群体的规模更大、范围更广的流行病学研究，以更全面地了解这一本地农村人口的健康状况。本研究采用的方法是成功的，可作为此类研究的模型。
