‘It absolutely changed my life,” says 75-year-old Seán Egan of Fit Farmers, a novel health promoting intervention in Roscommon, designed and run by a nurse to improve the well-being of her local farming community. In her 21-year nursing career, farmer’s daughter Laura Tully — currently based at Athlone Institute of Technology — noticed that farmers often overlooked the most important aspect of farming — themselves.
We tend to imagine farmers as being active, fit, strong, healthy and social professionals but the reality is they have a very poor personal health profile,” says Laura, a passionate advocate for farmer and rural population health. My work as a practice nurse led me to question why we were not seeing farmers until it was too late. Often their toe would be black before they would come in the door or they would be in a lot of pain or have had a heart attack before they got to the doctor.
“I was standing in a queue to pay my respects at the funeral of a farmer who died unexpectedly young from a heart attack when I decided it was time to try to include farmers in my ventures and educate and empower them to take better care of themselves. I wanted to try to prevent some of the health hardship.”
Her professional and personal experience of the toll that farming takes on the health and well-being of farmers and their families is supported by a growing evidence base which highlights that Irish farmers are disproportionately affected by illness, injury and disease.
“The Farmers Have Hearts cardiovascular health programme report, published in June 2020, concluded that 74pc of male farmers have four or more risk factors for cardiovascular disease. This means they are three times more likely to have an acute cardiac event compared to those with fewer risks,” Laura says.
The Health and Safety Authority in its 2018 publication Reducing the Risk of Back Injuries on the Farm pointed to a survey of 600 Irish farmers, by Dr Aoife Osborne, which found that 56pc had experienced a musculoskeletal injury. The most common type of injury or disorder related to the back. “In addition, farming is listed by the Health and Safety Authority as the most dangerous occupation in Ireland, with the majority of workplace accidents occurring on farms. By its nature, farming is an isolating profession which is a main driver for poor mental health,” Laura says.
“Combine that with being at the mercy of mother nature, commodity price risks, financial stress and limited access to health and well-being services and you can see how the challenge of maintaining good health in farming can become overwhelming. Too often, aches and pains are pushed aside, symptoms are disregarded and health concerns are ignored and overlooked, with detrimental outcomes.”
The mum-of-two decided to rally the troops locally, devising the Fit Farmers initiative which kicked off in January 2019. To date, 76 farmers ranging in age from 21 to 75 in Roscommon have completed the six-week programme of health promoting workshops and physical activity workouts.
The workshops focus on the indicators of health and well-being and address nutrition, smoking, alcohol, physical activity and mental health in the context of farming. A series of health and fitness checks take place and a chartered physiotherapist provides a specially-designed back care programme for farmers.
Physical activity workouts are tailored to participant requirements and every programme fosters a guided ‘Farm to 5K’ walking programme in tandem with the weekly strength sessions. Participants are assigned ‘healthy homework’ and have the option of a daily support text group to encourage motivation and ongoing participation.
“The farmers have achieved outstanding results in weight loss, reductions in abdominal circumference, increases in strength and cardiovascular fitness and physical activity levels as well as notable improvements in mental and social health,” says Laura. It was these social health benefits that were keenly appreciated by Seán Egan, a separated dad-of-six who took part in the programme in February 2020.
“I have a 40-acre farm and keep dry cattle for the summer. I did some social dancing but apart from that I was inclined to just watch television. I found the social side of the Fit Farmers programme brilliant. It was great to talk to different people. The first week was hard as I found the exercise vigorous, but after doing exercises at home as well as walking, I got fitter. I also picked up some tips about my food as I was using too much sugar and salt. It was a great experience.”
Michael Mulryan (64), shed over three stone after completing the programme. He also reported feeling significantly better. “I make healthier choices now. I use the traffic light system Laura showed us on food labels to help me decide on my food purchases,” he says.
“I keep active and walk daily or do a workout. I was on blood pressure tablets but I came off them. My doctor couldn’t believe the improvements in my health.” Several farmers discovered significant issues as a result of the health screening provided as part of the programme. “Farmers who disclose a health issue, symptom or concern or have an issue detected are supported and encouraged to attend their GP for further investigation and management,” Laura says.
“Several cases of undetected hypertension were identified, which have been managed and treated appropriately. Some cases of undetected diabetes and a case of prostate cancer and skin cancer were detected earlier as a result of the programme.”
Laura delivers the programme throughout Roscommon with co-facilitator, Damien Martin, community sports development officer with Roscommon Sports Partnership, which funds its delivery with finance from Healthy Ireland/Sport Ireland. The programme received a high commendation at the 2019 National Age Friendly Recognition and Achievement Awards.
“The current global pandemic has brought our farmers many unique challenges. Maintaining food production and supply has been critical during very difficult circumstances,” says Laura. “Farmers now face the challenge of funding cuts, Brexit and global recession, all while living with the threat of Covid-19, so never has it been more important for farmers to mind their health.”
With the pandemic suspending delivery of Fit Farmers, Laura has redesigned the latest programme to be delivered online. “The Fit Farmers At Home programme commenced on March 3 with a full complement of 15 participants, ranging in age from 30 to 72, from Roscommon.
“Farmers are embracing the farm to 5K walking programme and have been making simple swaps in their diet,” Laura adds. She says the response has been positive. “We hope to embark on Sliabh Bawn in Roscommon as soon as restrictions permit us to meet as a group.”
All too aware of the issue of patchy rural broadband, she acknowledges that the move online is not ideal. “The success of Fit Farmers is underpinned by bringing farmers together as a social group, undertaking similar learning goals and challenges. Face-to-face consultations foster good rapport and trust as well as the participation in the group, giving rise to lively banter and fun. Farmers have been able to ask for support or help during the private one-to-one interactions,” Laura says.
“Moving online risks losing that valuable outcome and benefit. We are working hard to foster that sense among participants, however challenging it is for us all. We were also concerned that many of the farmers we really want to reach may not have access to broadband or devices to access the programme. They may also be lacking technical skills,” Laura acknowledges.
“Our preference is to work with a group in-person but Covid-19 is calling all the shots at the moment and rather than postpone another programme, we have moved ahead with the online programme to reach that cohort who can access the internet programme rather than feel helpless and doing nothing. We know that farmers have been engaging in Irish Farmers’ Association meetings and even the marts online so we were confident we could recruit a cohort,” she says.
“Our emphasis is on creating social connections, ensuring participants feel part of a group even though we’re apart,” Damien says. Laura, who initially worked on the programme voluntarily but now acts as a consultant, sees it as important that there are no barriers to participation, particularly in relation to cost and travel time.
“Prior to Covid, our emphasis was to deliver the programme in a venue local to the farm such as a parish hall so that farmers could be back on the farm, if needed, within five or 10 minutes. Farmers have embraced the programme with peer support and word of mouth, meaning we have had no issues recruiting participants. The programme is open to men and women but it’s been an all-male turnout to date,” says Laura whose drystock farmer dad is among past participants.
“On all programmes farmers have asked for more, so when the six weeks are over they often sign up to other ventures that the Sports Partnership run in the county or continue walking with their family or a group of farmers they have befriended. We keep in touch on WhatsApp groups long after the programme concludes.”
Similar initiatives are being rolled out in Laois, Wexford and other counties through local authorities as national emphasis begins to shift towards supporting farmers with their health and well-being, says Laura who is on the advisory oversight committee of the Men’s Development Network ‘On Feirm Ground’ project which will train farm advisors to assist farmers with their well-being.
Further information is available by emailing: roscommonfitfarmers@gmail.com
