The problem goes back decades, even centuries: our farmers live
They work with loud, dangerous machinery; breathe chemicals, pesticides,
and irritating grain dust; and push themselves long days without
adequate rest. Compounding all this, farm families typically pay
steep prices for private health insurance with high out-of-pocket
costs and deductibles. Despite the need, farmers rarely seek medical
care until they are injured or critically ill.
Back in 1990, Iowas Center for Agricultural Safety and Health
(I-CASH) was formed. Headquartered within the College of Public
Health at The University of Iowa, the center coordinates with Iowa
State University, the Iowa Department of Public Health, and the
Iowa Department of Agriculture, reaching out to the agricultural
community to reduce injuries and illnesses.
One of its programs is a network of AgriSafe clinics across Iowa,
and within this network is an innovative intervention called Certified
Safe Farm (CSF). In 1996, families living on 300 farms in a nine-county
area around Spencer, Iowa, began participating in CSF, receiving
preventive health care, education, and remediation assistance.
"We have three primary forms of intervention," says Sara
Schneiders, CSF coordinator. "We offer a free health screening
at the AgriSafe clinic in Spencer, an education program, and an
on-site farm safety review."
AgriSafe tests farmers hearing, screens their blood for abnormal
pesticide exposure, and performs several measures of pulmonary function
and lung capacity. For many of the programs enrollees, it
is their only medical contact all year.
"The clinic saw one farmer who hadnt seen a physician
for more than 20 years before enrolling in CSF," Schneiders
says. "They discovered he had advanced heart disease and got
him into the hospital immediately for bypass surgery."
Farm reviewers from CSF visit each participating farm to do a complete
safety audit of machinery, chemical storage, buildings, livestock
pens, vehicles, and fields. Each farm receives points that are tallied
at the end of the review and must have an 85 percent success rate
to pass and become certified.
Carolyn Jones runs a 720-acre farm with her husband and 11-year-old
son in Linn Grove, Iowa. Together they raise 1,000 hogs and 65 cattle
a year, and they cultivate corn, soybeans, and alfalfa. She attended
a CSF advisory meeting when the program was young and received a
job offer just one week later. Following a period of intensive training,
shes now one of the most experienced farm reviewers in the
program, visiting 30-70 farms a year.
"Whenever I go out to a farm, I try to get the whole family
involved," Jones says. "Ill look at chemicals with
a special eye to see if theyre locked up where kids cant
get into them. Ive learned a lot, too, by looking at other
peoples farms. For instance, Ive always had Slow-Moving-Vehicle
signs on our tractors, but I realized theyre not as effective
when they get old and faded. So Ive replaced all my SMV signs."
Eventually, CSF hopes to partner with insurance companies and offer
farmers lower health and land insurance premiums in return for certification.
But meanwhile, Jones says, the program is paying off.
"Even if people do just one thing to improve safety on their
farms," Jones says, "their families live a better life."