Tideswell health survey: a population survey of the health needs and service utilization of a farming community

OBJECTIVES: 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. STUDY DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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.