The impact of farm lifestyle and health characteristics: cervical cancer screening among southern farmwomen.

BACKGROUND: Rural residence, access to healthcare facilities, and multiple roles of farmwomen may pose barriers to cervical cancer screening among women living in southern farm states. OBJECTIVES: To compare the proportion of women failing to obtain cervical cancer screening in three Southern states to state-level Behavioral Risk Factor Surveillance System (BRFSS) data and to identify factors contributing to cervical cancer screening and detection behaviors. METHODS: A cross-sectional study design was used. Data were collected using several Farm Family Health and Injury Prevention surveys via telephone interviews in three southern states. Farmwomen (N = 2,324) from three states comprised the sample on Pap testing. Data were used from summary reports of the BRFSS for each state to compare the proportion of farmwomen >or=18 years of age who had failed to obtain a Pap test within the past 3 years to failure to obtain Pap tests statewide. Multiple logistic regression analyses were conducted to examine the predictors of failure to obtain early screening. RESULTS: Pap testing did not meet Healthy People 2010 target goal of 90%. Farm lifestyle predicting failure to obtain cervical cancer screening included having a house on the farm and engaging in no off-farm work and minimal involvement in farm tasks. The risk of failing to obtain Pap testing increased with age and decreased with education. The only health access variable contributing to failure to obtain Pap testing was women with no insurance. Positive preventive risk factors contributing to compliance with up-to-date status were previous mammogram and previous breast exam. Being married was a positive risk factor. DISCUSSION: Although the failure to obtain Pap testing in Texas was comparable to state BRFSS rates, failure to obtain Pap testing rates in Kentucky and Louisiana were at least 6% greater for farmwomen than women living in the state. Farmwomen, a subgroup of the rural population, have unique barriers to obtaining screening services. Geographical isolation and minimal role involvement on the farm may contribute to the likelihood that women are not seeking cervical cancer screening.

Potential exposure to hazardous work activities: tractor usage among farmwomen.

Farmwomen are often an unacknowledged workforce, leading to a lack of targeted safety interventions. This study examined the involvement and work patterns of 665 women in Texas and 657 women in Louisiana who were 18 years old and older and whose family participated in farming operations. Surveys were used to gather specific data regarding tractor work patterns, tractor knowledge, sources of information about tractors, and demographic information in two southern states in which cattle and dairy were the major agricultural commodity. Among the sample of 1,322 women, 577 (43.6%) reported driving tractors at least one day a year. This subset was used to describe characteristics of tractors and tractor-related activities. Findings indicate that women learn to drive tractors in their 20s, use husbands as the primary source of their information about tractors, engage in a wide variety of farm activities including bush-hogging and plowing, and acknowledge knowing an average or less than an average amount about driving tractors. Women most often reported driving between 1 to 12 days/year (n = 321, 55.6%). When examining patterns of ROPS-equipped tractor use, women were 1.47 times more likely to drive a tractor without ROPS or enclosed when driving less than 12 days a year as opposed to 13-103 days/year or greater than 104 days/year. The results of this study support the need for health care professionals and safety specialists to design appropriate interventions that target women to become more knowledgeable regarding the injury risks associated with farm work while driving tractors.

Nonfatal injury experiences among women on family farms.

Agricultural injury occurrence was determined among 1,096 working farm women in Texas and Louisiana. The 1-year cumulative incidence was 4.8%. Lower extremities were the body parts most frequently injured. The leading external causes were contact with foreign object, followed by falls and overdoing/ lifting. The seasonal pattern of injury was consistent with warm weather. The factors predictive of increased injury risk in multiple logistic regression included large animal farm type, greater time commitment, recurrent or persistent back conditions or weakness during the previous 12 months, hauling goods to market, and driving a tractor more than 52 days per year. Most women consulted a physician as a result of the injury. Resolving the problem of preventable farm-related injuries will require a major and coordinated effort aimed not only at farm women themselves but also at multiple variables that profoundly affect the underlying conditions and behaviors that lead to farm-related injuries.