Disentangling French and US farmers' health needs and access to care: An application of Bourdieu's Theory of Practice

Globally agriculture is one of the most dangerous occupations, with farmers experiencing high injury rates, stress levels and, suicide rates. The literature on farmers’ health needs and access to care has thus far been... [ view full abstract ]

Globally agriculture is one of the most dangerous occupations, with farmers experiencing high injury rates, stress levels and, suicide rates. The literature on farmers’ health needs and access to care has thus far been divided into two main strands that have yet to be connected. Looking at risk factors, health scholars tend to look at physical and mental health separately and overall focus on individual’s actions with limited treatment of the impact of external forces and underlying social structures. On the other hand, agricultural economists tend to focus on the availability of health care facilities, access to health insurance, and costs with limited consideration for individuals’ dispositions and practices regarding access to care along with the social networks on which they rely. In this paper, I use a cross-national comparative approach by drawing from the French and US farm health and family farm literature and use Pierre Bourdieu’s Theory of Practice to join these bodies of literature. While the social policy environments in France and in the US are different, the comparative approach and Theory of Practice clearly show the complexity and interactions in farmers’ macro and micro environments and feedback loops between health risk factors and meeting health needs. I argue that research to date has overlooked how socialization into agriculture, in particular for multi-generational farmers, and the social pressures to play the role of farmers lead to farmers forging simple self-care and ignoring health problems until they can no longer be ignored even when they have access to affordable health care. Furthermore, I argue that the findings from this paper highlight the need for research and policy to move away from the siloed approaches of the current literature to a systemic approach. This systemic approach should not only consider the interactions between health needs and how health needs are met together but it also should consider the interactions between the farmers’ micro and macro environments, access to resources, and farmers habits and preferences. Beyond quality of life issues for farmers, health issues and access to care can have snowballing effects on the farm operation impacting farm persistence and social sustainability. Farm persistence and social sustainability are in turn connected to the challenges associated with the greying and shrinking of the farm population such as the renewal of the agricultural sector and economic activity in rural areas.