“Can I see your scratch?” my 4-year-old granddaughter asked when she visited me at a Des Moines hospital in January. I had undergone triple coronary artery bypass surgery a couple weeks earlier. As she inspected the stitches holding my sternum together, she asked, “Does it hurt?”

Nodding, I answered honestly, “Yes a little” and for added effect, I said “But a hug helps me feel better.” She wrapped her sturdy arms around my midsection to the extent she could reach, but carefully below the healing wound.

There were no concerns then to maintain social distance before the COVID-19 epidemic hit the U.S. My granddaughter’s questions were forthright as she considered if her Grandpa was brave.

“You have a big owie,” she proclaimed. Besides earning sympathy, most youngsters consider bruises and scabs as badges of honor, and compare their wounds and scars with those of others. I was an admired hero.

We all have scars, our belly button usually being the first. The next time my granddaughter, now 5, sees me, she will likely want to inspect my newest and biggest scar. Surgeons opened me from my sternum to lower abdomen on July 9 to repair an aneurysm on my lower aorta and an umbilical hernia.

I’ve lost count of the number of people who teasingly advise me, “You should have asked the doctors to put in a zipper so they won’t have to cut you open next time.”

“Ha, ha,” I laugh. “I have scars on my scars.” Indeed I do, because my belly and chest have been cut open so many times for cancer surgery, repairs to my cardiovascular and intestinal plumbing, and from farming injuries.

Scars are signs of healing, but they don’t restore the repaired body parts to their former condition. A 2015 article by W. Darren Hammond in the journal, Mobility Management, reviewed surgical scars; he concluded that scar tissue is less strong than the tissue it is replacing because the collagen in scar tissue grows in a less organized fashion than the original tissue. It is less elastic and about 70 percent as strong as undamaged tissue.

The agricultural population experiences more physical injuries and occupation-related fatalities than most other occupational populations, according to annual reports in Injury Facts, which are compiled by the National Institute for Occupational Safety and Health (NIOSH). NIOSH reports that tractor rollovers, truck and farm equipment crashes on roadways, and entanglements in farming equipment are major causes of fatal injuries. These same events, along with working with animals, are among the major causes of nonfatal occupational injuries to farmers as well.

The federal Bureau of Labor Statistics (BLS) indicated that in 2019 lumber harvesters and fishers ranked first and second respectively as the most dangerous occupation; farmers, ranchers and farm workers ranked 7th among the most dangerous occupations. The BLS has also reported that suicide is more likely to occur in the agricultural occupational workplace than in any other occupational workplace.

The Centers for Disease Control and Prevention (CDC), of which NIOSH is a part, considered the agricultural population to have the highest rate of suicide in a July 2016 study involving 17 states, but recalled the study in June 2018 and published a clarification in November that year. Male workers in construction and extraction occupations had the highest rates of suicide, but farm laborers, fishers, and workers in the lumber industry followed close behind. Additional data involving many more states and updated data are now being analyzed but I have not seen a report yet.

Because all these occupations involve the production of food, fiber and renewable energy, NIOSH and the United States Department of Agriculture (USDA) consider them to be agricultural occupations. It is no surprise that the NIOSH and the USDA have assumed important roles in reducing the rates of both physical and psychological injuries and fatalities among all persons engaged in agriculture.

Since the early 1990s NIOSH coordinates regional Centers for Agricultural Safety and Health, of which there are 10 currently, to conduct research and training of professionals and farm people to make agriculture safer. The USDA funds the National AgrAbility Program (www.agrability.org and telephone: 1-800-825-4264) and awards grants to assist 22 state and regional AgrAbility projects that provide education, assistive technology, and social-psychological support to injured farmers and their families so they can remain active agricultural producers.

The USDA National Institute of Food and Agriculture oversees the Farm and Ranch Stress Assistance Network (FRSAN), which was launched in 2019 (https://nifa.usda.gov/program/farm-and-ranch-stress-assistance-network-frsan). The FRSAN aims include these:

• Establish a network of supports that reduces the high rate of suicide among persons engaged in agriculture;

• Link those needing counseling with behavioral health professionals who understand agriculture;

• Improve the psychological literacy of the agricultural population and essential persons who serve them, such as the USDA Farm Service Agency personnel, Extension staff, lenders, and veterinarians;

• Conduct research that advances the new field of agricultural behavioral health;

• Evaluate the effectiveness of the FRSAN.

Currently, the FRSAN program has established 4 regional centers throughout the U.S. that carry out these functions and assist smaller state and regional service delivery programs to carry out the FRSAN aims.  

NIOSH and the USDA both assist nonprofit organizations, like the following, to advance the physical and emotional well-being of agricultural producers:

• The AgriSafe Network (www.agrisafe.org) which coordinates agricultural health clinics around the U.S.;

• Farm Safety Day Camps (https://nasdonline.org/225/d000024/farm-safety-day-camps.html).

State telephone hotlines and helplines, such as New York FarmNet, the Nebraska Rural Response Hotline, and the Wisconsin Farm Center, to name but a few of the farm crisis centers, all of which have websites and toll-free telephone numbers

Most farmers and others who furnish food, fiber, and bioenergy have both physical and psychological scars from this dangerous but necessary choice of livelihood. This is why the 3rd week of September has been declared National Farm Safety Week.

In closing, I hope this COVID pandemic diminishes soon to the point that we all can get physically and emotionally close to our loved ones. I need hugs from my grandkids and I’ll bet they would like a hug from me too, but after they inspect my latest signs of healing.

Dr. Mike Rosmann is an agriculturalist and clinical psychologist who lives near Harlan, Iowa. Contact him at: mike@agbehavioralhealth.com.

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