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For Farmers, Rise in Suicide Rate Is Old News


What didn't make the papers last week is that for American farmers in economic distress, suicide has always been the leading killer.

The recent news from the Centers for Disease Control and Prevention that more Americans now die of suicide than in car accidents made headlines.

Though reasons for suicide are extremely complex and individualized, economic concerns were cited by the CDC as one of the potential reasons for the rise.

"The increase does coincide with a decrease in financial standing for a lot of families over the same time period," Dr. Ileana Arias, deputy director of the CDC, told the New York Times.

What didn't make the news last week, is that on American farms, suicide has always been the leading killer.

Last year, Dr. Eileen L. Fisher, PhD, Associate Director at the University of Iowa's Center for Agricultural Safety and Health, told my colleague Alex Brokaw and me, "Suicide rates for farmers in general are higher than the general population."

Indeed, according to a 2000 study from the Colorado State University Extension, suicide has historically been "the most frequent external cause of death on farms and ranches." And statistics show the suicide rate is higher among farmers than other occupations in the United States, as well as India, Japan, the United Kingdom, and Australia.

But why?

One reason, and perhaps the most obvious, is financial. As is now being seen in the general population, the higher incidence of suicide on farms is also often tied to economic distress. After the 2001 outbreak of foot-and-mouth disease and BSE, or mad cow, the suicide rate among British livestock producers went up by as much as 1,000%. As dairy prices cratered in 2008, calls to the Sowing the Seeds of Hope suicide help line, serving farmers in seven Midwestern states, jumped by 20%. Fourteen Colorado farmers and ranchers killed themselves, twice the number reported five years earlier. One shot himself dead following his banker's warning to make his payments or risk "being cut off."

With fewer than 25% of all American farms earning gross revenues above $50,000, it's family farmers -- not the Tysons (NYSE:TSN) and Smithfields (NYSE:SFD) of the world -- who are left exposed when the economy turns cloudy.
"The only thing I will regret is leaving the children and you. This farming has brought me a lot of memories, some happy, but most of all grief. The grief has finally won out -- the low prices, bills piling up, just everything. The kids deserve better and so do you. I just don't know how to do it. This is all I know and it's just not good enough anymore. I'm just so tired of fighting this game, because it is a losing battle. Everything is gone, wore out or shot, just like me."
That's what an Iowa farmer wrote to his wife before he killed himself in 1999. Currently the US Secretary of Agriculture, Tom Vilsack was the Governor of Iowa at the time. He shared the letter -- and a note from the farmer's widow, whose identity was kept private -- at that year's National Governors' Meeting.

"I am convinced from evidence in our house that my husband listened to the grain markets on Monday at noon, as he usually did, heard them go lower again, and then committed suicide," she explained.

(Naturally, there are dissenting opinions. As Roger Hannan, who sits on the board of directors of the National Association for Rural Mental Health, said in an interview with Minyanville last year, farmers today are "facing some of the same uncertainties as other business owners" in the US, but that he didn't see "any major difference with the incidence of mental health crises on farms versus their town dwelling neighbors, maybe a little less.")

Another theory comes by way of "The Agrarian Imperative," a 2010 paper by Michael R. Rosmann, PhD and published in the Journal of Agromedicine, which "proposes a construct, the agrarian imperative, as an explanation for why people engage in agriculture." Rosmann, a clinical psychologist and family farmer who is the Executive Director of AgriWellness, a non-profit organization that provides behavioral health services to "populations affected by rural crisis in agricultural communities," suggested that "domesticating animals and cultivating land to produce food, fiber, and shelter allowed humans to proliferate."

"In other words," writes Rosmann, "agriculture yielded survival advantages for the human species. Genetic and anthropological evidence is accruing which suggests that acquiring territories of land to produce these necessities has an inherited basis which is encoded into our genetic material."

In a telephone interview with Minyanville last year, Michael Marsh, CEO of Western United Dairymen in Modesto, California, spoke of the "frontier mentality" to which many modern farmers still subscribe.

"It's that mindset of, 'Me against the elements and we're gonna be survivors,'" he said. "Let's say your farm operation started in your family in 1880s and stayed in [the] family all these years. It comes to 2010 and you're the generation that loses the family legacy. Your parents, grandparents, great-grandparents, and great-great-grandparents built it, and here you have the business and all these beautiful animals and barns and milking parlors and employees and then, one day, it's gone. It's pretty easy to see how depressing that might be."

Ultimately, Dr. Rosmann's research concludes that the "inability to farm successfully…is also associated with an increased probability of suicide."

"The same traits that motivate farmers to be successful are associated with depression and suicide if their farming objectives aren't met," he writes. As he explained at a 2003 conference presentation to the Idaho Department of Health and Welfare:
"To farmers, 'the land is everything.' Ownership of a family farm is the triumphant result of the struggles of multiple generations. Losing the family farm is the ultimate loss -- bringing shame to the generation that has let down their forebears and dashing the hopes for successors."
Guns, Shrinks, and...Pesticides?

Of course, farmers also have ready access to guns and other lethal means; chillingly, Australia's National Centre for Farmer Health asserts, "Sometimes what looks like a 'farm accident' is actually a suicide." And some research even maintains the pesticides farmers use are causing behavioral issues leading to suicides down the line.

From the December, 2008 edition of Environmental Health Perspectives, a peer-reviewed journal from the National Institute of Environmental Health Sciences:
"A study of farmers finds that those with the highest number of lifetime exposure days to agricultural pesticides were 50% more likely to be diagnosed with clinical depression than those with the fewest application days and were 80% more likely if they had applied a class of insecticide called organophosphates."
Organophosphates, which are contained in many common agricultural insecticides like Dursban from Dow AgroScience (NYSE:DOW) and Aztec from American Vanguard (NYSE:AVD), are also fingered as substances that can lead to depression -- and ultimately, suicide -- by AgriWellness' Michael Rosmann and Dr. Lorann Stallones, MPH, PhD, an epidemiologist at Colorado State University.

They write:
"Many health care practitioners, even those in agricultural areas, are not aware that organophosphate and carbamate insecticide poisoning can lead to depression. There are established links between acute poisoning from organophosphate compounds and increased risk of suicide.

"Acute exposures to organophosphates and carbamates produce headache, nausea, muscle twitching, diarrhea, excessive salivation and sweating, difficulty breathing and severe exposures can lead to pulmonary edema, seizures, and death."
Amazingly, it is even suggested that treating depression resulting from pesticide poisoning with selective serotonin reuptake inhibitors (i.e. Prozac (NYSE:LLY), Zoloft (NYSE:PFE), Paxil (NYSE:GSK), Celexa (NYSE:FPI), and Luvox (NASDAQ:JAZZ)) may actually increase the risk of suicide.

All of this is easy to miss in a patient when that patient isn't being treated. Dr. Steven R. Kirkhorn, MD, MPH, Medical Director of the National Farm Medicine Center in Marshfield, Wisconsin, said last year in an interview that there was a lack of sufficient data to adequately address the broader problem of farm suicides.

"Depression in the farm community is under-reported, partially due to cultural issues of self-reliance and just as importantly, lack of access to behavioral health specialists," Kirkhorn told Brokaw and me. "This is an issue that is not addressed satisfactorily by any Agricultural Health or Safety Center that I am aware of and the assessment and care is scattered throughout the rural area. Many of those who need help don't have insurance that will cover behavioral health services and if they do, the waiting times may be months to be seen."

Beyond a dearth of accessible care, the cultural issues Kirkhorn mentions are significant.

Not an Epidemic; A Steady Pattern

Though the suicide rate among farmers is demonstrably higher in most parts of the world, some accounts can paint an inaccurate picture of an "epidemic," rather than a steady, elevated state that must be addressed.

Ron Herring, a professor of government at Cornell University, interviewed Indian farmers in 2006 after 200,000 suicides in 10 years. He called "the media construction baseless," and told the Cornell Chronicle, "Farmers were insulted and incredulous: If farmers committed suicide every time they fell into debt, they said, there would be no farmers."

Still, the mindset noted by Michaels Marsh and Rosmann persists. As California dairyman Frank Mendonsa told the San Francisco Chronicle last October, "I've never seen it as dire as it is now. Pride is just eating these guys up. People are calling me and asking me what to do. It becomes like a counseling session to stop people from hurting themselves. But it's not just losing our jobs that is driving the desperation. We're losing our houses, in some cases the same houses that our grandparents lived in, and we're losing our entire identities."

Ultimately, John Frey, Executive Director of the Pennsylvania Center for Dairy Excellence, is optimistic overall about the farmers he said he's personally seen pull through tough times before. The dairy business, he said via telephone last May, has come through time and time again. In short, he explained, it is simply "an incredible business with incredible people."

Follow Justin Rohrlich on Twitter: @chickenalaking

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