Farm Growth Limited by Health Care Costs

Charlene M. Shupp Espenshade
Special Sections Editor

Editor’s note: This is part of an occasional series on health care challenges in farm and rural communities.

“Americans who live in rural communities have a harder time finding the doctor they need and getting the care they deserve, and their health suffers,” says U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius. “Americans in rural communities also face some of the nation’s highest rates of obesity and high blood pressure and they struggle to get affordable health care.”

According to HHS, one in five uninsured Americans — 8.5 million people — live in a rural area. Rural Americans pay for nearly half of their health care costs out of pocket. Most pointedly, one out of every five farmers is in medical debt.

As a result, rural adults are more likely than urban adults to put off health care because of costs.

According to several studies, rural Americans are more challenged to receive health care services, more likely to be uninsured and more likely to pay more for insurance.

In a recent study released by Ohio State University (OSU), farmers said that health insurance was their top business concern. The study “Agricultural Adaptation at the Rural-Urban Interface: Can Communities Make a Difference,” shows that to access affordable family health care, farm operators or their spouses often seek benefits through off-farm jobs.

The cost of health care has impacted farms, according to the OSU study. It has limited farms’ ability to expand and hire employees. Insurance costs have pulled funds away from farms.

“Two things are working against the configuration of the business. One is the rising land value and the other is rising health care costs that have completely gone out of control,” said an OSU study respondent, a commercial fruit grower who sells wholesale and through direct markets. “Health care costs are driving everything. Everybody is afraid to have any full-time employees for fear you are going to have to pay for their health care costs because nobody is able to afford it.”

Another respondent said after an employee was injured on the farm and sued, the farm was kicked out of its workman’s compensation insurance group and their annual workman’s compensation cost skyrocketed.

A USDA study called “Health Care Access of Farm and Rural Populations” said that farm operator households spend more on health care than other U.S. households, spending an average of $5,200-$10,000 a year.

Another USDA study noted one-third of farmers purchase their insurance directly from an agent, far higher than the national average of just 8 percent.

The end result of the shortcomings of rural health care is that rural residents have higher mortality rates. However, the USDA study pointed out that farmers tend to make more money than their neighbors, are more physically active and less likely to smoke.

The report also noted that “farming has one of the highest occupational fatality rates of all occupations, and farm children also have high fatal accident rates. Farmers are at high risk for work-related lung diseases, noise induced hearing loss, skin diseases, and certain cancers association with chemical use and prolonged sun exposure.”

Across many of the studies, the underlying message is that health care reform is needed.

“An affordable and accessible national health care program would free up time and resources for farmers at the rural-urban interface and elsewhere,” said Shoshanna Inwood, an OSU research associate. “It would allow them to more easily reinvest in their enterprises, households and local economies.”

Sources include press releases from the U.S. Department of Health and Human Services, USDA and Ohio State University.

Charlene M. Shupp Espenshade can be reached at cshupp.eph@lnpnews.com.