Agriculture is one of the most hazardous occupations worldwide.1
In Canada between 1991 and 2000, for example, 1,256 adults and children were killed in farm-related activities and 14,980 people were hospitalized due to traumatic injury caused by the farm occupational environment.2
Losses associated with farm injury in terms of permanent disability, treatment costs, rehabilitation, and reduced potential are substantial.3
Subpopulations of people on farms who are vulnerable to injury include farm operators,2
adolescent and young adult workers,5
and the elderly.2
Existing etiological research in the field of injury control has been generally nontheoretical in nature, which is also characteristic of farm injury research. While various studies of risk factors for farm injury exist,6,7
few if any of these studies are based upon underlying theoretical constructs. Further, although presumed roles for the physical, social, and cultural environments in the etiology of farm injury are recognized,8
few attempts have been made to study these roles by applying theory to the development of epidemiologic models.
Population health theory,9
or the “new public health”10
that reemerged during the 1990s, provides a framework for examining structural and environmental influences on health. Proponents of this theory state that determinants of health operate at two levels: (1
) ecological (contextual—e.g., physical, economic, or cultural environments) and (2
) individual (e.g., personal health practices, health service use, and human biology).9
With respect to the etiology of farm injury, application of this theory suggests that contextual and individual determinants have direct and multiplicative effects that would interact to produce varying levels of risk for injury. Both levels of determinants require focused study, alone and in combination. Study of these interactions may lead to advances in the understanding of mechanisms that underlie the occurrence of injury in these settings. To our knowledge, this theoretical approach has not previously been applied to the study of farm injury.
The Saskatchewan Farm Injury Cohort (SFIC) is a major new Canadian study that provides an opportunity to test this theory. This study involves 5,492 farm people on 2,390 Saskatchewan farms over a two-year study period (2007 to 2009). This article describes the rationale and methodology for the SFIC and the characteristics of the farm operations and people who are participating. Given the importance of understanding the physical, cultural, and socioeconomic environments for injury etiology, our model and approach could be portable to the study of injury in agriculture and other contexts.