Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil

Alves, Roberta Machado; Santos, Emelynne Gabrielly de Oliveira; Barbosa, Isabelle Ribeiro

doi:10.11606/s1518-8787.2022056003522

Brasil

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Original Article • Rev. Saúde Pública 56 • 2022 • https://doi.org/10.11606/s1518-8787.2022056003522 linkcopy

Factors associated with common mental disorders among farmers in a medium-sized municipality in Northeastern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To identify the prevalence and factors associated with common mental disorders among farmers living in a medium-sized municipality in Northeastern Brazil between 2019 and 2020.

METHODS Trained interviewers applied the standardized questionnaire in 450 participants. Sociodemographic, health, income and working characteristics were assessed. The screening of common mental disorders was performed using the Self-Reporting Questionaire, with the cutoff point ≥ 7 for women and ≥ 5 for men. Poisson regression with robust estimation was applied to verify the prevalence ratios in the bivariate and multivariate analysis.

RESULTS The prevalence of common mental disorders among farmers was 55.1% (95%CI: 50.4–59.6). The variables that remained significant and associated with common mental disorders were: men (PR = 1.7), > 60 years old (PR = 0.5), poor or very poor self-assessment of health (PR = 1.4), previous mental health treatment (PR = 1.2), alcohol abuse (PR = 1.2) and loss of production (PR = 1.3).

CONCLUSION These results indicate that common mental disorders are associated with individual factors and with the farmers’ context of life and work, which shows the importance of social, economic and health services support to this group of workers.

Rural Population; Mental Disorders, epidemiology; Risk Factors; Socioeconomic Factors

Variable	n (%)	Common mental disorder			Prevalence ratio
Variable	n (%)	%	95%CI	p^a	_crudePR	95%CI	p^b
Gender
Women	185 (41.1)	38.3	31.6–45.6	< 0.001^c	1	-	-
Men	265 (58.9)	66.7	60.8–72.2	< 0.001^c	1.7	1.3–2.2	< 0.005^c
Age
18–39 years	139 (31.0)	61.1	52.7–68.9	0.003^c	1	-	-
40–59 years	186 (41.3)	42.1	33.9–51.2		0.9	0.7–1.2	0.817
≥ 60 years	125 (27.7)	59.1	51.8–66.0		0.7	0.4–0.9	0.036^c
Marital status
Married	315 (70.0)	56.1	50.6–61.5	0.669	1	-	-
Single/divorced	100 (22.3)	54.0	44.1–63.5		0.9	0.7–1.3	0.798
Widow/widower	35 (7.7)	48.5	32.4–64.9		0.8	0.5–1.4	0.566
Race/Skin color
White/other	212 (47.2)	49.5	42.8–56.2	0.080	1	-	-
Black	42 (9.3)	59.5	44.0–73.3		1.2	0.7–1.8	0.409
Mixed-race	196 (43.5)	60.2	53.1–66.8		1.2	0.9–1.5	0.146
Schooling level
Higher education	38 (8.5)	57.8	44.1–74.8	0.135	1	-	-
High school	21 (4.7)	52.4	31.3–72.6		0.8	0.3–1.7	0.608
Elementary school	256 (56.8)	51.1	57.1–68.9		0.8	0.5–1.3	0.592
No schooling	135 (30.0)	47.6	66.7–81.4		1.0	0.6–1.7	0.726
Religion
Yes	332 (73.7)	57.2	51.8–62.4	0.130	1	-	-
No	118 (26.3)	49.1	41.8–59.8	0.130	0.8	0.6–1.1	0.311
Number of residents
0–2 individuals	101 (22.4)	54.4	44.6–57.2	0.073	1.0	0.7–1.4	0.662
3–4 individuals	221 (49.2)	50.6	44.0–63.9		1	-	-
≥ 5 individuals	128 (28.4)	36.7	54.5–71.2		1.2	0.9–1.6	0.128
Area of residence
Urban area	34 (7.5)	52.9	36.1–69.0	0.791	1	-	-
Rural area	416 (92.5)	55.2	50.4–60.0	0.791	0.7	0.5–1.1	0.223
Sanitation access
Yes	108 (24.0)	56.4	46.9–65.5	0.743	1	-	-
No	342 (76.0)	54.6	49.3–59.9	0.743	0.9	0.7–1.2	0.826

Variables	n (%)	Common mental disorder			Prevalence Ratio
Variables	n (%)	%	95%CI	p ^a	_crude PR	95%CI	p ^b
Self-assessment of health
Very good/good	234 (52.0)	51.7	45.2–58.0	0.052	1	-	-
Regular	129 (29.7)	53.4	44.8–61.9		1.0	0.7–1.3	0.823
Bad/very bad	87 (19.3)	66.6	56.0–75.8		1.2	0.9–1.7	0.112
Diagnosis of mental disorder in the family
No	200 (44.4)	45.0	38.2–51.9	< 0.005 ^c	1	-	-
Yes	250 (55.6)	63.2	57.0–68.9	< 0.005 ^c	1.4	1.08–1.8	0.010 ^c
Have already undergone mental health treatment
No	332 (71.6)	52.2	46.9–57.6	0.047 ^c	1	-	-
Yes	118 (28.4)	62.5	53.7–70.4	0.047 ^c	1.2	0.9–1.5	0.184
Smoking habit
No	327 (72.7)	51.6	46.2–57.0	0.017 ^c	1	-	-
Yes	123 (27.3)	64.2	55.3–72.2	0.017 ^c	1.2	0.9–1.6	0.111
Drug use
No	445 (98.9)	54.8	50.1–59.4	0.261	1	-	-
Yes	5 (1.1)	80.0	25.53–97.90	0.261	1.4	0.5–3.9	0.454
Alcohol abuse
No	306 (68.0)	45.4	39.9–51.0	< 0.005 ^c	1	-	-
Yes	144 (32.0)	75.6	67.9–82.0	< 0.005 ^c	1.6	1.3–2.1	< 0.005 ^c
Access to health care services
Yes	340 (75.6)	57.9	52.6–63.1	0.034 ^c	1	-	-
No	110 (24.4)	46.3	37.2–55.7	0.034 ^c	0.8	0.5–1.0	0.156
FHS coverage
Yes	426 (94.7)	55.1	50.3–59.8	0.924	1	-	-
No	24 (5.3)	54.1	34.1–72.8	0.924	0.98	0.5–1.7	0.949

Variable	n (%)	Common mental disorder			Prevalence ratio
Variable	n (%)	%	95%CI	p ^a	_crude PR	95%CI	p ^b
Employed
Yes	313 (69.6)	60.0	54.5–65.3	0.001 ^c	1	-	-
No	137 (30.4)	43.7	35.6–52.2	0.001 ^c	0.7	0.5–0.9	0.033 ^c
Monthly income
No income	30 (6.7)	50.0	32.5–67.4	0.727	0.84	0.4–1.7	0.636
Up to 1/2 minimum wage	81 (18.0)	50.6	44.5–66.0		0.93	0.5–1.6	0.825
1 minimum wage	312 (69.3)	55.5	65.5–75.6		1.19	0.7–1.9	0.491
> 1 minimum wage	27 (6.0)	56.7	39.8–76.1		1	-	-
Hours of daily work
< 6 hours	302 (67.1)	55.6	49.9–61.1	0.838	1	-	-
> 6 hours	111 (24.7)	56.7	47.3–65.7	0.838	1.0	0.7–1.36	0.892
Not applicable	37 (8.2)	-	-
Access to credit
Yes	215 (47.8)	63.2	56.5–69.4	0.002 ^c	1	-	-
No	217 (48.2)	48.3	44.7–55.0	0.002 ^c	0.7	0.5–0.9	0.039 ^c
Not applicable	18 (4.0)	-	-
Have debts
No	235 (52.2)	49.3	42.9–55.7	0.003 ^c	1	-	-
Yes	197 (43.8)	63.4	56.4–69.9	0.003 ^c	1.2	0.9–1.6	0.051
Not applicable	18 (4.0)	-	-
Relationship with the land
Owner	307 (68.2)	55.0	49.4–60.5	0.710	1	-	-
Tenant	84 (18.7)	53.5	42.8–64.0		0.9	0.7–1.35	0.695
Employee/temporary	46 (10.2)	60.8	54.7–81.2		1.1	0.1–1.6	0.770
Not applicable	13 (2.9)	-	-
Already had loss of production
No	149 (33.1)	48.3	46.9–62.8	0.028 ^c	1	-	-
Yes	269 (59.8)	59.4	66.0–76.8	0.028 ^c	1.2	0.9–1.6	0.143
Not applicable	32 (7.1)	-	-
Have contact with pesticides
No	264 (58.7)	50.3	44.3–56.4	0.002 ^c	1	-	-
Yes	146 (32.4)	66.4	58.3–73.6	0.002 ^c	1.3	1.0–1.7	0.038 ^c
Not applicable	40 (8.9)	-	-
Use PPE
Yes	84 (18.7)	60.7	49.8–70.6	0.671	1	-	-
No	200 (44.4)	58.0	51.0–64.6	0.671	0.9	0.6–1.3	0.785
Not applicable	166 (36.9)	-	-
Pesticide poisoning
No	294 (65.3)	58.1	52.4–63.7	0.078	1	-	-
Yes	22 (4.9)	77.2	54.9–90.4	0.078	1.3	0.8–2.1	0.264
Not applicable	134 (29.8)	-	-

Variables	_adjusted PR	95%CI	p ^a
Gender
Women	1	-	-
Men	1.7	1.3–2.1	< 0.005
Age
18–39 years	1	-	-
40–59 years	0.9	0.7–1.1	0.497
≥ 60 years	0.5	0.4–0.7	< 0.005
Self-assessment of health
Very good/good	1	-	-
Regular	1.1	0.9–1.4	0.168
Bad/very bad	1.4	1.1–1.7	< 0.005
Have already undergone mental health treatment
No	1	-	-
Yes	1.2	1.0–1.5	0.004
Alcohol abuse
No	1	-	-
Yes	1.2	1.0–1.5	0.004
Already had loss of production
No	1	-	-
Yes	1.3	1.0–1.5	0.004
Constant	0.27	0.2–0.3	< 0.005

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[TFN1] 95%CI: 95% confidence interval; _crudePR: crude prevalence ratio.

[TFN2] ^a Statistical significance obtained by the chi-square test.

[TFN3] ^b Statistical significance obtained by the Poisson regression.

[TFN4] ^c Significant value at 5%.