The north Carolina AgroMedicine institute: a response to health and safety needs of north Carolina farmers, fishers and foresters

摘要

The climate of declining federal support for initiatives in rural communities makes development of an inter-disciplinary, mutli-institutional, integrated safety and health program very difficult. North Carolina's agriculture, with the nation's second largest population of farmers, along with large fishing and forestry industries provides 28% of the state's employment. Farming, forestry, and fishing are the second, third and fourth most dangerous occupations in the US. Each year in NC, about 50 die and 2,000 are disabled while farming. Moreover, fitmers, fishers, and loggers are primarily older workers so any interventions to reduce occupational morbidity and mortality must take age-related interactions into account. The great diversity of commodity and livestock operations, diversity of work tasks, and diversity in the worker population requires that interventions must be multi-disciplinary. Further, NC farmers, fishers, and foresters lack health insurance and reside in areas with very limited health services. The North Carolina Institute for Health and Safety in Agriculture, Forestry, and Fisheries, more commonly known as the North Carolina AgroMedicine Institute, was established to support research, education, and multi-disciplinary outreach efforts to deal with these health and safety needs. Ultimately, the Institute was based on organization and development of working relationships among multiple units of three separate universities, four state agencies, and three producer organizations with health and safety outreach programs. Three key Boards guide the Institute's direction, prioritize programs, and evaluate effectiveness of its projects. The organizational issues and cultural challenges encountered in forming this multi-disciplinary, multi-organizational Institute are reviewed.