The effect of joint pain and arthritis on the Montana ranching and farming community

Abstract Background: Arthritis and joint pain have shown high prevalence rates in agricultural workers and is of concern because many agricultural operations are sustained by a small number of workers. The disability of even one worker may therefore contribute to economic hardship. This study investigated joint health in Montana agricultural workers and its economic effects on ranches and farms. Methods: The aims of this study were to determine associations between years working in agriculture and joint health, and between joint health and the economic health of a ranch or farm. A total of 299 ranchers and farmers in nine Montana counties completed a survey that included an assessment of the economic health of the ranch or farm, work capacity, and the need to rely on others to complete one’s work. Focus groups were then held with ranchers in two Montana counties, discussing similar topics. Results: 87.6% of survey respondents reported joint pain, 47.8% a diagnosis of arthritis, and 22.4% osteoarthritis (OA). Using proportional odds regression analysis, a 10-point increase in the Western Ontario and McMaster University arthritis index (WOMAC) score was significantly associated with lower work capacity (OR 2.00; 95% CI [1.58, 2.55], p<0.01), worse financial condition (OR 1.23; 95% CI [1.01,1.48], p=0.04), and increased reliance on others (OR 1.82; 95% CI [1.32, 2.55], p<0.01). A diagnosis of arthritis was associated with moving to a worse category of work capacity (OR 4.66; 95% CI [2.71, 8.01], p<0.01) and increased odds of relying on others (OR 3.23; 95% CI [1.56, 6.66], p<0.01), compared to those without arthritis. A diagnosis of OA was significantly associated with decreased work capacity (OR 3.47; 95% CI [1.97, 6.11], p<0.01). Adjusting for age and BMI, we found no association between years spent working in agriculture and joint health. Focus group themes included decreased productivity with increased joint symptoms and a tendency for ranchers to avoid interaction with the health care system. Conclusions: This mixed-methods study demonstrated an association between poor joint health and economic risk on Montana ranches and farms.