Jennifer Kowalkowski has long been aware of the many health challenges farmers face. Growing up on a small dairy farm in Wisconsin, she had firsthand exposure to the toll farming takes on both physical and mental health, and understood the many occupational hazards that can lead to injuries, chronic pain, depression, and even suicide.
Kowalkowski, an assistant professor in the Nese College of Nursing, says these issues have worsened over time for varied reasons, not least the dwindling number of health care clinics in rural settings, making care difficult for farmers to access. Also, the nature of the work is unpredictable—so many things can happen in a farmer’s life that are completely out of their control: the weather changes, equipment breaks down, livestock get sick.
“Keeping a medical appointment is very difficult—yet farmers get labeled noncompliant or nonadherent,” Kowalkowski says.
But perhaps the greatest challenge farmers face is the mental stress of owning and running a farm—and then, in many instances, being forced to sell it. Kowalkowski still feels the pain her father felt when he had to sell his farm. If the sale weren’t tough enough, she says, reinventing himself after was even tougher. “Since the ’80s, depression and suicide rates in farmers have continued to go higher and higher despite all the interventions that have been put in,” she says.
Kowalkowski, who was awarded the Social Science Research Institute’s 2025 Lloyd Prize for Innovative Health Research, is developing a conceptual model to explain how farm owner-operators experience and respond to occupational stress. Her goal is to identify the pathways through which occupational stress can impact mental well-being to help develop appropriate interventions.
“I feel we have an obligation to figure out how to improve farmers’ situations locally in a way that’s accessible and supportive to them, and really demonstrates that we understand their way of life and what it means to them,” she says.
Stemming the tide and supporting farmers—”the backbone of the global economy,” Kowalkowski says—requires a large and concerted effort to provide them with accessible and affordable health care closer to where they are, rather than expecting them to come to where the health care industry is. That requires gaining deeper insight into farming, and understanding the unique situations of individual farmers.
There is no one-size-fits-all approach to providing better health care to farmers, says Kowalkowski; effective delivery of health care solutions, even telehealth options, means meeting them where they are.
