America's farmers and farm workers feed and clothe the United States and much of the world as well. Yet these men, women, and youth experience rates of occupational injury, illness and death that are up to 4 times higher than those of workers in other occupations. In cooperation with the Centers for Disease Control / National Institute for Occupational Safety and Health (CDC/NIOSH), the Southeast Center supports and conducts research, education, and prevention activities to reduce occupational illness and injury and improve the safety and health of agricultural workers and their families in the southeastern United States.

The Southeast Center is directed by Robert H. McKnight, MPH, ScD, Professor of Preventive Medicine and Environmental Health in the University of Kentucky College of Public Health

The Southeast Center for Agricultural Health and Injury Prevention was established in 1991 as one of a select number of agricultural research centers funded by the United States Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (CDC/NIOSH). Dedicated to developing and promoting transdisciplinary approaches to the health and safety of agricultural workers and rural populations, the Center serves stakeholders in ten states: Kentucky, Tennessee, Alabama, Mississippi, North Carolina, South Carolina, Florida, Georgia, West Virginia, and Virginia.

As a NIOSH agricultural research center located on a land-grant university campus with a College of Public Health, the Southeast Center is well positioned to achieve its mission. The Center's location allows for mutually beneficial collaboration among researchers and practitioners in public health, agriculture, behavioral science, communications, engineering, economics, nursing, toxicology, and other disciplines. On May 4, 2004, the Board of Trustees granted college status to what was at that time a school of public health within the College of Preventive Medicine, making the UK College of Public Health the sixth college at the University of Kentucky Chandler Medical Center and the first new college at UK in nearly 40 years. In May 2005, the College of Public Health received full accreditation for the maximum five years from the Council on Education for Public Health (CEPH). As a result, the UK College of Public Health is now an accredited member of the Association of Schools of Public Health. The College and the Southeast Center serve a state that ranks fifth in the nation for its total number of working farms.

Recognizing the multiple linkages affecting public health (IOM, 2001) and the importance of strategic systems thinking when addressing challenges in public health, the Center’s investigators and staff work closely with colleagues from the UK Colleges of Medicine, Agriculture, Nursing, Education, Communications, and Engineering, as well as with researchers and practitioners from various external agencies and institutions. This transdisciplinary approach lends an array of resources and skills to the Center and enhances its capabilities in research, education, outreach, and prevention. Today, the Southeast Center continues to focus on -

Advances in science and technology have greatly improved the safety of workers in agriculture, forestry, and fishing (NIOSH, 2004). Nevertheless, agricultural production remains one of the most hazardous industrial sectors, with a fatal occupational injury rate more than four times greater than that of the private sector during 1992-2002. The average annual rate of agricultural fatalities is high in the southeastern United States, with Florida, Tennessee, and Kentucky reporting some of the largest annual numbers of fatal occupational injuries in agriculture, forestry, and fishing (NIOSH, 2004).

Source: CDC/NIOSH Worker Health Chartbook, 2004

During 1992-2000, the highest numbers of fatal occupational injuries in agriculture, forestry, and fishing were reported by California (646), Texas (384), Florida (313), Kentucky (298), Pennsylvania (289), and Tennessee (271).

In addition to serving stakeholders in Kentucky, Tennessee, and Florida, the Southeast Center for Agricultural Health and Injury Prevention serves agricultural populations in Georgia, Alabama, Mississippi, North Carolina, South Carolina, West Virginia, and Virginia. In this 10-state region, agricultural workers and their families face health and safety hazards that frequently differ from those experienced by their counterparts elsewhere in the nation. Topography, crops, machinery, and livestock that are common to Wisconsin, Iowa, or California, for example, are not necessarily the same as those found in the Southeast. Exposure patterns and their sequelae differ based on regional landscape, heat, humidity, product(s), and transport variables. Agriculture in the Southeast is highly diversified, with multiple crops often growing year round.

The differences are not only environmental and agricultural, but often socioeconomic as well. The strong sense of cultural pride and community self-sufficiency found in many regions of the Southeast poses a potential barrier when prevention programs designed by “outsiders” are implemented without respect for, and adaptation to, the cultural and historical aspects of farming in the South. Program implementation is also often difficult because of the diffuse, small-scale nature of the region’s agricultural base: owners and operators in the Southeast tend to be small-acreage family farmers, who often maintain off-farm employment as well.

Three additional factors set the Southeast apart from much of the nation: racial diversity, poverty, and illiteracy. Rural communities in the Southeast exhibit some of the nation’s highest rates of morbidity and premature mortality (Mansfield et al, 1999). The cycle of poverty found in Appalachia and the Mississippi Delta severely restricts society’s ability to address basic health problems -- much less focus on agricultural health and safety concerns. Not only are many people in the Southeast poor, but tax bases are often inadequate to build and maintain a vibrant public health infrastructure. Illiteracy and low education levels in the Southeast among whites, African Americans, and migrant populations create barriers to communication and to effective delivery of prevention programs.

Another barrier to improving agricultural safety and health in the Southeast is the remnant of a dual system of higher education that separated agricultural programs at large land-grant colleges (historically white campuses) from programs at smaller Historically Black Colleges and Universities. This division, which has affected even Cooperative Extension Service activities, is a product of the Morrill land-grant acts of 1862 (white) and 1890 (African American).

The Southeast Center covers a region that is both historically and culturally fascinating and fraught with public health challenges and needs. These characteristics create an array of meaningful opportunities for research and service.

References

Mansfield CJ, Wilson JL, Kobrinski EJ, Mitchell J. Premature mortality in the United States: The roles of geographic area, socioeconomic status, household type, and availability of medical care. Am J Public Health.1999 Jun;89(6):893-8.

Safran ES, Cohen LP, Caplan LS, Ohuabunwa UK, Pharagood-Wade F. Barriers to occupational and environmental medicine services in the southeastern United States. J Occup Environ Med. 2005 Mar;47(3):219-25.

United States Bureau of the Census. Historical Poverty Tables. Table 9. Poverty of people, by region: 1959 to 2005. Available online at http:// www.census.gov/hhes/www/poverty/histpov/hstpov9.html [accessed September 13, 2006]

Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. Worker Health Chartbook, 2004. Available online at http://www.cdc.gov/niosh/docs/chartbook/pdfs/ Chartbook_2004_NIOSH.pdf [accessed September 13, 2006].

National Institute for Occupational Safety and Health (NIOSH) funded agricultural centers:

• Great Lakes Center for Agricultural Safety and Health
• Great Plains Center for Agricultural Health
• High Plains Intermountain Center for Agricultural Health and Safety (HICAHS)
• National Children's Center for Rural and Agricultural Health and Safety
• Northeast Center for Agricultural and Occupational Health
• Pacific Northwest Agricultural Safety and Health Center (Washington)
• Southern Coastal Agromedicine Center
• Southwest Center for Agricultural Health, Injury Prevention, and Education
• Western Center for Agricultural Health and Safety (UC-Davis)

University of Kentucky

University of Kentucky College of Public Health