Cardiometabolic risk factors among commercial farmers: a narrative review with systematic methodology

Early Abstract:

Introduction: Farmers and agricultural workers are a socioeconomically vital rural group who live with an unnecessary burden of ill health. This review aims to summarise current research addressing risk factors for farmers of cardiometabolic disease[CMD] which is relevant to primary care. 
Methods: We searched Pubmed, Medline and CINAHL for peer-reviewed articles published between January 1990 and January 2025 combining terms for CMD risk factors and ‘farmers’, and ‘agricultural workers’. Grey literature searching and manual citation searching from included studies was also incorporated. 
Results: 22 studies addressing CMD risk factors among farmers were identified alongside references from agricultural, environmental, health and social care research, and government policy resources for context and comparison. Farmers in the UK and RoI are ageing and predominantly male and appear to carry a higher proportion of CMD risk compared to other occupational groups. Influencing factors include job insecurity and precarious incomes, barriers to accessing rural healthcare, rising mental ill health, hazardous alcohol consumption, and disruption to diets and physical activity. There is mixed or limited evidence about behavioural and demographic trends available in the UK and RoI. There is limited data to describe how and when farmers interact with healthcare providers who can assess overall CMD risk. 
Conclusion: This review demonstrates that CMD risk assessment amongst UK and RoI farmers requires consideration of complex socioeconomic and behavioural determinants alongside established clinical risk factors. It also highlights the importance of cross sectoral solutions in mitigating CMD risks amongst farmers. It is, at present, unclear how transferable international agromedicine study findings are to farmers in the UK and RoI. Future primary care research of CMD risk factors in the UK and RoI could inform the development of collaborative approaches to caring for farmers.
Keywords: agriculture; cardiometabolic risk factors; cardiovascular; farmers; metabolic syndrome; socioeconomic factors.