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A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide

Department of Population Medicine, University of Guelph, Guelph, ON N1G 2W1, Canada
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Int. J. Environ. Res. Public Health 2020, 17(24), 9376; https://doi.org/10.3390/ijerph17249376
Received: 10 November 2020 / Revised: 7 December 2020 / Accepted: 10 December 2020 / Published: 15 December 2020
(This article belongs to the Special Issue Mental Health in Agriculture)
A systematic review and meta-analysis were conducted to determine the overall prevalence of depression among farming populations globally, and explore any heterogeneity present. Eligible studies were primary research articles published in English, which involved the collection of data for the purpose of determining the prevalence of depression among a farming population. Four relevant databases were searched in January 2019. Potential for bias was assessed using a modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. From 7662 records, 72 articles were deemed relevant and had data extracted. Of these, 45 utilized the Center for Epidemiologic Studies—Depression Revised scale (CES-D/DR) to quantify depression, 42 of which were conducted in the United States (U.S.). As a result, meta-analyses were restricted to this geographic location. Substantial heterogeneity was seen in the initial whole-group analysis (I2 = 97%), and while sub-group exploration suggested a significantly higher prevalence of depression among migrant farm workers (26%, 95% CI = 21–31%) than in studies examining a non-migrant farming population (12%, 95% CI = 8–17%), substantial heterogeneity remained (I2 = 96%), indicating that the majority of between study variation was due to factors other than sampling error. Additionally, the majority of studies (81%) in migrant farm worker populations were published since 2010, while only 21% of studies in non-migrant farming populations were published in this timeframe. It is possible with recent efforts to de-stigmatize mental illness, participants in more recent studies may be more likely to self-report depressive symptoms. Hence, while it appears that migrant farmworker populations may have an elevated prevalence of depression, it is also apparent that little research in the U.S. has been done to evaluate depression among non-migrant farming populations in recent years. Perhaps a reporting bias may account for some of the difference between the two populations. A research gap also appears to exist in estimating the prevalence of depression among farming populations outside of the US. Assessment for bias at the study level revealed challenges in reporting of key study design elements, as well as potential for selection bias in the majority of studies. View Full-Text
Keywords: farmer; mental health; migrant farm worker; agriculture; depression; systematic review; meta-analysis farmer; mental health; migrant farm worker; agriculture; depression; systematic review; meta-analysis
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MDPI and ACS Style

Hagen, B.N.M.; Winder, C.B.; Wootten, J.; McMullen, C.K.; Jones-Bitton, A. A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide. Int. J. Environ. Res. Public Health 2020, 17, 9376. https://doi.org/10.3390/ijerph17249376

AMA Style

Hagen BNM, Winder CB, Wootten J, McMullen CK, Jones-Bitton A. A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide. International Journal of Environmental Research and Public Health. 2020; 17(24):9376. https://doi.org/10.3390/ijerph17249376

Chicago/Turabian Style

Hagen, Briana N.M.; Winder, Charlotte B.; Wootten, Jared; McMullen, Carrie K.; Jones-Bitton, Andria. 2020. "A Systematic Review and Meta-Analysis of Depression among Farming Populations Worldwide" Int. J. Environ. Res. Public Health 17, no. 24: 9376. https://doi.org/10.3390/ijerph17249376

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