The health and wellbeing of rural women

Our guest blog writer for International Women’s Day is Di Dixon— a graduate of the NCFH Graduate Certificate in Agricultural Health and Medicine and founder of Panoramic Health and Fitness. In this blog, Di combines her expertise in farmer health and her passion for empowering people to overcome lifestyle obstacles with confidence, courage and ease.

When you think of a woman on a farm, what picture comes to mind?

Is it an image of them holding a baby on their hip waving their husband off for the day, then heading back in to tidy up the breakfast dishes?

Or do you imagine them in boots, jeans, old shirt and hat rushing around getting the kids to the school bus then heading out to work on the property for the day?

A day in the life of a woman in agriculture is now more often than not, the second one and with that comes a lot of mental load. This is what I’m going to discuss with you today.

Like many industries, the role of women in agriculture has evolved rapidly over the past 50 years. We’re no longer the main child rearer while our partner heads out to work for the day. We head out into the paddocks, dairies, shearing sheds and onto tractors and physically take on our share, while, in many cases, also contributing to the family finances through off-farm employment. This can also be the case with our male counterparts, yet, what we do know is that women take on a disproportionate amount of the mental load that comes along with the actions of running a family household, farm and outside employment.

What is mental load? Mental load is the often unseen actions performed and the decisions made on a daily basis that ensure our lives continue to run smoothly. Things like making sure budgets are on track, appointments are made on time, knowing when household chores need to be performed, being the first to drop everything to pick sick kids up from school, and knowing the safety protocols for farmworkers. In more recent times, it’s organising that there’s enough sheep drench ready and booking appointments for her partner’s vaccinations too.

So how does carrying this mental load affect our health?

According to the Australian Institute of Health and Welfare, chronic stress, regardless of the cause — it’s all just stress to your body — can cause problems with your:

• immune and digestive systems
•  reproductive and cardiovascular systems,
• sleep, and
• Can cause serious chronic health issues like diabetes, high blood pressure, heart disease, depression, and anxiety.

To add to that, in July 2021 the National Rural Health Alliance reported that while rural men have consistently higher suicide rates, incidences of non-lethal self-harm are higher for rural women. It is suggested that these self-harm occurrences are often intended to alleviate negative emotions or for self-punishment. Can we concede from these rates that the stress and expectations rural women are putting themselves under from carrying this mental load is leading to an increase in poor mental health? While I may not be able to decrease your mental load, I’d like to chat about how to ensure you care for yourself while carrying it.

When coaching my clients through caring for themselves, I focus on the five pillars of healthy habits and pick simple strategies to surround them.

 𝑬𝒂𝒕 – eat slowly at mealtimes and stop when you feel 80% full.

 𝑴𝒐𝒗𝒆 – aim to move in some capacity 5 days per week. Somedays this might be a full workout, others it might be a 10min walk. It all counts.

 𝑻𝒉𝒊𝒏𝒌 – take time to enjoy and reflect on your day. Practice gratitude. You can keep a journal or not, but actively focusing on what you are grateful for can help to turn the tide of negative emotion. Did your kids do the dishes today without being asked? Did it rain? Is the harvest finished for another year? There are many things to be grateful for in our days, but sometimes they’re harder to see.

 𝑹𝒆𝒔𝒕 – take time to stop and recover. Sleep for 7+ hours per night and try to enjoy at least one slow morning each week.

 𝑪𝒐𝒏𝒏𝒆𝒄𝒕 – take time away from farm work and your outside employment to connect with those around you. Maybe this is heading out for a short walk by yourself and calling a friend along the way, maybe it’s catching up for a hot beverage. Whatever works for you, our social connection plays a large role in improving mental health outcomes.

If you’re reading this and thinking that’s way too much and only adding to the mental load. Pick one. Work on one strategy at a time and work to implement that in a way that works for you. Our health is not a race. Take as much time as needed to build these habits slowly to ensure they’re not just a flash in the pan. Consistency and doing something will always win over trying to do it all. 

References used in this blog

nrha-mental-health-factsheet-july2021.pdf (ruralhealth.org.au)

Stress and trauma – Australian Institute of Health and Welfare (aihw.gov.au)

Further information

NCFH Fact Sheets – Stress and farming – coping tips | National Centre for Farmer Health

NCFH Managing Stress on the Farm Managing-Stress-on-the-Farm Booklet

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Preventing bullying on the farm: a workplace obligation

This topic will be discussed as part of our online Bonfire Q&A on March 9th at 7:30pm, “Preventing bullying in the farming workplace” with John Darcy (Victorian Farmer’s Federation).

My name is Sharon. Not Shazza, not Shaz and absolutely not Girlie or Dopey.

It doesn’t seem such a big deal; but very quickly after I landed my first ‘dream’ job it was sounding alarm bells in my head.

Growing up on a ‘hobby’ farm all I ever wanted to do was work on a real one, and I had not been able to resist those dreamy-faced Jerseys on a dairy down the road – so that became the dream.

I couldn’t believe how lucky I had been to find a job straight out of ag school; it all just seemed perfect.

Just as I still can’t believe how wrong it all went; or how long I put up with it.

I was employed after an interview with the farm owner and his wife; but their son-in-law Steve actually ran the business; the owners were stepping back and spending more time away from the farm.

And he started on me from day one; introducing me to the rest of the team as ‘Shazza’ and when I politely said I preferred Sharon he just laughed and said: “Hey, it’s just a nickname”.

But it wasn’t. Clearly, he didn’t like being corrected and when I look back my first day was the beginning of the end of my dream.

I got on well with everyone else; was a good worker who rarely needed to be told anything twice, but it was never good enough. Steve was always watching me, complaining I was too slow, wasn’t treating the animals properly, was cleaning up and Shazza soon became “bloody hell, girl, you are a useless lump”.

Yes, I know, I should have walked out then but for some unknown reason I thought it would make me a failure. And I wasn’t the only one suffering. Steve treated the two other women just the same – but was all buddy-buddy with the guys we worked alongside.

Even worse, his ‘mates’ knew what was happening, you could see it in their faces, but not one of them ever spoke up, or said anything to support us. It wasn’t until much later I realised they were probably intimidated by him too, and worried about their jobs.

Within 10 months I had had enough. The day Steve grabbed the cups I was reaching for, called me “useless bitch” and shouldered me aside I simply kept going in the direction he had pushed me, walked out of the dairy and out of the job.

I tried to explain it to the owners, but they simply said Steve “didn’t mean anything by it, he was just getting used to managing people”. If I hadn’t been taught respect by my parents; I would have laughed at them; I certainly felt like it.

But in the end, the worst thing about it all was not the job lost, it was my loss of self-confidence; and it would take me a couple of years and a bit of therapy before I realised none of this was my fault, that dairy had been simply set up for disaster.

I learnt, through time and talking about my experience, that the workplace had an obligation to me to set a culture and standard that does not tolerate bullying. That obligation wasn’t met.
It should never have been my responsibility to walk away from the job, to solve the problem – there should have been systems in place to prevent it ever happening.

Sadly, Sharon’s story is much more common than most of us would know – or like to admit. Perhaps the one upside of the pandemic is the focus it has put on mental health; especially in the workplace. Because if it isn’t positive and fair, somewhere, someone, is going to pay the price.

Injuries on the farm can lead to stress, long-term health concerns and loss of income or even fatalities, so preventing them from happening is the best way of protecting your mental health. When it comes to running the family farm, investing in mental health initiatives is not only good for your family and workers, but it’s good for business too. The NCFH is supporting farmers just like you to manage and respond to work-related risks that impact on workplace mental health – these are factors in your work that can affect an employee’s mental health and include high job demands, low job control, low role clarity and more. Managing these factors, means decreasing the risk of work-related stress, which can prevent physical injury, mental injury or even both at the same time.
Find out more about being mentally safe on farm at www.farmerhealth.org.au/campfire.

Reflecting on our role in the COVID-19 response

By Susan Brumby.

Recently a family member and friends arrived home to play a weekend game of cricket. It was an exciting time as, due to COVID, it was the first opportunity for activities like this to go ahead. We followed the rules and everyone did RAT tests before coming into the house.  A couple of them had young families and were looking forward to school going back.  One of them mentioned that they had a nice break over Christmas and January and felt rested and grateful for the holiday. I reflected on the break – or short break – that many of us had recently had in health care.

For many of us working in healthcare we had been called back from our week of leave to assist with an outbreak of COVID – 19 (Omicron variety).   

The Western District experienced a large outbreak following the Christmas and New Year period where families and lots of young people had come together at the traditional district beach spots (Port Fairy, and Robe in SA) to celebrate the conclusion of 2021 and welcome with hope 2022.  As cars of young people appeared at our drive-thru testing clinic on the week of January 3, 2022, many were showing signs of COVID. They were unsure if it was a hangover or really something to be worried about and wanted to be tested and do the right thing.  Some lived on farms and were worried about taking COVID back home with them. Later in the week the demographics started to shift, with older people and parents bringing family members in. 

As a result of the COVID-19 pandemic and the outbreak in Southern Grampians, a huge number of individuals, groups, and businesses all stepped up to help in their local communities. Extra volunteers were called in and staff were recalled from leave.  Our NCFH team was among them, and I wanted to share some insight into the small parts we played in the COVID-19 response, and thank the many people who assisted and volunteered to help our community.

Across the pandemic, our team have helped in the delivery of contact tracing efforts to slow the spread of infection in our local community of the Southern Grampians. We have also taken on responsibility for managing our local COVID-19 hotline, providing information, vaccination bookings and referrals to local COVID-19 support services to help with meals, food delivery, and hospital in the home to our community members–fielding over 640 calls since January 2022. In addition, various team members have taken on responsibilities assisting with the mass testing screening clinics which involved working at the showgrounds, swabbing and triaging and generally helping where we could along with the coordination of the COVID-19 respiratory clinic. It’s been a very busy start to the year!

What was also amazing was the huge work of volunteers who were there directing cars for testing, helping with vaccinations, delivering meals, and completing numerous other tasks behind the scenes – selflessly assisting to keep our community safe. There is no doubt that together we are stronger.

As for the cricket – it was a great weekend and wonderful for the community to get together and enjoy everything our district has to offer. Let’s hope we see more of this in 2022.

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Farmer Health eNews March 2022

Find out the latest from the National Centre for Farmer Health

• Empowering farmers to thrive
• We want to learn from your experiences
• Our role in the COVID-19 response
• Wellness Wednesday

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Ageing on the farm: Making a safe transition

This topic will be discussed as part of our online Bonfire Q&A on February 23rd at 7:30pm, “Healthy ageing on the farm”.

Bill always wanted his son to take over his farming business at Lockhart in NSW, it’s just now he doesn’t know what he should do with himself.

He doesn’t regret his decision. Bill has seen what can happen when parents hold on for too long, and not hand over the farm responsibility to the next generation. So when his son, Richard came back to their sheep and wheat farm at the age of 30, they drew up a plan to share ownership and hand over the management to Richard and his wife Isabelle.

“The transition happened over a few years and was pretty smooth”, Bill said. “We got some help from a professional to get some ideas and work through some of the trickier bits.”

“However, what I now realise is, that I basically forgot about myself – and never really discussed my ongoing role on the farm, once the transition was over.”

Bill’s experience is an example of the mental health problems caused by low role clarity, as detailed in Worksafe’s guide on managing work related stress.

 At 66, Bill felt far from old. His back wasn’t up to a full day of crutching sheep anymore, but he also wasn’t ready to retire completely.

“I guess, I also didn’t realise how much farming was a part of me, until I stepped back,” Bill said.

 Bill was doing some odd jobs around the farm, but he wasn’t finding it very fulfilling.

Then, he had an accident.

He was on a new tractor, cleaning up the farm, when a stick flicked up underneath, puncturing the radiator hose. His hearing has been affected by decades of working with farm machinery … and he didn’t hear that something was wrong.

 Ultimately, the engine overheated and was completely destroyed. It wasn’t an easy conversation to have with his son.

.“I didn’t want to be seen as too old or a safety risk,” Bill said.

Ageing on farm is of course a natural process, but a new concept, which Cultivate Farms is investigating. It’s developing a project to help farmers identify pathways to stay on farm as long as they want, even if they don’t have a family successor.  The median age of farmers and farm managers in Australia is 56, making it an especially important topic for the industry.

Physically ageing farmers can often experience hearing loss. This not only poses a risk for accidents and injury, but can also affect farmers’ social connection and mental health. Ageing can also exacerbate arthritis and muscular pain, often caused by the physical tasks of farming over a long period.

The Managing Director of Cultivate Farms, Sam Marwood says there’s little research available on how to best age on farm, so he’s developing case studies and research.

Ageing on farm does not need to be a negative process, but it does require farmers to consider, and make changes to support their physical, social and mental wellbeing on their farm.

“Our message to retiring farmers is you don’t have to sell or walk away from your farm.”

The first step for Bill was to set up a family meeting. Which he did, after his tractor incident.

“I had to be open and say I was struggling in not having a leadership role on the farm.”

Bill says he realises he needs to be more mindful of his hearing loss, but another factor in the tractor incident, was that because he’d been working less on farm, he was out of practice.

“It’s not because I’m too old,” he said.

“You know, as soon as I spoke to my son and daughter-in-law about it, they understood. And they were actually relieved for me to help them more in the farm business sense.”

Richard didn’t realise his Dad wanted more involvement.

Now Bill’s role is set out, he’s involved in business management decisions and is consulted about what physical work he’d like to do. Feeling that he doesn’t constantly have to prove himself has also made Bill feel more comfortable in stepping back at times as well. He’s finding a better balance between work on the farm and life off-farm—even spending a day a week at the Men’s Shed in town.

“I feel like I still have that flexibility I wanted when I decided to step back, but now I have my identity and purpose again too,” Bill said.

Injuries on the farm can lead to stress, long-term health concerns and loss of income or even fatalities, so preventing them from happening is the best way of protecting your mental health. When it comes to running the family farm, investing in mental health initiatives is not only good for your family and workers, but it’s good for business too. The NCFH is supporting farmers just like you to manage and respond to work-related risks that impact on workplace mental health – these are factors in your work that can affect an employee’s mental health and include high job demands, low job control, low role clarity and more. Managing these factors, means decreasing the risk of work-related stress, which can prevent physical injury, mental injury or even both at the same time.
Find out more about being mentally safe on farm at www.farmerhealth.org.au/campfire.

High-Heat Days and Presentations to Emergency Departments in Regional Victoria, Australia

Abstract

Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption.

Keywords: occupational health; farmers; extreme heat; heat-related illness; high-heat climate change; injury; heat exposure

Farmer Health eNews February 2022

Find out the latest from the National Centre for Farmer Health

• Agricultural Health and Medicine is moving ONLINE
• Injury risk and safety behaviours of children on Victorian farms survey
• The Campfire has been lit for 2022!
• Wellness Wednesday

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Child Safety on Farms: help us make a difference

Are children on farms at increased risk of injury?

Farms are very unique environments, as they are both a workplace and home to many Australian families. Growing up on a farm is unlike most other childhoods, largely due to parents involving, and often depending on, their children to be farm helpers. Child farm safety is important as we want children to grow up learning and engaging in farming. However, we do not want to see any child get hurt.

There are many factors that may contribute to children’s increased risk of experiencing farm-related injury. Some of these include; children’s development level and exposure to dangerous environments, multi-generational farming families and the dependence on children’s assistance with tasks on the farm, the lack of workplace regulations, the risk-taking culture within farming communities, competing financial priorities, lack of supervision and use of safe play areas, poor understanding and use of the hierarchy of control (1).

How common are child farm-related injuries?

To set the scene, the agriculture industry in Australia experiences the highest rate of workplace fatalities per number of workers (2). Adding children to this already hazardous environment further increases the chances of injury.

Children under the age of 15 years represent 15% of all farm-related deaths in Australia. Unfortunately, this rate has remained consistent over a long period of time (at least 20 years), despite efforts to reduce them.

Our knowledge on the number of children injured on farms (non-fatal), is not as well understood, however, a report by the Australian Institute of Health (3) identified over 2,000 children under 15 were hospitalised due to farm-related injuries between 2010/11 to 2014/15. This is 9% of all farm-related injury hospitalisations.

What are the common hazards causing these injuries?

The main hazards responsible for child farm-related deaths are water bodies (eg. dams, troughs, tanks, and creeks), quad bikes and motorbikes, utes/cars, tractors and horses. There are obviously many other things present on farms that can cause injury to children, such as; animals, chemicals, machinery, firearms, noise, electricity, heights, mowers, chainsaws.

What can you do to keep your children safe on the farm?

Now that children are transitioning back to school, and parents and guardians hopefully have some more time on there hands, it might be a great opportunity to get the family together and do a safety audit or walk around and discuss the hazards and what can be done to reduce the risks. This is also important to do if you are expecting child visitors.

Farming hazards are different from farm to farm, as well as differing between children (eg. age, developmental stage). Some key considerations to keep children safe on farms:

1. Toddlers and small children (typically under 5 years):
   • Constant active supervision – it is important that an adult should be within sight, sound and reach of the child.
   • Safe play areas – create a physical barrier (at least 1.2m meters high) that prevents your child from entering dangerous environments. Adding interesting things like a sandpit or toys can assist in entertaining your child.
   • Young children are curious and have no understanding of the dangers around them. Therefore, a combination of constant active supervision and safe play areas are recommended as great strategies to keep your young child safe.
2. Young children (5 to 9 years):
   • Young children are starting to be able to understand basic rules and wanting to become more independent.
   • Constant active supervision is still required.
   • As children start to engage with tasks on the farm, it is important they are developmentally appropriate, both physically and mentally(e.g. feeding baby animals)
   • When children are on the farm, appropriate safety measures should be in place (e.g. wearing high Vis vests, helmets, rules).
   • Potentially can still use safe play areas.
3. Older children and young teenagers (10 to 14 years):
   • Typically older children want to prove themselves as being capable.
   • Supervision is still required.
   • Ensuring children are still only completing developmentally appropriate tasks. Additionally, ensuring appropriate training/explanation of tasks and potential hazards present is important.
   • Use of appropriate safety measures and ensure Personal Protective Equipment (PPE) is correctly fitting

Throughout all these ages, constant open communication about farm safety is vital.

Using the hierarchy of control could be a way to reduce the risks for everyone on your farm – https://www.worksafe.vic.gov.au/hierarchy-control

How can I help the NCFH make a difference to child safety on farms?

We are conducting a study to investigate children’s exposure to occupational risk on farms to ultimately reduce injury rates.

We are asking farming parents and children (aged 5 to 14 years) to assist by completing our study. Parents will be asked to first complete the survey, then a link will be sent asking for your child to assist by completing the survey.

Please find the link to the survey here: Injury risk and safety behaviours of children on Victorian farms | National Centre for Farmer Health

This article was written by Jessie Adams, who is conducting this survey. Jessie’s contact details are:

References

1.             Adams J, Kennedy A, Cotton J, Brumby S. Child Farm-Related Injury in Australia: A Review of the Literature International Journal of Environmental Research and Public Health. 2021;18(11):1-16.

2.             Safe Work Australia. Work-related Traumatic Injury Fatalities, Australia Canberra: Safe Work Australia; 2019.

3.             Henley G, Harrison J. Hospitalised farm injury, Australia, 2010-11 to 2014-15 Canberra: AIHW Australian Institute of Health and Welfare & Flinders University 2018.

Farmer Health eNews January 2022

Find out the latest from the National Centre for Farmer Health

• Returning to work after stroke in rural communities
• Agricultural Health and Medicine unit (HMF701) returns to Hamilton!
• What HAT will you wear in 2022?
• Wellness Wednesday

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Empowering farmers to take health into their own hands

Originally published in Partyline, Issue 77.

The increase in digital literacy, coupled with the healthcare industry’s innovation in creating user-friendly, useful health and wellbeing digital platforms, has opened doors for our rural and remote communities to access new healthcare resources across Australia.

Fast to adapt to this changing space is the National Centre for Farmer Health (NCFH). Based in Hamilton in the Western District of Victoria, the NCFH opened their doors in 2008. Over the past 13 years the NCFH has conducted numerous research, education and service delivery initiatives, seeking to improve the health, wellbeing and safety of farmers, agricultural workers, farming families and rural communities. In translating these findings into online resources, the NCFH helps address the health inequality traditionally experienced by rural and remote Australians.

Farmer HAT

To empower farmers and increase personal awareness of health, wellbeing and safety, the NCFH created the free online platform Farmer Health Assessment Tool. Farmer HAT, as it is affectionately known, is a simple online form that can be used by individuals or farming groups. Questions relate to health, wellbeing, lifestyle behaviours and farm safety practices. Instant results are generated using a traffic light system. Farmer HAT is easy to use, gives practical tips for improving the personal health, wellbeing and safety of the user and can be completed from the comfort of their own home.

Campfire

Farming and agricultural work can be isolating, with large amounts of time spent working solo and a range of factors presenting risks to mental health. To help improve the mental health, safety and wellbeing of farmers in their workplace, the NCFH have co-designed (with farmers and industry) an online interactive platform called Campfire. Campfire is a text-based platform that invites anyone in the agricultural industry to join the conversation every Wednesday night, where topic experts and farmers share practical knowledge, resources and experience. It is a place to connect, learn and develop an understanding of various topics relating to life on the farm. The format offers attendees the anonymity to ask questions and discuss topics they may not feel confident discussing otherwise. Topics covered range from preparing for the fire season, succession planning, working effectively in a family business and child safety on the farm. Campfire topics are also covered by a growing number of podcasts, blogs and hard copy resources available on the landing page.

Steering Straight: My plan to stay on track

Farmers often get bogged down in the endless cycle of farming tasks, rarely taking time to turn their focus from the wellbeing of the farm business to what supports their own wellbeing.

 Steering Straight is a resource that has been developed in collaboration with members of the farming community. It aims to help farmers look beyond the endless cycle of tasks and help with reflection, planning for the challenges ahead and preparing for action, with a focus on wellbeing. Available in a digital form or as part of the Managing Stress on the Farm booklet, Steering Straight offers individuals a guided assessment and action plan that they can complete, keep as a handy reference and update as required.

For more information about the National Centre for Farmer Health and the work they do, you can check out their website www.farmerhealth.org.au.

Originally published in Partyline, Issue 77.

Farmer Health eNews December 2021

Find out the latest from the National Centre for Farmer Health

• Managing stress in the most stressful time of year 
• ‘How to be a leader: no matter what your role is’
• The Safety Shop is back just in time for Christmas!
• Wellness Wednesday

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Mental health at the COVID-19 frontline: An assessment of distress, fear, and coping among staff and attendees at screening clinics of rural/regional settings of Victoria, Australia

Abstract

Purpose

Research examining psychological well-being associated with COVID-19 in rural/regional Australia is limited. This study aimed to assess the extent of psychological distress, fear of COVID-19, and coping strategies among the attendees in COVID-19 screening clinics at 2 rural Victorian settings.

Methods

RA cross-sectional study was conducted during July 2020 to February 2021 inclusive. Participants were invited to fill in an online questionnaire. Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale, and Brief Resilient Coping Scale were used to assess psychological distress, fear of COVID-19, and coping, respectively.

Findings

Among 702 total participants, 69% were females and mean age (±SD) was 49 (±15.8) years. One in 5 participants (156, 22%) experienced high to very high psychological distress, 1 in 10 (72, 10%) experienced high fear, and more than half (397, 57%) had medium to high resilient coping. Participants with mental health issues had higher distress (AOR 10.4, 95% CI: 6.25-17.2) and fear (2.56, 1.41-4.66). Higher distress was also associated with having comorbidities, increased smoking (5.71, 1.04-31.4), and alcohol drinking (2.03, 1.21-3.40). Higher fear was associated with negative financial impact, drinking alcohol (2.15, 1.06-4.37), and increased alcohol drinking. Medium to high resilient coping was associated with being ≥60 years old (1.84, 1.04-3.24) and completing Bachelor and above levels of education.

Conclusion

People who had pre-existing mental health issues, comorbidities, smoked, and consumed alcohol were identified as high-risk groups for poorer psychological well-being in rural/regional Victoria. Specific interventions to support the mental well-being of these vulnerable populations, along with engaging health care providers, should be considered.