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Improving health
Previously NHS Health Scotland

Improved engagement with agriculture sector

The following case study looks at action taken by NHS Grampian who identified the agriculture sector as not having previously engaged with workplace health and wellbeing promotion and as being at an increased risk of workplace health inequalities.

They wanted to

  • define and implement an engagement strategy that better reflected the needs of those working in farming
  • align and refine the approach and resources to most effectively meet those who work in farming
  • assess the response and satisfaction with the approaches and the resources developed.

Reason action was taken

As noted in our take the right actions page, one of the key ways to reduce health inequalities is by having effective partnerships across sectors.

Agriculture is a major sector in the economy, employing around 67,000 people and with 360,000 jobs (1 in 10 of all Scottish jobs) being dependent on it.

Suicide rates in farmers are among the highest in any occupational group. It is a harsh reality that access to highly lethal means such as firearms, poisons and machinery results in a large number of suicide attempts by farmers being fatal.


NHS Grampian worked collaboratively with the North East regional manager of the National Farmers Union Scotland (NFUS) to survey 250 people who visited their stand at the Turriff Show 2016.

Responses showed

  • a higher number of males (58%) to females
  • that most were within the age bracket of 56 to 74 years old (46.4%)
  • nearly half wanted more information or support with stress, anxiety and depression.

Action taken


The results of the survey led to the development of a mental health campaign targeting those working in the rural and agricultural sector in Grampian who were struggling with mental health issues. It urged them to ‘Know Who To Turn To’. This was to raise awareness of services and reduce the stigma of mental health.

The campaign was on TV, radio, press and social media. Posters were also permanently displayed at the Thainstone Agricultural Centre and leaflets were made available in the NFUS offices around Grampian.


The booklet ‘Fit for Farming’ by Men’s Health Forum was reviewed and updated, this included other health topics identified by the survey. The booklet contains NHS Health Scotland information and legislation, as well as Scottish support services.

This was advertised on the TV, radio, social media platform and in the Press and Journal published a monthly health column with a supplement written by the NHS Grampian Director of Public Health. Talks by a public health practitioner were given at Craibstone Agricultural College in Aberdeen to first year students on Fit to Farming topics including mental health.

Free booklets are available throughout Grampian.

People who helped

The actions were developed through a number of data collection points and learning outcomes informed the next steps.

As the actions targeted a marginalised population group spread over a wide demographic area, contacting and engaging with people was extremely difficult.  It would not have been possible to gather the information that directed the actions without the trust that was built with the farmers in Grampian whilst working collaboratively with the North East regional manager of the NFUS.

Impact and lessons learned

A health topic survey and follow up questionnaire on awareness of the ‘Know Who to Turn To’ campaign was carried out again in 2017 at the NFUS stand at the Turriff Show. 304 people responded and results informed additional venues and locations to promote resources.

Returning to the Turriff show in 2019, 63 people completed the surveys on whether the information in the ‘Know Who To Turn To’ and the Fit for Farming’ campaigns had raised awareness of mental health and wellbeing and whether the campaigns had any direct impact.

92% of those surveyed said that the ‘Know Who To Turn To’ campaign had raised their awareness of mental health in farming, 73% said that the campaign had helped them. Examples of quotes include 

  • “able to talk about it, made me more ready to enquire of a friend or neighbour if I feel there is something wrong”
  • “I talked to a friend who needed help”
  • “allows the discussion to take place now, able to talk about my own mental health”.

97% of those surveyed said that the ‘Fit for Farming’ booklet had raised their awareness of how to stay healthy. Examples of quotes include 

  • “being careful with heavy lifting”
  • “aware of how to avoid accidents”
  • ”staying hydrated”.

69% said that the booklet had encouraged then to make lifestyle changes. Examples of quotes include 

  • “diet and exercise more”
  • “drink less”
  • "walk more and stay active, lose weight”
  • “try to reduce stress and eat healthier”
  • “be more aware of body changes, look after my back”.

Further information

You can find out more about ways to reduce health inequalities within our reducing health inequalities section.

You can find out more about mental health and wellbeing and suicide within our sections on these topics.

This case study is based on information provided by Andrea Gilmartin from NHS Grampian. If you would like to discuss further, you can contact our Health Promoting Health Service (HPHS) team by email at