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Thursday, 10 March 2011 16:17

Case Study: Argomedicine

Written By: Brittain, Jere A., Schuman, Stanley H.
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Since animal husbandry and crop production began, agriculture and medicine have been interrelated. A healthy farm or livestock operation requires healthy workers. Famine, drought, or pestilence can overwhelm the well-being of all of the interrelated species on the farm; especially in developing countries that depend on agriculture for survival. In colonial times plantation-owners had to be aware of hygienic measures to protect their plants, animals and human workers. At present, examples of agromedical teamwork include: integrated pest management (an ecological approach to pests); tuberculosis (TB) prevention and control (livestock, dairy products and workers); and agricultural engineering (to reduce trauma and farmer’s lung). Agriculture and medicine succeed when they work together as one.

Definitions

The following terms are used interchangeably, but there are noteworthy connotations:

  • Agricultural medicine refers to the subdivision of public health and/or occupational medicine included in the training and practice of health professionals.
  • Agromedicine is a term coined in the 1950s to emphasize interdisciplinary, programmatic approaches which give a greater role for the agricultural professional based upon the equal partnership of the two disciplines (medicine and agriculture).

 

In recent years, the definition of agricultural medicine as a subspeciality of occupational/environmental medicine located on the health sciences campus has been challenged to develop a broader definition of agromedicine as a process of linking agricultural and health resources of a state or a region in a partnership dedicated to public service, along the lines of the original land-grant university model.

The essential unity of biological science is well known to plant chemists (nutrition), animal chemists (nutrition) and human chemists (nutrition); the areas of overlap and integration go beyond the boundaries of narrowly defined specialization.

Content areas

Agromedicine has focused on three core areas:

    1. traumatic injury
    2. pulmonary exposures
    3. agrichemical injury.

         

        Other content areas, including zoonoses, rural health services and other community services, food safety (e.g., the relationship between nutrition and cancer), health education and environmental protection, have received secondary emphasis. Other initiatives relate to biotechnology, the challenge of population growth and sustainable agriculture.

        Each core area is emphasized in university training and research programmes depending on faculty expertise, grants and funding initiatives, extension needs, commodity producers’ or corporate requests for consultation and networks of inter-university cooperation. For example, traumatic injury skills may be supported by a faculty in agricultural engineering leading to a degree in that branch of agricultural science; farmer’s lung will be covered in a pulmonary medicine rotation in a residency in occupational medicine (post-graduate specialization residency) or in preventive medicine (leading to a master’s or doctorate in public health); an inter-university food safety programme may link the veterinary discipline, the food science discipline and the infectious disease medical speciality. Table 1 compares two types of programmes.

        Table 1. Comparison of two types of agromedicine programmes

        Parameter

        Model A

        Model B

        Site (campus)

        Medical

        Medical and agricultural

        Support

        Federal, foundation

        State, foundation

        Research

        Primary (basic)

        Secondary (applied)

        Patient education

        Yes

        Yes

        Producer/worker education

        Yes

        Yes

        Health provider education

        Yes

        Yes

        Extension education

        Elective

        Yes

        Cross-discipline education

        Elective

        Yes

        Statewide community outreach

        Intermittent

        Ongoing (40 hours/wk)

        Constituency:sustainability

        Academic peers
        National peers
        International peers

        Growers, consumers,
        health professionals,
        rural physicians

        Prestige (academic)

        Yes

        Little

        Growth (capital, grants)

        Yes

        Little

        Administration

        Single

        Dual (partners)

        Primary focus

        Research, publication, policy recommendations

        Education, public service, client-based research

         

        In the United States, a number of states have established agromedicine programmes. Alabama, California, Colorado, Georgia, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Nebraska, New York, Oregon, Pennsylvania, South Carolina, Virginia and Wisconsin have active programmes. Other states have programmes which do not use the terms agromedicine or agricultural medicine or which are at early stages of development. These include Michigan, Florida and Texas. Saskatchewan, Canada, also has an active agromedicine programme.

        Conclusion

        In addition to collaboration across disciplines in so-called basic science, communities need greater coordination of agricultural expertise and medical expertise. Dedicated localized teamwork is required to implement a preventive, educational approach that delivers the best science and the best outreach that a state-funded university system can provide to its citizens.

         

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