How some farmers meet the challenge of long-term health conditions

Farmers living with chronic illness are adapting their businesses, routines and working practices to stay in agriculture, often while managing pain, fatigue and uncertainty on a daily basis.

From kidney disease and Crohn’s to arthritis, diabetes, endometriosis and multiple sclerosis, many are continuing to work by redesigning jobs, relying on family support, changing roles on farm and learning how to pace themselves physically and mentally.

Northern Ireland GP and farmer Rebecca Orr, who has been researching chronic illness and preventative healthcare in farming communities through Queen’s University Belfast, said the industry’s culture of resilience can sometimes delay diagnosis and treatment.

See also: Find all our Level the Field content in one place 

“Farmers are by nature optimists,” she says. “But optimism will not help you whenever it comes to these chronic diseases, because they will progress if you don’t intervene.”

Dr Orr says chronic illness remains under-researched in agriculture, despite evidence suggesting farming occupations carry significant health risks.

Her work has focused particularly on cardio-metabolic disease, including heart disease, diabetes, kidney disease and obesity.

Research among livestock farmers in Ireland found 74% had four or more risk factors for cardiac disease.

 In Dr Orr’s own survey of 249 farmers, concerns around blood pressure, weight gain, alcohol intake and diet are common.

However, she says the bigger issue is often not a lack of time, but the barriers that prevent people from seeking help.

She recalls one telling her about the stigma attached to physical illness.

“One farmer told me he can’t be seen to be sick, because people won’t do business with you if you’re sick.”

Planning ahead

Dr Orr believes many farmers could benefit from approaching health in the same structured way they approach farm safety or succession planning.

“We’ve got safety plans on farm, but have we got an ill health plan?”

She encourages farmers to seek advice early, explain the realities of farming during appointments and build relationships with healthcare professionals who understand agricultural work.

“Tell them that you are a farmer,” she says. “Explain what you have to do day to day, including if you are responsible for livestock.”

Dr Orr also believes peer support between farmers living with chronic illness can help reduce isolation and encourage earlier intervention.

Managing unpredictability

For 18-year-old Cornish agricultural contractor Ryan Benny, learning to work around Crohn’s disease has required constant forward planning.

Mr Benny works with his father near Helston, handling silage, potatoes, daffodils, and producing thousands of hay and silage bales each year.

After years of worsening symptoms, emergency surgery in 2024 removed a severely damaged section of bowel.

He now manages the condition with medication, injections and regular monitoring.

 The unpredictability of Crohn’s remains one of the biggest challenges.

“I could be fine one day and have exactly the same thing to eat tomorrow and be in absolute agony with it,” he says.

Long days in tractors and working far from home can make symptoms difficult to manage, particularly during flare-ups when immediate access to toilets becomes critical.

To continue working, Mr Benny carefully plans around food, medication and medical appointments.

Before long days away from home, he sometimes relies on prescribed medication to control symptoms, while support from understanding customers and specialist nurses has helped him remain in work.

“The best thing I’ve done is definitely referring to the GP,” Mr Benny says.

Planning around diabetes

County Durham farmer Emma Lawson says farming with type 1 diabetes has become an exercise in constant preparation and routine.

Ms Lawson, who farms about 80ha of sheep and arable land with her family while also carrying out seasonal contract work, was diagnosed aged 25 while working on a cattle ranch in Canada.

“It was a big shock, it’s a big change,” she says.

But adapting quickly became essential. She now carefully plans around blood sugar levels before heading out to work, carrying sugary snacks and carbohydrates in tractors, vehicles and sheds in case physical work triggers dangerous low blood sugar episodes.

Different farming tasks affect her condition differently. Sheep work can trigger hypoglycaemia, while long hours driving a tractor can push blood sugar levels higher because of reduced activity.

To stay on top of fluctuations, Ms Lawson uses a continuous glucose monitor linked to her phone and adjusts her insulin accordingly.

Despite the extra planning, she says farming remains entirely achievable: “You can still do anything you want.”

Adjusting roles

At Belmont Farm in north London, farm manager Rhianna Deeble has had to adapt her role following a diagnosis of relapsing-remitting multiple sclerosis (RRMS).

The 85ha farm combines sheep production with public engagement and educational activities.

Ms Deeble’s symptoms have included numbness, vision loss and chronic fatigue.

Treatment temporarily suppressed much of her immune system, meaning direct livestock work during lambing became too risky because of infection exposure.

Instead of leaving farming, her role shifted towards volunteer management, education work and public engagement while colleagues covered higher-risk animal tasks.

“I’m not able to help out any animal that has an infection,” she says.

She credits flexibility from employers, support from family and colleagues, and learning to manage stress as key factors in staying in the industry.

“Just because you have a diagnosis doesn’t mean anything really,” she says.

“You just have to learn about it and manage it the best that you can.”

Pacing and persistence

For Worcestershire sheep farmer and sheepdog trainer Alison Smith, managing endometriosis means breaking work into manageable stages and recognising physical limits.

Ms Smith, who runs about 300 sheep on rented land along the Herefordshire-Worcestershire border, has lived with severe symptoms for decades before finally receiving a diagnosis last year.

The condition causes extreme abdominal, back and leg pain alongside severe fatigue.

“Everything feels very, very heavy, everything feels very slow,” she says, describing the exhaustion associated with flare-ups.

During lambing in 2024, symptoms became so severe that she sometimes crawled through the lambing shed because she feared passing out while working alone.

Medication has since reduced some symptoms, but Ms Smith still manages her workload by pacing herself carefully, planning breaks and splitting physically demanding jobs into smaller tasks.

“The animals and particularly the dogs are the reason I get up every day,” she says.

She urges others not to ignore symptoms or accept dismissal from healthcare professionals.

“If one GP does not take symptoms seriously, you go to another and another and another, until somebody is listening,” she says.

Learning limits

West Wales dairy farmer Annie James has also had to reshape her working life after chronic arthritis severely affected both feet.

Mrs James and her husband Liam run a 150-cow spring-calving herd near Carmarthen.

Following years of pain, surgery and failed treatments, she now uses a walking stick on uneven ground and has undergone joint fusion surgery to stabilise one foot.

Rather than leaving farming, she has reorganised her workload around what she can physically manage.

Milking, calf rearing and office work now form most of her role.

Like many self-employed farmers, Mrs James says the financial impact of ill health remains a major concern, particularly during recovery periods following surgery.

“There just doesn’t seem to be any kind of structure to support people from small businesses and the self-employed,” she says.

“Ill health is a nail in the coffin for many businesses.”