Researchers: Health care and child care hold back family farms

kids at farmers market stand
he Horner family started two farmers markets, in Scioto County, Ohio and beefed up their backyard garden to market their produce, all while working off-farm jobs and raising two daughters. (Submitted photo)

Josh and Megan Horner’s daughter was diagnosed with a brain tumor when she was 2. Sophie had to go through a year of chemotherapy treatments.

“During this hardship, we decided to lean on our love of gardening for extra income,” Megan said. “This made us realize the importance of sustainability and healthy living and the need for it in our own little community.”

When Sophie was cleared and out of treatment, the Horners wanted to give back to their community, who had supported them in their time of need.

So, they started a farmers market, in South Webster, Ohio, in Scioto County. The Horners didn’t have any farming experience. But they did have a backyard gardening and about five acres of land that their home sat on.

“It was just us and maybe one other vendor set up at the first one,” Megan said. “It grew from there to about a dozen or more people.”

Sophie is now 8. The tumor never went away, but it stopped growing. The Horner family continued growing their market garden and farmstead, while Josh and Megan both worked other jobs. They established another farmers market, in nearby Wheelersburg, Ohio last year.

“One of the biggest barriers we have right now is time,” Joshua Horner said. “I’m tied to the job, both financially and because we need to carry insurance on Sophie. She’s still getting MRIs every year. “

horner family photo
The Horner family: Sophie, Josh, Megan and Chloe. (Submitted photo)

They’re not alone. Social scientists at Ohio State University recently published an article in The Conversation detailing research they completed on how to support the next generation of farmers.

Shoshana Inwood, Florence Becot and Andrea Rissing conducted thousands of interviews, surveys and conversations with farmers across the country. They found health care and child care are critical for a successful food system.

Health care

Their research found that two-thirds of farmers have a preexisting health condition, and one in three farms has a family member whose health issues makes farming difficult. More than 90% of farmers have health insurance, but the way in which they get it belies another problem.

Half of all farm families have at least one adult working an additional full-time job, often to get health insurance coverage. While that may work to have extra cash flow and health care, working off farm pulls time and energy away from farm work, the researchers noted.

Nationwide, 68% of all personal bankruptcies are connected with health and medical expenses. One in two farm families reported to the researchers that “they worried they would have to sell farm assets to pay health expenses.”

Josh Horner said another big challenge for them is money.

“We didn’t have any reserve left from the whole year of chemo and staying three hours away from home, and being out of work while [Sophie] was in isolation,” he said. “Every little piece of equipment, we’ve got to buy one piece at a time and go without any conveniences.”

Fortunately, they can get by working primarily by hand on their intensive market-style garden. It takes up about an acre of their land, but it’s labor intensive work.

Child care

The Ohio State team also found that child care is a huge struggle for working and farming parents.

Farming can sometimes seem like a job where you can take your children to work, but farming is inherently dangerous work. According to the Centers for Disease Control and Prevention, every day 33 children are seriously injured in agriculture-related incidents; every three days a child dies on a farm.

“In a national study of farm parents before the pandemic, we found that two-thirds had struggled with the cost, availability and quality of child care,” the researchers wrote.

“Surveying farm parents during the early months of COVID-19, we found 58% reported that taking care of children became harder during the pandemic – especially for women farmers and those with children under age 6.”

Women are one of the fastest-growing groups of farmers, but still, child care often gets thrust upon the woman’s shoulders in a farming operation.

“In our research, women were almost twice as likely as men to report that child care was an important factor in farm decisions, 44% compared to 24% among men,” the researchers wrote.


Fortunately, child care has never been an issue for the Horners. Sophie and their older daughter, Chloe, 10, have always been able to help out with the farmstead, while Megan works full time from home. The girls help out with picking produce and have their own daily chores, taking care of the family’s ducks, rabbits and goats.

In addition to the market garden and  farmers markets, the Horners tried their hands at raising pastured chicken last year. This year they launched a small CSA. It has only 10 members for the pilot year, but they sold all the shares within two hours of advertising the program on social media, Megan said.

When the Horners get worn down, they lean on each other.

“When I have to step back for a little bit, Megan’s got to take over. Then sometimes I take over some of Megan’s roles,” Josh said. “In the heat of summer, you get burnt out. I start to lose interest. But something resparks, and I keep going.”

The Ohio State University researchers found that farm families said public insurance options, affordable rural child care and making insurance easier for self-employed people to access would help them grow their businesses. Some of those changes may be on the wind.

The U.S. Department of Agriculture announced April 21 that it was seeking comments from producers on an effort to “improve and reimagine” supply chains for food production. This included meeting the needs of the agricultural workforce and addressing the needs of socially disadvantaged and small to midsize producers.

“This is an opportunity to integrate health insurance and child care as core infrastructure that supports the future of farmers and rural communities, along with the U.S. food supply,” the researchers said.

(Reporter Rachel Wagoner can be contacted at 800-837-3419 or


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Rachel is a reporter with Farm and Dairy and a graduate of Clarion University of Pennsylvania. She married a fourth-generation beef and sheep farmer and settled down in her hometown in Beaver County. Before coming to Farm and Dairy, she worked at several daily and weekly newspapers throughout Western Pennsylvania covering everything from education and community news to police and courts.



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