Sociology Class Study

Michael Dulitz, a senior Sociology major from Webster, South Dakota, is working with faculty mentor Dr. Susan Schrader on researching health insurance access and health quality among family farmers in South Dakota.

Dulitz presented study results as a poster at the 2013 Midwest Sociological Society Annual Meeting in Chicago, Ill., in March and as a paper at the 2013 Augustana Symposium.

A manuscript with study results entitled "Betting the farm: Health coverage, behaviors and concerns among South Dakota farmers" will be published in the October 2013 issue of the journal South Dakota Medicine published by the South Dakota State Medical Association.


Introduction: This research investigates the health and health insurance status of South Dakota farmers before the onset of the Affordable Care Act of 2010 health insurance mandate set to begin January 1, 2014.

Methods: After IRB approval, surveys were sent to 1400 randomly selected rural addresses in nine South Dakota counties. The surveys used both qualitative and quantitative means to inquire about the health usage, status, and insurance status. Quantitative data were analyzed using SPSS, and qualitative data were analyzed for thematic content.

Results: With an overall return of 205 surveys (135 farmers), the rate of insurance was 90.6%. Four-fifths of farmers (80.2%) reported having an established provider, and 84.6% reported visiting a provider in the past year. Those with non-group insurance coverage were significantly more likely to report using high deductibles and limiting insurance use due to cost, but maintained a high self-reported health and preventative care use. Farmers under 50 had significantly higher rates of cutting usage and increasing deductibles in order to afford coverage. Farmers over 65 had high healthcare utilization. Farmers ages 51-65 had both a high rate of using strategies to cut cost along with having an increasing utilization of care. Qualitative themes included concerns about obtaining health insurance, high deductibles, and lack of coverage.

County-Wide Directory logoSupport for this Augustana-funded survey has also been provided by Country-Wide Directory.

Conclusions: The health insurance and usage among farmers is high. Farmers ages 51 to 64 experience increased burden due to increasing healthcare needs along with need for health insurance coverage. Respondent comments suggest concern with increasing rates and financial loss.


Copy of the study manuscript can be obtained from the South Dakota Medicine website or by calling 605.336.1965.

Additional questions or requests can be directed to Michael Dulitz at

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