A PheWAS Analysis of the Risks and Benefits of Growing Up on a Farm

Growing up on a farm presents a health paradox, with increased risks of injuries but some purported benefits. This study estimated differences in the burden of medical comorbidities between youth who live versus do not live on farms. No a priori hypotheses were tested.

A phenome-wide association study (PheWAS) was used in a cohort of youth in north-central Wisconsin. Those who lived on farms were matched (1:3) to a non-farm comparison group. Outcomes included a comprehensive set of diagnoses (Phecodes) that occurred between 2017 and 2021. PheWAS analyses included logistic regression models of Phecode associations with farm residency.

There were 36 Phecodes that significantly differentiated the two groups. Youth who lived on farms had significantly higher odds of agricultural injury, dermatophytosis, spinal neuritis, and strabismus compared to non-farm youth. Remaining Phecodes indicated protection in the farm group. Notably, relative to the non-farm group, farm youth had a 20%-30% lower odds of respiratory illnesses, as well as 30%-40% lower odds of mental health and neurological conditions.

This was the first known study to utilize a PheWAS approach to comprehensively compare medical comorbidities in farm versus non-farm youth. Findings confirmed the known injury hazards in farm youth, but there appeared to be more health benefits of living on farms. Some of these apparent protections were novel, particularly those related to affective disorders, but require future confirmatory testing to understand how care seeking behaviors may also influence farm and non-farm households.