Food & Water featured

Health & welfare in a small farm future, Part 3

November 7, 2022

We debated the pitfalls of diving too deep into the likely politics, including the social policy, of small farm societies of the future under my last post. Maybe this post runs that risk. Or maybe it doesn’t dive deep enough. Anyway, here I’m going to broach under five headings a few aspects of social policy that I think small farm societies of the future will wrestle with – I hope without easy solutionism or false optimism. Then in my next post I’ll publish the draft chapter about social policy issues I cut from my book. And that will conclude this little cycle-within-a-cycle about human welfare in a small farm future.


It’s been put to me that arguments for a small farm future are disablist, because the physical demands of agricultural work are unsuitable for people with many kinds of disability. If I thought any other kind of future was feasible for most of humanity, perhaps this critique would trouble me more. As it is, I’d say the challenge is how to make a small farm future fit as well as possible with the needs of disabled people.

Lacking expertise in this myself, I think it’d be great if disability experts and activists applied themselves to this question. My opener for the debate would be to say that local, primarily horticulture-based food and fibre production is eminently suited to people with many kinds of disability, and societies more geared around it than our present one could actively mitigate or remove conditions that are quite disabling in our present urbanized and commodified world. Of course, it’s true that some disabilities preclude any significant physical farm work – but they don’t necessarily preclude the work of community connectivity, the other key component of community self-reliance. So again it’s possible that a small farm future offers richer opportunities than a commodity-capitalist future for disabled people as social connectors and for their own social connection.

There would remain people for whom neither option is possible and who would require a lot of care. This is a concern because it’s possible there will be less economic surplus or ‘slack’ available in a small farm future to enable such people to receive the care they need. But this is debatable – as discussed in previous posts, an end to serving the god of capital accumulation releases a lot of human time, which is what the severely disabled most need. Caring responsibilities would no doubt tend to fall disproportionately upon the families of those in need, and – within those families – upon women. The challenge, then, will be to spread the load more fairly. The challenge in contemporary welfare systems is exactly the same. In this sense, the daily care aspects of severe disability may not be much different in a small farm future.

Old age

For all the talk of overpopulation that dominates the conversation (talk that, incidentally, rarely acknowledges the impact of life expectancies rather than birth rates on human numbers), from a social policy perspective the bigger issue is that many countries face greatly increasing proportions of old people as the population boom of the mid-20th century followed by the more recent fertility crash works its demographic logic out across the life course.

Being old is not, of course, intrinsically a problem. But age is associated with increasing care needs of the kind I was just discussing and this may prove challenging. The good news in the medium term is that, among all the profound problems we’re bequeathing to later generations, a large population of dependent elderly people is not going to be one of them in most places. But it’s going to be a problem in the shorter term. Here in Britain, Liz Truss’s administration wasn’t in power long, but long enough to foreshadow several troubling future problems. One of them manifested in the tension between Home Secretary Braverman’s burning desire to reduce immigration and Prime Minister’s Truss’s burning desire to boost economic growth, prompting her to reach for the easiest policy lever on the latter front – increasing in-migration by young adult workers. Inasmuch as this aspect of Trussonomics might still win the day despite the eclipse of its eponymous originator, rich countries with ageing populations may turn out to be disadvantaged relative to poorer ones with younger populations. This will be part of the painful rebalancing toward the cycling of local resources (including labour) involved in the path to a small farm future.

Looking at a slightly younger part of the age distribution, an awful lot of care work and other activities that build and sustain local communities rests on the shoulders of what might be termed the ‘young elderly’ – that is, people aged, say, 58-75 (an inevitably arbitrary range I’ve carefully chosen so as to exclude me from it). Thank heavens for the young elderly! One of the reasons they can fulfil this role is because they’ve had the time over their life course to buy themselves out of serving capital accumulation. In small farm futures where that possibility is inherently restricted, perhaps the lower bound of the young elderly range could stretch down to such young ages that it includes even the likes of me. More community building. More wellbeing.


The education of young people in a small farm future raises many questions that I propose to leave for another time. Other than suggesting that it will need to be, well, pretty different from most present school and college curricula, here I’ll just make a couple of general points.

I think it’s a good idea for young people to have rich interactions with other people across the stages of the life-course rather than to spend a lot of time in large groups rigidly segregated by age. Hilary Cottam, whose book Radical Help I mentioned recently, likewise says that in her research with young people she found that they sought connections with the wider world and with people of other ages, yet “public services emphasise youth-only activities and spaces and so they break the natural links through which young people learn and flourish” (p.93).

It’s probably easier for young people to experience non-youth only activities and natural links in rural and agrarian settings, so that’s one possible benefit of a small farm future.

Another kind of youth programme – one that was quite widespread in Western European countries in the late 20th century, though now in decline – was compulsory community service, involving spending a year or two working in residential care facilities, farms and other occupations contributing to wider common good. Ecological thinkers like John Barry have called for its restoration and rollout. This strikes me as a good idea that could bring considerable benefit to young people themselves and to wider society. I don’t think it should necessarily be restricted only to young people, but it should definitely include them. It’s one way of complementing and perhaps of usefully limiting the power of the family. I will say a little more about it in my next post.

Slide Anything shortcode error: A valid ID has not been provided

Health and health care

This is probably the real raw nerve welfare question posed against arguments for a small farm future. It manifests especially at the heroic and high-tech end of the medical spectrum, as in Philip’s question under a recent post – “How would a low cost social-economic environment deliver, say proton beam therapy for cancer treatment – £250m for the two that are operate in the UK?”

I’ll provide an honest answer to that question in a moment (spoiler: “it probably wouldn’t”), but first I want to say a little about the health benefits of a small farm future and, more importantly, why Philip’s question, while reasonable, probably isn’t the best one to ask.

So first, assuming a good basic level of hygiene and public health, a distributist society of job-rich employment in low-energy local food and fibre production could have these health advantages over the present situation:

  • less inequality, social isolation and unemployment or underemployment, all of which we know are deeply causative of ill health
  • more exercise, dietary diversity and whole foods, all of which we know are deeply causative of good health
  • more distributed, less mobile populations with less use of antibiotics outside of human medical need, all of which are protective against infectious disease
  • less exposure to harmful agricultural and industrial pollutants
  • less exposure to high-energy, high-velocity machinery, hence protective against injury

So there are grounds for thinking that population health status could be considerably better in a small farm future. Nevertheless, a small farm future is no defence against individual bad health, and in view of its low-capital, deindustrialized character, it’s possible that the health care available in this situation will be inferior.

I’ll raise four questions for discussion on that point. First, could it be possible that health care in a small farm future wouldn’t necessarily be inferior, because we have the wrong image of what health care involves? Just as high-tech, low labour input, capital-intensive industrial farming isn’t superior to job-rich, skills-intensive agroecology, so the professions of medicine and nursing are fundamentally labour and skills intensive practices – might these survive in new guises or even prosper in a small farm future?

That question prompts the second one. It’s often assumed that effective contemporary health care emerged in lockstep with modern capitalist surplus generation. But can we separate the ‘modern’ from the ‘capitalist’? Though it’s not a panacea, the effectiveness of modern medicine stems in large part from its (‘reductionist’) cause-and-effect biological modelling – not an achievement of capitalism as such, but of modernity. So maybe a more important health care question about a low-capital small farm future is whether such a society can sustain this intellectual model and the kind of prioritization of resources it involves, than whether it can muster the liquid capital.

Prioritization of resources leads to the third question. I’ve often heard people say “I’d be dead if it wasn’t for modern medicine” as a kind of unanswerable final gambit for any alternative way of organizing human affairs. It may be true in any given case. Hell, it may even be true for me. But people enjoyed a reasonable lifespan in many nonindustrial societies, with three caveats – mortality was high for infants, women in childbirth and people in dense cities. A small farm future easily takes care of the latter, especially with a good grasp of basic water hygiene. The first two can largely be addressed via good anti-microbial hygiene, core medical skills and infectious disease prevention, possibly including vaccination. These are not high tech or capital intensive in the grand scheme of things, and in terms of avoidable years of life lost would be far and away the most important priorities for medical intervention in a small farm future.

In fact, a good deal of the burden of ill health today relates to chronic and community-related conditions that expert medical services are powerless to simply cure. Conditions such as diabetes, various forms of heart disease, hypertension and obesity are complemented by more mysterious presentations such as TATT (‘tired all the time’) and MUS (‘medically unexplained symptoms’) which account for about 30% of doctor visits in the UK. To quote Hilary Cottam again, TATT and MUS “are the codes of the twenty-first-century doctor trying to cope with the complex troubles of modern life: part physical, part mental, part spiritual, and deeply embedded in the wider cultural and economic pressures within which we live” (Radical Help, p.138).

Cottam reports research across the life course that shows medical interventions may improve a patient’s health status in the short run, but generally have little long-term impact in these chronic modern conditions. Perhaps, as the shamans of old-time cultures knew, what matters most is the patient’s proper integration into the wider community. Which I take to be an encouraging pointer to the possible good health available in a small farm future.

Still, ultimately I have to face Philip’s question. There are some medical interventions requiring super-expensive or high-tech therapies that probably won’t be available in a small farm future. There’s no way of saying it gently, and I don’t take it lightly. All the same, I do feel the need to put some qualifiers around it. Once again, I’d emphasize that we’re heading into a low capital and low energy future whether we like it or not. In this sense, the health outcomes that a wealthy citizen of North America or Western Europe expects today probably isn’t a relevant comparator. Besides, the decline of high-tech health care in the wealthy countries would barely dent global population health stats, and would probably be more than offset by the gains from agrarian localism worldwide.

I recall a figure from thirty years ago back in the days when I worked in the health policy sector that claimed something like a third of all health care expenditure was devoted to people in the last six months of their lives. I’ve been unable to locate a contemporary reference on that point, but if it’s true I suspect rethinking our priorities around life and death as part of the general rethink now needed about the place of humanity in the wider biosphere might sweeten the pill of a less salvation-oriented and more person/community-centred end-of-life care. As Giorgos Kallis puts it in his interesting book, Limits, “Western societies consider high life expectancy to be the ultimate indicator of social well-being … We are supposed to take care of ourselves in order to live as many years as possible. But why? We do not really know why. Living, for us, is the meaning of life, and we aim to extend it indefinitely” (p.91).

Should I be faced with a terminal diagnosis, maybe I’ll angrily disavow Giorgos’s words. Life wills itself. But human life also wills wisdom, and wisdom entails knowledge of limits that cannot be crossed.

Poverty, employment and social security

This touches on wider issues discussed in the previous couple of posts and that I’ll come back to when I get onto Part IV of my book in this blog cycle. So I’m going to keep it brief and simply offer this provocation for discussion. In many so-called ‘indigenous’ or ‘tribal’ societies, there is neither unemployment nor poverty as such, though the people may be judged materially poor by the standards of modern, high-energy, capitalist societies. Might the passing of such societies into a lower energy, postcapitalist small farm future create opportunities for people to likewise become indigenous to place and largely overcome the problems of poverty and unemployment? And if so, could it be compatible with other aspects of welfare I’ve discussed, like science-based health care?

Well, I believe that we’re heading into insecure times, and perhaps one other thing to be learned from several indigenous societies is that allaying insecurity is often neither possible nor, when overzealously pursued, desirable. But seeking to minimize certain insecurities is an understandable and indeed inevitable human trait. How we do so, and how we judge our efforts and those of others are the stuff of politics. And I’ll be exploring some aspects of that in future posts.

Chris Smaje

After studying then teaching and researching in social science and policy, I became a small-scale commercial veg grower in 2007. Nowadays, when I’m not writing about the need to design low-impact local food systems before they’re foisted on us by default, I spend my time as an aspiring woodsman, stockman, gardener and peasant on the small farm I help to run in Somerset, southwest England Though smallholding, small-scale farming, peasant farming, agrarianism – call it what you will – has had many epitaphs written for it over the years, I think it’s the most likely way for humanity to see itself through the numerous crises we currently face in both the Global North and South. In my writing and blogging I attempt to explain why. The posts are sometimes practical but mostly political, as I try to wrestle with how to make the world a more welcoming place for the smallholder. Chris is the author of A Small Farm Future: Making the Case for a Society Built Around Local Economies, Self-Provisioning, Agricultural Diversity, and a Shared Earth, and most recently, Saying NO to a Farm-Free Future: The Case for an Ecological Food System and Against Manufactured Foods.

Tags: building resilient societies, health and welfare, small farm future