Broadening the narrative on rural health: from disadvantage to resilience

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Paul A Peters



What is the common conception of “rural”? We’re likely to picture someone Canadian-born, employed in the resource industry, perhaps with some emerging chronic conditions. Maybe instead we picture grandparents on a family farm, working to continue making a living in the face of agricul- tural change. Or, we may think of a young family with a hobby farm who enjoys the outdoors and is seeking space away from the city. The reality is that within rural communities there are all of these stories and more.

This brief commentary seeks to highlight issues facing rural health research that are drawn from broad perspectives outside of medical health research. My outlook on rural health is one that takes the whole individual and entire community into consider- ation, and moves beyond the dataset and outside the clinic. There is a tendency within health and medical research to stay within nar- row silos rather than looking outside for new insights into practice and research.1 However, as this discussion will show, the study of rural health is necessarily inter-disciplinary and requires ‘borrow- ing’ methods and theories from a range of disciplines including epidemiology, sociology, psychology, geography, and economics.

A wide range of literature has shown that the health needs fac- ing people in rural regions and communities are unique.2 There are documented differences in health behaviours, health literacy, perceived health, and health outcomes within and between rural regions and rural communities.3 The reasons for these differences are broad and not necessarily well understood. While geographic accessibility is most often thought of as the primary driver, dif- ferences go beyond simple distance and include demographic changes, economic restructuring, neoliberalism and globalization, changing working conditions, and continued reduction in health and social services.