Rural health

In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine. In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine. Research shows that the healthcare needs of individuals living in rural areas are different from those in urban areas, and rural areas often suffer from a lack of access to healthcare. These differences are the result of geographic, demographic, socioeconomic, workplace, and personal health factors. For example, many rural communities have a large proportion of elderly people and children. With relatively few people of working age (20–50 years of age), such communities have a high dependency ratio. People living in rural areas also tend to have poorer socioeconomic conditions, less education, higher rates of tobacco and alcohol use, and higher mortality rates when compared to their urban counterparts. There are also high rates of poverty amongst rural dwellers in many parts of the world, and poverty is one of the biggest social determinants of health. Many countries have made it a priority to increase funding for research on rural health. These efforts have led to the development of several research institutes with rural health mandates, including the Centre for Rural and Northern Health Research in Canada, Countryside Agency in the United Kingdom, the Institute of Rural Health in Australia, and the New Zealand Institute of Rural Health. These research efforts are designed to help identify the healthcare needs of rural communities and provide policy solutions to ensure those needs are met. The concept of incorporating the needs of rural communities into government services is sometimes referred to as rural proofing. There is no international standard for defining rural areas, and standards may vary even within an individual country. The most commonly used methodologies fall into two main camps: population-based factors and geography-based factors. The methodologies used for identifying rural areas include population size, population density, distance from an urban centre, settlement patterns, labor market influences, and postal codes. The reported number of individuals living in rural areas can vary greatly depending on which set of standards is applied. Canada’s rural population can be identified as anywhere from 22% to 38%, of the population. In the United States the variation is greater; between 17% and 63% of the population may be identified as living in rural areas. The lack of consensus makes it difficult to identify the number of individuals who are in need of rural healthcare services. Studies show that in many parts of the world life expectancy rates are higher in urban areas than in rural areas. There is some evidence to suggest that the gap may be widening in these countries as economic conditions and health education has improved in urban areas. In Canada, life expectancy in men ranged from 74 years in the most remote areas to 76.8 years in its urban centers. For women, life expectancy was also lowest in rural areas, with an average of 81.3 years. Those living in rural areas adjacent to urban centers also experience higher life expectancies (with men at 77.4 years and women at 81.5 years). Australian life expectancies ranged from 78 years in major cities to 72 years in remote locations. In China, the life expectancy of females is 73.59 years in urban areas and 72.46 in rural areas. Male life expectancy varies from 69.73 years in urban areas and 58.99 in rural areas. However, there are countries such as the United Kingdom, where life expectancy in rural areas exceeds that of urban areas. Life expectancy there is two years greater for men and one-and-a-half years greater for women in rural areas when compared to urban areas. This may be due, in part, to smaller economic disparities in rural areas as well as an increasing number of well-educated and wealthy individuals moving to rural areas in retirement. This is a significant departure to the rural poverty found in many countries. People in rural areas generally have less access to healthcare than their urban counterparts. Fewer medical practitioners, mental health programs and healthcare facilities in these areas often mean less preventative care and longer response times in emergencies. The lack of healthcare workers has resulted in unconventional ways of delivering healthcare to rural dwellers, including medical consultations by phone or internet as well as mobile preventative care and treatment programs. There have been increased efforts to attract health professionals to isolated locations, such as increasing the number of medical students from rural areas and improving financial incentives for rural practices.