Addressing the health disadvantage of rural populations: How does epidemiological evidence inform rural health policies and research?
Version of Record online: 4 MAR 2008
© 2008 The Authors
Australian Journal of Rural Health
Volume 16, Issue 2, pages 56–66, April 2008
How to Cite
Smith, K. B., Humphreys, J. S. and Wilson, M. G. A. (2008), Addressing the health disadvantage of rural populations: How does epidemiological evidence inform rural health policies and research?. Australian Journal of Rural Health, 16: 56–66. doi: 10.1111/j.1440-1584.2008.00953.x
- Issue online: 4 MAR 2008
- Version of Record online: 4 MAR 2008
- Accepted for publication 28 December 2007.
- developed country;
- health differential;
- health disadvantage;
- risk determinant;
- rural and remote
We reviewed evidence of any apparently significant ‘rural-urban’ health status differentials in developed countries, to determine whether such differentials are generic or nation-specific, and to explore the nature and policy implications of determinants underpinning rural-urban health variations. A comprehensive literature review of rural-urban health status differentials within Australia, New Zealand, Canada, the USA, the UK, and a variety of other western European nations was undertaken to understand the differences in life expectancy and cause-specific morbidity and mortality. While rural location plays a major role in determining the nature and level of access to and provision of health services, it does not always translate into health disadvantage. When controlling for major risk determinants, rurality per se does not necessarily lead to rural-urban disparities, but may exacerbate the effects of socio-economic disadvantage, ethnicity, poorer service availability, higher levels of personal risk and more hazardous environmental, occupational and transportation conditions. Programs to improve rural health will be most effective when based on policies which target all risk determinants collectively contributing to poor rural health outcomes. Focusing solely on ‘area-based’ explanations and responses to rural health problems may divert attention from more fundamental social and structural processes operating in the broader context to the detriment of rural health policy formulation and remedial effort.