The original of this paper was prepared as invited pre-reading for the Inaugural Rural Health Symposium held in Brisbane in July 2008 under the theme ‘The impact of “rurality” ’, sub-theme (a) Environmental determinants. The natural environment shapes human activity, both economically and socially. It also directly and indirectly influences health and well-being. People in rural and remote areas are more directly exposed to the natural environment than their urban counterparts. The built environment is largely a product of economic activity; thus, the built environment in rural areas tends to reflect the predominant primary industry/ies. The rural built environment presents many potential hazards and risks to health and well-being, particularly for those involved in the primary industries, which are either not present in urban areas, or are present on smaller or more contained scales. The natural and built environments also influence individuals' attitudes and behaviours, both positively and negatively.
The environmental determinants of rural health, therefore, can be considered in terms of the natural environment, the built environment and individuals' responses to environmental influences. This paper raises some of the common environmental determinants of rural health and well-being and briefly touches on what these mean for rural health service delivery.