Developing a conceptual understanding of rural health practice


Correspondence: Lisa Bourke, Department of Rural Health, PO Box 6500, Shepparton, Victoria 3632. Email:


Objective: This study presents a set of concepts underpinning rural practice that could assist teaching health and medical students.

Outcome: Five concepts, important in distinguishing rural health practice, are presented and discussed. These are rural–urban health differentials, access, confidentiality, cultural safety and team practice. Together these concepts impact the ways in which rural health professionals provide care, due to fewer services, greater distances, smaller populations, less choice of services and smaller workforce.

Conclusion: These concepts introduce students to some of the positive and negative aspects of rural practice, as well as opportunities for rural practitioners to have a diverse practice, to become involved in all aspects of health and to initiate change. They provide an understanding of rurality from which health students can learn from their practical experiences during rural placements.

What this paper adds?: The present study contributes to understanding rurality and its impact on rural health by the application of sociological concepts to rural health in Australia. The present study identifies five concepts important in understanding rural practice.

1. Health Differentials: The rural population is in some ways different and their health conditions can vary from the urban population.

2. Access: Rural residents have less access to services due to distance, cost, fewer services and smaller workforce.

3. Confidentiality: Confidentiality impacts on health consumers and practitioners because there is less anonymity and sometimes a faster flow of information in rural communities.

4. Cultural safety: Respecting the identity/ies and needs of everyone is important in rural health services because specialist services are fewer.

5. Team practice: Teamwork is vital in rural practice and can improve the management of health care.

Teaching these concepts should improve students’ understanding of rural health and expose them to some of the diversity, opportunities and challenges of rural practice.