Academic journal article Canadian Review of Social Policy

Health in Rural Canada

Academic journal article Canadian Review of Social Policy

Health in Rural Canada

Article excerpt

Health in Rural Canada Judith C. Kulig, Allison M. Williams Vancouver, BC: University of British Columbia Press, 2012.

Health in Rural Canada is an interdisciplinary collection that brings together the most current health research on rural, remote, and Indigenous communities. As the first comprehensive volume of its kind, it provides a much-needed resource for policy researchers, educators, students, policy makers, and professionals concerned with rural Canadian health issues. There is a great deal of breadth in this book, which presents research across Canada (although some provinces/territories are under-represented). Similarly, the authors represent a wide range of disciplines. The 27 chapters are organized into seven sections (rural health status, rural health human resources, rural health services delivery, rural health policy and research, rural health issues, First Nations in rural settings, and aging in rural contexts).

This book is a valuable resource simply for having compiled all this current health research in one place. However, it also makes an important contribution by offering new lenses through which to understand the research as well as explore its meanings for rural communities. The book seeks to create a paradigm shift, moving away from the dominant medical model preoccupied with deficits and expert solutions. Instead, it focuses on the strengths and resiliencies of rural communities as a means of addressing the gaps, deficits and challenges of various rural areas. The authors clearly advocate for solutions to come from those living in rural communities - the people in the best position to define the problems and their solutions. Policy approaches should be grounded in community strengths and resiliencies, grassroots approaches, and the diverse identities of rural inhabitants.

These ideas are all contained within the theme of "health and place" (developed in Chapter 1) and its three sub-themes, which provide the book's unifying framework. The first emphasizes the dynamic aspects of health and place, as many factors (i.e., social, economic, environmental, policy-related) affecting rural communities are continually creating change with potential health impacts. The second sub-theme highlights the uniqueness and heterogeneity of rural place. Diversity is considered with respect to gender, sexuality, different cultural groups, and socio-economic status, with a particular focus on Indigenous peoples and older adults. Finally, the third sub-theme looks at urban-rural differences. This urban-rural comparison is especially useful for readers more familiar with research on urban populations. Chapters 2 and 3 survey the rural health research and the rural-urban health gap respectively. Chapter 4 discusses variations in the provision and utilization of rural health services. Together, these chapters provide a comprehensive and current overview of Canadian research.

The second part of the book examines the difficulties of recruiting and retaining the rural health human resources needed for communities to work out their own health solutions. Chapter 5 calls for improved health human resource planning models to address important disparities in the geographic distribution of health professionals. Chapter 6 proposes an innovative, multisectorial model for a rural health training institute, drawing on interdisciplinary partnerships between education and practice settings. The following chapter then proposes continuing education as a means of recruitment, retention, and capacity building. Lastly, Chapter 8 suggests the benefits of a more community-based and holistic approach to mental health services rather than the individualistic medical model predominant in urban settings.

The next section, on rural health services delivery, emphasizes the theme of collaboration across sectors, disciplines, and jurisdictions. Chapter 9 discusses the essential role that such collaborations can have on improving access to services, while Chapter 10 addresses new technologies in rural health services. …

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