By Siaw-Teng Liaw, Sue Kilpatrick, Australian Rural Health Education Network
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Extra resources for A Textbook of Australian Rural Health
Examples of factors that can affect the health of individuals include a local culture of drinking, availability of fresh fruit and vegetables, the local economy and the role of sport. Local health professionals need to know about the 34 Chapter 2 Understanding rural health — key concepts community, its support networks and any planned healthy activities. They can identify patterns in health and be proactive in addressing health problems (eg recognising that drought may lead to high rates of depression).
Rural and remote communities, particularly those smaller and more remote, have been subject over the past decade to social and economic drivers that to a large extent work against improving health and wellbeing, and therefore fail to close the gap in health outcomes between the city and the bush. Global economic forces and re-adjustment by the rural sector have put economic pressure on rural areas for some decades. The neoliberal policy orientation of many western governments over recent years has resulted in a diminished role for government and greater emphasis on the marketplace for allocating resources.
Although anecdotes of this type are a useful introduction, rural health needs to move beyond anecdotes, to be based on empirical evidence and theoretical understanding. Therefore the goal of this chapter is to outline some of the evidence and theory crucial to understanding rural health. The term ‘rural’ is used throughout this chapter to refer to areas with small population centres that are distanced from metropolitan centres. Most definitions are based on population size, such as the five levels of the Australian Standard Geographical Classification (ASGC), while others, such as the Accessibility/Remoteness Index of 31 A Textbook of Australian Rural Health Australia (ARIA) (Hugo 2002), incorporate access and distance to metropolitan areas.