What is the current status of rural health research in Canada?

"In order to describe the current status of rural health research in Canada, one needs to know what 'rural' means. Like 'health', 'rural' is not a cut-and-dried concept. As Pitblado and associates have pointed out, there are many definitions and no one definition is universally accepted. For most official purposes, however, the Statistics Canada definition of rural is used, which refers to people living outside the commuting zones of larger urban centres, especially outside Census Metropolitan Areas (with populations of 100,000 or more) and Census Agglomerations (with populations of 10,000 - 99,999). Others prefer the OECD definition or a definition based on postal codes. Most people agree that 'rural' includes northern communities, because much of the Canadian north is sparsely populated and very isolated. Others believe that some remotely located cities, which may not fit the official definition of rural, are in fact rural in terms of geographical isolation, economic and labour force characteristics and access to services and amenities. Thus, approximately one-quarter to about one-third of the population can be considered rural, depending on whether the Statistics Canada definition or a less restrictive definition is used. In other words, as many as 10 million Canadians are rural residents.....

"It is not just the size of the rural population that is significant. Equally important is the fact that rural Canadians have many serious and protracted health problems that need to be better understood and resolved with the help of research. On the basis of data from the Quebec Health Survey, Pampalon has noted a trend toward a progressive deterioration in health status as one moves from areas around urban centres to the remote hinterland. Johnson et al. have documented the much poorer health status in northern Ontario, the large but mostly rural region of the province. Similarly, using national data, Statistics Canada has convincingly shown that life expectancy is considerably lower in remote, northern regions than in the rest of the country.....

"Because the health problems confronting rural Canada are serious, complex and changing, research should have a critical role to play in examining the nature of these problems, monitoring their progress or deterioration, identifying their causes, finding solutions and evaluating the effectiveness of interventions. However, in terms of support, rural health research has received mostly benign neglect. It is not that there is no rural health research. As a matter of fact, there are many rural health researchers and numerous studies on a broad range of rural health topics. However, rural health researchers have tended to work in relative isolation, just like the people and communities they study. Not surprisingly, the collective impact of such highly distributed activities tends to be reduced and diffused. It has also resulted in considerable duplication of effort and research gaps not being filled. In sum, the major weakness of rural health research is that it is not carried out in a coordinated, coherent and programmed manner. "All this notwithstanding, the situation appears to be changing for the better. Rural health has received considerable national attention and steps have been taken to address some of the issues. These include:

Special initiatives in almost every province to recruit and retain rural physicians.

Rural medicine programs in many medical schools (examples include the Rural Program in the Department of Family Medicine, University of Calgary: the Community Based Rural Residency Program in the Department of Family Practice. University of British Columbia; the Northeastern Ontario Family Medicine Program in Sudbury, Ontario; and the Southwestern Ontario Rural Medicine at the University of Western Ontario).

A number of rural nursing programs (examples include the Certificate in Rural and Northern Nursing Program at the University of British Columbia and the Northern Clinical Practice Program at Lakehead University).

Special committees in some professional organizations to address issues concerning rural practice (for instance, the College of Family Physicians of Canada has the Committee on Rural Family Practice and the Canadian Association of Emergency Physicians has the Rural and Small Town Committee).

The founding of the Society of Rural Physicians of Canada.

The creation of the Aboriginal Health Institute and the Office of Rural Health at Health Canada.

The emergence of various organizations dedicated to improving the health and well-being of rural residents such as the Canadian Coalition for Agricultural and Rural Safety and Health and the Canadian Rural Revitalization Foundation.

"There are a number of university-based research centres with a mandate to conduct research on various aspects of rural health. These include the Centre for Agricultural Medicine at the University of Saskatchewan, the Canadian Agricultural Injury Surveillance Program at Queen's University, the Northern Health Research Unit at the University of Manitoba, the Canadian Circumpolar Institute at the University of Alberta and the Centre for Rural and Northern Health Research at Laurentian and Lakehead Universities (the Centre for Rural and Northern Health Research is a conjoint research centre based at Laurentian University in Sudbury and Lakehead University in Thunder Bay, Ontario). A number of new rural health research centres are in the offering at the Memorial University of Newfoundland and the University of Northern British Columbia. Additionally, a considerable number of rural health research activities take place at the University of Guelph, the University of Lethbridge and other postsecondary educational institutions. Other favourable developments include the publication of the Canadian Journal of Rural Medicine and the hosting of several major conferences on rural health in recent years. Examples include the Fourth International Symposium on Rural Health and Safety in a Changing World (Saskatoon, 1998); the 'Health in Rural Settings: From the Ground Up' conference (Lethbridge, 1998) and the First International Congress on Rural Nursing (Saskatoon, 1998)."

From: Raymond W. Pong (2000). Rural Health Research in Canada: At the Crossroads. Australian Journal of Rural Health 8:261-265