Should Canada have an Institute for Rural Health Research?

"Rural health research in Canada has reached a new threshold. Although devoid of substantial and sustained support from major research granting bodies, it has accomplished much. Conducted by researchers in a variety of disciplines and in research centres, universities and health care agencies across the county, numerous studies have been done which address many important rural health issues. They range from basic to applied research and from the micro to the macro level. However, rural health research activities tend not to be well coordinated, integrative and programmed. Despite its incipient strength and immense potential, for rural health research to make further progress and to have a greater impact on the health of the rural population, it needs support. The creation of the Canadian Institutes of Health Research (CIHR) is most opportune because what the CIHR stands for is exactly what rural health research needs: collaboration among research sectors and researchers, an integrative and inclusive approach in research, emphasis on research excellence and a focus on research for the purpose of improving the health and well-being of Canadians. The CIHR has an opportunity to give rural health research in Canada the needed impetus, identity and wherewithal to ensure its further development.

"We believe the best way to advance rural health research in Canada is to create an Institute for Rural Health Research under the CIHR. This would allow rural health research to enjoy the same kinds of financial and infrastructure support that have been accorded other areas of health research. It would also allow rural health researchers from diverse disciplines and research sectors to collaboratively find solutions to some pressing rural health problems. Although the Institute for Rural Health Research is meant to be a stand-alone institute, it is designed to be truly cross-cutting in nature. Research conducted under its auspices will be cross-discipline, cross-sector, cross-region, cross-institute and cross-issue. A modest investment in rural health research, we are confident, will help improve rural health by providing the data and evidence needed to make informed clinical and policy decisions. An annual budget of $20 million, rising incrementally to $40 million by the fifth year, has been proposed for the five-year developmental and consolidation phase.

"Although it is our belief that an Institute for Rural Health Research under the CIHR is the best option, we realize there may be constraints that would prevent the creation of a stand-alone Institute at this time. Other viable options exist, one of which is the creation of a larger entity to be named the Health of Populations Research Institute. Rural health research and other areas of research which target populations that have special needs or that require special interventions could come under the Health of Populations Research Institute. Rural health research, however, has to maintain its unique identity within this larger entity in order for it to be viable.

"We also realize that rural health research has some catching up to do in order to achieve research integration, to build up the necessary infrastructure and to have a more substantial critical mass of researchers. To this end and adhering to the transformative principle, we propose that the first five years of the Institute for Rural Health Research, or the Health of Populations Research Institute, be considered a developmental and consolidation phase. At the end of the five-year period, an objective review of its performance will be conducted which will, among other things, determine the future course of rural health research and how it will be situated in the CIHR.

"The creation of the CIHR has generated a lot of excitement and expectations. Researchers, including rural health researchers, are excited about the expanded opportunities in health research. At the same time, researchers, particularly rural health researchers, expect the CIHR to chart a new course in health research by setting a research agenda that addresses the health needs of all Canadians, by supporting areas of health research which need to be strengthened, by being innovative and pro-active in its decision-making and by bringing the health research community together through an integrative and inclusive approach."

From: Raymond W. Pong et al. (1999). Rural health research in the Canadian Institutes of Health Research. (A position paper prepared for the Canadian Health Services Research Foundation and the Social Sciences and Humanities Research Council.) Sudbury, Ontario: Centre for Rural and Northern Health Research, Laurentian University.