Canadians living in rural communities are diverse, with individual communities defined by unique strengths and challenges that impact their health needs. Understanding rural health needs is a complex undertaking, with many challenges pertaining to engagement, research, and policy development. In order to address these challenges, it is imperative to understand the unique characteristics of rural communities as well as to ensure that the voices of rural and remote communities are prioritized in the development and implementation of rural health research programs and policy. Effective community engagement is essential in order to establish rural-normative programs and policies to improve the health of individuals living in rural, remote, and northern communities.
This report was informed by a community engagement workshop held in Golden Lake, Ontario in October 2019. Workshop attendees were comprised of residents from communities within the Madawaska Valley, community health care professionals, students and researchers from Carleton University in Ottawa, Ontario, and international researchers from Australia, Sweden, and Austria. The themes identified throughout the workshop included community strengths and initiatives that are working well, challenges and concerns faced by the community in the context of health, and suggestions to build on strengths and address challenges to improve the health of residents in the Madawaska Valley.
The small size coupled with remoteness of rural communities in Canada, Australia, and Sweden introduce challenges in accessing sufficient health services (1-3). The sparse health services in rural areas impose “the tyranny of distance” on rural and remote populations, necessitating lengthy travel times to receive care. Despite the increased challenges rural communities face, a dearth of research on rural health persists, particularly rural youth health (4,5).
A broad scoping review was undertaken to identify literature regarding rural youth health in Canada, Australia, and Sweden. The studies were coded according to
population focus, health focus, access, and general. The scoping review produced the Rural Youth Health Scoping Review Database, which provides an overview of the available research on rural youth health.
Rural and remote communities in both Australia and Canada have a higher burden of mental illness relative to their urban counterparts. Suicide rates, particularly, are higher across all age groups among men in rural communities as compared to metropolitan areas. Mental health issues are especially present in younger populations within these communities. Additionally, rural and remote communities tend to have higher proportions of Indigenous origin individuals, who face additional challenges and service barriers.
Rural and remote communities often encounter significant barriers to accessing mental health care. Individuals from these communities may be serviced solely by general health care providers that are not trained in mental health treatment. Travelling away from the community to alleviate this issue only further hinders accessibility as these individuals must travel larger distances to access specialized health services. When services are accessed, those from rural and remote communities are met with longer wait times than their urban counterparts. With no specialized treatment within the rural or remote community and inaccessible treatment outside the community, mental health care must shift to informal caregivers and the community as a whole.
Rural and remote communities are often not trained in mental health care. Interventions to address rural and remote youth mental health are needed to equip communities with the tools and skills to overcome access barriers and support community members. A review of recent literature related to rural and remote youth mental health interventions was conducted. The aim of the review is to characterize these mental health interventions in Australia and Canada and examine how they relate to youth.
Rural and remote communities in Australia and Canada experience barriers to accessing healthcare services (1). These barriers are especially pronounced when attempting to access more specialized health care services, such as paediatric (2–4). Both countries have implemented programs that aim to bridge the gap between rural communities and specialized healthcare. One such service is telepaediatrics.
Telepaediatrics, as part of telehealth, refers to any paediatric health-related service, network, or medical tool that transmits voice, data, images and information through telecommunication programs as part of providing health services (5–7). Telehealth services are ideal because they remove the need to relocate the rural patient to urban specialist sites (5–7).
In a WHO survey (2010), 60% of member countries had telehealth services in place but only 30% of these programs were implemented as part of routine care (8). Only 3 member countries had established telepaediatric services in place (8). No previous investigations examine the use of telehealth programs in urban versus rural settings (8). This review aims to identify the common barriers to telepaediatric services in rural Australia and Canada and outlines suggestions for future implementation.
Although health care is widely accessible in most developed countries, rural areas often struggle to adequately meet health care needs. Challenges in accessing and receiving adequate health care introduce large variations in disease levels, level of treatment, life expectancy,and overall health status for rural populations. eHealth, or electronic health,defined here as any electronic medium used to access health services,is a method used to bridge the gap between rural and urban centers to improve health care access. Including the above definition, eHealth also includes any technology designed to improve efficiencies and reduce costs in relation to health care. By providing a comprehensive overview of feedback from past interventions, policy-makers and program developers can develop strategies to improve the implementation and the use of eHealth technologies.