Five key themes of the Rural Health Module
Rural and urban areas show different patterns of health indicators and these will be discussed
during the RHM Orientation. Ways of addressing these disparities can be considered under the five
key conceptual themes underpinning the RHM.
Access to Care – The availability of health services differs between rural and urban
areas. Access to health services may include availability, accessibility, accommodation,
affordability and acceptability (is the service there? when is it open?). Distance, cost,
choice, workforce, quality of care, resources and location of services are all relevant.
Demand for care may be acute.
Overlapping Relationships - In rural areas health professionals and patients will meet
each other socially as well and this has ramifications for confidentiality and anonymity,
especially when seeking care for sensitive issues such as sexual or mental health. The
nature of rural communities can either mean that patients have strong social supports
and relationships of some type with most others, or that they are easily marginalized,
excluded and labelled. Information in a small town flows very quickly, whether or not
it is reliable, and many patients will know each other (and so what they say about others
is critical). Also health professionals have a high profile in the community so may be
more susceptible to both praise and criticism. Overlapping relationships also refers to
the multiple roles a health professional may have within their work – private, public,
community, hospital – or within one role – curative, palliative, family support, patient
advocate, policy maker, etc.
Models of Rural Health Service Delivery - Models of health services in rural areas can be
innovative and adapted to local needs. These may involve inter-professional teams, the
integration of primary and acute care and the same health professional working in several
organizations. Rural services often provide multi-skilled staff, GP-run hospitals, shared
care, co-location, shared funding, transferable medical records, community ownership &
control and patient-centered care.
Interprofessional Team Practice – One of the strengths of rural health care is
interprofessional practice. It provides excellent patient outcomes as well as mutual support
and educational opportunities for health professionals. Rural health practice tends to be
generalist and multi-disciplinary rather than specialist. The networking among healthcare
providers allows personalized care for patients and improves communication and continuity of care.
Cultural Safety – Cultural safety is the provision of services to all people in a safe context, where all identities, choices and beliefs are accepted without judgment. Cultural safety requires health professionals to acknowledge their position of power, reflect on their judgments and communication styles, and be proactive about providing a safe service. In rural areas, where choice of service may be limited, culturally safe practice is especially important.