Rural health

In medicine, rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments. The concept of rural health incorporates many fields, including wilderness medicine, geography, midwifery, nursing, sociology, economics, and telehealth or telemedicine.

Rural populations often experience health disparities and greater barriers in access to healthcare compared to urban populations. Globally, rural populations face increased burdens of noncommunicable diseases such as cardiovascular disease, cancer, diabetes, and chronic obstructive pulmonary disorder, contributing to worse health outcomes and higher mortality rates. Factors contributing to these health disparities include remote geography, increased rates of health risk behaviors, lower population density, decreased health insurance coverage among the population, lack of health infrastructure, and work force demographics. People living in rural areas also tend to have less education, lower socioeconomic status, and higher rates of alcohol and smoking when compared to their urban counterparts. Additionally, the rate of poverty is higher in rural populations globally, contributing to health disparities due to an inability to access healthy foods, healthcare, and housing.

Many countries have made it a priority to increase funding for research on rural health. These research efforts are designed to help identify the healthcare needs of rural communities and provide policy solutions to ensure those needs are met.

There is no international standard for defining rural areas, and standards may vary even within an individual country. The most commonly used methodologies fall into two main camps: population-based factors and geography-based factors. The methodologies used for identifying rural areas include population size, population density, distance from an urban centre, settlement patterns, labor market influences, and postal codes.

The reported number of individuals living in rural areas can vary greatly depending on which set of standards is applied. Canada's rural population can be identified as anywhere from 22% to 38% of the population. In the United States the variation is greater; between 17% and 63% of the population may be identified as living in rural areas. The lack of consensus makes it difficult to identify the number of individuals who are in need of rural healthcare services.

Rural areas within the U.S. have been found to have a lower life expectancy than urban areas by approximately 2.4 years. Rural U.S. populations are at a greater risk of mortality due to non-communicable diseases such as heart disease, cancer, chronic lower respiratory disease, and stroke, as well as unintentional injuries such as automobile accidents and opioid overdoses compared to urban populations. In 1999, the age-adjusted death rate was 7% higher in rural areas compared to urban areas. However, by 2019 this difference had widened, with rural areas experiencing a 20% higher death rate compared to in urban areas. There is some evidence to suggest that the gap may be widening as more public health resources are directed away from rural areas towards densely populated urban areas.

These trends are also observed on a global scale, as rural communities are more likely to have lower life expectancies than urban counterparts. Data collected from 174 countries found the maternal mortality rate to be 2.5 times higher in rural areas compared to urban areas. Additionally, the likelihood that a child born in a rural area will die before the age of 5 is 1.7 times higher than a child born in an urban area. Factors contributing to the increased risk of maternal and child mortality include healthcare worker shortages, as well as a lack of health facilities and resources in rural areas.

People in rural areas generally have less access to healthcare than their urban counterparts. Fewer medical practitioners, mental health programs, and healthcare facilities in these areas often mean less preventative care and longer response times in emergencies. Geographic isolation also creates longer travel times to healthcare facilities, acting as a barrier to accessing care in rural communities. The lack of resources in rural areas have resulted in utilization of telehealth services to improve access to speciality care, as well as mobile preventative care and treatment programs. Teleheath services have the potential to greatly improve access to providers in remote areas, however, barriers such as lack of stable internet access create disparities to accessing this care. There have also been increased efforts to attract health professionals to isolated locations, such as increasing the number of medical students from rural areas and improving financial incentives for rural practices.