What’s ‘rural’ about rural health? Introducing the Beyond Periphery model
There have been attempts in Sweden, Australia, Canada, and the UK to draw distinctions between different types of 'rural' areas for health planning and policy purposes. These distinctions have largely been ones of degree, with so-called 'remote' areas simply viewed as an extreme version of rural – with fewer people, greater distances between places, and more difficult access to services. More recently, a set of propositions has emerged which claims that more remote or sparsely populated areas are functionally different from 'standard' rural areas, and that these differences matter to activities like health services design, health workforce governance, and health professional education. The 'Beyond Periphery' model explains not only how rural communities differ from one another, but provides insights into how those differences impact things like workforce recruitment and retention and health service delivery. The model is based on eight 'Ds' which define rural areas – they are more or less Disconnected, Discontinuous, Diverse, Dynamic, Detailed, Distant, Dependent and Delicate. This seminar will offer some illustrations of the model as it has been researched in Australia, Sweden, Canada and Scotland, and provide 'food for thought' on how health systems design may better consider what is 'rural' about rural health."