Topics

The theme is 'Building collaboration and excellence in rural and remote health research'. Through a focus on three specific topic areas it is expected that progress will be made towards both a better understanding of excellence in rural health research, and the development of collaborative research proposals in the selected topic areas.

The three topics are:

Topic 1:
The impact of changing rural demography on community and regional sustainability and on rural health and wellbeing

Demographic changes in Australia are set to have a major impact on health and health services outside its metropolitan areas. Australia continues to share in the global trend towards ‘urbanisation’, with people moving from overseas and within the country to capital cities and large regional centres. In Australia these population shifts will be balanced by significant movements to smaller and even quite remote places, driven by either lifestyle choices (so-called ‘sea-change’ and ‘tree-change’ decisions) or by the labour demands of the resources boom.

The net effect of these different movements, as measured by the proportion of people who live in ‘rural areas’ (outside the major cities and regional capitals), is hard to predict, but some things are clear. Coastal areas will experience different demographic patterns to those inland. Resource regions will differ from those with economies based on farming, tourism and service industries – the ‘patchwork’ or two-speed economy. Settlement patterns in Australia will continue to be affected by the general affluence of the nation, so that people will be able to exercise choices that will help to overcome the tyrannies of distance. As an example, the sustainability of rural communities will be influenced by the capacity of governments and individuals to pay for advanced information and communications technologies.

Health services located in or delivered to rural and remote areas will therefore have the challenge of succeeding in a widely divergent range of settings. Fly in, fly out and drive in, drive out work practices will grow in importance, including in the health sector itself.

This session will focus on the impacts of these demographic factors on rural and remote health care, social capital, culture and identity. Research projects will be defined to inform appropriate policy responses to this range of demographic effects.

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Topic 2:
The impact on community functioning and mental health of weather-related disasters and other adversity in rural and remote Australia.

Most scientists agree that Australia will experience worsening weather-related disasters and environmental adversity. Because such adversities are harmful for wellbeing, and because they disproportionately affect locations which already experience multiple adversities, mental health is especially at risk in rural and remote Australia. Despite policy and service reform, mental health problems remain as common, expensive and disabling as they were a decade ago. There is much that individuals can do to manage environmental adversities, and governments can also help. However, for the most part, communities do best when their members join together to solve these problems. This is partly because local problems need local solutions. More importantly, when communities come together for the common good, they create an opportunity to build social capital, a formidable mental health promotion and prevention strategy.

Increasing environmental adversity poses massive risks to individual and community wellbeing in rural and remote Australia and, therefore, to agricultural productivity, general economic success and social functioning. Further, adversity discriminates, causing most harm to people and places already facing the worst disadvantage. The economic, environmental and healthcare costs are potentially unmanageable in the long term. Neither individuals nor governments alone can solve these problems: a local level of action and intervention is necessary. Galvanising and sustaining effective community action is difficult. It will require support from different levels of government and scientific evaluation to understand what works and how. If successful, however, such investment could return phenomenal dividends for people and place – and a sustainable future for rural and remote Australia.

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Topic 3:
The impact of change in rural culture and society on the provision of rural health services and rural health.

This session will focus on associations between culture and health, and between culture and health services. It will bear witness to the diverse cultures in remote and rural Australia, including the cultures of Aboriginal and Torres Strait Islander peoples, those from culturally and linguistically diverse backgrounds, and the fact that culture pertains to everyone. Some rural ‘cultures’ and associations with health behaviours or access have been highlighted in research literature; for example, culture may be linked with beliefs and behaviours about health, wellbeing and illness, potentially affecting health status. Culture affects the way health information is communicated and received, affecting accessibility and equity. Concepts of ‘the other’ and differentiation are endemic to cultural discourse; lack of awareness of this impacts on health interactions.

Addressing issues around culture, cultural asymmetries and the diversity of cultures in relation to health is crucial for policymakers in designing flexible programs, interpreting evidence and data, and asking penetrating questions. Service providers need to know how best to provide services for diverse cultures, how to keep health professionals aware of cultural diversity and how to bring coherence to communities around understanding of each other’s issues and mutually supportive behaviours. Communities and citizens need to understand the concept of culture, what it means and their role in addressing health problems caused by cultural difference and lack of understanding.

This session will ask what we know about how cultures affect health, health behaviours and accessibility in rural and remote Australia, what are the gaps and what are the key research questions to be addressed.

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