Abstract
BackgroundRural health outcomes are often worse than their urban counterparts. While rural health theory recognizes the importance of the social determinants of health, there is a lack of insight into public perspectives for improving rural health beyond the provision of health‐care services. Gaining insight into perceived solutions, that include and go beyond health‐ care, can help to inform resource allocation decisions to improve rural health.ObjectiveTo identify and describe shared perspectives within a remote‐rural community on how to improve rural health.MethodUsing Q methodology, a set of 40 statements were developed representing different perceptions of how to improve rural health. Residents of one remote‐rural island community ranked this statement set according to their level of agreement. Card‐sorts were analysed using factor analysis to identify shared points of view and interpreted alongside post‐sort qualitative interviews.ResultsSixty‐two respondents participated in the study. Four shared perspectives were identified, labelled: Local economic activity; Protect and care for the community; Redistribution of resources; and Investing in people. Factors converged on the need to relieve poverty and ensure access to amenities and services.Discussion and conclusionsFactors represent different elements of a multifaceted theory of rural health, indicating that ‘lay’ respondents are capable of comprehending various approaches to health improvement and perspectives are not homogenous within rural communities. Respondents diverged on the role of individuals, the public sector and ‘empowered’ community‐based organizations in delivering these solutions, with implications for policy and practice.Public ContributionMembers of the public were involved in the development and piloting of the statement set.
Highlights
Rural health outcomes are often worse than their urban counterparts, especially concerning mental health, with life expectancy in ‘developed’ countries being lower in rural communities.[1]
The aim of this paper is to identify and describe the shared perspectives of residents of one remote-rural island community in Scotland, on how to improve rural health
This study identified four shared perspectives on how to improve rural health
Summary
Rural health outcomes are often worse than their urban counterparts, especially concerning mental health, with life expectancy in ‘developed’ countries being lower in rural communities.[1]. A theoretical basis for understanding and analysing rural health emphasizes the influence of local cultures, amenities and health-care services as well as their interactions with broader health systems.[2,4]. While rural health theory recognizes the importance of the social determinants of health, there is a lack of insight into public perspectives for improving rural health beyond the provision of health-care services. Objective: To identify and describe shared perspectives within a remote-rural community on how to improve rural health. Method: Using Q methodology, a set of 40 statements were developed representing different perceptions of how to improve rural health. Discussion and conclusions: Factors represent different elements of a multifaceted theory of rural health, indicating that ‘lay’ respondents are capable of comprehending various approaches to health improvement and perspectives are not homogenous within rural communities. Public Contribution: Members of the public were involved in the development and piloting of the statement set
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