Abstract
Residents of rural and remote Australia have poorer health outcomes than their metropolitan counterparts. A major contributor to these health disparities is chronic and severe health workforce shortages outside of metropolitan areas—a global phenomenon. Despite emerging recognition of the important influence of place-based social processes on retention, much of the political attention and research is directed elsewhere. A structured scoping review was undertaken to describe the range of research addressing the influence of place-based social processes on turnover or retention of rural health professionals, to identify current gaps in the literature, and to formulate a guide for future rural health workforce retention research. A systematic search of the literature was performed. In total, 21 articles were included, and a thematic analysis was undertaken. The themes identified were (1) rural familiarity and/or interest, (2) social connection and place integration, (3) community participation and satisfaction, and (4) fulfillment of life aspirations. Findings suggest place-based social processes affect and influence the retention of rural health workforces. However, these processes are not well understood. Thus, research is urgently needed to build robust understandings of the social determinants of rural workforce retention. It is contended that future research needs to identify which place-based social processes are amenable to change.
Highlights
Residents of rural and remote Australia have poorer health outcomes than their metropolitan counterparts [1]
What are the types of place-based social processes impacting turnover and/or retention of rural health professionals identified in existing literature? Secondly, what is currently known through research about how these processes influence retention? To collate, summarize, synthesize, and report on the literature identified, a thematic analysis was undertaken
This review described the range of literature that addresses the influences of place-based social processes on the retention of allied health, nursing, and/or medical professionals in rural communities
Summary
Residents of rural and remote Australia have poorer health outcomes than their metropolitan counterparts [1]. Compared to metropolitan-based residents, those in rural and/or remote areas of Australia live shorter lives, acquire greater levels of chronic disease, sustain more injuries, experience poorer mental health, and have less access to and use of health services [1]. Given that a high proportion of Indigenous Australians live in rural and remote Australia, health disparities between metropolitan and rurally based residents reflect health inequities between Indigenous and non-Indigenous. A major contributor to reduced access to and use of health services by rural residents in particular is a chronic and severe health workforce shortage outside of metropolitan Australia [3,4]. Public Health 2019, 16, 314; doi:10.3390/ijerph16030314 www.mdpi.com/journal/ijerph
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