Abstract
A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing economic and social challenges, there is much to understand about the impact of adversity on mental health and wellbeing in rural populations. In this conceptual paper, we aim to review and adapt our existing understanding of rural adversity. We undertook a wide-ranging review of the literature, sought insights from multiple disciplines and critically developed our findings with an expert disciplinary group from across Australia. We propose that rural adversity be understood using a rural ecosystem lens to develop greater clarity around the dimensions and experiences of adversity, and to help identify the opportunities for interventions. We put forward a dynamic conceptual model of the impact of rural adversity on mental health and wellbeing, and close with a discussion of the implications for policy and practice. Whilst this paper has been written from an Australian perspective, it has implications for rural communities internationally.
Highlights
A growing body of literature recognises the profound impact of adversity on the mental health outcomes for people living in rural, regional and remote areas [1,2].Mental health is integral to our overall health and how we function in society [3]
We propose a dynamic conceptual model to demonstrate how rural adversity may impact on mental health and wellbeing in rural and remote communities and where interventions impact on mental health and wellbeing in rural and remote communities and where interventions may be Thisrevised revisedmodel modeldraws drawsupon upon earlier research about prolonged
The model assumes a rural mental health ecology perspective with an analysis of the types and impacts of life-course, rural and systemic adverse events and a range of interventions that may mitigate the impacts on mental health and wellbeing
Summary
A growing body of literature recognises the profound impact of adversity on the mental health outcomes for people living in rural, regional and remote areas (referred to as ‘rural’ forthwith) [1,2].Mental health is integral to our overall health and how we function in society [3]. A growing body of literature recognises the profound impact of adversity on the mental health outcomes for people living in rural, regional and remote areas (referred to as ‘rural’ forthwith) [1,2]. Recognising that rural health outcomes are often poorer than those achieved in large cities [6], Bourke et al, 2012, produced a framework to understand the drivers of rural health outcomes in Australia in different rural contexts [7]. This six-factor framework highlights that, when compared with urban settings, rural places are impacted by geographic locality, ‘rural locale’ Public Health 2020, 17, 7205; doi:10.3390/ijerph17197205 www.mdpi.com/journal/ijerph
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