Rural Small Towns Research Articles

Community-oriented action and wellbeing: Looking back to look forward

ABSTRACT Through the lens of interactional field theory, we examine what has been learned about community dynamics, particularly community-oriented action and its relationship with community satisfaction, quality of life, and wellbeing. We first discuss eight previously unpublished analyses of community-oriented action and wellbeing in various forms. Then, we look to new data from the Utah Wellbeing Project which provides a considerably larger set of localities that range from small rural towns to rapid growth and large cities. While greater participation in community-oriented action correlates with higher levels of wellbeing in some cases, there are nuances that suggest more attention is needed to changes over time and across different contexts. We conclude with new recommendations related to interactional field theory and the future of community-oriented action research more broadly.

Mid-career graduate practice outcomes of the James Cook University medical school: key insights from the first 20 years.

Previous studies demonstrate early-career James Cook University (JCU) medical graduates are more likely to practise in regional, rural and remote areas than other Australian doctors. This study investigates whether these practice patterns continue into mid-career, identifying key demographic, selection, curriculum and postgraduate training factors associated with rural practice. The medical school's graduate tracking database identified 2019 Australian practice location data for 931 graduates across postgraduate years (PGY) 5-14, which were categorised into Modified Monash Model (MMM) rurality classifications. Multinominal logistic regression was undertaken to identify specific demographic, selection process, undergraduate training and postgraduate career variables associated with practice in a regional city (MMM2), large to small rural town (MMM3-5) or remote community (MMM6-7). One-third of mid-career (PGY5-14) graduates were working in regional cities, mostly in North Queensland, with 14% in rural towns and 3% in remote communities. These first 10 cohorts were undertaking careers in general practice (n=300, 33%), as subspecialists (n=217, 24%), rural generalists (n=96, 11%), generalist specialists (n=87, 10%) or hospital non-specialists (n=200, 22%). The findings show positive outcomes from the first 10 JCU cohorts for regional Queensland cities, with a significantly higher proportion of mid-career graduates practising regionally compared with the overall Queensland population. The proportion of JCU graduates practising in smaller rural or remote towns is similar to the overall Queensland population. The establishment of the postgraduate JCUGP Training program and the Northern Queensland Regional Training Hubs for building local specialist training pathways should further strengthen medical recruitment and retention across northern Australia.

Pluvial Flash Flood Hazard and Risk Mapping in Croatia: Case Study in the Gospić Catchment

Since the beginning of the 21st Century, Europe has been affected by destructive floods. European Union Member States have an obligation to develop flood hazard and flood risk maps as support to the Flood Risk Management Plan (FRMP). The main objective of this study is to propose a methodological framework for hazard and risk assessment of pluvial flash floods in Croatia at the catchment level, which can be integrated into the FRMP. Therefore, a methodology based on the source–pathway–consequence approach for flood risk assessment is presented, which complies with the EU Floods Directive. This integrated and comprehensive methodology is based on high-resolution open data available for EU Member States. Three scenarios are defined for a low, medium, and high probability, defined by design storms of different durations. The proposed methodology consists of flood hazard analysis, vulnerability assessment, and risk analysis. Pluvial flash flood hazards are analyzed using a 2D hydrologic–hydraulic model. The flood vulnerability assessment consists of a GIS analysis to identify receptors potentially at risk of flooding and an assessment of susceptibility to potential flood damage using depth–damage curves. Flood risk is assessed both qualitatively in terms of risk levels and quantitatively in terms of direct damages expressed in monetary terms. The developed methodology was applied and tested in a case study in the Gospić catchment in Croatia, which surrounds a small rural town frequently affected by pluvial flash floods.

Beslaag, fleuris en roeeëdfônk. Een analyse van het doodsoorzakenpatroon in Maaseik, 1881-1885

In late 19th century Maaseik, a small rural town in Belgian Limburg, individual cause of death registers have been preserved until today. This is very unusual, since the registers were often destroyed because of privacy reasons. In this research I examine the cause of death pattern in adults and elderly people in Maaseik during the years 1881-1885, using descriptive statistics. During this period 475 deaths were reported and for 76 percent of them, the cause of death and other information about the persons in question are available. I look at the mortality of Maaseik with reference to three prominent theories in historical mortality research: the urban mortality penalty, the epidemiological transition theory and social inequality in mortality. Statistical analyses shows that the urban mortality penalty was also present in a small town as Maaseik, even though the environment was overall healthier than in highly industrialized or urbanized areas. With regard to the epidemiological transition, I note that degenerative diseases were already prevalent in the late 19th century. Regarding the social inequality in death, I find that people of middle and higher social classes were often affected by other health risks than lower classes.

An Aboriginal Community-Controlled Health Organization model of service delivery: qualitative process evaluation of the Tulku wan Wininn mobile clinic

BackgroundMobile clinics have been implemented in diverse clinical and geographical settings to provide proximal health care for specific populations. Primary health care mobile clinics have been implemented widely for Indigenous populations, with a paucity of research evaluations around service delivery models internationally. To redress factors impeding service accessibility for Aboriginal and Torres Strait Islander Peoples, Budja Budja Aboriginal Cooperative (Aboriginal Community Controlled Health Organisation located in a small rural town in Victoria, Australia), developed and implemented the Tulku wan Wininn primary health mobile clinic.MethodsA qualitative process evaluation methodology was used to explore contextual factors mediating the implementation of the mobile clinic, including the acceptability of the service to health service personnel, external key informants, and Aboriginal and/or Torres Strait Islander clients. A synthesis of international ethical guidelines, (Consolidated Criteria for strengthening reporting of health research involving Indigenous peoples (CONSIDER statement), was prospectively applied to shape the study design and research process. Semi-structured interviews were conducted with participants. Data collection occurred from July 2019 to October 2021. Inductive thematic data analysis was undertaken concurrently with data collection.ResultsData was collected from 19 participants which included 12 health service personnel and key informants, and 7 Aboriginal clients. In total, data from 22 interviews were included as interviews with three clients were undertaken twice. Four themes were developed: considerations for early implementation, maintaining face-to-face services during COVID-19, acceptability as a model of service delivery, and maintaining the mobile clinic as a service delivery model.ConclusionEvidence supporting the acceptability of a primary health care mobile clinic for Aboriginal Peoples residing in rural Victoria is provided. Despite the experience of early implementation challenges and adaptations, the mobile clinic addressed known transport and cultural barriers to accessing primary health care services. In the context of COVID-19 lockdowns, the mobile clinic was valued for the provision of face-to-face care for Aboriginal clients. Key issues for maintaining the mobile clinic include health workforce and funding. Findings are of value to other organizations seeking to implement a primary health mobile clinic service delivery model to redress barriers to accessibility experienced by the communities they serve.

In the Belly of the Night and Other Poems. En el vientre de la noche y otros poemas. Ndaani' Gueela' ne xhupa diidxaguie' by Irma Pineda

Reviewed by: In the Belly of the Night and Other Poems. En el vientre de la noche y otros poemas. Ndaani' Gueela' ne xhupa diidxaguie' by Irma Pineda Susan Smith Nash Irma Pineda In the Belly of the Night and Other Poems. En el vientre de la noche y otros poemas. Ndaani' Gueela' ne xhupa diidxaguie' Trans. Wendy Call with the author. Illus. Natalia Gurovich. Mexico City. Pluralia Edicionese Impresiones. 2021. 160 pages. TO PUBLISH POETRY written in endangered Indigenous languages not only preserves the language but also a way of knowing, which is often an alternative epistemology. The work of poet Irma Pineda is no exception. She writes in Isthmus Zapotec, from her rural small town in Oaxaca, Mexico, where the number of speakers is dwindling rapidly. She also writes in Spanish in what she considers to be "mirror poems" rather than denotative translations of each other. To accommodate both versions in a single English version, translator Wendy Call sat with the author, Pineda, who explained just how each poem is shaped, and the kinds of wordplay that each has, and why. In investigating the differences, core ideas about the world and systems of knowledge came to light. For example, in Spanish, en el vientre means "in the belly." However, Gueela does not mean belly or intestines at all but umbilical cord. Further, the umbilical cord is inextricably linked to the house where one was born, because, after birth, the umbilical cord is placed in a small pot, which is then buried under the house. The earth and the body have a unique connection that does not occur with the Spanish colonial impositional culture. The fact that the translator spent time to learn about the embedded beliefs and traditions, and to incorporate them into her English translation, and to explain the process in the preface, is a great contribution to an understanding of the Isthmus Zapotec culture and poetic output. The themes in the clusters of poems include the concept of the guenda, which is simultaneously spirit and animal. "Sun" reflects an animistic view of the world, where objects in the natural world can take on human traits and then shape-shift back. Similarly, the crocodile's eggs swim just as the observer's mind opens to the fecundity of all things and to unbreakable (albeit not always visible) connections. An animist perception of the world is also apparent in a poem from the first cluster of poems, "Red Belt," where the red ribbon wrapped around the narrator's pregnant belly both adorns and protects. The final cluster of poems, "From the Cord House to the Nine Handspans," incorporates Isthmus Zapotec traditions while reflecting on the deep love the narrator has for Sebastian in his journey through life, from the "[umbilical] cord house" where he was born to the "nine handspans" (the grave, nine handspans below the surface of the earth). Knowing that Pineda is writing from her home in Mexico City—and lives in a kind of self-imposed exile from the cluster of Isthmus Zapotec speakers she grew up with—adds another level of loss and nostalgia. Susan Smith Nash University of Oklahoma Copyright © 2022 World Literature Today and the Board of Regents of the University of Oklahoma

Enroling around—Reconfiguring place and space in the wake of a new reception centre in a small rural town

AbstractThe paper examines how a small rural town Kauhava, Finland, is reconfigured in the wake of a reception centre being established. Drawing on the conceptual toolbox of the sociology of associations, we find that regardless of attitudes towards asylum seekers, people springing into action and enroling others leads to the problematisation and intensification of place. This involves turning public and private spaces into contested places. Competing definitions of community and identity emerge. While new identities are configured, new associations and ways of linking actors and places together also take form. The paper examines how the micropolitics of place and belonging are carried out in practice, and what types of mechanisms bring about or prevent new conjunctions and transformations in places. The data consist of interviews in Kauhava with town officials, reception centre volunteers, opponents of the centre and refugees who have stayed in the town.

Tell Your Story, Save Our Community: Raising Local Consciousness and Reinforcing Political Mobilization in Bjurholm through Storytelling

The present article focuses on how storytelling events serve as a tool in reinforcing local identity. The case study presented here centres on Bjurholm, a small rural town in northern Sweden, where a local storytelling society called Bjurholms Berättarakademi has been emphasizing municipal community building as a singularly important task. Initially offering public storytelling evenings and festivals celebrating prominent local storytellers, it soon shifted strategy and instead concentrated on storytelling in schools and villages, by pupils and villagers, and addressing urgent local topics at special events. The tenuousness of relying on only a handful of activists and the problem of continuity has been countered through collaboration with other local societies, as well as by embracing new media.

“School is not for me”: Young people’s perceptions of being a self-directed learner in a small rural Tasmanian town

The Education Act (2016) was introduced in Tasmania to address the state’s high rates of early school leaving. Such legislative reforms may overlook informal factors that influence educational outcomes. In this paper we argue that a deeper understanding of the underlying drivers of retention and engagement in diverse social and cultural contexts is vital in supporting the Education Act. Drawing on qualitative data, this paper provides insights into how a group of Grade 10 students in a small rural town in Tasmania made the choice to leave school early or continue on to some form of post-compulsory education. Using Berger and Luckmann’s theory of sociology of everyday life together with Bourdieu’s (1990) concepts of social and cultural capital, this paper highlights how perceptions of being a self-directed learner and feelings about the future shaped the young people’s educational decisions. It emphasises how a localised form of social and cultural capital was associated with feelings of failure and anxiety about future learning, whereas a broader form of social and cultural capital was linked with more optimistic perceptions of being a self-directed learner. The paper suggests that the career aspirations, including university study, of young people living in regional areas may be supported through familiarisation with larger regional towns and raising their awareness of post school options.

Rural Parents' School Choices: Affective, Instrumental and Structural Influences

The paper discusses qualitative findings from an in-depth study of the school choices of 65 parents living in rural and remote areas of Tasmania and their views about the need for their children to move out of the area to pursue education at secondary and post-secondary level. A constructivist analysis of open-ended survey questions and focus group discussions formed part of a broader mixed-methods approach and probed the affective 'subtext' of instrumental survey responses. Findings contribute to our understanding of the interaction of affective, instrumental and structural factors influencing rural parents' educational decision-making in the neo-liberal policy context, especially with regard to decisions perceived by parents as 'risky' with respect to their own future employment and financial expectations. External threats to rural livelihoods, such as economic downturns and natural disasters create parents' feelings of anxiety about children's educational futures and are experienced differently by those living on farming properties or in small rural towns. Parents' perceptions of local and urban school availability, access and quality differ by locality and region. Educational outcomes reflect multidimensional structural, socio-economic and cultural constraints shaping school choice. Membership of voluntary associations, which provides supportive informational networks and develops shared social capital, appears to help parents to overcome socio-economic inequalities and improve their children's prospects of educational success. The interplay of social class, gender and place attachment is examined with reference to Bourdieu's concepts of habitus and disposition, as well as the processes by which parents try to transmit intergenerational advantage through educational choices.

"No One Cares In The City": How Young People's Gendered Perceptions Of The Country And The City Shape Their Educational Decision Making

This paper provides an in-depth analysis of a group of young rural men's and women's understandings of 'the city' and 'the country'and the relationship between this and their educational decision making. The analysis adds to a growing body of literature on young rural people's experiences and the emerging research on education in a rural context. Drawing on participant observation and interviews with a group of Grade 10 students in a rural Tasmanian high school, I argue that the everyday life of the young respondents is characterised by a high degree of ambivalence towards urban living which sits at the heart of their educational choices. They depicted living in a small rural town as involving a daily trade-off between a welcome familiarity and a problematic lack of privacy. Their perception of the city was that this relationship would be reversed, and that while they might be free from the constraint of everyone knowing your business, they would struggle to negotiate the alien environment. Using Simmel's (1950) ideas on how rural and urban environments produce different worldviews as well as Bourdieu's (1990) concept of habitus, this analysis captures this ambivalence and the sense of risk involved in exchanging the known difficulties of the town for the unknown risks of the city. This sense of the city as 'too risky' informed many of the participants' decisions to 'not make a choice' and remain in their familiar environment rather than moving to the city to continue their education and risk failure. The analysis also draws on Bourdieu's concept of cultural capital and Connell's (2005) theory of hegemonic masculinity to emphasise that although the young people shared common experiences, these were mediated by aspects of cultural knowledge and gender relations.

How to Become a Philosopher from the (dis)Comfort of Your Own Home

How to Become a Philosopher from the (dis)Comfort of Your Own Home

Neighborhood-Level Socioeconomic Deprivation, Rurality, and Long-Term Outcomes of Patients Undergoing Total Joint Arthroplasty: Analysis from a Large, Tertiary Care Hospital

ObjectiveTo assess the impact of neighborhood-level socioeconomic status factors (area deprivation index [ADI] and rural classification) and their interaction with individual-level socioeconomic status (education-level) on long-term outcomes following total joint arthroplasty (TJA) surgery. Patients and MethodsThis was a cohort study of 46,828 TJA surgeries performed on patients at a tertiary care hospital between January 1, 2000 and December 31, 2019. Cox proportional hazards models were used to examine the association between ADI and rurality and their interaction with individual-level education on the risk of periprosthetic joint infections, revision surgery, and mortality. ResultsAt the time of surgery, 2589 (6%) patients lived in the most deprived neighborhoods (ADI quintile >80%) and 10,728 (23%) lived in small isolated rural towns. Patients from the most deprived neighborhoods were more likely to experience revision surgery (hazard ratio, [HR], 1.39; 95% CI, 1.10-1.76) and mortality (HR, 1.24; 95% CI, 1.09-1.42). Patients from small rural towns were also more likely to undergo revision surgery (HR, 1.14; 95% CI, 1.01-1.28). The mortality risk was 13%, 18%, and 24% higher for patients in the 3 highest ADI quintiles than those from the lowest quintile. Education gradient was more notable in the least deprived neighborhoods than in the most deprived neighborhoods. ConclusionNeighborhood disadvantage and rurality are negatively associated with the risk of revision surgery and both independently and in interaction with individual-level education with the risk of mortality. There is a need for population-level health interventions to mitigate area-based socioeconomic disadvantages in TJA.

The Old Toponymy and New Topography of Zion: Utah, Photography, and Daniel George's Series God to Go West

The Old Toponymy and New Topography of Zion: Utah, Photography, and Daniel George's Series <i>God to Go West</i>

A comparison of rural Australian First Nations and Non-First Nations survey responses to COVID-19 risks and impacts: implications for health communications

IntroductionThis study investigated differences between rural Australian First Nations and non-First Nations survey respondents’ perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms.MethodsA cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents’ ability to do something about the virus and perceived economic impacts of the pandemic.ResultsThere were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status.ConclusionHealth risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.

Variation in General Dentists' Patterns of Sealant Use in Children with Elevated Caries Risk.

Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all children indicated for sealants receive this preventive intervention, even when they use routine dental care. The aim of this study was to explore the extent to which dentists' use of sealants varied in pediatric patients with elevated caries risk. Claims and enrollment data from a private dental program were used to identify a cohort of 6- to 17-y-olds with elevated caries risk (N = 27,677) and general dentists (N = 818) who provided services to the children. Children were identified as having elevated caries risk based on history of restorative treatment over a 5-y period (2010-2014). The 2 outcomes of interest were whether a dentist provided any sealants to children with elevated risk and, if so, the extent to which these were used during a 2-y observation period (2013-2014). A 2-stage hurdle model was used for multivariable analysis to identify dentist characteristics associated with sealant use. Over the observation period, 13.3% (n = 109) of dentists did not provide any sealants to their elevated risk patients from the study cohort. Logistic regression found that female dentists were significantly more likely to have used sealants (odds ratio = 2.27); dentist age and practice in an isolated small rural town were negatively associated with any sealant use. However, among dentists who did place sealants (n = 709), female dentists, older dentists, dentists in solo practice, and those working full-time were significantly more likely to provide sealants to a child. Overall, substantial variation in practitioners' use of sealants was observed. This is the first study to explore provider-level variation in sealant use, representing a critical step in future efforts to increase routine use of sealants by dentists and eliminate oral health disparities. Findings from this study can be used to design targeted policy and behavioral interventions to increase sealant use by general dentists. This study provides foundational evidence for future research that explores motivation and barriers to routine use of preventive dental interventions by clinicians.

Waste sorting acceptability with information provision

To decrease the environmental degradation due to increasing amount of municipal solid waste the Ecology National Project was implemented in Russia. Its main goal is to increase recycling and liquidate all unauthorized landfills within the urban borders. While the key objective of the project is to ensure ecological improvement and to amend environmental situation in Russia its public acceptability and awareness is under question, especially in rural communities. The paper analyses rural waste management reform in small rural town in region (Sverdlovskay oblast). The main focus is on peoples’ knowledge, acceptability and perceptions of the reform and its components, especially separate waste collection.

Towards circles of care and education: Exploring understandings of quality in early childhood development

Background: Early childhood development (ECD) is increasingly being recognised as vital for the care and education of our children, particularly in countries such as South Africa where vast social disparities have a significant influence on development and well-being.Aim: This study aimed to explore and develop understandings of quality in early childhood care and education in a particular setting.Setting: The setting of this community research project is a small rural town in the Eastern Cape of South Africa. The project is facilitated by a non-governmental organisation affiliated with a university in the Eastern Cape of South Africa, working with participants from two neighbourhood hubs. This study coincided with the onset of the COVID-19 pandemic.Methods: Located in a social constructionist paradigm, the research methodology may be described as participatory, polyphonic and appreciative. Responses from simple, positively constructed questions, framed by dimensions of an ecological systems model, were interrogated through a multilayered process of content analysis.Results: Analysis of the data led to a range of themes and evidence of significant role players, around quality ECD. These were developed into two simple frameworks, capturing conceptual and contextual aspects of quality ECD: ‘Quality Early Childhood Development’ and ‘Circles of Care and Education’.Conclusion: The juxtaposition of the conceptual and contextual frames is offered as a simple, yet comprehensive, tool to scaffold ongoing research and support further development of quality ECD practice.

Characterizing the Health of Older Rural Australians Attending Rural Events: Implications for Future Health Promotion Opportunities.

This paper describes the health of older Australians (>65 years) attending rural events to inform health promotion interventions for rural populations. This cross-sectional study collected survey data and objective health measures between 2017 and 2020 at two events held in rural New South Wales, Australia. Participants included in the analysis were adults > 65 years of age. Data included demographic and health information, anthropometric measures (height, weight, waist circumference), and dietary and physical activity data. A total of 256 people > 65 years participated. Our sample, which was mostly male (59.0%), contained people aged between 66 and 75 years (72.3%). Participants lived in either a large rural (34.0%) or small rural town (22.3%), with low levels of education (60.9% did not complete high school). Dietary quality was rated as below average. All but 17.2% of the participants reported having a health condition. The risk of a health condition was associated with increasing age, lower education, and higher waist circumference, but not remoteness. Rural events may provide an opportunity to access, engage with, and understand the health of older rural Australians, especially males. They may offer ideal contexts for health and nutrition promotion opportunities in rural areas where access to health professionals is limited.

Pride Events in the periphery between hyper-localisation and hyper-contextualisation: a comparison between Italy and the UK

ABSTRACT In the last decade, Pride Events across Europe have multiplied, and they are now held in both big cities, as well as small rural towns and villages. This change is particularly interesting considering the predominant ‘metronormative’ [Halberstam, J. (2005). A queer time and space: Transgender bodies, subcultural lives. New York University Press] character of LGBTQI+ activism that overshadows forms of organisation for LGBTQI+ persons in rural locales and semi-peripheries. Through a theoretical comparison between Pride Events in rural and peripheral localities in both the UK and Italy, this article seeks to understand, why and how Pride Events in rural locales have exponentially multiplied in the last ten years across Europe. To do so, this article looks at the significance of the processes of hyper-localisation and hyper-contextualisation of Pride Events in rural or peripheral settings, focusing on the potential for social and political transformation beyond the dictates of ‘metronormative’ understandings of queer life in Europe.