Differences in health outcomes between city and country need specialised attention, says rural health commissioner
Research into health services in rural areas needs to be more connected to the end-users and less driven by theory, a national seminar has been told.
The seminar, organised by the Spinifex health research network and held on 2 December, came as a report found significant differences in health issues between city dwellers and those living in remote locations.The National Rural Health Alliance’s annual health snapshot highlighted lower life expectancy, different disease burdens and less effective healthcare in Australia’s regions.
Ruth Stewart, Australia’s national rural health commissioner, told the seminar that in some cases, research money was being wasted through poor engagement with local knowledge.
Stewart said that when she had worked as a rural health practitioner, “there were questions that I had, and when I went searching for the answers, the literature didn’t help at all. And that’s because the people who were doing the research weren’t people like me, working in clinical situations like mine.”
She added: “If you want to make a difference in your practice, think about the clinical questions that are important to you, and seek to design research that will answer those questions. Don’t think about the questions that are important to, you know, to the heads of universities; think about the issues that are important to you in your practice and to your community.”
She said that when Indigenous communities were affected, it was important to ask: “‘What are the health issues that are important to you? What do you want to see improve?’ Sit down with them, talk about what they think will make a difference to their health—and by having that conversation, you can then begin to design research studies.”
Warren Payne, convenor of the Spinifex network, said that “we believe we need solutions that are fit for purpose in rural settings. We need to avoid simply transplanting metropolitan models of care into those rural settings.”
There have been some recent advances, Payne said, with the addition of rural health to the Medical Research Future Fund’s priorities list and a boost in rural health research representation on the fund’s board to 30 per cent.
He said he would like to see a national health research mission declared, which could provide up to A$200 million over a 10-year period. But to achieve that, “we need to acknowledge a health [outcomes] disparity”, he said. “We need to acknowledge that in rural communities, life expectancy goes down with increasing remoteness.”
He said that targeted funding would solve the issue of specialist researchers being “locked out because they don’t have publications in The Lancet or a very strong, page after page, research track record”.
The organisation is planning another membership drive to get more practitioners and researchers involved, in addition to the 60 organisations already signed up, he said. “We need to put a stake in the ground and talk about equity and access.”
Spinifex’s lobbying has included meetings with “key parliamentarians”, the publication of a special edition of the Medical Journal of Australia focused on rural health, and the submission of policy proposals, he said.