Rural and Remote Health is an open-access international academic journal serving rural and remote communities and publishing articles by rural health practitioners, educators, researchers and policy makers.

Rural healthcare human resources challenges persist, despite the existence of many different initiatives to increase rurally focused training opportunities. This Commentary makes the case for a paradigm shift away from specialist curricula and training in urban centres, towards decentralization of training and capitalizing on the opportunity to increase rural practitioner mentorship of trainees. The concept of rural training in place is introduced, enabled by distance learning technology, to provide an immersive, longitudinal, rural training model, that would allow learners to build and maintain community integration throughout training.

Inequalities often exist between urban and rural areas in health status and in the distribution of social determinants such as income, education and employment. Monitoring regional health inequalities can provide evidence and support for policies to reduce inequality. Much point-in-time evidence exists for Australia, but this Original Research article reports on analyses of Public Health Information Development Unit (PHIDU) data to investigate the nature of change in inequalities over 3 decades and to categorise local government areas into remoteness categories. Improved understanding of what has changed over time (or not) and diversity in health and social determinants of health both within and between remoteness categories can inform more effective policy and services to rural and remote areas.

Internationally, racism, historical and present trauma and settler colonialism are catalysts for compromised health and well-being in a landscape of community and family dysfunction. The health impacts of racism are well documented in the lower life expectancy, burden of disease and elevated levels of psychological distress experienced by First Peoples. There is evidence to suggest that the ability of health professionals to integrate cultural safety into their practice is intrinsic to dismantling racism and to improving the health of First Peoples and other marginalised groups but little is understood about how health professionals understand racism in the context of providing culturally safe care. Utilising international research, this Scoping Review explores how interdisciplinary health professionals in the aged-care sector in rural areas understand and respond to racism and understand and provide culturally safe care.

Rural and remote Indigenous communities are disproportionately affected by diabetes-related foot disease (DFD), one of the most prevalent causes of global hospitalisation and morbidity. Early identification of wounds and multidisciplinary management can significantly reduce amputation rates, but there are important barriers to health care for rural Indigenous communities, including access to culturally appropriate care, distance to care, dislocation from family and cultural support, exposure to racism, and poor communication with healthcare professionals. Telehealth has been identified as a strategy to improve access to health care for rural and remote communities and may address some of these barriers, but there is little research exploring the use of telehealth in the management of DFD in Indigenous people. This Original Research study investigated experiences of rural and remote Aboriginal and Torres Strait Islander people with DFD utilising a newly established real-time video-based telehealth service.

Infectious diseases associated with poverty disproportionately impact rural populations with limited access to health care. Cutaneous leishmaniasis (CL) is caused by infection with leishmania parasites and spread by the bite of sandflies; it is challenging to control owing to its epidemiological, clinical, and biological complexity. Colombia reported the second-highest number of CL cases in the Latin America region in 2020. Community capacity building and education is needed to achieve effective prevention and control. This article presents the learning process of implementing a capacity-building program, which sought to provide tools to the community to improve CL prevention and control in the municipality of Pueblo Rico, Colombia

Doenças infecciosas associadas à pobreza têm impacto desproporcional em populações rurais com limitado acesso à atenção em saúde. A Leishmaniose Cutânea (LC) é causada pela infecção por parasitas leishmania e é transmitida através da picada de flebotomíneos; é um desafio controlá-la devido à sua complexidade epidemiológica, clínica e biológica. Em 2020, a Colômbia notificou o segundo maior número de casos de LC na América Latina. A capacitação e a educação da comunidade são necessárias para alcançar a prevenção e o controle eficaz da LC. Este artigo apresenta o processo de aprendizagem para a implementação de um programa de capacitação que buscou fornecer ferramentas à comunidade para melhorar a prevenção e o controle da LC no município de Pueblo Rico, Colômbia.

Las enfermedades infecciosas asociadas con la pobreza afectan de manera desproporcionada a poblaciones rurales con acceso limitado a atención médica. La Leishmaniasis Cutánea (CL) es causada por una infección por parásitos leishmania y se transmite por la picadura de mosquitos flebótomos. Su control es difícil debido a su complejidad epidemiológica, clínica y biológica. Colombia reportó el segundo mayor número de casos de LC enLatinoamérica en 2020. Se necesita educación y desarrollo de capacidades comunitarias para lograr una prevención y un control efectivos. Este artículo presenta el proceso de aprendizaje de la implementación de un programa de desarrollo de capacidades, que buscó brindar herramientas a la comunidad para mejorar la prevención y el control de LC en el municipio de Pueblo Rico, Colombia.