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.

Access to health care for rural and remote Australians remains an issue, despite continued efforts to improve the distribution of the medical workforce. Numerous studies have shown that rural experience for medical students, particularly if they have a rural background, is effective in recruiting and retaining a rural health workforce. Until recently, this has involved short-term or extended rural clinical school placements. The Murray-Darling Medical Schools Network (MDMSN) has established a network of rurally based medical programs in New South Wales and Victoria in which students can complete the entirety of their medical degree in a rural area. The MDMSN offers a unique opportunity to explore the effect of complete rural immersion during medical school on subsequent rural practice. This article describes the establishment of a research collaboration to undertake multi-institution and longitudinal research into rurally based end-to-end medical training programs and their impact on rural workforce maldistribution.

Iron deficiency anaemia is a particular risk for pregnant women because additional iron is needed to meet the needs of the growing foetus and to supply the increased maternal red blood cell mass. Sub-optimal levels of iron during pregnancy are associated with adverse outcomes including low birth weight, preterm birth and, in more severe cases, maternal death. Reported figures of maternal and infant mortality remain high in rural populations of low-income countries. This study determined the iron status of rural-dwelling Nigerian women in the second and third trimesters of pregnancy and predicted their risk of giving birth to babies with sub-optimal iron endowment.

Surgical care is limited in many rural areas, with a shortage of general surgeons contributing to this gap in services. This qualitative study explores the meanings surgeons associate with community characteristics to better understand the role that community plays in surgeons' practice location choices. Reflections around themes of physical environment symbolism, health resources' relationship to scope of practice, and overlap of professional and personal roles differed between rural and urban surgeons. The authors suggest that educators and rural healthcare organizations can improve recruitment and retention by better preparing potential rural surgeons for the expected role overlap and highlighting the value of the unique physical environment found in rural areas.

Rural people in the USA, 20% of the population, suffer higher all-cause mortality and are more likely to die of each of the 10 leading causes of death than urban counterparts. They are more likely to be uninsured, live in poverty, and be exposed to unique occupational and environmental toxicities. The ability to identify and address these disparities is directly dependent on the quality of rurality measurements, one of which is Rural–Urban Commuting Area (RUCA) Code. Although basing rurality on commuting distance may adequately measure accessibility of healthcare services, it might miss health-related behaviors and socioeconomic effects. A measure of rurality that considers individual’s perceptions of their community identity while maintaining efficiency for large-scale research is needed to better conduct patient-centered healthcare research. This study examined the concordance between people's self-identification of rurality and their ZIP code-derived RUCA of rurality among a nationally representative sample and determined patient-centered RUCA-based classifications of rurality and urbanicity.

Dementia is the second leading cause of death in Australia and is currently responsible for 4.4% of the total burden of disease in the country. To identify gaps and unmet needs within the health and social care system and potentially improve the quality of care and outcomes for people living with dementia in rural and remote areas, this study investigated the needs of people living with dementia and their informal or formal care-givers in Gippsland, a rural region of Victoria, Australia. Although there are services and supports available for people living with dementia, accessing them can be complex and the wait time can be several years. People living in rural and regional Australia often face multiple additional barriers to accessing health and social care services.

Respiratory disease, usually acute hypoxaemic respiratory failure (AHRF), is the predominant reason for paediatric retrievals from remote areas in northern Australia. AHRF requires oxygen treatment using nasal high flow (NHF) therapy, but although the use of NHF therapy is ubiquitous in Australian tertiary hospitals, implementation is inconsistent in remote Australian hospitals and there is no clear guidance for its use in limited resource environments. This Original Research study developed a guideline for the use of NHF therapy in three remote hospitals in Queensland, Australia.

People from rural riverside populations of the Amazon travel greater distances to access health care than urban people, have access to fewer dentists per individual, are less likely to have water fluoridation and tend to experience higher prevalence of dental caries and tooth loss. In Brazil, to increase access to health services for rural people, Fluvial Family Health Teams (FFHT) of health professionals visit many riverside communities monthly in a mobile unit to provide primary health care, including oral health and dental care. This study assessed the use of dental services, and the factors contributing to dental health access, by adults living in rural riverside areas covered by an FFHT.

Urban and rural areas have particular characteristics that impact the health and mortality of their inhabitants. In Mexico, the leading causes of mortality are cardiovascular diseases, diabetes mellitus, cancer, and accidents, but the differences in these trends between urban and rural populations is not clearly understood. This study describes the adjusted mortality rate in rural and urban areas and analyzes trends between 2000 and 2019.

Rural residents have an increased risk for dementia and face significant barriers accessing information, caregiving support, and memory-related services. Physical inactivity increases the risk of Alzheimer's disease, and rural communities experience barriers to participation in physical activity. This small pilot study focused on implementing and evaluating the feasibility and safety of a synchronous, remotely delivered, aerobic exercise telerehabilitation program for persons with subjective cognitive decline living in rural northern Minnesota, USA. The exercise intervention was synchronous, remotely supervised, moderate intensity activity using a recumbent bicycle. With no drop-outs, no adverse events, and an 85% session participation rate, the study provides evidence of preliminary feasibility of synchronous audiovisual telerehabilitation programs delivered to rural residents at risk for dementia.

Uruguay has an important livestock industry (cows, sheep, poultry, pigs). Predator attacks on productive species generate great concern for animal welfare and also cause economic losses for farmers but little is known about how predator attacks on productive species impact the mental health of farmers. This study explored how predator attacks on productive species during 2021 influenced the psychological distress of farmers in rural Uruguay.

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.