Bobiak Julia, Morris Julia, Nur Fozia, & Asad Fatima. (2021). Rural Health Infrastructure in Ontario: A Rapid Review. Spatial Determinants of Health Lab, Carleton University: Ottawa, ON. DOI: 10.22215/sdhlab/2021.5

A full PDF of this rapid review is also available.

Public Health Topic

The objective of this rapid review is to understand what types of evidence are used to identify and support policy development for rural health infrastructure.

Rural regions are composed of many unique and diverse communities where health behaviours, health literacy, perceived health, and health outcomes vary between widely. In general, rural populations in Canada are characterized as generally older, less affluent, and are faced with more health issues than their urban counterparts. While this may be the case in the aggregate, there are a diversity of communities across Canada with wide variation between and within rural places. Almost one-fifth of Canadians (18%) live in rural communities yet they are persistently faced with on-going challenges recruiting and retaining family physicians and other health-care professionals, maintaining infrastructure for health service provision, and adapting health policies developed for urban environments into rural settings. These challenges, among others, contribute to inequities in access to healthcare services for these individuals residing in rural Canada.

It is recognized that major systemic change is needed to improve health outcomes for communities in rural or remote areas, but that this cannot occur with addressing access inequities to health infrastructure such as hospitals, mental healthcare, and telehealth services.

Current Knowledge

Currently in Canada, there is a lack of systematic evidence-based rural health-care planning at national or provincial levels. The lack of this rural-focused planning proves challenging for the development of rural health infrastructure. As it is recognised that the needs of rural communities differ from their urban counterparts, rural communities need rural-based solutions. These solutions will allow rural communities to develop regional capacity to innovate, experiment, and discover what works for their needs.

Provincially, the Ontario Ministry of Health and Long-Term Care recognizes the need for the renewal of health care infrastructure and facilitates the Health Infrastructure Renewal Fund to address regional address renewal needs on a priority basis. However, such policies are often guided by urban health-care models which may be ill-suited or have negative impacts in rural communities.

Advocacy for the need for rural health research funding resulted in a pre-budget submission being made in August 2018 to the federal government to enable rural and remote communities to carry out rural health research through the use of infrastructure funding. In June 2019, the Canadian Institutes of Health Research (CIHR) announced that it is undertaking a strategic planning consultation with input from stakeholders across Canada. These investments are essential in order for rural health research funding to reflect the realities of rural healthcare.

It’s unclear exactly what kind of evidence, and exactly how and when it is used, to support the development of rural health care infrastructure. From initial research, it seems that a wide variety evidence is consulted; from personal anecdotes to in-depth and specific budget requirements. The objective of this rapid review is to understand what types of evidence are used to identify and support policy development for rural health infrastructure.

It’s unclear exactly what kind of evidence, and exactly how and when it is used, to support the development of rural health care infrastructure. From initial research, it seems that a wide variety evidence is consulted from personal anecdotes to in-depth and specific budget requirements. The objective of this rapid review is to understand what types of evidence are used to identify and support policy development for rural health infrastructure.