Drawing upon a comparative, qualitative study of the experiences of rural women accessing maternity care in two Canadian provinces, we demonstrate that availability of services, having economic and informational resources to access the services offered, and the appropriateness of those services in terms of gender, continuity of care, confidentiality, quality of care, and cultural fit are key to an accurate understanding of health care access. We explore the implications of living rurally on each of these dimensions, thereby revealing both gaps in and solutions to rural maternity care access that narrower, proximity-based definitions miss.

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The detection of the first indigenous case of bovine spongiform encephalopathy (BSE) in Canada on May 20, 2003, had significant consequences for the livestock industry. As a result, borders were closed by several trade partners, particularly the United States. The outbreak led to direct and indirect economic impacts to the "cattle" industry exceeding $6 billion. As a consequence of a number of risk management interventions implemented by the Canadian Food Inspection Agency (CFIA) and provincial agencies, the BSE outbreak appears to have been largely contained. The initial results from our study of the socioeconomic and psychosocial impact of BSE on the health and well-being of rural and farm families living in Canada, a topic that remains largely unexamined are presented. Our analysis of the outbreak raises a number of questions concerning the resulting consequences for farmers, their families, and their communities, including considerations from a social determinants' of health perspective. In particular, our preliminary findings reveal that 5 years following the detection of the first indigenous case of BSE in Canada, ongoing uncertainty and stress resulting from unrecoverable financial losses continue to weigh heavily on the health and well-being of farmers, their families, and survival and sustainability of agricultural communities.

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