Culture and rural health

Abstract

This paper considers the role of culture in rural health, suggesting that the concept and its impacts are insufficiently understood and studied. It reviews some of the ways that culture has been considered in (rural) health, and states that culture is either used ambiguously and broadly - for example, suggesting that there is a rural culture, or narrowly - indeed perhaps interchangeably with ethnicity, for example Aboriginal culture as a unity. The paper notes that, although culture is a dynamic social concept, it has been adopted into a biomedical research paradigm as though it is fixed. Culture is often treated as though it is something that can be addressed simplistically, for example, through cultural sensitivity education. Authors suggest that culture is an unaddressed 'elephant in the room' in rural health, and that exploring cultural differences and beliefs and facing up to cultural differences are vital in understanding and addressing rural health and health system challenges.

Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities

“…In combination, social ecology and social capital can be conceptualised as a feature of both social organisations and as a community asset Putman 2000;Yang et al 2011). In particular, social trust, help (volunteerism), social connection and cohesion have been identified as social capital attributes that are protective of mental health in rural communities (Allen et al 2012;Berkman et al 2000;Farmer et al 2012;Yang et al 2011). Thus, a form of mental health protective social capital within a framework of rural social ecology can be seen to be a subset of such social capital.…”

“…However, as changes occur, either internally or externally, a deterioration of practical competency can develop, and further so if a person is required to travel to unfamiliar places and access unfamiliar services to receive the supports they may need. It is therefore important for mental health service providers to consider how mental health support can be delivered in a way that supports and enhances the usual practical competence of rural people, and to minimise the ways in which services are provided that involve unfamiliar locations, places, or practices, so that vulnerability can be minimised, and mental health can be protected and not further eroded (Farmer et al 2012). Locally accessible services may be more likely to enhance the strengths and protective attributes needed for the timely recovery for rural people.…”

“…Rural social mental health helping capital is defined as a sub set of the social capital that is available in rural communities and it is characterised by the way in which local rural people are able to support and resource each other towards meeting or improving the mental health and wellbeing needs of people who are vulnerable towards mental health decline within their community Allen et al 2012;Farmer et al 2012;Wilson et al 2012). For example, rural churches, sporting clubs and service groups are often involved with the practical provision of mental health care and support to vulnerable people in their communities, with the expression of care taking the form of sharing time and experiences or stories of coping success, providing transport to health appointments, facilitating social inclusion in community activities, and assisting with the practicalities of daily living when needed.…”

“…A rural health system that is limited to a traditional biomedical and generic model of service delivery will inevitably fail to comprehensively meet demands of all rural situations. In other words, a 'one size fits all' service delivery may not effectively address the cultural aspects which underpin the social capital resources, values, and beliefs evident within many rural settings, yet these are crucial aspects to be considered when deploying a sufficiently diverse health service to rural communities (Fraser et al 2002;Farmer et al 2012). However, while it is apparent that a generic or traditional system of health service delivery will be sufficient for a proportion of the population, it does not necessarily hold that it will be sufficient for all members of the community.…”

Regional responses to the challenge of delivering integrated care to older people with mental health problems in rural Australia

“…Rural locale may influence which behaviours are accepted, either promoting or undermining health, and may impact the manner in which health services are delivered. Rural communities are often viewed as having a culture of social cohesion and collective problem solving alongside self-sufficiency (Farmer et al, 2012a). As a consequence, rural service providers have been identified as being more likely to work collaboratively and to adopt generalist and extended roles to maximise available resources (Bourke et al, 2012;Mitton, Dionne, Masucci, Wong, & Law, 2011;Petrich et al, 2013).…”