Rural health systems : Spotlight on equity and access

Australia is a vast and geographically diverse continent with a population of approximately 25 million people. The majority of the population (71%) lives in major cities while the remainder is typically sparsely spread across rural and remote communities within an area of 7.5 million square kilometres.

Addressing the relatively poor health status of rural populations is a national priority in many countries and, in Australia, the health of rural communities is frequently highlighted in the media. However, there is little discussion on what we actually mean by ‘rural health’. People living in rural (or metropolitan) areas are not homogeneous populations. That is, within these populations there are vast differences in health status and access to care. In such a high-income country as Australia these inequities are objectionable – so in this chapter we explore what rural health is and how it is influenced by geography; the social determinants of health; the health system, workforce and funding; health policy; and rural communities.