Abstract
Our understanding of and ability to describe rural health conditions can be considerably enhanced by the use of rural health indicators which allow us to compare rural and non-rural areas or areas differentially located on the urban-rural continuum in terms of various health conditions. However, while health indicators abound, there are very few that can be used to describe the health conditions of rural Canada. This paper discusses the concepts of health in a rural context and adopts a broad definition of health that goes beyond the mere absence of disease or impairment. We propose five broad categories of health indicators: health status indicators, health determinant indicators, health behaviour indicators, health resource indicators, and health service utilization indicators. The most commonly used health indicators in Canada and the datasets from which they are derived are examined in order to assess their applicability to “communities” or “regions”. This review highlights the strengths and limitations of various datasets and indicators and their applicability to the “community” and “regional” scale for rural environments. Finally, challenges in data availability and use are discussed as they relate to rural health indicator development.
Résumé
Le recours à des indicateurs de santé en milieu rural, qui permet de comparer les régions rurales et les régions non rurales ou des régions situées en des endroits distincts d’un même grand territoire, peut améliorer grandement la compréhension de l’état de santé en milieu rural. Toutefois, alors que les indicateurs de santé sont nombreux, très peu peuvent servir à décrire l’état de santé des régions rurales au Canada. Les auteurs analysent les concepts de la santé en milieu rural et optent pour une définition large de la santé, qui dépasse la simple absence de maladies ou de déficiences. Ils proposent cinq grandes catégories d’indicateurs de santé: des indicateurs de l’état de santé, des indicateurs des déterminants de la santé, des indicateurs des comportements liés à la santé, des indicateurs des ressources en santé et des indicateurs de l’utilisation des services de santé. Ils étudient les indicateurs de santé les plus utilisés au Canada et les ensembles de données dont ils découlent afin d’en évaluer l’applicabilité aux collectivités ou aux régions. L’étude souligne les avantages et les limites de divers ensembles de données et d’indicateurs et compare leur applicabilité aux milieux ruraux à l’échelle de la collectivité et de la région. De plus, les auteurs traitent des problèmes de disponibilité et d’utilisation des données en rapport avec l’élaboration d’indicateurs de santé en milieu rural.
Footnotes
formerly a Senior Researcher with the Centre for Rural and Northern Health Research, Laurentian University
Acknowledgements: The authors acknowledge the financial contribution from the National Health Research and Development Program, Health Canada. The original report on which this paper is based was written with the assistance of Dave Pearson (Centre for Rural and Northern Health Research), K.V. Nagarajan (Laurentian University), and V. Sahai (Northern Health Information Partnership) in collaboration with the Canadian Institute for Health Information (Jennifer Zelmer) and the College of Family Physicians of Canada (Lynn Dunikowski).
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