EQUITABLE ACCESS TO CARE
Well-known health and health care disparities exist in rural communities in Canada [1, 2]. Obesity, cardiovascular disease, diabetes, and hypertension along with lower life expectancy are known to be higher in rural than urban areas . Despite their greater health care needs, rural residents often have less health care access . Rural health service delivery is challenging due to diseconomies of scale, the small client base, and the remoteness from specialist services in smaller and less densely populated areas .
Considerable evidence has advanced the role of citizen-led coalitions (CLC) in supporting the health and social needs of rural citizens.
There has been little research focusing on the experiences and strategies of coalitions, with their limited resources and status, in targeting health inequities in their rural communities.
The aim of this study was to understand the entrepreneurial strategies and experiences of rural coalitions to effect change in the delivery of health services for their older adult populations.
Two over-riding themes emerged: entrepreneurial strategies and societal recognition. CLCs engaged in numerous entrepreneurial strategies that enabled actions and outcomes in meeting their health care needs.
These strategies included: securing quick wins, leveraging existing resources, and joining forces with stakeholder groups/individuals.
However, despite these strategies and successes, coalitions expressed frustration with not being seen and not being heard by decision-makers.
This pointed to a key structural barrier to coalition successes — a broader societal and institutional problem of failing to recognize not only the health needs of rural citizens, but also the legitimacy of the community coalitions to represent and act on those needs.
Despite the potential for coalitions to mobilize and effect change in addressing the inequities of rural health service access for older adults, broader barriers to their recognition, may undermine their entrepreneurial strategies and success.
International Journal for Equity in Health, 18, Article number: 119.
Rush, K.L., Chiasson, M., Butterfield, M., Straka, S., Buckley, B.J. (2019).
Note: It was at this meeting that a suggestion was made to have the participants form a network, which eventually became the BC Rural Health Network
To read the full study, click on: Entrepreneurial Activities of Rural Coalitions in Advancing Access to Healthcare.