Public perspectives on health improvement within a remote-rural island community

Bobby Macaulay*, Neil McHugh, Artur Steiner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Rural health outcomes are often worse than their urban counterparts. While rural health theory recognizes the importance of the social determinants of health, there is a lack of insight into public perspectives for improving rural health beyond the provision of health‐care services. Gaining insight into perceived solutions, that include and go beyond health‐ care, can help to inform resource allocation decisions to improve rural health.

Objective
To identify and describe shared perspectives within a remote‐rural community on how to improve rural health.

Method
Using Q methodology, a set of 40 statements were developed representing different perceptions of how to improve rural health. Residents of one remote‐rural island community ranked this statement set according to their level of agreement. Card‐sorts were analysed using factor analysis to identify shared points of view and interpreted alongside post‐sort qualitative interviews.

Results
Sixty‐two respondents participated in the study. Four shared perspectives were identified, labelled: Local economic activity; Protect and care for the community; Redistribution of resources; and Investing in people. Factors converged on the need to relieve poverty and ensure access to amenities and services.

Discussion and conclusions
Factors represent different elements of a multifaceted theory of rural health, indicating that ‘lay’ respondents are capable of comprehending various approaches to health improvement and perspectives are not homogenous within rural communities. Respondents diverged on the role of individuals, the public sector and ‘empowered’ community‐based organizations in delivering these solutions, with implications for policy and practice.

Public Contribution
Members of the public were involved in the development and piloting of the statement set.
Original languageEnglish
Pages (from-to)1286-1299
Number of pages14
JournalHealth Expectations
Volume24
Issue number4
Early online date6 May 2021
DOIs
Publication statusPublished - Aug 2021

Keywords

  • health
  • island
  • public perspectives
  • Q methodology
  • rural

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