Rural Health Research Resources

Rural health research is not the most popular research field in Canada. There are several reasons for this including the lack of a national research agenda and lack of investment in funding and infrastructure. Most rural health researchers in Canada work independently. This has resulted in gaps and duplication, and lessened the impact of individual research findings.

The Canadian Institutes of Health Research (CIHR) is the agency that funds health research in Canada. As of 2019, CIHR allocated less than 1% of their total grant funding to rural-focused health research topics.  

In 2018, the College of Family Physicians of Canada and the Society of Rural Physicians of Canada called for more investments in rural health research. They asked the federal government for two things:

1. To invest $12 million per year to create a Canada-wide network of rural health innovation generators (RHIGs). This would help communities develop, test, and evaluate health care solutions made by and for rural communities. 
2. To create long-term funding to support the RHIC and rural research. 

They argue that having a Canadian rural research agenda with dedicated funding will help to focus research on areas of highest need and benefit patients, health service providers, and rural communities. 

Australia was in a similar position two decades ago but has since built one of the best rural health teaching and research infrastructures. It has an academic network of 16 Rural Health University Departments and 19 Rural Clinical Schools with substantial funding behind it. Clinician researchers associated with the network contribute substantially to the quality and effectiveness of rural health care.

An independent evaluation of the network also found that these rural programs increased the number of health professionals working in rural areas and had some direct social and economic benefits for rural communities.

While the challenging work of creating a unified rural health research agenda in Canada is ongoing, we can look to examples from elsewhere for inspiration. In the United States, for over 30 years, the Federal Office of Rural Health Policy (FORHP) has coordinated activities related to rural health care.

As part of their mandate, FORHP funds 10 Rural Health Research Centers. This is the only US federal program dedicated to policy-relevant, rural health research. The research centres focus on different issues. For example, the Maine Rural Health Research Centre conducts research in the areas of elder care, mental health, sexually-transmitted infections, opioid and tobacco use, and emergency care. You can view a full list of their projects here.

The Rural Health Research Gateway is a free online library containing all the research produced by the 10 Rural Health Research Centers over the last 20 years. Through this important website, the public has timely access to rural health research.

The top three topics accessed in the past year were:

1. Substance abuse and treatment
2. Healthcare access
3. Mental and behavioural health

Another key resource offered by the Federal Office of Rural Health Policy (FORHP) is the Rural Health Information Hub. This website is a national expert site for rural health issues with sections on: 

• rural project examples 
• evidence-based strategies for rural programs like aging in place, diabetes & obesity prevention, oral health or suicide prevention
• rural health data, including Rural Data Explorer and Chart Gallery

To learn how to locate and use data, they have a topic guide on Finding Statistics and Data Related to Rural Health. On this page, there is an excellent FAQ section that describes different data sources, data limitations, how to compare data, and analytic methods.  

The Rural Health Information Hub is an incredible resource for community members, health-care providers and researchers alike. The Hub offers background articles and modules on many rural health issues. New content is always being added. You can stay up-to-date via the Rural Health Information Hub weekly newsletter and custom daily or weekly alerts. 

Canada has a few research centres that offer excellent resources on rural health research or general research issues.

Centre for Rural Health Research (UBC)

The University of British Columbia Department of Family Medicine is home to the Centre for Rural Health Research. The centre conducts research and uses the results to inform policy and planning for rural health services in British Columbia.  

The Centre has a special focus on rural maternity care. Due to closure of rural health centres and/or loss of some rural health services, women and their families have had to travel outside of their communities to receive care. They also received less social support. This has resulted in less healthy mothers and newborns.  

The centre has conducted a number of research projects to solve these issues, including: 

• Building Blocks for Sustainable Rural Maternity Care: looked at creating system-level support for small rural maternity services. The team is currently creating a road map to identify the key supports needed for these services. 
• Mobile Maternity: This service uses technology to connect patients in one community with specialists that are often located in urban hospitals. It also creates collaboration between rural general practitioners and specialist obstetricians. 

The Centre for Rural Health Research has many resources on their website, including policy briefs, community reports, and publications. They also have a podcast with a mini-series about rural patients that help improve health care in BC. You can listen to it here. 

Gateway Centre of Excellence in Rural Health 

Gateway is Canada’s only community-based rural health research institute. It is an independent not-for-profit corporation located in Goderich, Ontario. Their goal is to improve the health status of rural residents with a specific emphasis on: 

• healthy aging  
• healthy communities 
• mental health and addictions 
• lung health 

You can explore their bi-annual newsletter here.

One of their projects looked at the impact of COVID-19 on the wellbeing of rural health care workers. Through a survey, they learned that 65% of health providers had experienced personal stress at work because of the pandemic. They also found that 71% of health providers relied on support from family and friends to manage their stress, rather than professional mental health services. Their full report is publicly available.

Centre for Rural and Northern Health Research (CRaNHR)

CRaNHR  is an academic and applied research centre at Laurentian University in Sudbury, Ontario. The centre focuses on interdisciplinary research on rural health. The goal is to improve health services, access to health care, particularly in rural and northern communities, and to enhance understanding of the health care system.

The centre focuses on four topic streams:

• Francophone health
• Indigenous health
• Health human services
• Impact studies on the Northern Ontario School of Medicine
• Virtual Care

Their Research in FOCUS on Research section summarizes studies conducted by CRaNHR researchers over the past twenty years.

The Alberta SPOR SUPPORT (AbSPORU) Unit

The Alberta SPOR SUPPORT (AbSPORU) Unit is a specialized research service centre. It is funded by the Canadian Institutes of Health Research (CIHR) and there are versions in each province across Canada. The role of AbSPORU is to support high quality research with patients and their families. Researchers can access many different services including data platforms, research tools, and expert advice on research methods and data analysis. AbSPORU can also help researchers to connect with others and assist with distributing research findings through the broad SPOR network. The SPOR Patient Engagement Platform is a special service to guide research with patients and their families.  

Health researchers across the province are collaborating with health-care workers, policy makers, and Indigenous communities to form the Alberta Indigenous Primary Health Care and Policy Research Network. The network emerged from a workshop in 2015 that brought together 65 First Nations and Métis community leaders, primary health-care providers, government health policy officials, and academic researchers. In the workshop, they explored innovative initiatives for delivering primary health-care services to Indigenous communities from across Canada.  

The Network is aligned with the calls to action promoted by the Truth and Reconciliation Commission of Canada. Their vision is to transform Alberta’s primary health care system to achieve Indigenous health equity by sharing knowledge and creating dialogue aimed at improving health outcomes with Indigenous peoples.  

 We want to listen to personal experiences and collaborate to highlight priorities for policy change. We need a deeper understanding of what works and what doesn’t work for communities. – Danika Goveas, Network student

Click on the links below for new rural health research:

• Integration of Care in Northern Ontario: Rural health hubs and the Patient Medical Home Concept (2021)
• Defining Rural Teaching Hospitals in Canada: Developing and Testing a New Definition (2020)
• Recruitment and Retention of healthcare Professionals in Rural Canada: A Systematic Review (2020)
• Progress Made on Access to Rural Healthcare in Canada (2020)
• A Systematic Review of Reviews: Recruitment and Retention of Rural Family Physicians (2020).
• Impact of Telemedicine on Diagnosis, Clinical Management and Outcomes in Rural Trauma Patients: A Rapid Review (2020)
• Lessons from 20 Years of Research on Nursing Practice in Rural and Remote Canada (2019)
• Learners’ Experiences of an Enhanced Surgical Skills Training Program for Family Physicians (2018)
• Recruitment and Retention of Physicians in Rural Alberta: The Spousal Perspective (2016)
• Patients at the Centre: Sustaining Rural Maternity–It’s All About the Surgery! (Western Provinces Collaborative, 2016)

The Society of Rural Physicians of Canada (SRPC)  – Rural Research Spotlight 

The Society of Rural Physicians of Canada (SRPC) champions rural generalist medical care through education, collaboration, advocacy, and research.

SRPC recently launched the Rural Research Spotlight, a resource designed to promote collaboration and excellence in Canadian rural health research by: 

• Listing relevant research opportunities for students, residents, and physicians across Canada
• Promoting upcoming rural health research events
• Highlighting the results of recently published Canadian rural health research.

The website is maintained by their Standing Committee for Research and you are invited to submit research opportunities, events, comments, and questions to the committee.

Academic Journals 

Academic journals publish peer-reviewed research articles. When researchers submit a study to a journal, other experts assess the work for its quality. This “peer review” process ensures that research meets high research standards before it is made available to the public. Journal editors also make sure that authors make known any conflicts of interest, particularly how they receive money for their work, and that articles are brief and clearly written. 

Many academic journals require a paid subscription to read the articles. Universities and libraries can purchase subscriptions for their faculty, students/alumni, and members to access. Interested individuals who have no connection to a university or library can pay to read articles.  

In recent years there has been a move towards ‘open-access’ research. This means that the public has access to many free research articles. Below are three examples of open-access rural health journals that publish scientific research articles: 

• Canadian Journal of Rural Medicine
• Rural and Remote Health
• Online Journal of Rural Nursing and Health Care

Interesting Reads 

A compilation of provincial and national research and reports on the rural health workforce.   

• Website: State of Rural Canada
• Report: How Healthy Are Rural Canadians?

A compilation of international research and reports on the rural health workforce. 

• Academic article: Building Research Capacity in Regional, Rural and Remote Allied Health Services: Lessons from Evidence and Experience
• Academic article: Research Capacity Building Frameworks for Allied Health Professionals – A Systematic Review