How is rural defined and used in Canada?

Resumo

Introdução: Introduction: Despite a number of Canadian studies linking rural background and rural placements to rural practice, there remains variation within this literature with regard to what constitutes “rural.” A consistent definition of “rural” may be a useful tool for medical schools, governments, and other interested stakeholders as policies and programs to increase rural practice are created.

Objetivos: Objective: This study reviews selected Canadian research articles that include an operational definition of rural. Our aim is suggest a definition of rural that could be applied nationally and consistently.

Metodologia ou Descrição da Experiência: Methodology: From July to August 2013 PubMed was used to identify Canadian-based research articles that: 1) utilized a clearly operationalized definition of ‘rural’ to describe or categorize medical student background, educational placements, or physician practice location 2) tested for a statistical relationship between rural background or rural educational placements and rural practice locations. Search terms included (but were not limited to): rural background, rural origin, rural placement, rural education, rural doctors, rural physicians. Abstracts were reviewed; articles that fit criteria 1) and 2) above were subjected to full review and definitions of rural were categorized.

Resultados: Results: In all, 14 articles were identified for inclusion in this review. Among these articles, definitions of “rural” used included: community of under 10,000 population; community of under 25,000; community of under 100,000; provincially specific combinations of size and distance from a larger center; and self-perception (e.g. self-perception of community of practice location as ‘rural’). A table was produced to show the frequency with which each definition was used and the statistical relationships identified by the studies under review.

Conclusão ou Hipóteses: Conclusions: This review points to the usefulness of standard and graduated definitions of rural. We argue for the adoption of operational approach that defines communities of under 25,000 as rural, with a major subgroup of those communities of under 10,000, but recognizes gradations of rural from under population under 1000 to population under 100000.