An investigation of equity of rural speech-language pathology services for children: A geographic perspective

Abstract

The World Health Organization's equity objective states that there should be equal access to healthcare for equal need, regardless of location. Disparities between health services and challenges to achieving the equity objective have been documented both in Australia and around the world. However, little is known about the extent to which this objective has been met in the field of speech-language pathology in Australia. This study used structured interviews with 74 speech-language pathologists working in rural areas of New South Wales and Victoria. The data obtained were used to develop maps to describe the availability of paediatric speech-language pathology services through consideration of location and frequency. The findings show that 98.60% of localities are unserviced at the ideal frequency of weekly or more often. It is important to note that these percentages include all localities in the represented rural areas of New South Wales and Victoria, some of which are minimally populated. The maps also depict travel and distance as barriers to the accessibility of services and have been used to suggest a critical maximum distance for paediatric outpatient speech-language pathology services in rural New South Wales and Victoria. From the data collected, 50 kilometres was suggested as the critical maximum distance past which consumers become unable or unwilling to travel to access weekly rural speech-language pathology services in rural New South Wales and Victoria. Thus, people living in almost one third of rural localities in rural New South Wales and Victoria lie beyond what is considered by rural speech-language pathologists to be a reasonable travel distance to weekly speech-language pathology services. These results highlight barriers to the achievement of equitable services in rural areas. The results also provide an essential foundation to inform policy development and assist health service planning to meet the needs of rural consumers.

Keywords:

• Equity
• accessibility
• availability
• speech-language pathology services

Acknowledgements

The authors would like to acknowledge Lucie Shanahan, who assisted with the development of the structured interview schedule used for data collection. We would also like to acknowledge and thank the 74 rural speech-language pathologists who participated in the research and the researchers who undertook data collection. Thanks are also due to Simon McDonald from the Spatial Analysis Network at Charles Sturt University, who trained and supported the first author to use the ArcGIS software. We also wish to thank the peer reviewers of this paper for their valuable feedback. This research was partially funded by a Community of Scholars grant from Charles Sturt University, for which the researchers are grateful.