When the social meets health in rural Australia: confronting the disconnect

ABSTRACT

What happens in contemporary rural Australian communities when health consumers, health practitioners and health services intersect is the focus of this article. Using a hypothetical case of intimate partner violence, we analyse the power relations within what we call the ‘intersecting space’ to examine how each of these three central and ‘typical’ actors – rural consumers, health practitioners and rural services – is positioned. Drawing on Foucault’s concepts of power and discourse, we deconstruct dominant discourses of sameness and neutrality which (i) marginalise the perspectives and needs of rural health consumers, (ii) immobilise the ability of health practitioners to connect the social to health and (iii) restrict the flexibility of rural health services to address the social as part of health need. We argue that these discourses of sameness and neutrality have generated a longstanding disconnect that constrains social and health care systems, thwarting the production of client-centred care. We suggest that system-level change is required to provide client-centred, integrated and inclusive rural health care that recognises and addresses the social as a fundamental part of health.

KEYWORDS:

• Rural health
• the social
• power
• discourse
• client-centred care

Acknowledgements

We thank the anonymous reviewers for providing constructive feedback.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. In this article, we refer to rural Australia and rural health and do not make reference to remote Australia or remote health. This is a conscious decision. We acknowledge that rural health and remote health, while they share some features, like rural health and urban health, are different fields and different contexts and we did not want to present remote as if it were synonymous with rural.

2. Consumers are required to pay an additional fee if they need/wish to be book a longer consultation.

Additional information

Funding

This research was funded by the Australian Government Department of Health through the Rural Health Multidisciplinary Training Program.