Define “rural”: some contributions from the Wonca Rural Discussion Group

I attach the document our Rural Health Advocacy Project (RHAP) compiled on defining rural, reviewing the then current landscape – essentially, it states that rural definitions must be fit for purpose, as some others have already said in their responses.

Visit RHAP at www.rhap.org.za

RHAP_Defining_Rural_Version_1 060614

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Ian Couper

Director: Ukwanda Centre for Rural Health

Professor of Rural Health, Centre for Health Professions Education

Faculty of Medicine and Health Sciences

Thers are many ways of defining rural and this makes it dificult to compare data from country to country
The UK Rural Definition can be found on https://www.gov.uk/government/collections/rural-urban-classification
In essence it defines rural as communities under 10,000 and this can be split into sparse or less sparse.

You can define rural in many ways based on:

• Population Density
• Landscapes (ie Forestry/Agriculture etc)
• Activities (ie Agriculture, residency, tourism etc…)
• Access & remoteness (Distance to services etc…)

Take a look at EUROSTAT and also the United Nations Website. Here they try to compare rural statistics.

The UN is described as “Rural areas are usually defined as “what is not urban” (UN, 1998 and 2004), and so inconsistencies in the definition of what is urban lead to inconsistencies in characterizing what is rural. … When definitions are based on quantitative thresholds, the minimum population for a place to be considered urban varies greatly.” Take a look athttps://unstats.un.org/unsd/demographic/sconcerns/densurb/densurbmethods.htm

Its really confusing and frustrating

Lets see what everyone else thinks?

Regards

John

Since there are so many definitions, I think it is helpful to simply make them explicit in our communications, our meeting presentations, and our publications. In the US, I use “Am I Rural?” (https://www.ruralhealthinfo.org/am-i-rural) which uses a street address to provide a series of definitions. I love all of these definitions, including “perceived as rural (i.e. self-report),” which has been shown to be as important to some outcomes (like eventual rural practice among students) than our official definitions, perhaps even more important.

Randy

Randall Longenecker MD

Professor of Family Medicine and Assistant Dean, Rural and Underserved Programs

Executive Director, The RTT Collaborative

Ohio University Heritage College of Osteopathic Medicine

Irvine Hall 126

1 Ohio University

Athens, Ohio 45701

Email: longenec@ohio.edu

Thanks John,

Actually that is not, strictly speaking, a UK definition since we have a separate Scottish system with varying degrees of sophistication.  You can find the Scottish definitions of UR2. UR3, UR6 and UR8 at: https://www2.gov.scot/Topics/Statistics/About/Methodology/UrbanRuralClassification

Best wishes

Phil

Dear all,

Very interesting document, it show the limits of such studies.

The question of what is rural and what is not rural is still in debate inside EURIPA, because the countries in Europe are so different.
The definition of rurality depends of the context, and the objective , for instance is it for transportation, taxes, education, health etc ?
If we consider Health system, we have to go deeper and consider the relevance for GP/FM. Each criteria to define rurarily must be weighted, and at the end it is puzzling.
The conclusion of a Workshop on the topic we has  was:
If you think you are rural, you are rural
if your colleagues think you are rural , you are rural
and if you dream that you are rural it is probably true.
This definition can’t be analysed as a quantitative study, the odd ratio or p value can’t be calculated, but at least it is relevant for our mind.:-):-):-)

Warm regards

Jean-Pierre Jacquet