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BackgroundIn 2011, approximately 14 percent of B.C. residents lived in rural and remote areas, and according to the Ministry of Health, 11.3 percent of the rural population identified as Aboriginal, compared to the 3.7 percent in urban B.C. Furthermore, as younger generations leave these communities for educational and economic opportunities, the population tends to fluctuate, leaving baby boomers, many of which are now considered seniors, to make up an increasingly large portion of the rural population. In 2015, individuals aged 45-64 made up 28% of the Northern Health Authority population, and individuals aged 65+ made up 13 percent. Within the Interior Health Authority, individuals aged 65+ made up 22% of this population.
Among the rural and remote population, there is a higher rate of disease and injury, as well as premature death compared to those living in urban areas. Major contributors to this health gap include lower socioeconomic status, isolating employment conditions, unhealthy lifestyles leading to high rates of chronic disease and lack of access to perinatal, primary care, surgical and trauma services due to geographic location. The Ministry of Health policy papers also indicate that across rural B.C., many regions report poorer perinatal indicators, increased potential years of life lost to causes such as motor vehicle accidents, falls, and drownings, and differences in life expectancy (as high as five years when compared to some urban areas).
Major barriers to improving service provision in rural and remote B.C. include difficulties in recruiting and retaining healthcare providers into rural and remote communities, as well as establishing a balanced staff mix. Incentives to recruit healthcare providers, particularly physicians, have helped to increase the number of healthcare providers in some rural and remote areas of B.C., however difficulties persist in retaining these providers due to poor professional development opportunities and lack of support. In addition, incentives for non-physicians such as nurses are virtually non-existent.
- Individuals living in rural and remote areas generally have poorer health outcomes compared to their urban counterparts because they have difficulty accessing healthcare services in a timely and cost-effective way.
- Aboriginal peoples and seniors make up a large portion of the rural population in B.C. and services need to be targeted towards these subgroups (e.g. assisted living, home care, primary healthcare, chronic disease management, etc.)
- Nurses have worked in rural and remote areas in Canada since the 1950s, and provide the bulk of primary healthcare in rural and remote B.C. While they have the expertise to develop solutions in mitigating existing barriers, nurses should be provided the necessary support for professional development and continuing education opportunities in order to care for increasingly complex patients.
- All healthcare providers should be utilized to their full scope and government should ensure that incentives, continuing education and professional development opportunities are available to support these providers.
- Innovative technology and models of care must be continued to be explored and used to its full potential in order to improve the health outcomes of British Columbians living in rural and remote communities.