Rural Health Inequalities

Freddie Finlay Consultant The Strategy Unit

Rural Health Inequalities

The UK Government (2016) define rural areas as those which “fall outside of settlements with more than 10,000 resident population”. This accounts for 90% of England, with 17% of the total population living in local authorities defined as rural (Department for Environment, Food & Rural Affairs, 2021).

Perceptions of rural living as healthier, ignore the deprivation, isolation and social exclusion experienced by many people living in rural areas. Often with less access to services that can offer relevant support.

The Covid-19 pandemic and cost of living crisis have exacerbated inequalities experienced by those living in rural areas (Nuffield Trust, 2020). The economies of seasonal, tourist locations have been heavily hit. The housing stock in rural areas is larger, older and less energy efficient, making them expensive to heat and leading to fuel poverty.

NHS England (2018) outlined that “Where these characteristics (older age group, rural location and socio-economic disadvantage) coexist there is likely to be intersectionality where complex determinants of health relate, intersect and reinforce each other leading to delayed diagnosis, poor quality of care, higher mortality and greater inequality”.

This evidence review explores the following recognised drivers of rural health inequalities:

  • Patients and services being more geographically dispersed
  • Funding and increased costs
  • The demography of rural areas
  • Digital exclusion
  • Lack of transport
  • Housing and fuel poverty
  • Deprivation, isolation and social exclusion
  • Workforce issues within the NHS
  • Climate change
  • Coastal issues

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