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Health Promotion in Rural Ontario--Tell Us Your Story


I Introduction
II Gateway Rural Health Research Institute
III The Ontario Rural Council
IV What’s Your Story?

-- submitted by Robb MacDonald, consultant, The Health Communications Unit

I Introduction

For those living in rural Ontario, the health benefits seem obvious: fresh air, a slower pace, numerous outdoor recreational opportunities and more. However, in the 2006 document, How Healthy are Rural Canadians?, the Canadian Institute for Health Information reported “In general, rural residents exhibited less healthy behaviours than urban residents.” The researchers found rural residents to have higher rates of smoking, and lower rates of physical activity and fruit and vegetables consumption than their urban counterparts. Additionally, rural communities tend to have higher mortality rates for circulatory diseases, injuries and suicide.

The health of rural and remote Ontario may be even worse than the rest of the nation. In Small Towns: Big Impact, a report from the Ontario Trillium Foundation (2007), found, “compared to other rural provincial regions, Ontario’s rural regions had a higher annual death rate, a higher infant mortality rate and a lower life expectancy.”

We also know from The Ontario Medical Officer of Health’s 2004 Healthy Weights, Healthy Lives report that obesity rates are higher in rural and more remote areas, including the regions of Huron, Northwestern and Northeastern Ontario, and Grey Bruce. According to Dr. Basrur, possible explanations for these differences include a lack of facilities, increased reliance on vehicular transportation (versus active transportation), higher food costs in remote areas and cultural dietary differences. The report concludes that there is a need to better understand the reasons for the regional differences.

Indeed, there is a need to better understand and share our knowledge around the issues, needs and opportunities related to rural health promotion. To help facilitate this understanding, the purpose of this week’s feature is twofold: First, it is designed to briefly profile two rural-based organizations that have a rural health focus: Gateway Rural Health Research Institute and The Ontario Rural Council. The second purpose of this feature is to invite health promoters in rural communities to forward their success stories to us so that we can help facilitate the exchange of knowledge with other health promoters who have an interest in rural Ontario.

II Gateway Rural Health Research Institute

One organization that is attempting to better understand the particular health issues of rural Ontario is the Gateway Rural Health Research Institute in Seaforth, Ontario ( Modelled after the University of Kentucky’s Center for Excellence in Rural Health, Gateway opened in 2008. Gateway is promoted as the first community-driven research centre in Canada addressing health issues in rural populations.

According to Dr. Claudio Munoz, Head of Research at Gateway, rural Ontarians – and particularly residents in the Huron-Perth-Grey-Bruce region – are more at risk for chronic diseases, including heart disease and diabetes than their urban counterparts. For example, Gateway’s research has identified that the rate of “diabetes in the Grey-Bruce area is double (8.0%) that of the Middlesex-London (4.1%), a neighbouring urban area.”

To address the issue of diabetes, Gateway embarked on an innovative research study. Under Munoz’s direction, Gateway worked with the Lawson Health Research Institute in London on a diabetes prevention initiative. Using Blackberry phones and Bluetooth adaptors attached to blood pressure, heart and glucose monitors, the researchers examined the impact of progressively longer daily walks on 25 pre-diabetes residents in Huron County over a two-month period. The purpose of the study was to “find out if increased activity and self monitoring [would] turn around symptoms, such as obesity, high blood pressure, high blood glucose and high triglycerides before they cause diabetes.”

According to Munoz, there were dramatic changes in blood pressure and weights of the 25 participants. The overall success of the study has paved the way for a more extensive study that will involve 300 participants, 150 from London and 150 from Huron and Bruce counties. An additional element of the upcoming study will be to examine the differences between the rural and urban samples.

Lin Steffler, President of the Board of Directors, identified that an overall goal of Gateway is to work with community health professionals to identify the need, conduct the research into disseminate the results back to the health care workers to help lower chronic disease levels within rural communities. Additionally, Steffler believes Gateway has the opportunity to become a link among rural health researchers, health care professionals and the community.

III The Ontario Rural Council

The Ontario Rural Council (TORC, has also identified the need to address the issue of rural health. Through its Rural Health Working Group, TORC “continues to work toward a better understanding of the changing landscape of our healthcare system and how it impacts rural Ontario. In addition to the ongoing exploration of new health delivery models and consolidation of available health information, this group works to ensure a rural voice remains heard at the table of decision makers.”

Although TORC’s Rural Health Working Group has more of a focus on health care than health promotion, the forum Rethinking Rural Health: Innovations Making a Difference (November 5, 2009, in Stratford) was designed to explore trends in rural health care, innovative community solutions and provincial initiatives and strategies for rural health. Speaker presentations and a follow-up report will be available on the TORC site (see Resources section).

IV What’s Your Story?

Recently (August 2009), the Public Health Division of the Ontario Ministry of Health and Long-Term Care released its Initial Report on Public Health, in which numerous case studies of public health initiatives are profiled. Examples of rural cases include: The Chatham-Kent Health Unit’s Public Outreach in Rural Communities initiative, and the Haldimand-Norfolk Health Unit’s 2007 research report, Rural Health: A Qualitative Research Approach to Understanding Best Practices for Rural Health Service Delivery in a Public Health Setting.

However, we want to learn more! It is our hope that if you have a rural health promotion story or event, that you will share it with us so that we can share it with others. Share your stories with Robb MacDonald at

V References

Canadian Institute for Health Information. How Healthy are Rural Canadians? An Assessment of Their Health Status and Health Determinants. September 2006.

He, M., Beynon, C., Sangster Bouck, M., St. Onge, R., Stewart, S., Khoshaba, L., & Lemieux, S. Ministry of Health Promotion. Ontario’s Action Plan for Healthy Eating and Active Living.

Kitty, Heather Lee. Rural Health: A Qualitative Research Approach to Understanding Best Practices for Rural Health Service Delivery in a Public Health Setting. Haldimand-Norfolk Health Unit. 2007.

Ontario Ministry of Agriculture, Food and Rural Affairs. Strong Rural Communities: Working Together for Success…And Getting Results. Rural Plan Update 2007.

Public Health Division. Ministry of Health and Long-term Care. Initial Report on Public Health. August 2009. [Includes case study descriptions of various public health unit initiatives throughout the province according to various health themes/issues. Many of the case studies reflect a rural area of focus.]

The Ontario Trillium Foundation. Small Towns: Big Impact. Selected Findings from the Ontario Trillium Foundation’s Research into Grantmaking in Small Ontario Communities. 2007.