Action still needed on health disparities affecting rural and remote communities

As you read this I will have just returned from the WONCA Rural—Ubuntu 2024 conference in Cape Town, South Africa.¹ There, doctors from around the world met to discuss the importance of providing high-quality care to people living in rural and remote communities and brainstormed how we can make sure people living in these settings have the same access to care as their urban counterparts.

This conference and the issues and solutions discussed there are relevant to people living in rural and remote communities in Canada. While approximately 18% of Canadians live in rural areas²—with rural defined as “communities that are geographically located in rural and remote regions of Canada and are distinctly or partly populated by Indigenous people”³—that population is being served by only 8% of physicians practising in Canada.⁴

Canadians living in rural communities tend to be “older, poorer, and sicker” than those living in urban areas.³ Canadians in these communities must travel farther to find care and often find it difficult to access. Family doctors practising in these communities often do so without the kind of access their urban colleagues have to other specialists or to diagnostic imaging. These doctors are also more likely to be working in areas with shortages in the health workforce. Many, however, take great satisfaction in their ability to serve their communities as comprehensive rural generalists who maintain broad scopes of practice.

As a rural family physician in my early years of practice I experienced this satisfaction first-hand, and in my research and teaching roles I have seen these issues persist over time. In fact, they have become more acute in recent years.

Health disparities between those living in rural and remote areas of Canada and those in urban centres are not new. The CFPC continues to work to improve health care for people who live in rural and remote communities.

The CFPC and its partners—Advancing Rural Family Medicine: the Canadian Collaborative Taskforce and the Society of Rural Physicians of Canada—released The Rural Road Map for Action: Directions³ in 2017, created the Rural Road Map Implementation Committee⁵ in 2018, and published the Rural Road Map: Report Card on Access to Health Care in Rural Canada⁶ in 2021. The committee, which wrapped up in 2021, raised awareness about rural health disparities and released several publications on the topic of rural and remote health.

The CFPC continues to work on solutions outlined in the road map.

In July 2024 CFPC Executive Director and Chief Executive Officer Mike Allan and I met with the Society of Rural Physicians of Canada to keep pushing all levels of government for progress on the actions outlined in the Rural Road Map, including systemic changes needed to improve health care access. One such change is greater support for team-based care, a key aspect of the CFPC’s Patient’s Medical Home vision and the recent Team Primary Care initiative.

Access to high-quality equitable health care for all Canadians, regardless of their geographic location, is possible but will not be achieved without intentional investment in the rural health care workforce. The CFPC continues to advocate for this with all levels of government.

I offer a big shout-out and thank you to CFPC members who practise in rural and remote areas and make important contributions to their communities. You are amazing examples of what a comprehensive family physician can be.

• Copyright © 2024 the College of Family Physicians of Canada