Why Rural Health Matters – Looking After the Next Generation

Jane Randall-SmithChief Executive, Institute of Rural Health

Jig-So, 17th October 2011

Outline

• Introduction to the IRH• Setting the scene • The issues• Things to think about

Institute of Rural Health

The Institute of Rural Health (IRH):• UK-wide academic charity• Three main academic programme areas: – research and consultancy – education and training – policy analysis (including rural proofing)

“working to inform, develop and promote the health and wellbeing of rural people and their communities.”

IRH

• Research: – Contributing to the evidence base

• Education:– Developing a workforce fit for purpose

• Policy: – Informing and promoting

Setting the scene…

Rural

Health

• IRH takes an interdisciplinary approach which reflects our belief in the WHO definition of health...“health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.

Determinants of health and wellbeing

Source: Barton, H. and Grant, M. (2006) A health map for the local human habitat. The Journal for the Royal Society for the Promotion of Health, 126 (6). pp. 252-253.

Health and wellbeing

Influenced by:• Employment• Income• Education • Housing• Access to the natural environment• Access to services• Community safety

The Issues

Deprivation

• The Welsh Index of Multiple Deprivation 2008 ranks specific small areas in Wales in terms of relative deprivation.

• In Ceredigion, none of the areas fall in the 10% most deprived areas in Wales and overall the majority of its areas are less deprived than the Wales average.

WIMD Domains

Child Index

Access to services – For children

• “Distance Decay”– The further a person is away from a service the

less likely they are to use that service• Service utilisation is not a proxy for need• More marked in certain sectors • Access is influenced by social and cultural factors

not just physical aspects

What do we know

• Ceredigion as a whole does not show as “deprived” but there are – pockets of need and – hidden deprivation elsewhere

• Access to services is a huge issue• Poverty of choice

Things to think about …

Tackling child poverty in a rural setting

• Addressing inequalities:

– Acknowledging the “rural idyll”– Removing the “rural mask”

• Poverty affects life chances

The rural setting

• Data at county level doesn’t tell the whole story

• One rural town is one rural town• Dispersed populations• Hidden deprivation• Hard to reach• Understanding the culture and social

context

Young people in Ceredigion

• % of young people 0-15 yrs old 14.9% (Pembrokeshire 18.5%, Wales 18.2%)

• % of young people 0-4 yrs old 4.3% (Pembrokeshire 5.5%, Wales 5.8%)

And,• Ceredigion has the highest life expectancy in

Wales!

WHY rural health matters

• Wellbeing: – The early years are crucial (and the

importance of pregnancy) – Holistic approach: including family and the

community – Looking at prevention / promotion – Raise expectations

To make things happen:

• Small and dispersed population: services to users and users to services - Making the links

• Working together: Integrated working: building on team-working - within and between organisations

• Role of the third sector• Caring communities – resilience

Thinking ‘outside the box’ -

Further information• Institute of Rural Health

T 01686 650 800e Janers@irh.ac.uk

www.irh.ac.ukwww.ruralsupportwales.org.ukwww.ruralhealthgoodpractice.org.ukwww.ruralwellbeing.org.uk