Rural Community Well-being: The Perspectives of Health Care Managers in Southwestern Manitoba, Canada

Abstract

Health care issues in rural areas are dominating the public policy agendas throughout the western world. The issues are many and varied. Canada is no different in this regard, as there are many rural areas with concerns about health care delivery in the face of declining populations. With 80 percent of Canadians living in urban, making the case for designating health care resources in areas with declining populations becomes more difficult. The purpose of this paper is to investigate how health care managers perceive rural community well-being, including indicators of well-being and determinants of well-being. The paper begins with an overview of the literature that places the context of this research in three areas. First, the literature on social capital is reviewed as in recent years both the social and medical sciences have been adopting it for analyzing community health. Second, the determinants of health literature is reviewed as the paper is concerned with the factors (determinants) that affect rural community well-being. Third, an overview of the definitions and models of health and well-being is provided to establish the context for measuring rural community well-being. A model is then applied through a survey of the twenty health care managers responsible for the operations of the 44 health care and seniors’ centres located within the Assiniboine Regional Health Authority in southwestern Manitoba. The model also proves useful in identifying determinants of health as well as assessing the role of social capacity in fostering rural community well-being.