The editorial in the June issue of the Australian Journal of Rural Health (AJRH) argues that health providers should play a stronger role in addressing the social determinants of health. Jenny May, Timothy A Carey and Rob Curry, all health professionals working in rural or remote Australia, remind us that an individual’s health and wellbeing is strongly influenced by issues outside the health sector such as housing, education, transport, employment and income. And, as well as these distributional and circumstantial determinants, a person’s health is also affected by issues of personal, family and community empowerment, and the capacity for a person to have control over their life, as well as the concepts of self-esteem and social inclusion.
The authors argue that the health sector itself should play a more constructive and active role in addressing these broader determinants of health. “If it is not the job of health professionals working at the ‘coalface’ and seeing the results of long-standing often preventable disease, then whose responsibility should it be?” they ask.
A second editorial, by AJRH's Editor, David Perkins, considers the Strategic Review of Health and Medical Research (McKeon) and the contribution of research to health and wealth – both through the uptake of research findings to improved practice and better health outcomes, and through the commercialisation of research.
In his review article in the June issue, Richard Franklin considers the barriers and facilitators to older people undertaking exercise. Given the high proportion of people in rural and remote areas who live a sedentary lifestyle, and the relative difficulty of accessing formal fitness infrastructure, this is an important issue.
Leonard Crocombe’s original research article: Is clinical oral health poorer in regional areas compared to major city areas? reports that in 2004-06 the prevalence of dental caries was greater in inner regional areas than in major cities. However the prevalence of caries was no higher in outer regional areas than in the major cities. The reasons for the higher rate in inner regional areas appear to have been a mixture of service access, environment and risk factor issues. Given current developments in some local government areas, especially in Queensland, it is useful to note that the article suggests that another cause of the differential may be that water fluoridation is less common outside the capital cities. "Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride."
In another article in the June issue, Ratilal Lalloo provides cost estimates for providing students with a dental clinical placement in a rural area. The analysis highlights the value of partnerships between universities and both local and state or territory governments for cost-sharing, in order to ensure sustainability of placements.
The study reported by Janice Sangster shows that rural residents were more likely than urban residents to enrol in a telephone coaching program for the prevention of cardiovascular disease.
Maria Gardiner reports on a study of the effectiveness of cognitive behavioural coaching in improving the wellbeing and thus the retention of rural GPs. With most funding currently being directed towards financial incentives and obligation schemes for rural GPs, this study suggests that it might be worthwhile for retention initiatives to focus on self-management skills for rural GPs.
Other articles in the June issue of the AJRH include Embracing Autism in Canadian Rural Communities by Lindsey Hoogsteen, and Splenic injury admitted to a rural Level 3 trauma centre: a ten-year audit by Wayne Hoskins.
There are also short reports from Cathy Owen and Cynthia Piantadosi.
Intending authors can submit papers on line at http://mc.manuscriptcentral.com/ajrh
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