A Medical Student Study of Rural Health Concerns, Community Determinants and Whole Person Care

Background: Following a short rural health placement in the second year of medical school five students opted, as an extra-curricular activity, to conduct an exploratory research project into the wellbeing and health concerns of rural residents in the Wheatbelt of Western Australia. The project was conducted in collaboration with the local shires. The aim was to document, analyse and understand the health concerns and experience of rural residents. Methods: A phenomenological research approach was employed. Seventeen rural residents selected by the shires, and four key informants responded to open-ended interviews. Their narratives were subjected to a thematic analysis. Results: The narratives described a wide range of health concerns relating to health services, mental illness, transportation, accommodation, marginalisation of the community, bureaucratisation of administration, community fragmentation and the desire for community partnerships. Frustration and inconvenience from community factors were associated with anxiety, depression, isolation, and loss of wellbeing. Discussion: The respondents described a dysfunctional and under resourced local rural community. They defined numerous health concerns related to deficiencies in community cohesion and integration. They illustrated how whole person health involving prevention, acute and chronic treatment and aged care are all impacted by rural community circumstances. The narratives highlight the need for community development at the population level and for community context to be a principal focus in the clinical practice of whole person care in rural communities.