This image depicts someone's pulse being taken to illustrate issues in healthcare in rural Canada.

Health & Healthcare in Rural Canada

We continue our series, “Struggles in Small Town Canada,” highlighting problems faced in rural North America. Makenzie McNeill discusses the topic of health and healthcare in rural Canada.

The Problem of Healthcare in Rural Canada

The state of health and access to quality healthcare in rural places is in rough shape, to say the least.

According to the Canadian Mental Health Association, people in rural communities “have a lower life expectancy than the average Canadian.” Furthermore, “residents of rural or remote communities often have greater healthcare needs than their urban counterparts…” reports WaterToday.

The reasons rural Canadians have poorer health and find themselves unable to receive the medical treatment they need, from primary care to specialty care, are as plentiful as they are complex. To better understand this complicated reality, let’s look at a few defining reasons that contribute to this problem that affects millions across rural Canada.

But most importantly, I want to highlight how Village Missionaries play a role in this dynamic challenge, how they love and serve the physically and mentally vulnerable in their communities and share the hope of Christ in the midst of hardship.

Lack of Doctors

As plain as it sounds, rural Canada simply faces a shortage of physicians.

The Canadian Journal of Rural Medicine released an article in 2018 that focused on the supply and retention of rural physicians. They found that although around “20% of the Canadian population reside in rural areas…only 9.3% of physicians practise [there].”

To look at the problem from another angle, the Canadian Health Workforce Network reports that “while Canada as a whole averages one doctor per approximately 450 residents, this ratio can be as low as one in 3,000 in some remote communities.”

To compound matters, rural communities also experience a generally high turnover rate of healthcare positions. An article from the University of Northern British Columbia lists “nurses, physicians, [and] dentists” as a few examples.

Additional Resource:
Video: Doctor shortage in Canada pushes patient to desperate act

Lack of Specialty Services

Furthermore, many rural communities also experience a lack of specialty care for more advanced health problems. Even if primary care is available near you, “access to more specialized services (e.g., diagnostic imaging or referral to specialists) could be hindered by long travel times, a lack of funds for travel, and a dearth of public transportation options” (Canadian Rural Revitalization Foundation).

Village Missionary Chris White of Rich Valley, Alberta, who also serves as a chaplain at a local hospital, has personally experienced this problem in the context of mental health services:

“I remember one patient who was in the hospital for a psychotic episode. I talked with them about their life, their situation, and their struggle with mental health. They were trying to keep a positive outlook but it was hard for them because they didn’t really belong in the hospital but there was nowhere else for them to go. Sadly the hospital had become a revolving door for them because there was no place for them to get the help they needed.”

Brenden Peters, a fellow missionary also serving in rural Alberta (the small community of Boyle), has also experienced the strain of distance from specialty care.

“With my degenerative eye condition, I am required to make a yearly visit to the city of Edmonton, which is around two hours away. The hospital and clinic in Boyle also does not do much for prenatal care, which means that we have to go to the city for all ultrasounds and doctor’s appointments and eventual delivery.”

Rural Disinterest

There is a multitude of reasons why rural Canada faces such an immense shortage and low retention of physicians and services. However, one factor could simply be a lack of interest or incentive to practise medicine in rural communities.

WaterToday cites “a heavy workload, professional isolation, and limited career options” as a few reasons why attracting physicians to small communities proves difficult. Career and educational opportunities for spouses and children also play big roles.

After all, if prominent hospitals and clinics in cities can provide higher pay, more amenities, and career advancement, it makes sense that physicians would be less eager to work in places that cannot promise those comforts.

Additional Resource:
Video: Ontario Hubs: Recruiting in Rural Medicine

Help is Far Away

When adequate healthcare, either for primary or specialty services, is not available near you, the next inevitable option is to travel. But that is much easier said than done.

The same article from the University of Northern British Columbia states that because “health care facilities in northern and rural areas are fewer and more dispersed…it is not uncommon for persons requiring specialized health services or diagnostic testing to travel 200 kilometers or more to the nearest hospital.” And depending on where you live and what treatment you need, the distance could be even more.

We should also consider the problem of how far away emergency services are when a medical crisis arises. The Canadian Journal of Emergency Medicine reports that not only are “rural populations at a higher risk of trauma and trauma death” (trauma being the leading cause of death in Canadians between ages 1 and 44), but also “22.5% of Canadians reside more than 1 hour by road from a level I or a level II trauma centre.” Since rural areas often have more physically challenging jobs – mining, ranching, farming, logging, etc. – it follows that more trauma-related injuries occur here.

Therefore, the vast distances that often prevent rural Canadians from receiving care is even more exacerbated during emergencies when medical care is required immediately, but may not arrive in time. The Federation of Canadian Municipalities notes that “Canada’s rural communities…face acute challenges in responding to emergencies…”

Health and Well-being

Considering all these factors, it is not surprising then that the general health and wellbeing of rural Canadians fares worse than those of their urban counterparts.

Canadian Journal of Rural Medicine

  • Rural Canadians experience lower life expectancy, higher infant mortality, higher accident rates, and higher levels of disability

Canadian Mental Health Association

  • Rural and small towns have elevated rates of obesity, smoking, arthritis/rheumatism, and high blood pressure
  • Rural and northern areas have higher than average rates of major depressive disorder

WaterToday

  • Rural and remote communities experience higher rates of chronic disease, traumatic incidents, and poorer mental health
  • The health of Indigenous peoples tend to be poorer than the average Canadian

Farmers

I want to touch on the topic of mental health again as an illustration and to highlight members of the rural community who struggle greatly in this area – farmers.

A 2016 study from the University of Guelph discovered that roughly 45% of farmers had high levels of stress and 35% met the criteria for depression – percentages that are much higher than the general population.

Farmers and ranchers across Canada also experience “stress, anxiety, depression, emotional exhaustion, and burnout” more than other professions; compound this with the scarcity of mental health resources in rural areas and the stigma that surrounds mental health problems, “many farmers have not been getting the help they need” (Radio Canada International).

Taking all that information together, it is therefore not surprising, but tragic, that the “suicide rates in farmers are the highest of any occupation” (Huffington Post).

Additional Resources:

How Village Missionaries Help

You can see the problem of healthcare in rural Canada. All this data, taken as a whole, shows that rural places are not the idyllic stereotypes that dance around in peoples’ minds. They are broken places that are overlooked by society, and largely by the medical world, as well.

Yet, it is precisely these fractured, struggling places that Village Missionaries willingly enter.

And for sure, our missionaries have truly followed in Jesus’ footsteps by caring for the physical, mental, emotional, and spiritual well-being of their communities. Here’s an example from missionaries Rod & Denise Nikkel in Golden Prairie, Saskatchewan:
“The water in our town is not officially drinkable. It has high nitrate levels, well above what the standards allow for. So we can’t drink the tap water in town, though it is safe for bathing, laundry, etc. The town still does treat its water with chlorine and tests it regularly for minerals and bacteria. One of the people in town has this responsibility. When she is away or can’t do the testing, I (Denise) often do it for her. This past month she and her husband were quarantined for two weeks because he was sick (it turned out not to be COVID-19), and during that time I tested the water daily.”

But what’s even greater, more eternally significant, is that Village Missionaries can point people to the Great Physician, the God who can heal and save what matters most – their souls.

As Jesus said in Mark 2:17, “Those who are well have no need for a physician, but those who are sick. I came not to call the righteous, but sinners” (ESV).

Rural Canada not only faces a shortage of doctors, but also a shortage of missionary-pastors.

But in 30 small, forgotten communities across Canada, Village Missionaries are keeping the hope of the gospel alive. They are proclaiming the good news of Jesus to people who desperately need to hear it, so that they can experience His transforming grace and power.

Village Missionaries can’t magically solve people’s health problems.

But, the Lord can use them to serve the lowly and proclaim that He alone is the Resurrection and the Life (John 11:25), and that for those who hope in Him, we can believe His promise in Revelation:

“He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away.”
– Revelation 21:4 (ESV)

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