title: Rural community and health care interdependence: an historical, geographical study.
abstract: The relationships between rural health care and community development were examined over time, for the case-study area of Huron and Perth counties in Southwestern Ontario. The underlying premises were that an historical-geographic study could provide both a perspective on the development of rural health services and explore the interdependent relationship between rural community and health care. The research concentrated on examinations of the 2 key elements of rural health care, namely the rural practitioner and the community hospital. Detailed reconstruction revealed that, over time, both physicians and hospitals moved from a marginal to a central position and identity within the community, in parallel with the stages of community development in the 19th and 20th centuries, with hospitals emerging as major foci of rural sustainability. In the last 2 decades, the strength of the area's rural community health system was successfully marshalled to offset the potentially negative aspects of provincial health care restructuring. This reinforced both the perception and the reality of the interdependence of health services and communities in the predominantly rural area.
authors.affiliation: Department of Geography, Social Science Centre, University of Western Ontario, London, Ont.
authors.forename: Denise
authors.initials: D
authors.lastname: Grafton
authors.forename: Michael
authors.initials: M
authors.lastname: Troughton
authors.forename: James
authors.initials: J
authors.lastname: Rourke
mesh_terms: D018672:Community Health Planning / Q000266:history; D005194:Family Practice / Q000266:history*; D006301:Health Services Needs and Demand / Q000266:history; D006302:Health Services Research / Q000266:history; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006764:Hospitals, Community / Q000266:history*; D006779:Hospitals, Public / Q000266:history; D006780:Hospitals, Rural / Q000266:history*; D006801:Humans; D007373:Interinstitutional Relations; D009313:National Health Programs / Q000266:history; D009864:Ontario; D009936:Organizational Innovation; D010819:Physician's Role / Q000266:history; D019035:Rural Health Services / Q000266:history*; D012922:Social Change / Q000266:history; D014507:Urbanization / Q000266:history