'Perimeteritis' and rural health in Manitoba, Canada: perspectives from rural healthcare managers.
BACKGROUND
Rural areas in many parts of the world are facing issues such as economic restructuring, environmental degradation, aging, and depopulation. These issues impact the health and wellbeing of the people living in rural communities. The purpose of this study was to assess rural healthcare managers' understanding of rural community wellbeing. Specifically, definitions were sought for rural, community, health, wellbeing, and healthy rural community.


METHODS
The research reported in this article is based on a set of interviews with each of the 20 healthcare professionals who either managed healthcare centres or administered specialized programs in the rural health care centres in the Assiniboine Regional Health Authority in southwestern Manitoba, Canada.


RESULTS
Capitalizing on the open-ended structure of the interviews, respondents were thoughtful and philosophical in their responses. This produced a rich array of definitions of rural, community, health, wellbeing, and healthy rural community. In doing so, the struggles for rural communities in southwestern Manitoba were highlighted. The findings also illustrated that definitions of health and wellbeing do not fit standard biomedical or health determinant models alone.


CONCLUSIONS
This study was a follow up to another study that employed focus groups to obtain rural resident perceptions of rural, community, wellbeing, and health in southwestern Manitoba. The study reported on here argued that the specific views of healthcare managers were necessary to further illustrate the complexities in understanding definitions of community and condition. The results are consistent with previous research on this topic in southern Manitoba and the recent literature in that there are no universally accepted definitions of rural, community, wellbeing, or health. Further, the study illustrated that professionals charged with managing healthcare services in rural Manitoba maintain very broad definitions of health and wellbeing. Most significantly, the determinants of health and wellbeing were central to defining individual and community condition and quality of life.
Ramsey
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Department of Rural Development, Brandon University, Brandon, Manitoba, Canada. ramsey@brandonu.ca
Beesley
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KB
D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D012423:Rural Health; D019035:Rural Health Services / Q000458:organization & administration*; D000078329:Workforce