People living in rural and remote communities can face many challenges when it comes to maintaining their health. Residents of three mining communities in rural and remote Queensland had both good and bad things to say about their health and health services available in their communities.
Researchers from James Cook University used semi-structured interviews to investigate the perceptions of residents of these communities about community wellbeing and the mining industry. Residents were asked about both their own direct experiences within the communities and their perceptions of the community as a whole. The communities were of varying sizes, with populations of around 20,000, 15,000 and 9,000. In two of the communities coal mining was the primary industry; in the third a mix of heavy metals was mined.
"...because there is a big sporting community in town. I think…the average person is probably…pretty active or does something outside when it’s not too hot." (Participant 14)
Some of the positive aspects residents reported included the perception that many members of their community were engaged in exercise and physical activities such as playing sports and using exercise infrastructure such as walking paths.
However, other residents perceived there were high rates of overweight residents due to a lack of exercise. In some communities it was thought that the hot climate inhibited residents’ ability to exercise. Some residents also noted unease about air pollution from the surrounding industries.
"...[health professionals are] doing Skype…people fly-in and fly-out to still deliver services for the community...I feel that there’s a lot of good things happening within the…health industry." (Participant 30)
Residents reported positive aspects of the health services available within their community. Specifically, residents noted the importance of outreach services and schemes giving access to medical care outside of their communities. The use of technology was also seen as a positive as it increased residents’ ability to consult with medical and allied health professionals remotely.
“I think people tend [to] live away if they’re…too unwell.” (Participant 29)
Residents also noted some challenges to accessing health services both within and outside of their communities. A lack of bulk billing doctors was noted as a challenge for many to access medical care. They also perceived a lack of understanding from private health funds of the extra costs incurred by those who live in rural and remote areas when accessing tertiary and specialist health services. In two communities residents reported concern about the lack of local birthing facilities as a cause of stress for families.
One participant in particular discussed the challenges of travelling to see health specialists outside the community. This participant had lived and worked in the community for 16 years and was now retired. They explained the frustration in travelling long distances to see the doctor for a quick check-up, explaining that:
“…I have to fly down there and then you’re waiting there for three hours and then you go in and he has 20 minutes.” (Participant 24).
This participant was so impassioned by the community’s lack of access to travelling specialists that they had contacted their local politician. This participants’ story highlights the need for specialists in major centres to consider the circumstances of patients who live in rural and remote areas when scheduling appointments. Greater use of technology could reduce the costs for those who live in rural and remote communities.
Although there were reported challenges to residents’ health in these communities, residents did acknowledge factors they perceived to enhance their health. In particular, the interviews highlighted that residents were aware of the importance of exercise in maintaining personal health. Improving available community exercise facilities, such as shaded walking paths, could help address residents’ concerns regarding difficulty exercising. Additionally, promoting and improving currently available health travel rebates, from Government and private health funds, could help reduce challenges to accessing healthcare.
Katerina Kanakis undertook this research as part to her PhD through James Cook University, with supervisors Dr Connar McShane, Dr Meegan Kilcullen and Dr Anne Swinbourne.