目的:本文探讨了\'place\'作为生态,健康和福祉的社会和文化决定因素,重点关注澳大利亚农村和偏远生活的好处和挑战。
背景:卫生系统,包括健康促进,可以积极为创造支持性环境和场所做出贡献,以促进居住在农村和偏远地区的个人的健康和福祉。对于第一民族人民,生活在乡村,关心国家和人民,是土著世界观的核心,以及促进土著和托雷斯海峡岛民的健康和福祉。他们被迫从祖传土地上移走是灾难性的。对所有人来说,生活在农村和偏远地区可以提供丰富的元素,有助于“宜居”社区,包括呼吸新鲜空气,绿色和蓝色的空间,农业就业,紧密联系的社区,一种归属感和认同感,和社会资本。然而,远程生活也会限制就业机会,干净的水,负担得起的食物,可靠的运输,社会基础设施,社交网络和预防保健服务。\'place\'是维持健康生活的关键推动者。然而,目前的趋势导致当地服务和资源减少,增加了对气候变化影响的暴露。
方法:本评论提出了一些想法和策略,通过这些想法和策略,农村和偏远地区的人们可以增强宜居性,他们社区的韧性和认同,并重新获得基本保健和健康促进服务和资源。
结论:推荐的策略包括在线获取教育,就业和远程医疗;灵活提供社会基础设施;以及有意义和反应迅速的大学卫生服务伙伴关系。
OBJECTIVE: This article explores the crucial role of \'place\' as an ecological, social and cultural determinant of health and well-being, with a focus on the benefits and challenges of living rurally and remotely in Australia.
BACKGROUND: The health system, including health promotion, can contribute actively to creating supportive environments and places that foster health and well-being among individuals residing in rural and remote locations. For First Nations peoples, living on Country, and caring for Country and its people, are core to Indigenous worldviews, and the promotion of Aboriginal and Torres Strait Islander health and well-being. Their forced removal from ancestral lands has been catastrophic. For all people, living in rural and remote areas can deliver an abundance of the elements that contribute to a \'liveable\' community, including access to fresh air, green and blue space, agricultural employment, tight-knit communities, a sense of belonging and identity, and social capital. However, living remotely also can limit access to employment opportunities, clean water, affordable food, reliable transport, social infrastructure, social networks and preventive health services. \'Place\' is a critical enabler of maintaining a healthy life. However, current trends have led to a reduction in local services and resources, and increased exposure to the impacts of climate change.
METHODS: This commentary suggests ideas and strategies through which people in rural and remote locations can strengthen the liveability, resilience and identity of their communities, and regain access to essential health care and health promotion services and resources.
CONCLUSIONS: Recommended strategies include online access to education, employment and telehealth; flexible provision of social infrastructure; and meaningful and responsive university-health service partnerships.