Re-producing rural health: Challenging dominant discourses and the manifestation of power

Malatzky, Christina; Bourke, Lisa

doi:10.1016/j.jrurstud.2016.03.005

Cited by 67 publications

(82 citation statements)

References 65 publications

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“…One of the early readings has included a short overview of rural health; it talked about 'bush doctors' 15 and the generalist type of work they do, mostly with ageing patients. 6 When training, the majority of students learn that specialisation is the pathway to accrue higher status, income and respect. It is clear that rurally based doctors are lower on the hierarchy.…”

Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

“…17 Students and professionals might hear and experience different messages to the ones portrayed in the above fictionalised scenario. 3,6 These dominant messages about generalism inform the thinking of many students and professionals and the career-related decisions they make. 6 When training, the majority of students learn that specialisation is the pathway to accrue higher status, income and respect.…”

Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

“…However, research indicates that the most dominant message received by students is that becoming a generalist is not a 'wise' choice. 6 It is in such contexts that Hafferty argued 'one of the great challenges facing medical educators lies in being willing and able to step back and assess just what messages are being created by and within the very structures they have developed and are responsible for'. 15 In contrast, generalism is associated with boring, monotonous practice that is poorly paid, less clinically skilful and unsophisticated.…”

Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

“…2,4 Much of this research is associated with attracting an adequate workforce to better resource rural health systems. In drawing critical attention to dominant deficit constructions, we are not seeking to diminish the disadvantage that rural populations encounter under health care systems predominately designed for metropolitan conditions, 6 nor undermine the evidence currently produced in the discipline of rural health. 5 It is this construction of rural health through such deficit knowledge that is the concern of this article.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, rural health has to be understood as an area of need. 6 In drawing critical attention to dominant deficit constructions, we are not seeking to diminish the disadvantage that rural populations encounter under health care systems predominately designed for metropolitan conditions, 6 nor undermine the evidence currently produced in the discipline of rural health.…”

Section: Introductionmentioning

confidence: 99%

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Different perspectives on the key challenges facing rural health: The challenges of power and knowledge

Malatzky

Bourke

2018

Australian J Rural Health

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The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood.

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Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

Section: Dominant Portrayals Of Generalismmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Different perspectives on the key challenges facing rural health: The challenges of power and knowledge

Malatzky

Bourke

2018

Australian J Rural Health

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Exploring the role‐based challenges of providing culturally inclusive health care for maternal and child health nurses: Qualitative findings

2020

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Aims To explore how maternal and child health nurses (MCHNs) working in a specific regionally located service perceive and experience delivering health care to a diverse population. Design Qualitative exploratory study. Methods Qualitative interviews were conducted with MCHNs (N = 6) working in a particular regionally located service. Data were selectively coded, categorized and interpreted through a process of argument writing influenced by poststructuralist thought and Foucauldian conceptualizations of power. Results The data analysed were interpreted into the following categories: (a) system‐level expectations of the maternal and child health role; (b) what these system‐level expectations mean for the role and practice of MCHNs; and (c) what MCHNs themselves report prioritizing in their work. The analysis suggests that a substantial hindrance to the development and support of culturally safe, inclusive and quality maternal and child health care lies in the very ways contemporary health institutions seek to discipline the routine practices of MCHNs.

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Cancer‐related help‐seeking in cancer survivors living in regional and remote Australia

et al. 2021

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Objectives To measure rates of detection via screening, perceived self‐imposed delays in seeking medical attention, and support seeking in a sample of regional and remote people with a cancer diagnosis and to test whether an association exists between these behaviours and minimising problems and resignation, a need for self‐control and reliance and fatalism. Correlations and binary logistic regressions were conducted to test the associations between demographic characteristics, attitudes and behaviours. Results Females were more likely to have had their cancer detected via screening (OR = 10.02, CI = 3.49–28.78). Younger participants (r = −0.103, p = 0.009) were slightly more likely to seek at least one form of support and online support was sought more often by younger patients (r = −0.269, p < 0.001), females (r = 0.152, p < 0.001), those from higher socio‐economic (SES) areas (r = 0.100, p = 0.012), and those with higher education levels (r = 0.247, p < 0.001). Younger (r = −0.161, p < 0.001), and female (r = 0.82, p = 0.013), participants were also slightly more likely to seek support specifically through cancer support groups. No significant relationships between minimising problems and resignation, needs for control and self‐reliance or fatalism and detection via screening, support seeking, or perceived self‐imposed delays to seeking medical attention were apparent, with the exception that those with higher fatalism (predetermined health) were slightly less likely to report seeking support or information online (OR = 0.79, CI = 0.65–0.95) and slightly more likely to report using Cancer Council's support services (OR = 1.24, CI = 1.02–1.52). Conclusions Strategies to improve the accessibility and appropriateness of support available for regional and remote cancer patients should consider interventions that remove barriers to access associated with age, gender, and education as opposed to those which address the attitudinal traits measured here.

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Re-producing rural health: Challenging dominant discourses and the manifestation of power

Cited by 67 publications

References 65 publications

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge

Different perspectives on the key challenges facing rural health: The challenges of power and knowledge

Exploring the role‐based challenges of providing culturally inclusive health care for maternal and child health nurses: Qualitative findings

Cancer‐related help‐seeking in cancer survivors living in regional and remote Australia

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