Wikipedia

Rural poverty in Canada

Rural poverty in Canada refers to socioeconomic deprivation in rural areas. It is discussed in policy literature as a condition affecting income, employment, and living standards in remote regions.[1] Indigenous peoples living in rural and remote areas of Canada are identified in the literature as facing higher levels of socioeconomic disadvantage, including elevated rates of poverty and reduced access to services.[2]

Access to care

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Barriers to accessing health care

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Despite universal health insurance under the Canada Health Act, rural residents with lower socioeconomic status continue to face barriers to accessing specialist care. Lower income and educational attainment were associated with greater reported difficulty obtaining specialist services.[3] Rural Canadians experience reduced access to health care because services and specialists have become increasingly regionalized in urban centres. Shortages of health professionals, long travel distances, and difficulties recruiting and retaining providers contribute to poorer access for rural residents, particularly caregivers. To receive Federal funding from the government, the Canada Health Act acknowledges that five principles must be met, these include universality, accessibility, comprehensiveness, portability, and public administration.[4] For those living in rural communities, these five principles are not always met, they may face various challenges when trying to access health care. Difficulties which rural areas experience when accessing health care include long distances between health services, lack of transportation, increase amount of elderly, fewer health care providers, and limited awareness of resources available. With 90% of Canada identified as geographically rural, and approximately a quarter of the population are dwelling within rural areas with fewer than 10,000 people, this is a concern when identify health barriers.[5]

Health care is considered accessible when within a 30-60 minute drive in rural settings, and emergency vehicles are considered accessible when there is less than a thirty-minute drive.[6] This is a concern in emergency situations as an individual has a long wait time before being provided medical attention. Transportation is a significant factor that is a barrier to accessing health care. In rural areas an individual may have to travel great distances to seek medical attention, road quality may be very poor, weather conditions effecting driving, and rural areas seldom have access to public transportation.[7] The elderly have the greatest need for transportation services, a challenge to this is services is they may have to be booked a week in advance.[7] Also, with the baby boom generation, there will be an increasing number of elderly needing access to health care. A large percentage of people over 65 have a number of comorbidities, and need regular visits to a family doctor, the cost of regular transportation to a healthcare provider can be substantial. For many living in rural poverty, financial difficulties impede a person from being able to own a vehicle. The need for transportation to health care will only decrease when there is greater availability to health care programs, this involves bringing more health care providers to rural areas.[7]

Resource accessibility

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Rural and small-town communities in Canada often rely heavily on voluntary-sector organizations to deliver social services, particularly in contexts where formal service provision is limited. These organizations frequently operate with constrained financial and human resources, making it challenging to meet growing community needs and maintain service capacity.[8]

Physician accessibility

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While around 20% of Canadians reside in rural and remote Canada, only 8% of the physicians practice within these areas.[9] Rural Canadians experience reduced access to health care because services and specialists have become increasingly regionalized in urban centres. Shortages of health professionals, long travel distances, and difficulties recruiting and retaining providers contribute to poorer access for rural residents, particularly caregivers.[10]

Physician shortages and high turnover are particularly acute in rural Canada, often resulting in patients having to transition between family physicians. Because family physicians serve as the primary coordinators of care and gatekeepers to specialist services, these transitions can disrupt continuity of care. Participants described the need to repeatedly explain their medical histories and rebuild trusting relationships with new physicians, a process that was especially challenging for individuals managing chronic illnesses.[11]

Rural communities often experience shortages of family physicians, making it difficult for residents to establish and maintain ongoing relationships with primary care providers.[12] These challenges disproportionately affect people with chronic illnesses, who depend on continuous access to primary care for disease management, specialist referrals, and coordination of treatment.[13] The Canada Health Act provides coverage for medically necessary physician and hospital services through provincial health insurance plans regardless of ability to pay. Despite this, Canadians may experience barriers to accessing specialist care, with wait times representing one of the most commonly reported difficulties.[3] This increases health risk for those living in rural poverty, as there is a greater difficulty accessing health care. There is an increase in number of those living with chronic illness, greater elder population, and fewer health care professionals available in rural communities.[11]

Nursing accessibility

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Rural and remote communities in Canada experience disparities in access to nursing services compared with urban areas. Geographic isolation, lower population density, and difficulties recruiting and retaining health-care professionals contribute to shortages of registered nurses, nurse practitioners, and other nursing personnel in many rural regions.[14]

Limited access to nursing services may increase travel distances and waiting times for primary care, home care, chronic disease management, and preventive health services. These barriers can disproportionately affect older adults, Indigenous communities, people with disabilities, and low-income households, for whom the costs of transportation and time away from work may further limit access to health care.[15]

To improve access, provincial and territorial health systems have expanded the roles of nurse practitioners and community health nurses in many rural and remote communities. Telehealth and mobile health services have also been adopted to supplement in-person care, although access may be limited by infrastructure, including the availability of reliable broadband internet.[16]

Vulnerable populations

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Poverty among rural Canadians is a continuing issue within Canada. Although rural living can be challenging for any population, there are several groups in which are considered more vulnerable to poverty. Several contributing factors such as employment, education, geographical location, cost of living and low income are definite issues among these specific groups. With that being said, many of these populations are finding themselves struggling to keep above the poverty line.[17]

Single-parent families

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Lone families or single parent families are incredibly susceptible to poverty in Canada, especially those who reside in rural areas. Although single male parent families are at risk, families with a woman as the only parent are at a much greater risk.[18] Women who are raising their families on their own are at a huge risk for poverty among Canada.[19] Women in rural Canada are at disadvantage for employment opportunities due to the lack of jobs within the community. Formal education is also a challenge for rural women because of the general low income status and high cost of education. Without formal education, rural women often cannot find good paying jobs that provide stability and benefits to support their families. In order to find affordable housing for a single parent income, one must often look outside of town to more remote areas.

Although housing is cheaper, the employment opportunities decrease; causing women to look for employment closer to town or within the community. By having to travel to work, vehicle costs or alternative transportation costs are increased. Wages in rural Canada are lower than those in urban areas, which contributes to the overall lower income and poor income status among these families. For women supporting a family, the poor wages, low employment rate, high cost of living and lack of financial support are the risk factors in which increase the incidence of poverty among this population. This creates a huge expense for travel and transportation, as well as child care. If the children in the family attend school, transportation to school is often limited to those residing in remote areas. Providing or paying for alternative transportation for children to attend school is also an additional cost.[20]

The elderly

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Elderly people living in rural areas are at an increased risk for poverty in rural areas in Canada. Elderly individuals, especially one family women, in rural Canada are at a great risk for poverty and low economical status. With a more direct focus on elderly poverty, rural women over the age of 65, are found to have a much lower annual income than adults living in non-rural communities. Over 19% of women over the age of 65 were living in poverty in Canada, as opposed to 10% of elderly males. There are several factors that put the rural elderly, especially women, at risk of poverty.[21]

Due to the decreased population density in rural areas in Canada, there is a mass shortage of public services that are offered to individuals. Although all populations are affected, the elderly experience a major negative impact. For example, transportation becomes a major issue. More than 25% of the elderly living in rural areas did not own or have access to a car. This means that other means of transportation is required; however there are very limited public transportation services available, especially for individuals living in extreme remote areas. Finding methods of transportation can become expensive and often discouraging for elders.[22]

The elderly in rural Canada often live in older, single family homes that often have larger property sizes. Maintaining a home is costly. Maintenance such as cutting the grass or shoveling snow can be too much for the elderly to complete, therefore help is needed in order to keep up. In rural areas, public services are often hard to find and can be expensive. Maintaining their homes can create an added cost to individuals, whereas in previous year they would have been able to perform these tasks themselves. With the lack of services, the elderly often find they are unable to maintain their homes or perform maintenance duties.[22]

Children and young adults

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Children living in rural Canada are negatively affected by poverty and low income situations; especially children from single parent families. Single parent families in rural communities are more likely to have a low income and poor economical status.[22] Child poverty is an issue in rural Canada due to the decreased job opportunities and stability for families in low income situations. In addition, financial support is often not enough to ensure the children are provided with the basic essential of daily living.[23] Children who grow up in poverty are less likely to improve their economical status as they grow older. Children of poverty are less likely to achieve a high school diploma or a post secondary education, due to the financial strain of the family and inability to afford to get to school or to move away.[22]

This same idea ties into the issues of young adults and rural areas. Young adults in rural Canada are extremely susceptible to poverty for many additional reasons. Jobs are incredibly hard to find for young adults because of their lack of experience. Employers will often require experience in order to be a successful candidate. With the huge shortage of jobs already existing, young rural Canadians find it challenging to start their careers.[24] In addition, formal education or post secondary is often set aside because of the lack of funding and affordability to leave their community. There are very few post secondary institutions located in remote and rural Canada, meaning that most people would have to travel or relocate in order to attend.[24] This is often impossible for those living in these communities. Furthermore, financial assistance or employment insurance is not always an option because in order to be eligible, one must obtain a specific amount of working hours. If a young adult is unable to find work, this type of assistance would be denied due to the lack of worked hours and employment.[19]

Indigenous people

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There are several factors in which contributes to poverty among aboriginals in Canada.[25] Despite many beliefs, poverty risk factors continue to exist for aboriginals living on and off the reserves[15] Although the Canadian aboriginal population living off of the reserves are at risk of poverty, individuals living on the reserves demonstrate a much greater risk.[26] Lack of employment, poor paying jobs, alcohol abuse, poor access to health care and low education levels are all areas in which contribute to the increased risk of poverty.[27]

The overall earnings of aboriginal Canadians living in rural areas in significantly lower than non-aboriginals living in more urban areas.[25] Many Canadian aboriginals reside on reserves where their families grow and their communities develop. There is a massive job shortage among these reserves. With that being said, many attempt to seek employment outside of the reserves within the rural community.[28] However, due to the remote and isolated geographical location of many aboriginal communities, jobs are scarce even off of the reserves. Within the Algonquin native reserves, approximately 90% of the residents are unemployed. For aboriginal’s who are employed and living in rural areas, they are paid much less than those living in more urban areas.[29] Wages in rural Canada are typically much lower than those in urban areas, simply because the economical status of rural communities are often lower and small businesses cannot afford to pay large wages to their employees.[29] Also, many of the rural jobs are seasonal or temporary for these individuals, meaning that they may be out of work for many months of the year.[29] In addition, the cost of living is a major contributor to aboriginal poverty in rural Canada. The cost of food and daily living supplies are more expensive in rural areas than in urban cities.[29] cost than urban areas, the maintenance and up-keep of the housing is a costly factor that contributes to poverty among aboriginals.[29]

While the education rate among Aboriginals living in rural Canada is much lower than urban areas, there is vicious cycle that occurs when examining the correlations.[18] Among aboriginal Canadians, on and off the reserve, 32% have not achieved their high school diploma, as opposed to 15% of non-aboriginal Canadians.[30] On the other hand, approximately 8% of aboriginal men in Canada have a university degree, as opposed to 25% of non-aboriginal men.[30] There are several reasons in which contribute to the gap in educational levels. For rural aboriginals in Canada, poverty can affect the availability as well as eliminate educational options. Some individuals find that they have to leave high school in attempt to find a job to help support their struggling families.[31] Post secondary school is incredibly expensive, and for people living in poverty, college or university is not a realistic goal.[18] Therefore, the vicious cycle takes place. People cannot find jobs because they do not have the educational background, but in yet their families cannot afford the cost of education.[31]

In terms of gender and aboriginal poverty in Canada, there does tend to be a gap between aboriginal men and women when it comes to income and economical status.[32] Among aboriginal individuals living in rural Canada, women are less likely to have employment and often have a much lower annual income.[32] In many cases, aboriginal women are the primary caregivers for their children and the elderly in their families.[32] Women who are able to seek employment often have difficulty due to the job shortages, as well as requirements for education and experience.[33] This can cause a serious financial strain on the families, especially for single parent families trying to manage all of their expenses.[33]

Individuals with disabilities

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Individuals with disabilities living in rural Canada are at high risk of living in poverty. Disability is defined as a long term difficulty with daily living activities such as mobility, learning, hearing or communicating.[17] People living with a disability may find it challenging to work, depending on their condition. Among the rural jobs, many of which involve physical labor and less than ideal working conditions.[34] Some individuals with disabilities would be unable to work in these conditions. This contributes to the risk of poverty among rural residents, because the inability to work has a significant impact on their income.[34] Disability support services are available; however the cost of living is incredibly high. Especially for those living in rural areas, home care and home services are limited which creates a challenge for some. In addition, rural living has an increased risk of injury due to the remote locations and few health services. This also because a challenge for individuals with a disability.[17]

Health outcomes

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Health inequality in Canada has a clear geographical and socioeconomic gradient, in which populations experiencing disadvantage have a higher burden of chronic conditions. This includes conditions such as diabetes and obesity, which are more prevalent in rural and remote populations and reflect broader structural patterns.[35]

People in rural areas experiencing poverty are having poorer health outcomes than their urban counterparts as evidenced by a lower self-reported general health and a higher inability to engage in major activities because of their health.[36]

Admissions

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Patterns of hospital utilization and procedure use differ by geography, admission rates for newly diagnosed congestive heart failure are lower among metropolitan residents than among rural and regional residents. Metropolitan hospitals are also more likely to perform advanced cardiac interventions, while regional hospitals show different distributions of case severity and resource use.[37] Rural healthcare delivery is subject to structural factors, including geographic distance to services and the centralization of specialized care centres. Rural and remote residents experience different patterns of end-of-life care, including a higher frequency of transfers between care settings.[38]

Recovery

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The recovery process of Canadians after surgery and risk of infection can be increased by a short length of hospital stay, alcoholism, diabetes, obesity, and living in a rural residency. Rural poverty potentiates the risk of post-op infection as well. Alcoholism, diabetes and obesity are often health outcomes related to rural poverty which makes recovering from any illness of surgery more difficult for Canadians living in rural poverty.[39]

While rural residence itself is not a direct biological risk factor for infection, it is associated with contextual differences in healthcare access and underlying health status. Chronic conditions such as diabetes and obesity are more prevalent in populations experiencing socioeconomic disadvantage, which may include rural and remote communities. These conditions are independent clinical risk factors for post-operative complications, and their higher prevalence may contribute indirectly to differences in surgical outcomes.[40]

Social supplementary

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Rural Canadians living in poverty often face compounded barriers to accessing healthcare and social supports, including reduced availability of healthcare providers and services. These access disparities are associated with higher levels of unmet healthcare need and may contribute to poorer health outcomes in rural populations.[41]

Social determinants of health and health outcomes

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The poor health outcomes mentioned seem to be a product of the impact of social determinants of health in a rural setting for a person living in poverty. Social determinants of health are strong contributors of respective health outcomes education.[42] Causes of poverty in rural areas includes low income, lack of employment, the high costs of new housing construction, poor quality of housing (leading to higher costs for heating), poor health and lack of healthcare within a reasonable traveling distance, and low levels of education.[42] All of which are related to social determinants of health and impact health outcomes for those living in poverty. Specific social determinants of health that contribute to rural poverty and poor health outcomes include: income, employment and working conditions, economy, population demographics, housing, health, education, child and youth development, gender, and culture.[43] Social determinants of health are extremely relevant to the cause and effect of rural poverty and health. For example, those living in lower-income households tend to live in older, poor quality housing units which are often inadequately insulated and have high heat and utility costs.[44] This poor heating can affect health, and the high utility costs are often unrealistic for Canadians living in rural poverty. Also, the cause and effect element of rural poverty is certainly evident when looking at food as a critical component to health and a product of income. Many Canadians living in poverty find themselves without adequate food, or are unable to afford the appropriate groceries to support their family and their own nutritional and developmental needs.[45] It can be even more difficult for rural Canadians living in poverty as they have less access to social supports because of the greater distances between rural and urban centres, and cannot spend the money on gas and transportation to seek food security within urban areas where supports are often located.[45]

Health disparities

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Poverty in Canada has extensive influence on the quality of many aspects of life for rural citizens. With social determinants of health in mind, poverty in rural areas can cause out-migration and population decline, poorer education outcomes, poorer employment opportunities due to transportation costs and child care costs, poorer living and eating conditions. All of which directly affect health. The lack of education, employment and then income levels affect a rural Canadian’s ability to travel for work, or afford groceries. When the necessary social determinants of health are not being met, it has a direct effect on health outcomes for rural Canadians, and creates a strain or the few social supports available within rural communities.[46]

Poverty also influences the personal life choices of those living in rural areas as they develop coping methods to face daily challenges which affect health as which creates the recognition that personal life “choices” are greatly influenced by the financial circumstance that people live with.[47]

Recognizing the gap

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There is clearly a difference between rural and urban poverty in Canada and their respective health outcomes. When comparing rural and urban residents, rural Canadians tend to have lower education levels, lower levels of literacy, lower incomes, fewer job opportunities, fewer higher paying job opportunities, more seasonal employment, more housing that is in need of repairs, poorer health, and poorer access to health care services than urban Canadians.[46]

In stroke recovery, lower socioeconomic status and treatment at low-volume hospitals have both been associated with poorer outcomes, including higher mortality and disability. Evidence also suggests that higher-volume, specialized stroke centers achieve better outcomes. However, access to such facilities is uneven across regions, and rural patients may experience delays in receiving advanced stroke care due to geographic distance from comprehensive stroke centers, contributing to disparities in outcomes between rural and urban populations.[48]

Closing the gap

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In a response to the poor health outcomes and health disparities specific to rural poverty in Canada, there have been many coalitions and initiatives that nurses, physicians and researchers are attempting to implement in order to close the gap between rural and urban health outcomes.[49] Changes in research are being called for as there is an evident lack of research that focuses on rural poverty, but plenty of studies done for urban poverty in Canada.[50] Nurses and organizations are recognizing areas for further research in areas such as rural immigrants, foreign migrant workers, rural family violence, labour force mobility of low income households, barriers specific to rural health settings, rural aboriginal homeless, rural adolescents, and more longitudinal studies measuring long-term outcomes related to health care gaps.[51] More information on rural poverty in Canada would aid in the evolution of much needed interventions towards ending the long-term poverty found in rural Canada.[52] Many studies have illustrated the need for rural networks and supports to address a broad spectrum of personal and social needs. Unfortunately many of these “solutions” only provide short term fixes and are not able to work long term to assist rural Canadians in their journey out of poverty.[53]

The Nurse–Physician Collaborative Partnership was developed to improve access to and the quality of primary health care for chronically ill older adults living in rural Alberta through collaboration between homecare nurses and general practitioners. Evaluation of the program found improvements in activities of daily living, cognitive status, psychological well-being, knowledge of disease processes, and confidence in managing health issues. Patients' use of acute care services also declined, including reductions in hospital admissions, days spent in hospital, emergency department visits, and acute health-service costs (excluding program costs). The findings suggest that collaborative interdisciplinary home care may improve outcomes for chronic illness older adults in rural communities.[54]

References

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  1. ↑ Burns, Ausra; Bruce, David; Marlin, Amanda (2007). Rural poverty discussion paper (PDF). Agriculture and Agri-Food Canada. Rural Secretariat (Report). A114-32/2007E-PDF. Ottawa, Ontario: Government of Canada. p. 101. ISBN 978-0-662-47312-1. Retrieved 2026-06-16.
  2. ↑ Wilson, Daniel; Macdonald, David (2010). The Income Gap Between Aboriginal Peoples and the Rest of Canada (Report). Canadian Centre for Policy Alternatives. ISBN 978-1-897569-97-9. Archived from the original on 2025-04-20. Retrieved 2026-06-17.
  3. 1 2 Harrington, David W.; Wilson, Kathi; Rosenberg, Mark W.; Bell, Norman (2013). "Access granted! Barriers endure: determinants of difficulties accessing specialist care when required in Ontario, Canada". BMC Health Services Research. 13 (1): 146. doi:10.1186/1472-6963-13-146. PMC 3637586. PMID 23607393.
  4. ↑ Wilson, Kathi; Rosenberg, Mark W. (2004). "Accessibility and the Canadian health care system: squaring perceptions and realities". Health Policy. 67 (2): 137–148. doi:10.1016/S0168-8510(03)00101-5. PMID 14720632.
  5. ↑ Crosato, Kay E.; Leipert, Beverly (2006). "Rural women caregivers in Canada". Rural and Remote Health. 6 (2): 520. PMID 16752958.
  6. ↑ Glazier, Richard H.; Gozdyra, Peter; Yeritsyan, Naira (2011). Geographic Access to Primary Care and Hospital Services for Rural and Northern Communities: Report to the Ontario Ministry of Health and Long-Term Care (PDF) (Report). Toronto, Ontario, Canada: Institute for Clinical Evaluative Sciences. Archived from the original (PDF) on 2023-11-18. Retrieved 2026-06-17.
  7. 1 2 3 Arcury, T. A.; Preisser, J. S.; Gesler, W. M.; Powers, J. M. (2005). "Access to transportation and health care utilization in a rural region". The Journal of Rural Health. 21 (1): 31–38. doi:10.1111/j.1748-0361.2005.tb00059.x. PMID 15667007.
  8. ↑ Ryser, Laura; Halseth, Greg (2014). "On the Edge in Rural Canada: The Changing Capacity and Role of the Voluntary Sector". Canadian Journal of Nonprofit and Social Economy Research. 5 (1): 41–56. doi:10.22230/cjnser.2014v5n1a162.
  9. ↑ Crosato, Kay E.; Leipert, Beverly (2006). "Rural women caregivers in Canada". Rural and Remote Health. 6 (2): 520. PMID 16752958.
  10. ↑ Wilson, Kathi; Rosenberg, Mark W. (2004). "Accessibility and the Canadian health care system: squaring perceptions and realities". Health Policy. 67 (2): 137–148. doi:10.1016/S0168-8510(03)00101-5. PMID 14720632.
  11. 1 2 Randall, Ellen; Crooks, Valorie A.; Goldsmith, Laurie J. (2012). "In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada". BMC Family Practice. 13 125: 125. doi:10.1186/1471-2296-13-125. PMC 3548744. PMID 23259681.
  12. ↑ Randall, Crooks & Goldsmith 2012, pp. 2–8.
  13. ↑ Randall, Crooks & Goldsmith 2012, pp. 6–10.
  14. ↑ MacLeod, Marjorie L.; Stewart, Noreen J.; Kulig, Judith C.; Pitblado, J. Roger; Knop, Candace; Bhanji, Fatima; Smith, Barbara (2017). "Nurses who work in rural and remote communities in Canada: A national survey". Human Resources for Health. 15 (1): 34. doi:10.1186/s12960-017-0209-0. PMC 5442670. PMID 28535773.
  15. 1 2 Burns, Bruce & Marlin 2007, pp. 1–89.
  16. ↑ How Canada Compares: Results From the Commonwealth Fund's 2024 International Health Policy Survey of Older Adults in 10 Countries (Report). Ottawa: Canadian Institute for Health Information. 2025-06-26. Retrieved 2026-06-16.
  17. 1 2 3 Burns, Bruce & Marlin 2007, p. 58.
  18. 1 2 3 Burns, Bruce & Marlin 2007, p. 17.
  19. 1 2 Burns, Bruce & Marlin 2007, p. 23.
  20. ↑ Burns, Bruce & Marlin 2007, p. 21.
  21. ↑ Burns, Bruce & Marlin 2007, pp. 17–18.
  22. 1 2 3 4 Burns, Bruce & Marlin 2007, p. 19.
  23. ↑ Burns, Bruce & Marlin 2007, p. 20.
  24. 1 2 Burns, Bruce & Marlin 2007, p. 22.
  25. 1 2 Wilson & MacDonald 2010, p. 6.
  26. ↑ Burns, Bruce & Marlin 2007, p. 27.
  27. ↑ Burns, Bruce & Marlin 2007, p. 28.
  28. ↑ Wilson & MacDonald 2010, p. 8.
  29. 1 2 3 4 5 Wilson & MacDonald 2010, p. 11.
  30. 1 2 Wilson & MacDonald 2010, p. 15.
  31. 1 2 Wilson & MacDonald 2010, p. 17.
  32. 1 2 3 Wilson & MacDonald 2010, p. 20.
  33. 1 2 Wilson & MacDonald 2010, p. 21.
  34. 1 2 Burns, Bruce & Marlin 2007, p. 41.
  35. ↑ Public Health Agency of Canada (2018). Key Health Inequalities in Canada: A National Portrait (PDF) (Report). Ottawa: Government of Canada. Archived from the original (PDF) on 2019-09-24.
  36. ↑ Auchincloss, Amy H.; Hadden, Wilbur (2002). "The Health Effects of Rural-Urban Residence and Concentrated Poverty". The Journal of Rural Health. 18 (2): 319–336. doi:10.1111/j.1748-0361.2002.tb00894.x. ISSN 1748-0361. PMID 12135153.
  37. ↑ Jin, Y; Quan, H; Cujec, B; Johnson, D (2003). "Rural and urban outcomes after hospitalization for congestive heart failure in Alberta, Canada". Journal of Cardiac Failure. 9 (4): 278–285. doi:10.1054/jcaf.2003.43. PMID 13680548.
  38. ↑ Menec, Verena H.; Nowicki, Scott; Kalischuk, Alison (2010). "Transfers to acute care hospitals at the end of life: Do rural/remote regions differ from urban regions?". Rural and Remote Health. 10 (1): 1281. doi:10.22605/RRH1281. PMID 20095758.
  39. ↑ Daneman, N; Hu, E; Redelmeier, DA (2010). "Duration of hospital stay and post-discharge surgical site infections: a population-based analysis". Journal of Hospital Infection. 75 (3): 188–194. doi:10.1016/j.jhin.2010.01.013. PMC 7132464. PMID 20299133.
  40. ↑ Public Health Agency of Canada (25 November 2001). "What determines health?". Government of Canada. Public Health Agency of Canada. Retrieved 2026-06-17.
  41. ↑ Sibley, Lyn M.; Weiner, Jonathan P. (2011). "An evaluation of access to health care services along the rural-urban continuum in Canada". BMC Health Services Research. 11 20. doi:10.1186/1472-6963-11-20. PMC 3045284. PMID 21281470.
  42. 1 2 Burns, Bruce & Marlin 2007, p. 30.
  43. ↑ Burns, Bruce & Marlin 2007, p. 3.
  44. ↑ Burns, Bruce & Marlin 2007, p. 48.
  45. 1 2 Burns, Bruce & Marlin 2007, p. 35.
  46. 1 2 Burns, Bruce & Marlin 2007, p. 44.
  47. ↑ Burns, Bruce & Marlin 2007, p. 51.
  48. ↑ Saposnik, Gustavo; Jeerakathil, Thomas; Selchen, Daniel; Baibergenova, Akerke; Hachinski, Vladimir; Kapral, Moira K. (2008). "Socioeconomic Status, Hospital Volume, and Stroke Fatality in Canada". Stroke. 39 (12): 3360–3366. doi:10.1161/STROKEAHA.108.521344. PMID 18772443.
  49. ↑ Burns, Bruce & Marlin 2007, p. 1.
  50. ↑ Burns, Bruce & Marlin 2007, p. 15.
  51. ↑ Burns, Bruce & Marlin 2007, p. 54.
  52. ↑ Burns, Bruce & Marlin 2007, p. 14.
  53. ↑ Burns, Bruce & Marlin 2007, p. 49.
  54. ↑ Mitton, Craig; O'Neil, David; Simpson, Liz; Hoppins, Yvonne; Harcus, Sue (2007). "Nurse-Physician Collaborative Partnership: A Rural Model for the Chronically Ill". Canadian Journal of Rural Medicine. 12 (4): 208–216. PMID 18076814.
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