In Canada, geography is a determinant of health: people living in rural and remote areas experience poorer or different health outcomes than their urban counterparts. Rural communities have lower rates of self-reported health, lower rates of physical activity, and higher rates of overweight and obesity, and smoking. They also have lower rates of depression and higher sense of social cohesion. In Canada, mortality from preventable causes increases with remoteness. The COVID-19 pandemic uniquely affected rural communities; although impacts related to substance use, mental health, food security, gender-based violence, and financial security have been documented across Canada, each of these was amplified or at least experienced differently in rural communities, as were disparities related to inequitable access to broadband Internet.​
The WHO reminds us that “Health is created and lived by people within the settings of their everyday life”; how we govern these settings is how we create health. In the context of significant provincial downloading, municipalities are challenged to fulfill their potential as actors in health and wellbeing on limited income and a growing list of responsibilities. Rural governments in particular are challenged by the need to offer the same support to their small populations, with lower tax bases and small municipal staff structures. ​
There are up to 5 phases of the Emergency Management Cycle (prevention, mitigation, preparedness, response, and recovery) that are interrelated but often siloed, and the pandemic highlighted opportunities to improve all of them. Research has identified gaps in emergency management literature related to resilience, collaboration and system integration, and generally a lack of attention to equity, high risk or at-risk populations and resilience. ​Lessons learned from SARS, and now COVID-19, indicate the importance of complementing outbreak response with health promotion, community development, and policy work in support of environmental and socioeconomic determinants of health. Recovery, then, becomes an opportunity to set the stage for future mitigation and prevention. ​Because local public health units have a mandate to work with others, including municipalities, on emergency preparedness, health equity, healthy public policy, the built environment, climate change, chronic disease prevention, injury prevention, and wellbeing, they are well positioned to collaborate with local governments and organizations in supporting all phases of the emergency management cycle. ​
The funding opportunity was directly tied to Canada's Chief Public Health Officer report from 2021 to support transformation of Canada's public health system. This qualitative study will highlight opportunities to better support local governments in small and rural communities with promoting the health and wellbeing of their populations. ​The research question is, "What enabling supports and structures would help small/rural communities in Northern Ontario to more effectively respond to disruption?"​
 
The research question will be addressed through four phases of research undertaken over one year:​
Phase 1: To identify municipal decisions related to the COVID-19 pandemic; ​
Phase 2: To explore successes and challenges experienced by small and rural communities in responding to the COVID-19 pandemic; ​
Phase 3: To identify supports and structures that will help small and rural communities more effectively respond to disruption; ​
Phase 4: To compile and share findings from research to inform policy and practice. ​
An Advisory Committee has been formed to gather guidance and local perspectives.
Principal Investigator: Dr. Leith Deacon, Associate Professor, University of Guelph
Co-Applicants: Amanda Mongeon, PhD Student, University of Guelph; Dr. Kate Mulligan, Assistant Professor, University of Toronto
Knowledge Users: Hilary Cutler, Algoma Public Health; Kerry Schubert-Mackey, Timiskaming Health Unit; Renée St-Onge, Public Health Sudbury and Districts;
Project Supporters: Federation of Northern Ontario Municipalities (FONOM); Northern Policy Institute (NPI); Rural Ontario institute (ROI); Association of Municipalities of Ontario (AMO); Algoma Public Health (APH); Timiskaming Health Unit (THU); Public Health Sudbury and Districts (PHSD); Thunder Bay District Health Unit (TBDHU); Porcupine Health Unit (PHU)
 
For further information, please contact Leith.Deacon@uoguelph.ca