Rural health research and rural health in the 21st century: The future of rural health and the future of rural health services research

Rural health research is a unique field. It is neither a nested subcategory under general health services research nor a separate field of policy analysis or advocacy. Rural health research faces three potential crises: of content, of applicability, and of credibility. The content of the field is driven often by funds, its applicability is thus limited by its purview as well as its special constituency, and its credibility is challenged by its findings, sometimes contrary to accepted positions in the larger health services field. Rural health research can strengthen its position by accepting the paradoxes it presents, especially the paradox of continuing disparity in the face of substantial investment to eliminate differences, and by seeking to answer why this occurs across the rural-urban spectrum. Rural health research can answer questions about why the distribution of resources is unfair without depending solely on pure definitions of rural.