Comparing Rural Health and Health Care in Canada and the United States: The Influence of Federalism

Canada and the United States have significantly different arrangements for the provision of health care. They also have contrasting federal systems. While much research has considered the implication of these factors in terms of national health outcomes, there is little consideration of how these differences affect subpopulations within the countries. This article compares rural health outcomes between the two countries and how the variant federal arrangements address rural health. It is found that rural health outcomes are similar in spite of significant divergence in their institutional and intergovernmental responsibilities. Thus, it appears that rural health disparities are best understood as a function of social and economic environments of rural areas rather than institutional and policy assignments flowing from differences in their federal systems.