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When the social meets health in rural Australia: confronting the disconnect

ABSTRACT What happens in contemporary rural Australian communities when health consumers, health practitioners and health services intersect is the focus of this article. Using a hypothetical case of intimate partner violence, we analyse the power relations within what we call the ‘intersecting space’ to examine how each of these three central and ‘typical’ actors – rural consumers, health practitioners and rural services – is positioned. Drawing on Foucault’s concepts of power and discourse, we deconstruct dominant discourses of sameness and neutrality which (i) marginalise the perspectives and needs of rural health consumers, (ii) immobilise the ability of health practitioners to connect the social to health and (iii) restrict the flexibility of rural health services to address the social as part of health need. We argue that these discourses of sameness and neutrality have generated a longstanding disconnect that constrains social and health care systems, thwarting the production of client-centred care. We suggest that system-level change is required to provide client-centred, integrated and inclusive rural health care that recognises and addresses the social as a fundamental part of health.