Dissertation Abstracts

The contribution of health organisations to the cultural capital and health outcomes for regional people and their communities.

Author: Clune, Samantha J, sclune234@gmail.com
Department: Sociology
University: La Trobe University , Australia
Supervisor: Tim Marjoribanks
Year of completion: In progress
Language of dissertation: English

Keywords: Health , rural , capabilities , risk
Areas of Research: Community Research , Health , Risk and Uncertainty


Rural populations experience poorer health outcomes that their urban counterparts. Multiple, complex factors combine such that burden of disease is greater as the distance from metropolitan centres increases. World Health Organisation guidelines demonstrate the positive relationship between increased access to health services and supports and health outcomes. Australia, like other nations, has invested large amounts of ongoing funding to the design and delivery of health services, as well as education programmes for health professionals, in an attempt to enhance population health outcomes.

However, local culture can exacerbate poor health outcomes particularly in an already vulnerable population. Cultural change via social interaction can be observed within social groups as well as between organisational representatives and community members. Interactions between community members and health organisation representatives can potentially bear influence on cultural change with subsequent influence on behaviours and ultimate health outcomes. The presence of health organisations is included in the capability set of individuals. Conversion factors influencing the capability to be healthy may include place based, cultural influences. The interaction between community members and health organisations can both positively and negatively influence local health practices. Consequently, gaining a locational understanding of any possible influence on group and individual behaviours via a capabilities framework is a worthy study. This is of particular interest in areas also experiencing inherent environmental risks.

This project uses a case study approach that applies the capabilities framework to an Australian rural community, in relation to the capability to be healthy. Particular attention was paid to the presence of large health organisations and any influence there may be on conversion factors for individuals and groups. The study was conducted within a highly vulnerable rural community with some of the worst health outcomes, across numerous domains, for the nation. Data collection included archival data interrogation as well as participant interviews.

Two distinct themes emerged have emerged. In particular, the interaction between place and the capability to be healthy. A strong sense of connection to place was noted and within this connection was a tacit understanding, and acceptance, of inherent local environmental risks. Allusions were made to a fundamental lack of control over broader, long-term health outcomes based solely on accepted local risks. This is particularly evident in discussions about a recent environmental crisis event. Additionally, the interaction between community members and health organisations was described by participants as less than optimal. That is, participants saw local organisations, at times, as remote and unreliable and that this directly affected participant’s decision making in relation to individual and group health.