Climate change and health research: has it served rural communities?

If climate change is the 21st Century's biggest public health threat, research faces the major challenge of providing adequate evidence for vulnerable communities to adapt to the health effects of climate change. Available information about best practice in climate adaptation suggests it is inclusive of socio-economic disadvantage and local community factors such as access to health services. Since 1995, at least 19 164 papers have been published on climate change in the health sciences and social sciences. This body of literature has not yet been systematically examined for how well it serves rural communities.The ultimate aim of the study was to contribute to better understandings about what climate adaptation research has been done and is needed for rural communities. The two research questions were: 'What kinds of content define climate change research in disciplines that could potentially contribute to adaptation for health?' and 'How is content about rural and Aboriginal communities and best practice in adaptation related to this content?' A quantitative content analysis was performed using 'computational linguistics' Leximancer software. The analysis included 19 164 health and social sciences abstracts, batched by years, from 1 January 1995 to 31 July 2012. The relative frequency and co-occurrence of 52 concepts in these abstracts were mapped, as well as associations with positive or negative sentiment for selected concepts.Aboriginal' concepts tend to be relatively infrequent (3% and 5% overall likelihood of occurrence, respectively) and are more associated with socio-economic concepts in the social sciences than the health sciences. Multiple concepts in the health sciences literature are typically connected with 'disease' and ultimately 'science' storylines, with a 38% likelihood of paired co-occurrence of 'health' and 'disease' concepts alone. The social sciences appear more focused on the local and particular issues of community in climate change than the health sciences. 'Rural' and 'Aboriginal' concepts have increased by 1% across both discipline areas, since 2011 for the 'rural' concept and since 2004 for the 'Aboriginal' concept. 'Health' concepts in the health sciences and 'economic' concepts in the social sciences, as well as 'urban' concepts, are referred to more positively than either the 'rural' or 'Aboriginal' concepts.While care needs to be taken in interpreting the results of this study too negatively for rural and Aboriginal communities, they suggest that a disease focus dominates climate and health research typically unconnected to wider socio-economic and human system factors. This finding needs to be considered in light of the accumulating evidence of the importance of such contextual systemic factors in understanding climate and health effects and responses. The study adds some support to the view that a key priority is bringing the learnings of applied community-based researchers, from those in rural health to those in the social sciences, to climate research. There is a need to build confidence, including in the rural health sector which has arguably been slow to participate in programs of climate change research, that community-based research could make a difference to rural health in a climate-changing world.