Exploring the experiences of small and rural municipalities during the COVID-19 Pandemic to identify enabling supports and structures that will strengthen response to future disruption

In Canada, geography is a determinant of health: people living in rural and remote areas experience poorer or different health outcomes than their urban counterparts. While approximately 29% of the Canadian population lives in small and rural areas, this project will focus on communities in Northern Ontario with fewer than 10,000 residents. Rural communities have lower rates of self-reported health, lower rates of physical activity, and higher rates of overweight and obesity, and smoking. They also have lower rates of depression and higher sense of social cohesion. In Canada, mortality from preventable causes increases with remoteness. The COVID-19 pandemic has uniquely affected rural communities; although impacts related to substance use, mental health, food security, gender-based violence, and financial security have been documented across Canada, each of these was amplified or at least experienced differently in rural communities, as were disparities related to inequitable access to broadband Internet. This research study asks: what enabling supports and structures would help small/rural communities in Northern Ontario to more effectively respond to disruption? Using a pragmatic and a systems approach, this project will employ a qualitative, case study research design including semi-structured interviews, thematic discourse analysis, and a participatory workshop to address the research question. Results will contribute to strengthening Canada's public health system by identifying opportunities to better support local governments in small and rural communities to promote health and wellbeing.