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Introduction: While individuals living in rural areas often have poorer health outcomes and reduced access to healthcare services compared with those in urban areas, there is a disproportionate gap in research examining rural health issues and identifying solutions to healthcare challenges. This is likely due to the numerous barriers to conducting rural health research, including the centralisation of research in urban areas and limited trained personnel and resources to conduct research in rural communities. This realist review aims to identify articles focused on building rural health research capacity and develop an evidence-based framework to be used by researchers, clinicians and policymakers to improve rural health services and well-being for rural populations.

Methods and analysis: We will conduct a realist review using the following steps: (1) develop a search strategy, (2) conduct article screening and study selection, (3) perform data extraction, quality appraisal and synthesis, (4) engage stakeholders for feedback on our findings and (5) report our findings and engage in knowledge translation. Search terms include variations of the terms ‘research’, ‘capacity building’ and ‘rural’. Databases include (since inception) Ovid MEDLINE, Embase, CINAHL Plus, APA PsycINFO, ERIC and Scopus. A separate search of the same databases was also designed to identify relevant theories or frameworks related to research capacity building, using variations of the terms ‘research’, “‘capacity building’, ‘theory’ and ‘framework’. Studies will be screened by title and abstract and full text by two research team members and included based on their relevance to rural health research capacity building. We will exclude articles not published in English. We will also search the grey literature to identify rural health research centres, networks or training programmes that have not been described in the academic literature. Two research team members will extract relevant data from included studies and perform a qualitative analysis based on guidelines for realist reviews.

Ethics and dissemination: This review does not require ethical approval as it draws on secondary data that is publicly available. The findings will be disseminated at academic conferences, published in peer-reviewed journals and summarised in a lay report for individuals interested in developing strategies, programmes or policies to improve rural health research. The results will inform individuals developing rural health research training programmes, establishing rural research centres, or others interested in building rural health research capacity.

PROSPERO registration number: CRD42023444072.

This paper investigates municipal government initiatives targeting ‘local development’ and community sustainability in municipal peripheries in rural Västerbotten, Sweden. Analysing planning documents, we identify 142 initiatives from 2022 to 2023 using a social determinants of health (SDH) framework, particularly focusing on labour, business development, technology adoption, municipality-business collaboration, supporting village associations, and alternative modes of service delivery. We conclude that municipalities are attempting to support individual villages and place-based communities in determining their own development paths across all SDH domains, suggesting a shift from central-place to decentralised planning models.

This paper investigates rural–urban disparities in the experiences of in-home care services for older adults in a sparsely populated municipality (Storuman) in Northern Sweden. Such municipalities are characterised by long-term population loss and ageing, an increasing concentration of residents and services in municipal centres and resultant rural ‘resource deserts’. Disparities are measured through four ‘endpoint’ measures—exits to residential care, resource use, longevity and survival in the in-home care system. Data were drawn from the municipality’s care service contract database (2014–2020). Users living in the municipal centre had lower resource use and used direct care less frequently than those in smaller and more distant settlements. Those living near a grocery store were more likely than others to survive long term in the in-home care system. The research reveals a potential to reduce exits to residential care, to make more effective use of direct care and shopping services and to limit disruptive transfers of care, particularly between municipal and regional health services. Overall, there was limited evidence of rural–urban disparities in in-home care outcomes, but particular attention should be paid to transactional proximity of different parts of the care system and proactive rather than reactive care planning. The paper contributes to debates about quality measures for in-home care and the impacts of micro-urbanisation on the lives of people living in sparsely populated areas.

Background: This scoping review identifies strategies potentially addressing the ‘workforce crisis’ in rural social care. The increasing global demand for social care has been coupled with widely recognised challenges in recruiting and retaining sufficient staff to provide this care. While the social care workforce crisis is a global phenomenon, it is particularly acute in rural areas.

Methods: The review identified 75 papers which (i) had been published since 2017, (ii) were peer reviewed, (iii) concerned social care, (iv) were relevant to rural settings, (v) referenced workforce shortages, and (vi) made recommendations for ways to address those shortages. Thematic synthesis was used to derive three analytical themes with a combined 17 sub-themes applying to recommended strategies and evidence supporting those strategies.

Results: The most common strategies for addressing social care workforce shortages were to improve recruitment and retention (‘recruit and retain’) processes without materially changing the workforce composition or service models. Further strategies involved ‘revitalising’ the social care workforce through redeploying existing staff or identifying new sources of labour. A small number of strategies involved ‘re-thinking’ social care service models more fundamentally. Very few papers specifically considered how these strategies might apply to rural contexts, and evidence for the effectiveness of strategies was sparse.

Conclusion: The review identifies a significant gap in the literature in relation to workforce innovation and placed-based studies in rural social care systems. It is unlikely that the social care workforce crisis can be addressed through continuing attempts to recruit and retain workers within existing service models.

Hospital to home transfers for older people require effective communication, coordination and collaboration across multiple service settings. Rural Nursing Theory and the Beyond Periphery model explain why this is particularly difficult in rural areas, but there are few examples of how rural services respond. This paper presents a case study of the district of Tärnaby in the inland north of Sweden. Data are drawn from interviews with health and care staff in Tärnaby, observations, and experiences of the researchers. Data were analyzed thematically, with four main themes emerging–role clarity, communication, geography, and understanding of the rural context. Responses to challenges included increasing opportunities for communication between service providers and improving documentation. The paper concludes that informal "workarounds" run the risk of further disconnecting rural service settings from "the city". Rather, the aim needs to be to improve contextual understanding through formally incorporating "the rural" in service design.

De kommande tio åren kommer att vara avgörande om världen ska nå en hållbar utveckling. Hela samhällssystem, sektorer och branscher måste ställa om. Det krävs modiga politiska beslut, nya sätt att organisera, styra och planera våra samhällen, nya affärsmodeller och förändrade konsumtionsvanor. Inget av detta är lätt eller uppstår av sig själv.

Denna bok är en översatt och omarbetad version av boken Dipping in to the North: Living, Working and Traveling in Sparsely Populated Areas, utgiven på engelska av Palgrave Macmillan förlag (år 2020). Redaktörerna för den boken är Linda Lundmark, Dean B. Carson och Marco Eimermann. Boken är utformad som en samling kapitel runt tre teman: i) vilka som lever, ii) vilka som arbetar och iii) vilka som reser inom det glest befolkade norr. Inom varje tema fokuserar kapitlen på olika former av mobilitet, migration och icke mobilitet och placerar individer som lever, reser och arbetar i norr i relation till aktuella frågor för området samt inom deras historiska och samtida kontext. Boken nyanserar vanligt förekommande myter som porträtterar glest befolkade områden som att de antingen ständigt kämpar med flertalet utmaningar eller som en tidlös lantlig idyll.

Om du har plockat upp denna bok är du förmodligen en av många som ä rintresserad av Norrland. Du kanske arbetar med utveckling i norr, samhällsprojekt på lokal, regional, nationell eller annan myndighetsnivå, eller kanske inom privat näringsliv. Kanske är du en del av en grupp studenter eller akademiker som formar och bidrar till de olika debatterna kring nordlig utveckling i eller utanför Sverige. Om du är intresserad av demografi, ekonomi, geografi, historia eller statsvetenskap kommer du att se att dessa är centrala för innehållet i denna bok.

I detta kapitel introduceras begreppen ”tomrum” och ”platser emellan”. Begreppen är delvis kopplade till en jämförelse mellan Nordnorge och norra Sverige. Tomrum kan begreppsliggöras på många sätt, från ett fysiskt vakuum till ett rum tomt på företeelser eller geografiska objekt. Inom samhällsvetenskap och geografi hänvisar det ofta till bristen på något i det geografiska rummet, brist på resurser, människor eller aktiviteter. Fördelningen av geografiska objekt som människor är också relaterad till aktiviteter, resurser och andra människor. Rummet blir relationellt. Den relationella förståelsen av rummet refererar bland annat till hur individer försörjer sig. Människans eller individens relation till det fysiska rummet förändras också över tid. Det relationella rummet genomgår en förändring. Många idéer om relationen mellan människor och rum är baserade på Torsten Hägerstrand och hans tidsgeografi (Hägerstrand 1974, Stjernström 1998, Rönnlund & Tollefsen 2016). Det relationella rummet (Lefebvre 2014) och tanken om den dynamiska relationen mellan aktör och struktur, som utvecklats av Anthony Giddens (1984) (inspirerad av Hägerstrands tidsgeografiska postulat om det fysikaliska rummet), markerar en av de teoretiska utgångspunkterna i denna text.