Editorial

In the cool morning sun, the eucalypts cast long shadows across the tarmac and on to the yellow paddocks of summer. Dust rises from the tracks, as farm workers head out to their tasks for the day. A small queue of utes and trailers are at the drive-through cafe, as tradies pick up their morning coffee and toastee en route to work. The campsite is quiet, as tired families enjoy the twilight of their summer break, in their tents, caravans, campers and occasional swags. Despite a pandemic, this country town still keeps at the task of feeding the nation and providing safe havens for holidaying urbanites. Yet, each community battles with its own challenges, drought and dwindling water, managing and recovering from the latest deluge and flood, the aftermath of bush fire, the migration of the young to our metropolises and getting appropriate care for family. Meanwhile, the Indigenous community continues with its struggle against continuing colonisation, racism, poverty and oppression. Whilst many survive the demands of rural life, and some give up, others thrive like the lush green irrigated field of corn that stands stark, almost artificial, against the backdrop of the summer sunburnt paddocks. Stories of individual and community resilience, technological and social innovation, entrepreneurship and hard work are to be found across regional, rural and remote Australia. Listening for these stories and sharing them, so others can learn from them and thrive too, is the mission of the Australian Journal of Rural Health. This is the charge that has been handed to me by the departing Editor, Prof Russell Roberts. Russell held the reigns of editorship for the past 5 years and has achieved much to be proud of in that time. He diversified the gender, cultural and geographical membership of the editorial board, whilst managing the substantial growth in journal submissions. Most recently, Russell has facilitated the development of a joint position statement by 3 rural health journals (Australian Journal of Rural Health, Canadian Journal of Rural Health and Rural and Remote Health) as first step in the process to ensure that we ‘publish nothing about Indigenous People, without Indigenous People.’ He continues to work with the statement authors and the editorial board, on how to turn this statement into meaningful and manageable policy for the journal. Moving forward, some parts of the task of sharing what others have learnt have become a bit easier. Wiley and the Council of Australian University Libraries have entered into a new read and publishing agreement from January 2022 onwards. This allows authors from participating institutions (52 university institutions have signed up to the 3-year deal) to publish open access into the majority of Wiley journals, without paying any transactional article publication charges, as well as giving researchers access to all hybrid and subscription journals (https://caul.libguides.com/read-and-publish/wiley). This agreement replaces the traditional subscription arrangement that supports reading access to the Wiley portfolio. This means that corresponding authors from participating institutions can opt to publish Open Access in any of Wiley's hybrid journals (hybrid = subscription-based model that also offers OA publication as a choice for authors) at no cost to them (the fees are covered under CAUL's agreement with Wiley). This is Wiley's first transformative agreement in the Australia and New Zealand region and the largest of its kind in the local market. As the new Editor, for me, there are 2 big issues we need to be addressing for our readers, what is it about living in rural Australia that puts us at increased risk for a number of health problems, and how do rural people get access to consistently high-quality health care, so that the outcomes for rural people are the same as metropolitan residents. For the first questions, I am not convinced that living rurally is inherently bad for you. Consider the blue zones project, which identified places in the world where the longevity of the population is substantially above the average. The majority of these blue zones are not metropolitan areas or even large regional cities. Many of them are rural areas. So is it rurality, or the level of socio-economic disadvantage, lower paid work or exposure to hazards in the work environment (chemicals, sleep disruption and fatigue), or the stress of income dependent on external factors (weather, climate, fires and pandemics) that leads us to see higher rates of disease, illness and injury in rural areas? This question stills seems frustratingly unanswered for our Australian communities. Without understanding the root causes, it is highly unlikely that we can generate successful solutions. In this issue, Stefan Bozic et al examine the role of psychological distress and alcohol consumption across, urban, semi-urban and rural areas from 6 waves of the National Drug Strategy Household Survey. Whilst rates of heavy-episodic drinking and long-term risky drinking were highest in the rural cohorts, this was only linked with distress in rural females, but not rural males. This indicates that alcohol consumption might be contributing to illness disparities for rural residents and that different approaches are needed for men and women in rural areas. When it comes to consistent high-quality care, I think we are clear about the problem. We just do not have the access to the workforce, the health technology and infrastructure in our rural communities to provide the same quality of care that our metropolitan counterparts can access. Thus, we do not really need more data outlining the problems of health care for rural communities. What we need are insights from successful technological, educational, social and economic innovations that reduce the impact of the known disparities on health care. In this issue, Kate Gunn and Donna Hughes-Barton highlight the important role that rural financial counsellors play in supporting the mental health and well-being of their rural community. They see clients in distress and see they have an important role in recognising signs of distress in farmers and referring them to appropriate psychological supports. However, this is a demanding role and ensuring financial counsellors have appropriate services to refer farmers to, and support with their own well-being is imperative. Thus, rural financial counsellors might be an, as yet, untapped resource to facilitate early help seeking for distress management in our rural communities. Ongoing developments with COVID-19 with vaccinations, boosters and new variants add to the challenges of sustaining thriving rural communities, the shape of the year ahead looks uncertain. However, as those living and working in rural Australia continue to innovate, try new solutions and tell their stories, there is hope that we at the Australia Journal of Rural Health can bring you research and practice insights that will support rural people to thrive as well as receive innovative and effective health care.

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