Dr. Jude Kornelsen and Paul Adams
April 24 2025
By Paul Adams, Executive Director, BC Rural Health Network
In rural British Columbia, we often say that local knowledge is our greatest untapped healthcare resource. A new report co-authored with Dr. Jude Kornelsen of UBC’s Centre for Rural Health Research reinforces this belief and provides a powerful roadmap for transforming how we plan and deliver healthcare in rural and remote communities.
The report, Strategic Directions for Community Engagement in Rural Health Planning, builds on a provincial gap analysis by directly asking rural residents: What needs to change to ensure your voice shapes the healthcare decisions that affect you?
The answer, resoundingly, is that meaningful community engagement is not optional. It is essential. Without it, policies risk being out of touch, programs go underused, and frustration mounts.
What We Heard
Across seven regional focus groups from Interior, Island, Northern, and Coastal health regions, participants voiced a common experience: being consulted only after decisions had already been made, or not at all. Community members want to engage, but they need processes that are inclusive, respectful, and led by people who understand the lived realities of rural life.
Participants also spoke to the difficulty of engagement for marginalized populations. Indigenous people, low-income families, neurodivergent individuals, and those who have been systemically excluded are rarely reached by standard consultation formats. We must build safer, more intentional spaces to hear from them.
What Needs to Change
The report’s recommendations call for a fundamental rethinking of engagement and decision-making in rural health:
- Fund community-based engagement hubs that provide consistent, locally led opportunities for consultation, not just when things go wrong.
- Partner with existing non-profit networks to co-design consultations and build trust at the grassroots level.
- Center equity by reaching out proactively to those historically excluded, using trauma-informed, culturally safe methods.
- Embed rural representation in all health governance structures, from local planning tables to provincial advisory councils.
- Establish accountability mechanisms that ensure feedback is reported, acted on, or transparently explained if not.
- Invest in rural innovation by supporting community-led pilots and valuing lived experience as evidence.
A Call for Transformational Change
Perhaps most importantly, the report calls for a cultural shift. Bureaucracy must become responsive to community wisdom. Decision-makers need to understand the realities of the places they serve, not just through reports, but by being present, listening deeply, and staying in relationship with communities over time.
One participant said it best: “People are already angry. People are not having their needs met. So at least try something, learn from it, and then edit it and implement it again.”
That is what we are asking for. A system that is willing to learn, change, and truly partner with the communities it serves.
Moving Forward
At the BC Rural Health Network, we see this report not as an end, but as a beginning. We will be sharing its findings with the Ministry of Health, the Minister of Health, the Parliamentary Secretary for Rural Health, Health Authorities, and community leaders across the province. And we will continue to advocate for systems that are designed with rural people, not for them.
When rural voices lead, healthcare gets better for everyone.
