CCEDARR Project
Background
In 2024, Statistics Canada reported that 6.3 million Canadians (15.2%) lived rurally1. While at the national level the rural growth rate has been considerably less than that of its urban counterparts, the COVID-19 pandemic has highlighted the considerable strengths and challenges of rural living. Healthcare in particular is at a crisis point in much of rural Canada. This context provides the foundation for why rural resilience to threats such as the COVID-19 pandemic should be seen as an opportunity to build long-term sustainability in the face of climate change and ecosystem disruption. CCEDARR has collected qualitative data and translated some of those lessons learned into ongoing work aimed at supporting resilient healthcare strategies across BC and Canada.
The Climate Change and Ecosystem Disruption Adaptation Responses in Rural Canada (CCEDARR) project, funded by the CORIG Phase II grant, explored lessons from the COVID-19 pandemic and how they can be translated into community-level resilience in the face of climate change and ecosystem disruption. The qualitative work included interviews with 64 participants, made up of healthcare professionals and community members across 22 rural Canadian communities. The exploratory analysis identified that physician leadership, community cohesion, team-based practice, and innovative models of care were pivotal to participants’ self-reported community resilience. The RHSRNbc team is building on this work by focusing on implementing climate-resilient strategies for healthcare provision in rural Canadian communities.
Methods
Research Questions:
1. What has the COVID-19 pandemic taught us about rural community resilience in Canada?
2. How can these lessons be translated to support resilience in the face of climate change and other future ecosystem shocks?
The research team employed snowball sampling. Snowball sampling is a recruitment method used in qualitative research to reach specific or hard-to-access populations, particularly those in rural and remote areas. The method starts with a small group of participants who meet the study criteria, and they are then asked to refer others with similar characteristics. This chain-referral process continues until the desired sample size is achieved. Snowball sampling is beneficial for exploring niche communities, sensitive topics, or groups with limited visibility. The team conducted initial outreach through the Society of Rural Physicians of Canada (SRPC) to make connections with physicians across the province. Interviews were conducted over Zoom between Nov 2021 and Feb 2022. At the end of the three months, the team had connected with:
64 participants in 22 rural communities, including physicians, health care team members, and community members
- 7 communities in BC
- 7 communities in Alberta
- 2 communities in Saskatchewan
- 6 communities in Ontario
After data collection, the interviews were professionally transcribed and thematically analyzed using Nvivo 12. Six community forums, based on geographic regions, were held to return the research findings to the communities and to provide a final opportunity to gather additional data.
Findings
Our qualitative research findings highlight key factors in strengthening healthcare resilience in rural communities. Physicians emphasized the importance of effective communication, sustainable scheduling systems to address staffing shortages, and proactive approaches to vaccination strategies and quarantine policies. Strategies such as triaging hospital patients effectively and expanding online appointments and virtual care were also critical. Additionally, physicians noted that team-based care, continuity of care, prioritizing physician well-being, and openness to innovative care models played pivotal roles in improving healthcare delivery. Alternative payment models appeared to foster stronger physician-community engagement compared to traditional fee-for-service models.
From the community perspective, trust in physician leadership was a significant factor, particularly when physicians were actively engaged in their communities beyond clinical care. Community members also stressed the importance of consistent and clear communication from healthcare providers. Lastly, strong community cohesion—especially when established before the pandemic—proved a key factor in enhancing overall resilience.
Many participants felt that the challenges of the pandemic may help prepare them for future ecosystem disruptions, including those driven by climate change. However, there was a general lack of awareness regarding community-level preparedness measures for climate change, highlighting a critical gap in adaptation planning. Further information on the research findings can be found in our publications:
This work has been supported by:
References
- Government of Canada, Statistics Canada. ‘Rural and Small Town Canada, 2023 to 2024’. 18 June 2025. https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2025039-eng.htm. ↩︎