Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Arts




Willson, Andrea


The Canadian urban - rural health disparity is concerning, as rural residents are more likely to experience deleterious health outcomes such as injuries, chronic conditions, obesity, and shorter life expectancy. There are several rural social-structural explanations for the disparity such as an aging population, less education attainment, greater unemployment rates, poorer working conditions, lack of health professionals, greater distance from quality health resource, and poorer health behaviours. Some of these findings have been linked to higher Body Mass Index (BMI) scores in rural areas. However, no study has considered the health lifestyle differences of urban - rural Canadians and how it can further explain negative health outcomes, like increased BMI rates.

Canadian research evaluates rural health behaviours and experiences as a mechanism for the health discrepancy. Yet, these studies treat health behaviours independently, thereby neglecting the behavioural patterns and how these patterns group to form unique health lifestyles. This thesis employs the health lifestyle framework, which proposes that health behaviours cluster within an individual and represent underlying lifestyles reflective of an individual or group's shared social environment. The study generates health lifestyle classes in Canada and examines its relationship along the urban – rural continuum. In addition, the health lifestyle framework is used to investigate the relationship between urban - rural residency and BMI scores, net of socioeconomic and sociodemographic indicators.

This thesis uses nationally representative data from the 2014 Canadian Community Health Survey (CCHS), and latent class analysis and regression models. It uncovers unique health lifestyles within urban and rural areas of Canada based on the following health-related indicators: fruit and vegetable intake, physical activity, smoking status, alcohol consumption, hazardous industry, health care use, and sense of community belonging. Overall, results indicate that the urban - rural health disparity exists between urban and the most remote Canadians. Health lifestyles are shown to provide some explanation for the BMI disparity, while socioeconomic and sociodemographic indicators further contextualize these findings.

Summary for Lay Audience

In general, rural Canadians are less healthy than urban Canadians. There is a lack of research investigating this issue. This study examines urban - rural residency and its relationship to health lifestyles (classification of grouped health behaviours). In addition, this study uses the health lifestyle classes to link urban - rural residency with BMI rates.