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Research & Insights: From Data to Decisions�Building Healthier and More Resilient Communities

Dr. Leith Deacon�Associate Professor, University of Guelph�McCall MacBain Research Chair in Resilient Rural Communities

Good morning, and thank you for the opportunity to be here. What I’d like to talk about today is rural data—but really, this isn’t a presentation about data. It’s about the decisions we make with it.

Over the next 40 minutes, I’m going to share some of the early findings from work we’re doing across rural Ontario through the HEAR Initiative. But I also want to talk about a larger question: Do we actually have the information we need to understand how rural communities are changing—and to make good decisions about their future?

Because whether we’re talking about healthcare, housing, workforce attraction, infrastructure, economic development or climate adaptation, we’re increasingly discovering that these aren’t separate rural issues. They’re interconnected.

And that’s really the premise I’d like to explore with you today.

“So rather than beginning with the survey, I want to begin with a much simpler question.”

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What does it take to build a life in a rural community—and stay?

Health · Housing · Work · Connection · Resilience

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There is no single “rural Ontario.”

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There is no single “rural Ontario.”

Place matters.

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We have lots of data. But do we have the right data?

01

TOO AGGREGATED

Provincial and regional averages can hide the local differences that matter most.

02

TOO FRAGMENTED

Health, economy, housing, infrastructure and environment are often examined separately.

03

TOO STATIC

Snapshots tell us where we are — but not how communities are changing.

LOCAL DECISIONS REQUIRE LOCAL EVIDENCE.

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What if we could see the whole picture?

The important questions are often found between the datasets.

RURAL�COMMUNITY

HEALTH

HOUSING

POPULATION

ECONOMY

TRANSPORTATION

INFRASTRUCTURE

ENVIRONMENT

CLIMATE

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HEAR Initiative

Health · Economy · Adaptation in Rural Communities

2025–2031

HEALTH

How people access care,�experience wellbeing and�navigate rural services.

ECONOMY

How households, workers�and communities experience�economic change.

ADAPTATION

How people and places�prepare for and respond�to disruption.

A longitudinal rural evidence initiative designed to understand change — not simply describe a moment in time.

Beginning in Ontario. Designed for national expansion.

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HEAR is more than a survey.

WHAT PEOPLE TELL US

INDIVIDUAL SURVEY

Experiences, access and wellbeing

HOUSEHOLD SURVEY

Household conditions and community context

COMMUNITY ENGAGEMENT

Local knowledge, priorities and interpretation

+

WHAT OTHER DATA TELL US

Population

Health

Economy

Housing

Environment

Infrastructure

Climate

Land use

A MORE COMPLETE PICTURE OF PLACE

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Understanding change — not just a moment in time

Resilience is about trajectories.

2026

WAVE 1

2028

WAVE 2

2030

WAVE 3

INDIVIDUAL SURVEY — ONGOING

DATA INTEGRATION + COMMUNITY ENGAGEMENT — ONGOING

Did access improve? Did affordability change? Did an intervention make a difference?

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Survey Sample and Geographic Representation

As of October 12, 2026, we had received 865 survey responses. We were interested in data from five Ontario Health Regions (OHRs). Toronto was excluded because none of the forward station areas (the geographic units used to define survey targets) were classified as rural (i.e., the middle digit was not 0).

The sample is geographically uneven relative to the estimated regional population distribution. The North East and North West are overrepresented, particularly the North East, which accounts for approximately 43% of completed surveys compared with an estimated 11% of the population.

Conversely, the West, East, and Central regions are underrepresented. The West is particularly notable: it accounts for approximately 41% of the estimated population but only 17% of completed surveys.

This geographic imbalance is important context for interpreting the findings. The results provide valuable early insights into respondents' experiences, but the overall sample should not automatically be treated as representative of rural Ontario. Regional differences may also reflect differences in the characteristics of respondents within each region.

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Survey Sample Sociodemographic Profile

Gender: Respondents were predominantly female (77%), with men representing 21% of the sample.

Age: Respondents were concentrated in the 45–74 age groups, with relatively fewer younger adults (under 35) and older adults (75+).

Identity and groups: Representation across the identity groups surveyed was limited, with approximately 74% indicating that none of the listed categories applied to them. However, 12.3% reported a long-term health condition or disability that limits their daily activities. This may partly reflect the older age profile of respondents, although further analysis would be needed to assess this relationship.

Household income: The sample showed a fairly broad distribution across household income categories, although representation was lower at the highest income level ($150,000+) and 8.3% of respondents preferred not to disclose their income.

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Healthcare access: barriers extend beyond having a primary care provider

Only 13% of respondents did not have a regular primary care provider, yet 27% reported being unable to access healthcare in the past year.

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Healthcare access: respondents with unmet healthcare needs report poorer self-rated health

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Economic security - financial resilience is about more than income

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The rural resilience paradox�Households feel more prepared than the systems around them.

Respondents reported having access to several preparedness and resilience resources, including transportation (75%), emergency supplies (57%), backup power and heat (51%), local knowledge (42%), and having an emergency plan (36%).

Despite reporting these resources, 49% rated their municipality as not very well or not at all well prepared to support residents during hardship or emergencies, while only 5% rated municipal preparedness as very good.

This suggests an important distinction between household preparedness and perceived community preparedness. Residents may feel prepared based on the resources they have available, but they still depend on municipal infrastructure and services, including roads, utilities, communications, healthcare, and emergency response and may feel these are inadequate in terms of preparedness and resilience.

Looking at household and community preparedness together could help us understand whether residents’ personal resources align with the support and infrastructure they feel their municipality can provide.

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As discussed on Slide 5, financial resilience is about more than income. We’re looking at financial strain because income alone doesn’t necessarily capture who is struggling to meet their basic needs.

Financial difficulty was most common among respondents aged 25–44, at around 35–39%, and generally declined among older age groups, reaching 6.6% among those aged 75–84.

We see a somewhat similar pattern for unmet healthcare needs, which also tended to decline after age 44. However, unmet healthcare needs were still relatively high among respondents aged 18–24, and the estimate was also high among those aged 85 and older.

We also see a clear descriptive difference by financial strain: 40.4% of financially strained respondents reported unmet healthcare needs, compared with 22.9% of those not reporting financial strain. Age could be part of this relationship, along with other factors, so it would be worth exploring whether this association persists after accounting for age and other relevant characteristics.

Another interesting finding is that respondents reporting a limiting disability were approximately 1.8 times as likely to report financial difficulty and unmet healthcare needs as those without a reported limiting disability. This points to a potential overlap between disability, financial strain, and barriers to accessing care.

Taken together, these early findings suggest that financial strain and unmet healthcare needs vary across groups and may overlap in important ways. The next step is to explore these relationships further and determine whether the observed differences remain after accounting for other factors.

Note: These are descriptive findings, and statistical testing has not yet been completed. Response numbers vary across questions and groups, and some estimates are based on small samples, so the patterns should be interpreted cautiously.

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What are we hearing in Western Ontario?

Preliminary Individual Survey findings · West region n = 153

37%

delayed or went without�specialized healthcare because�access was difficult

39%

have concerns about the�safety, quality or availability�of their water supply

18%

say lack of public/community�transportation made it difficult�to get where they needed to go

These are early signals to follow as the Western Ontario sample grows — not population estimates.

The value is not any one number. It is the pattern across systems.

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What would make rural residents more resilient?

When asked what would most improve their ability to manage challenges, hardships or emergencies:

More local healthcare access

57%

Financial supports for home energy / repairs

45%

Better transportation access

44%

Better local food access

42%

Improved internet or cell service

32%

Clearer emergency communications

26%

RESILIENCE IS BUILT EVERY DAY — NOT JUST DURING EMERGENCIES.

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These aren't separate problems.

They form a rural system — and they need to be understood together.

RURAL�COMMUNITY

HEALTHCARE

HOUSING

WORKFORCE

TRANSPORTATION

INFRASTRUCTURE

CLIMATE

ECONOMY

FOOD

If we measure each problem separately, we risk missing the community.

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From Data → Evidence → Decisions

The purpose is not simply to describe rural communities — it is to strengthen the decisions made about them.

PLAN

Where are pressures�emerging?

TARGET

Who and where are�most affected?

INVEST

Where could limited�resources have the�greatest impact?

ADVOCATE

What evidence supports�the case for investment?

The test: can a community use the evidence to plan, prioritize, fund and advocate?

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Imagine being able to ask…

1

Where is healthcare access getting better — and where is it getting worse?

2

Where is housing beginning to constrain workforce growth?

3

Which communities are most vulnerable when power or transportation systems are disrupted?

4

Why can one rural community attract and retain workers while a neighbouring community struggles?

5

Which investments actually improve resilience over time?

…and answer those questions with rural evidence.

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Data are only useful if communities can use them.

HEAR is being designed to return evidence to rural communities in practical, accessible forms.

●

INTERACTIVE�DASHBOARD

Explore indicators,�patterns and change

●

REGIONAL +�COMMUNITY PROFILES

Understand local�conditions

●

MUNICIPAL�BRIEFS

Support planning,�funding and advocacy

●

WORKSHOPS +�TRAINING

Build capacity to�interpret and use data

Collecting the data is not the end point.

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Beginning in Ontario. Designed for national expansion.

The longer-term goal is durable rural evidence infrastructure — not a one-time research project.

ONTARIO

Build the longitudinal platform�Integrate rural datasets�Develop community-facing tools�Learn with partners

→

CANADA

Understand where communities are�See how they are changing�Identify emerging pressures�Learn what works across places

A stronger evidence base for rural policy, planning and investment.

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What does it take to build a life in a rural community — and stay?

A home they can afford.

Healthcare they can access.

Work that supports a household.

Infrastructure they can depend on.

A community capable of responding to change.

A sense that there is a future there.

BETTER RURAL DATA CAN HELP US BUILD THAT FUTURE.

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Thank you.

www.hearinitiative.ca

hear@uoguelph.ca

Leith.Deacon@uoguelph.ca