Rural health and IT: a critical disclosure analysis perspective

The Internet has important implications for rural and remote health in terms of its potential both to address inequities in access to health services and to lessen isolation and provide support to health professionals. It is crucial to examine the Internet, with its own powerful superhighway travelling through a vast land of diverse cultures, in a critical way. Distinctions need to be made between 'window-dressing' decision-making, interference and imposition. Internet-based interaction needs to be socially and culturally sensitive as it may create socio-cultural conflicts between providers and users. Factors such as socio-cultural assumption and definition, cultural norms in social interaction, learning styles and cultural attitudes to community and health need to be taken into account and raise many questions. For instance, what choice of health issues should be included in online courseware in order to satisfy certain interest groups without excluding others? Critical Discourse Analysis (CDA) is useful in assessing issues such as this. Continuing a tradition that rejects the possibility of a 'value-free' science, Critical Discourse analysts argue that science, and especially scholarly discourse, are inherently part of, and influenced by social structure, and produced in social interaction. CDA primarily studies the way abuse of social power, dominance and inequality are enacted, reproduced and resisted by interaction in the social and political context.