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Background: Rural Australian populations experience an increased burden of ischaemic heart disease (IHD) compared to their metropolitan counterparts, similar to other developed countries, globally. Policy and other efforts need to address and acknowledge these differences in order to reduce inequalities in health burden. This paper examines rural health policy makers’ perceptions and use of evidence in efforts to reduce the burden of IHD in rural areas. Methods: Policy makers and government advisors (n = 21) who worked with, or advised on, rural health policy at local, state and federal government levels, with specific focus on the state of Victoria (n = 9) were identified from publicly available documents and subsequent snowball sample. Semi-structured qualitative interviews were conducted in regards to the use of evidence in policy to prevent IHD and thematic analysis undertaken applying two theoretical perspectives: context-based evidence-based policy making and the conceptual framework for understanding rural and remote health. Results: The rural context, particularly low resourcing, was seen as limiting potential for evidence based policy at local government (LG) level. Lower levels of political pressure and education were seen as constraints to evidence-based policy in rural communities. Participants described the potential for policy to have a greater impact on reducing heart disease in rural areas though they felt under-resourced and out of touch with the scientific evidence. Scientific studies were less valued than local anecdote to prioritise specific policy. At all levels (local, state and federal) low self-efficacy in interpreting evidence and perceived lack of relevance inhibited development of evidence informed policy. Conclusion: The rural context constrains the use of scientific evidence in policy making for the prevention of heart disease in rural areas in Australia with multiple factors influencing the capacity for evidenced based health policy. This is similar to findings at the international scale and is for consideration across other developed countries that experience inequalities in IHD disease burden between rural and urban populations. [ABSTRACT FROM AUTHOR]

Uncertainty around long-term droughts and water scarcity has been increasing as the impacts of El Nino cycles are felt globally. Understanding how the effects of these events are manifested on the ground in communities is particularly important if governments and associated agencies are to respond appropriately. Using a qualitative approach, this paper examines the impacts of drought on two rural towns in Victoria, Australia, and explores what lessons can be drawn from local experiences. The research suggests that previous responses to drought by governments have been largely ineffectual and as such, we question whether there is a need to reshape institutional understandings of what adapting to drought might mean. This research, therefore, seeks to further the discussion surrounding drought impacts and the myriad of challenges associated with it by drawing on locally situated knowledge to inform future decision-making in this evolving field of study. [ABSTRACT FROM AUTHOR]