How do we define 'rurality' in the teaching on medical demography?

CONTEXT There is growing interest worldwide in the teaching of rural and community medicine to medical students. Medical teachers have a responsibility to introduce their students to different health experiences, in both urban and rural environments. The definition of a rural area can be problematic. ISSUE There is no one universal definition of a rural area. This makes comparisons of data from differently defined areas problematic. Definitions of a rural area have been based on population size, access to health care, occupation and other socioeconomic variables, and political proclamations. LESSONS LEARNED There is no easy answer to such a complex issue as the definition of rurality. At best, medical teachers should inform their students that the definition of a rural area can be context specific, and may not be comparable between states. Defining the features of a particular rural area in academic writing may reduce some of the difficulties a reader may have in understanding the context. A universal definition of a rural area is not possible.