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.