The chapter describes how, because of the socio-economic diversity of rural communities, disadvantage, poverty and social exclusion are often invisible or not obvious in routinely available statistics. It explains why, because of lack of economies of scale, rural service provision is relatively expensive to provide yet under-resourced relative to urban areas and what this means for healthcare. Without an understanding of rural disadvantage, hidden social exclusion, digital inclusion, transport and access to healthcare, it is not possible to address the needs of relatively uncomplaining people in remote or sparsely populated areas.