Abstract: Objective To demonstrate the usefulness of a conceptual framework to increase the understanding of rural and remote health by applying it to specific rural and remote health scenarios. Design A conceptual framework was applied to two case studies illustrative of key issues in rural health to reflect different contexts, issues and responses. Results Application of the framework to both case studies highlighted that changes in rural and remote health are diverse. While power was a key element of the framework, the interaction of all framework components underpinned changes. Conclusion The framework facilitated understanding of change in these rural scenarios and demonstrated that improvement in rural health requires change at both the local and structural levels.