The current Statistics NZ definition of “rural” is not designed to be used in health research. When used for this purpose it can compromise efforts to ensure equitable health outcomes and access to health services for rural people. This geographic definition does not take available health services into account and so the population defined as “rural” differs from that which actually receives rural health care. Recent evidence suggests that around 40% of the people who actually access rural health services are currently classified as “urban”, and 20% of those defined as “rural” actually receive urban health care. The extent of this mismatch masks any inequality in healthcare access or outcomes that may exist and hampers all current and future research. We propose to develop and validate a “fit for purpose” rurality classification and to use this to analyse current health data to better understand rural health in NZ.