About rural health
The rural health gap
It is widely accepted that rural and remote communities experience difficulties due to geographic isolation. The health of Australians in rural and remote areas is generally poorer than those who live in major cities and towns. They experience:
- Higher mortality rates and lower life expectancy
- Higher rates of high blood pressure, diabetes, and obesity
- Higher mortality rates from chronic disease
- Higher prevalence of mental health problems (including dementia)
- Higher rates of alcohol abuse and smoking.
Influencing factors include environmental and socioeconomic issues, community capacity and individual behaviours.
Social reasons that account for these differences in health include:
- Lower levels of income, employment and education
- Higher occupational risks, particularly in farming and mining
- Geography and the need for long distance travel
- Access to fresh foods
- And acccess to health services.
Rural and remote health services are more dependent on primary health care services, particularly those provided by general practitioners. Facilities are generally smaller, provide a broad range of services (including community and aged care), have less infrastructure and fewer specialists, and provide services to a more dispersed population.
The limited number of specialist professionals and services means it's harder for people in remote areas to know about and access them, even if they want to. This means rural and remote patients are often forced to travel to metropolitan areas for treatment, sometimes at considerable cost. For example, the travel costs attributed to osteoarthritis and rheumatoid arthritis alone were estimated as $78.6 million in 2012.
As remoteness increases, communities are increasingly affected by environmental extremes (such as flood, fire or drought) and economic variability.
On the positive side, Australians living in rural areas generally have higher levels of social cohesiveness – for e.g. higher rates of volunteer participation and feelings of community safety.
- POOR OUTCOMES
The lowered health outcomes for rural and remote Australians include:
- Five-year relative survival rate for cancer (including bowel, breast, lung, ovarian, pancreatic, prostate and neglected cancers) decreases with increasing remoteness
- Diabetes (both type 1 and type 2) ranks higher as a cause of death among people in remote and very remote areas compared with regional and major city areas
- The prevalence of asthma is significantly higher in people living in inner regional areas compared with those living in major cities or outer regional and remote areas
- Adults living in outer regional and remote areas of Australia are 9% more likely to be overweight or obese
- An estimated 20% of adults, including about 960,000 people living in regional, rural and remote areas, have experienced a mental disorder (including schizophrenia) in the previous 12 months.
Although largely preventable, chronic diseases (once they develop) can often be effectively controlled through behavioural change, medication and other health-care interventions.
While Australia has had some successes in preventing and treating these diseases, their prevalence continues to grow as the population increases and better treatment allows people to live longer.
If left unchecked, risk factors like obesity, physical inactivity and insufficient fruit and vegetable consumption, combined with an ageing population, suggest that the burden of chronic disease (including cardiovascular disease, diabetes, arthritis and associated morbidities) will continue to grow.
The risk of developing chronic diseases is closely associated with smoking, physical inactivity, poor nutrition and the harmful use of alcohol.
Some of which, in turn, contribute to being overweight or obese, high blood pressure and high blood cholesterol levels.
Each of these risk factors, however, is modifiable.