Rural–urban healthcare gulf still wide: AIHW

The total disease burden in remote and very remote areas was 40% higher than in major cities, as of 2015.
 
The new data in the Australian Institute of Health and Welfare’s (AIHW’s) Rural and remote health report shows potentially preventable hospitalisation rates in very remote areas were 2.5 times higher than in major cities as of 2017–18, with the rate in remote areas 1.7 times as high.
 
Overall, people in very remote areas were hospitalised almost twice as often as those in major cities, as of 2017–18.  
 
Access to healthcare remains a key challenge, with Australians in remote and very remote areas aged over 45 more likely to report access as a barrier compared to cities, as of 2016.  
 
The gulf is clearest between remote and very remote areas compared to regional and urban areas, with potentially avoidable hospitalisation rates only slightly higher in regional areas compared to urban.
 
But the healthcare divide does not translate to lower satisfaction, with a key 2015 Household Income and Labour Dynamics in Australia (HILDA) survey finding Australians living in small towns of fewer than 1000 people reported generally higher levels of life satisfaction compared to their urban counterparts.
 
Rural and remote Australians also report better connectedness to their community, better social cohesion, and higher levels of community participation, volunteering and informal support.

Major cities are home to 72% of Australians, followed by 18% in regional areas, 8.2% in outer-regional, 1.2% in remote and 0.8% in very remote areas.
 
Smoking rates are notably higher outside of major cities, with almost 20% in outer-regional and remote areas smoking daily, compared to 12.8% in cities.
 
Many chronic conditions were seen at the same prevalence across all remoteness areas in 2017–18. Exceptions include mental and behavioural issues, which were highest in inner-regional areas (26%), compared to major cities (21%).
 
Asthma was highest in inner-regional, outer-regional and remote areas (13%) compared to major cities (11%).
 
Diabetes was higher in outer-regional and remote areas (7%) compared to cities (5.6%).
 
The longstanding healthcare gap between Aboriginal and Torres Strait Islander people and non-Indigenous Australians is a potential factor in these outcomes.
 
Aboriginal and Torres Strait Islander people are more likely to have higher rates of chronic conditions, hospitalisations and poorer health outcomes than non-Indigenous Australians.
 
‘The differences in health outcomes in remote and very remote areas may be due to the characteristics of these populations,’ the AIHW states.
 
In major cities, 1.7% of people are Aboriginal and Torres Strait Islanders, with the proportion rising to 47% in very remote areas.

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