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People living outside Australia’s major cities have shorter lifespans and have much poorer access to healthcare while reporting worse outcomes than those in metropolitan areas on several key measures, a new report has found, highlighting a “grim” healthcare divide.
Australians in rural, regional and remote areas record “potentially avoidable deaths” — which are those considered preventable in the health system — at four times the rate of those in metropolitan areas, the National Rural Health Alliance’s (NHRA) health latest snapshot found.
Large life expectancy gaps mean men in very remote areas can expect to die 13.6 years earlier and women up to 12.7 years earlier than those in metropolitan areas, according to the report released on Thursday.
Nearly 18,500 people live further than a one-hour drive from primary care, according to NHRA, which is an improvement from the 44,930 reported in 2022.
Health Minister Mark Butler acknowledged the “tyranny of distance,” saying Australians in regional areas often face significant health challenges.
In a statement, Butler said the federal government was focused on “rebuilding general practice” and improving access to healthcare in regional areas, adding there was “more to do to keep strengthening Medicare”.
‘Second-class citizens’
NRHA chief executive Susi Tegen said the data “highlights the shameful failure to adequately provide funding and services to rural Australians, who contribute so much to our economy”.
“Why are they treated like second-class citizens, with a staggering $848 less spent per person per year on healthcare?”
Tegen said the health of rural Australians “can’t wait any longer” amid “the urgent need for immediate action, especially with the federal election on the horizon”.
“For decades, we have known about the healthcare challenges, the additional costs, and the tyranny of distance, but there has been too little action.”
Australia Medical Association (AMA) president Dr Danielle McMullen said targeted investment in rural health is needed “to ensure doctors and other health care professionals working in rural and remote areas are well-supported”.
“We know that if we can recruit students and train them to become doctors and specialists in regional areas, they’re much more likely to stay there,” McMullen said.
“The AMA has proposed measures to tackle this issue, including the establishment of a National Rural Health and Workforce Strategy — with funding for an independent workforce planning agency — and expanded training pathways for doctors in rural areas.”
Health risks and poorer health outcomes in regional and remote areas
People living in rural areas are 24 times more likely to be hospitalised due to domestic violence than those in major cities, according to NHRA.
In remote areas, around 70 per cent of adults are overweight or obese, compared with 64.4 per cent in major cities
These are some of the factors — along with higher rates of smoking, alcohol consumption and UV exposure — that can be connected to worse health outcomes.
However, the report notes people living in outer regional, remote, or very remote areas experience longer waiting periods to see a GP than those living in major cities.
“The consequence of poorer access to primary health care in rural Australia is higher rates of potentially preventable hospitalisations in all areas outside of major cities,” it states.
People living in very remote Australia utilise Medicare almost 50 per cent less than those in metropolitan areas, while small rural towns have 55 per cent fewer health professionals than metropolitan areas.
Improvements in some states and territories
There has been a 75 per cent increase in the proportion of emergency medicine specialists working in rural and remote areas across NSW, according to a separate analysis by the Australasian College for Emergency Medicine released last week.
But workforce shortages continue to bite as country patients seek emergency care in greater numbers than their city peers.
The rate of emergency presentations was 548 per 1,000 population in regional and remote areas across the state, compared to 311 per 1,000 in the cities in 2021-22.
In the Northern Territory earlier this month, the prime minister committed to reduce disadvantage for Indigenous people — including funding for scholarships for people studying psychiatry in the territory, while hearing and oral health services will continue to be funded.
— With additional reporting by the Australian Associated Press.
