Death rates 10-50% higher in bush, but declining

Death rates in regional and remote areas are 10% higher than in major cities, and in very remote areas are 50% higher, according to a new report from the Australian Institute of Health and Welfare (AIHW).

Using major city death rates as a benchmark, between 1997 and 1999 there were about 3,300 more deaths a year in the bush than would have been expected.

The report, Rural, Regional and Remote Health-a study on mortality, compares the death rates of people living in rural, regional and remote areas with those in Australia's major cities, and looks at trends in these rates over time. It also disentangles the effects of high Indigenous death rates and high overall rural mortality Australia-wide-the first time that this has been done.

The major causes of higher death rates outside major cities are heart disease/other circulatory diseases, chronic obstructive pulmonary disease, motor vehicle accidents, diabetes, suicide and other injuries. Most of these are potentially preventable.

According to report author, Andrew Phillips, the good news is that death rates in all areas are coming down, especially in very remote areas.

'Since 1992 death rates have declined by about 3% a year for men and 2% a year for women in both metropolitan and rural areas. In very remote areas there has been a much bigger improvement-death rates have fallen by 10% per year for both men and women over the same period.'

The main drivers of the improvements over the 1990s in rural areas have been declines in deaths due to circulatory disease, and to a lesser extent, respiratory disease and cancer. There was, however, little change in death rates due to injury.

Mr Phillips said there were many factors likely to affect higher death rates outside major cities.

'Higher death rates in rural, regional and remote areas are likely to be explained by a combination of lifestyle and behaviour factors, lower access to some health services, riskier occupations, country driving conditions, and generally lower socioeconomic status.

'It had been widely speculated that high death rates outside major cities are due to the large numbers of Indigenous people who live there, coupled with their high overall death rates, which are three times those for other Australians.'

'In fact, even if we focus just on the non-Indigenous population in those areas, the death rates are still 10% higher than in metropolitan areas.

'Interestingly, the death rates for non-Indigenous people over 65 years of age in remote areas are frequently lower than in major cities.

'It may be that in order to access health and aged care services, the frail aged migrate to less remote centres, leaving the healthier people behind, who live longer,' Mr Phillips said.


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