AIHW media releases

Australians living outside major cities have shorter life expectancy, higher death rates, and are more likely to have a disability compared to city dwellers, according to a report released today by the Australian Institute of Health and Welfare.

This is so even when taking into account the effects of the known poorer health of Indigenous Australians, who make up a greater proportion of the population in regional and remote areas than they do in the cities, and affect health figures in remote and very remote areas in particular.

People outside major cities were also more likely to place themselves at a higher risk of poor health -for example, they were more likely to smoke, be overweight and drink alcohol excessively.

Rural, regional and remote health: indicators of health focuses on health status, determinants of health, and health service provision, and is the first systematic comparison of its kind.

The report confirmed that GPs and other health professionals were less prevalent outside major cities, and they worked longer hours.

'The findings on life expectancy, death rates and disability are not a surprise given the poorer health determinants and lower access to services outside major cities', said Mr Andrew Phillips, author of the report.

'For example, smoking rates are up to 25% higher and have not been decreasing in rural areas. Risky alcohol consumption is also more likely. But, in contrast, breast and cervical cancer screening participation is higher in rural areas.'

'Other factors associated with poorer health include the lower incomes in rural areas compared to major cities, and a lower proportion of adults who have completed high school to Year 12.'

'Seventeen-year-olds outside major cities were less likely to still be in school, and school leavers were less likely to go on to university', Mr Phillips said.

'Students outside major cities were also less likely to commence a health-related degree. But some good news is that over recent years students from outer regional and remote areas have become much better represented in medical courses, and these students are more likely than students from the city to eventually practise in rural areas.'

Other findings in the report include:

• Hospital admission rates for coronary artery bypass graft and coronary angioplasty were lower outside major cities, despite similar rates of self-reported coronary heart disease.
• Birth rates, particularly for teenagers, were higher in rural and remote areas.
• Immunisation rates were slightly lower outside major cities.
• Children outside major cities had, on average, more decayed, missing or filled teeth. This was partly explained by much lower incidence of fluoridation of the water supply in rural areas.
• Pertussis (whooping cough) notification rates were up to twice as high outside major cities.