Rural & remote health

Overall, more Australians live in Major cities compared with rural and remote areas. In 2017, the proportion of Australians by area of remoteness was:

• 72% in Major cities
• 18% in Inner regional areas
• 8.2% in Outer regional areas
• 1.2% in Remote areas
• 0.8% in Very remote areas (ABS 2019b).

On average, people living in Remote and very remote areas were younger than those living in Major cities (figures 1a and 1c).

Australians aged 25–44 were more likely to live in Remote and very remote areas and Major cities compared with Inner regional and outer regional areas. However, a higher proportion of people aged 65 and over lived in Inner regional and outer regional areas and Major cities, compared with Remote and very remote areas (figures 1a, 1b and 1c).

Figure 1a: Australian population, by age group and sex residing in Major cities, 2017

Source: ABS 2018c; Table S1.

Figure 1b: Australian population, by age group and sex residing in Inner regional and outer regional areas, 2017

Source: ABS 2018c; Table S1.

Figure 1c: Australian population, by age group and sex residing in Remote and very remote areas, 2017

Source: ABS 2018c; Table S1.

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 (AIHW 2015). The differences in health outcomes in Remote and Very remote areas may be due to the characteristics of these populations. The proportion of the population that is Indigenous, is much higher in more remote areas (ABS 2018b) (Table 1). However, more Indigenous Australians live in Major cities and Inner regional areas (61% of Indigenous Australians) compared with Remote and Very remote areas (19%) (ABS 2018b).

Table 1: Proportion of people in each remoteness areas that are Indigenous Australians and non-Indigenous Australians, 2016

	Major cities	Inner regional	Outer regional	Remote	Very remote
Indigenous	1.7%	4.4%	7.9%	18%	47%
Non- Indigenous	98%	96%	92%	82%	53%
Total	100%	100%	100%	100%	100%

Source: ABS 2018b.

For more information on Aboriginal and Torres Strait Islander health by remoteness see: The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015 and the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report

Social determinants of health

In general, people from poorer social or economic circumstances:

• are at greater risk of poor health
• have higher rates of illness, disability and death
• live shorter lives than those who are more advantaged (Mackenbach 2015).

Indicators such as education, occupation and income can be used individually or combined to define socioeconomic position. There is a complex interplay between health and welfare, where social factors such as an individual’s education, employment, and relationships can impact their overall health, and vice versa.

Education

In 2018, people living in rural and remote areas were less likely than those in Major cities to have completed Year 12 or a non-school qualification (Figure 2). Around half of people living in Inner regional, Outer regional and Remote and very remote areas had completed Year 12, compared with nearly three-quarters (74%) of those in Major cities.

Likewise, fewer people living in Inner regional (20%),Outer regional (17%) and Remote and very remote (16%) areas had completed a Bachelor’s degree or above, compared with those in Major cities (36%).

Figure 2: Proportion of 20–64 year olds with a Year 12 certificate or above, by remoteness area, 2018

Source: ABS 2018a; Table S2

Employment

The employment-to-population ratio shows the proportion of a country’s working-age population, aged 15 and over that is employed. As at December 2018, the employment- to-population ratio across Australia was 63%. With the exception of Greater Perth, greater metropolitan areas had a higher proportion of employed people than did the rest of the states and territories (Figure 3). This may be due to lower levels of access to work outside of metropolitan areas and decreased range of employment and career opportunities in these areas (ABS 2019a; NRHA 2013).

Figure 3: Employment-to-population ratio, by greater metropolitan areas and the rest of states and territories, 2018

Source: ABS 2019a; Table S3.

Income

People living in rural and remote areas generally have lower incomes but have to pay higher prices for goods and services (NRHA 2014). In 2015–16, Australians living outside of capital cities had, on average, 18% less household income per week compared with those living in capital cities, and 29% less mean household net worth (ABS 2017).

References

ABS (Australian Bureau of Statistics) 2017. Household income and wealth, Australia, 2015–16. ABS cat. no. 6523.0. Canberra: ABS.

ABS 2018a. Education and work, Australia, May 2018. ABS cat. no. 6227.0. Canberra: ABS.

ABS 2018b. Estimates of Aboriginal and Torres Strait Islander Australians, June 2016. ABS cat. no. 3238.0.55.001. Canberra: ABS.

ABS 2018c. Population by age and sex, regions of Australia, 2017. ABS cat. no. 3235.0. Canberra: ABS. Derived by AIHW from SA1 estimated resident populations.

ABS 2019a. Labour, force, Australia, detailed electronic delivery, December 2018. ABS cat. no. 6291.0.55.001. Canberra: ABS.

ABS 2019b. Regional population growth, Australia, 2017–18. ABS cat no. 3218.0. Canberra: ABS.

AIHW (Australian Institute of Health and Welfare) 2015. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015. Cat. no. IHW 147. Canberra: AIHW.

Mackenbach JP 2015. Socioeconomic inequalities in health in high-income countries: the facts and the options. Oxford textbook of global public health. Vol. 1. 6th edition. Oxford: Oxford University Press.

NRHA (National Rural Health Alliance) 2013. A snapshot of poverty in rural and regional Australia. Canberra: NRHA. Viewed 25 June 2019.

NRHA 2014. Income inequality experienced by the people of rural and remote Australia. Canberra: NRHA.