The State of Rural Health
Many country towns are witnessing cutbacks and are finding it difficult to attract health professionals. This is troubling considering that the health of rural and remote Australians continues to be significantly worse than their urban counterparts
The health of populations living in rural and remote areas of Australia is worse than of those living in capital cities and other metropolitan areas. Mortality and illness levels increase as the distance from metropolitan centres increases. Relatively poor access to health services, lower socioeconomic status and employment levels, exposure to comparatively harsher environments and occupational hazards contribute to and may explain most of these inequalities. Also, a large proportion of the population in the more remote parts of Australia are Aboriginal and Torres Strait Islander peoples, who generally have poorer health status (Australian Institute of Health and Welfare, Australia's Health 2000, 2000, page 223).
Click here to visit the Australian Institute of Health and Welfare (AIHW).
Mortality
Death rates from all causes are higher in rural and remote areas than in capital cities (AIHW, Health in Rural and Remote Australia, 1998, page 14). Rural Australians are more likely to suffer from coronary heart disease, asthma and diabetes among other diseases. Deaths of males in road accidents are 100% higher in remote areas than in capital cities (Proceedings of the National Rural Public Health Forum 12-15 October 1997, page 1). Suicide rates are especially high for young rural males. For males 15 to 24 years, the rural suicide rate is more than double the metropolitan rate (Proceedings of the National Rural Public Health Forum 12-15 October 1997, page 3).
Indigenous Health
Although Aboriginal and Torres Strait Islander people constitute about 2.1% of the total Australian population, they make up 1% of the capital city population and 20% of the population in remote areas (Australian Institute of Health and Welfare, Australia's Health 2000, page 224). For Aboriginal Australians:
- Life expectancy is 20 years less than for non-Aboriginal Australians
- Aboriginal boys born today have only a 45% chance of living to age 65 (85% for non-Aboriginal boys); Aboriginal girls have a 54% chance of living to age 65 (89% for non-Aboriginal girls)
- Over the last forty years, the Aboriginal infant mortality rate has declined (though it is still over three times the national average)
- Over the same period, adult mortality in the Aboriginal population has increased
(submission to Bush Talks from Central Australian Aboriginal Congress, Alice Springs, NT).
Image: Gathering of Elders at Timber Creek
Health Services
The number of health care professionals in an area is an important factor influencing the health status of country Australians. Although over the course of 1998-99 there was increasing recognition of the problem of diminishing health services in rural areas, essential health services are still lacking in many areas.
Availability of general practitioners (GPs) in rural areas is well below that of the cities. In 1998, small rural centres averaged 93 GPs per 100,000 population; other rural areas had 77 and remote areas 68. All country areas were well below capital cities, which averaged 122 GPs per 100,000; other metropolitan areas and large rural centres averaged 107 and 110 respectively.(Australian Institute of Health and Welfare, Medical Labour Force, 1998)
There is limited access to a range of other health care professionals including specialists and allied health workers. In addition, the supply of pharmacists is substantially lower in many rural and remote areas (Australian Institute of Health and Welfare, Health in Rural and Remote Australia, page 86).
Action by Governments
There have been some encouraging signs of governments' commitment to ensuring adequate health services in regional Australia. While most health funding comes from the Commonwealth, most programs are initiated and implemented by State and Territory health departments. For a full appreciation of recent and current activities in each State and Territory it is necessary to research each jurisdiction separately. Click here for a list of relevant websites. (Document I)
In October 1999 the Commonwealth government convened the Regional Australia Summit, bringing together key people from government and non-government sectors with interests and responsibilities in regional development. In the 2000 Federal Budget, the Commonwealth made some significant financial commitments to expanding a number of health services in regional, rural and remote Australia. Examples include a four-year financial commitment to increasing the availability of allied health professionals and nurses in multi-professional teams in rural and regional areas. However, it will take a sustained, integrated and inclusive strategy to solve the significant health disparities between many rural and remote communities and their urban counterparts.
