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Addressing poorer health in rural areas


During the election campaign, the National Rural Health Alliance released its Election Charter 2010. The metropolitan media paid little attention to this document and its proposed 10 key priorities to address rural health problems. Top of the list was the priority to improve the sustainability of rural communities; other top priorities included equity in funding, improvements to primary care services, workforce development and improving the health of Aboriginal and Torres Strait islander peoples. With some of the rurally based Independent MPs reportedly citing health services in the bush as a priority, the issue of rural health services may gain national prominence.


But just how poor is the health of those living in rural and remote areas? According to the Australian Institute of Health and Welfare, people in rural and remote communities generally experience poorer health status, higher rates of chronic disease and higher mortality rates than those who reside in metropolitan areas. See the figure below comparing death rates.

Figure: Regional and remote death rates compared to major cities

 The AIHW has identified some of the factors that contribute to this situation. Those in rural areas generally experience:
  • higher socioeconomic disadvantage
  • poorer access to health services
  • higher levels of smoking and alcohol consumption
  • greater travel distances
  • higher proportion of Indigenous people (Indigenous health outcomes are poorer than for other Australians)
The Productivity Commission also pointed to health workforce shortages and maldistribution as one of the contributors to poorer health outcomes in rural areas.

So what might help to overcome such inequities?

Various initiatives have been suggested, many of which were summarised in this Senate report. Some of these include expanding the Commonwealth funded Medical Specialist Outreach Assistance program, improving access to state-funded patient assistance travel schemes, developing e-health initiatives and related infrastructure and providing more support for the rural health workforce.

A useful contribution to the debate on how to address rural health inequities was made by this discussion paper which focuses on the provision of primary care services in rural areas. Primary care is often the first point of contact with the health system and could therefore play an important role in mitigating against rural health inequities. The paper discusses a range of possible models for delivering and funding primary care services in rural areas. These include stand alone GP practices, not-for profit community organisations, virtual e-health services and outreach models. The authors point out that multiple and flexible approaches may be needed in order to address the specific needs of individual communities.
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Tags: rural health