People in Rural and Remote Areas

People in Rural and Remote Areas2015-08-13T13:26:20+10:00

Roughly 30% of Australians live in regional and remote areas. Living in rural and remote areas fits into the environmental determinants of health, so it is not a surprise that people in these environments have poorer health outcomes compared to other Australians.

The nature and extent of the health inequities

People living in rural and remote areas have shorter lives and higher rates of disease and injury. Death rates increase with increased remoteness with very remote having 1.5 times the rate of major cities.

Australia's Health 2014

Australia’s Health 2014

The main causes of this increased death rate are: CHD, circulatory diseases, motor vehicle accidents and COPD. People living in rural areas also have a higher incidence rate for cancer, while people living in rural and remote areas had higher disability rates compared to major cities. Other inequities include:

  • Higher rates of diabetes and related deaths
  • Higher rates of transport accidents
  • Higher rates of suicide
  • Higher death rates from perinatal and congenital conditions
  • Higher death rates for liver cirrhosis
  • Higher burden of stroke
  • Poorer Oral health

These inequities may be linked with the poorer indicators of health and access to care in rural and remote areas. Some indicators include: higher rates of obesity, smoking, inactivity, risky alcohol consumption, cholesterol levels, rates of preventable hospitalisations and poorer access to aged care. Rural and remote people are also more likely to defer treatment for various health conditions, such as dental work. Rural and remote living people have higher levels of disease risk factors and illnesses.

Australia's Health in Brief 2014

Australia’s Health in Brief 2014

The sociocultural, socioeconomic and environmental determinants

The sociocultural determinants of health include: family, peers, religion, culture and media.. In rural and remote areas the proportion of ATSI peoples in higher than other areas and contributes to the poorer health outcomes for rural and remote living people. The poorer indicators of health also influence children being brought up in rural and remote areas. Children raised in families that have higher smoking rates, have higher rates of second hand smoke and are more likely to become smokers. Children of overweight and obese parents are more likely to be overweight or obese. This also applies to lower rates of activity, higher risky drinking, and cholesterol levels.

There are a variety of socioeconomic determinants of health for rural and remote living people. Socioeconomic factors include level of education, income and type of employment. Rural and remote living people are disadvantaged regarding education and employment opportunities, income and access to goods and services. They are more likely to work on farms, in transportation or mines, which are hazardous occupations with higher rates of tobacco and alcohol use. People living in rural and remote areas have a lower average income and poorer levels of education – leading to lower health literacy. On the positive side, rural and remote living people have higher levels of social cohesiveness and participation in volunteer work.

Environmental determinants refer to geographical location, access to health services, and quality of housing. In rural and remote areas the number of GP’s employed is rising, but is still lower that the rates in major cities. This limits access to general medical services. There is also a poorer distribution of medical specialists and medical technology. Use of medical services is also poorer than major cities, including some cancer screening programs such as bowel cancer. People with kidney disease are required to travel long distances on a regular basis and often moved to less remote areas to access medical services.

The interactions between remoteness, socioeconomic disadvantage and higher ATSI population along with the gaps in health information make the implications of remoteness hard to determine.

The roles of individuals, communities and governments in addressing the health inequities

Individuals can begin to address these inequities by focusing on good decision making and taking responsibility for their own health and the health of those around them. Actions such as remaining in school, or seeking to attend university either online or even at rural or remote based universities such as Charles Sturt will improve their knowledge, employment opportunities and income levels and help individuals make informed choices about their health and health care used. Individuals can also help promote health in their family and friends by encouraging good health choices, such as not smoking or reducing alcohol intake. These decisions reduce the risk factors to health and will help address the health inequities.

Communities can address the health inequities by providing relevant health care and support services. This includes the development of Multi Purpose Service Programs that often connect with community services, and the development of community health centres with the services they offer.

The government funds many rural and remote programs to assist in the delivery of health care to rural and remote living people. These include: the royal flying doctor service, which provides: health care clinics, medical evacuations, provide medical chests and remote consultations. The government has instituted the Rural and Remote General Practice Program to help increase the number of GPs available in these areas. They also help fund other services such as SARRAH, who provide allied health services. For further information visit:

http://www.ruralhealthaustralia.gov.au/internet/rha/publishing.nsf/Content/Organisations