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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

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.