Why are death rates higher in rural areas? Evidence from the Australian Longitudinal Study on Women's Health

Dobson, A, McLaughlin, D, Vagenas, D and Wong, KY (2010) Why are death rates higher in rural areas? Evidence from the Australian Longitudinal Study on Women's Health. Australian and New Zealand journal of public health, 34 6: 624-628. doi:10.1111/j.1753-6405.2010.00623.x


Author Dobson, A
McLaughlin, D
Vagenas, D
Wong, KY
Title Why are death rates higher in rural areas? Evidence from the Australian Longitudinal Study on Women's Health
Journal name Australian and New Zealand journal of public health   Check publisher's open access policy
ISSN 1753-6405
1326-0200
Publication date 2010-12
Sub-type Article (original research)
DOI 10.1111/j.1753-6405.2010.00623.x
Volume 34
Issue 6
Start page 624
End page 628
Total pages 5
Place of publication Richmond VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2011
Language eng
Formatted abstract
Objective: Death rates in Australia are higher in rural than urban areas. Our objective is to examine causes of death of urban and rural women to gain insight into potential explanations for differences in mortality.

Methods: Participants were a community-based random sample of women (n=12,400) aged 70–75 years when recruited in 1996 to the Australian Longitudinal Study on Women's Health. The main variables used were: area of residence classified according to the Australian Standard Geographic Classification (ASGC), survival to 31 October 2006, cause of death, selected risk factors.

Results: The total number of deaths at 31 October 2006 was 2,803 and total number of women still alive was 9,597. Mortality was higher for women in rural areas overall (hazard ratio (HR)=1.09; 95% confidence interval (CI): 1.01–1.18) and for most major causes of death compared to urban women. In particular, death rates were substantially higher for lung cancer (HR=1.52; 95% CI: 1.03–2.25) and chronic obstructive pulmonary disease (COPD) (HR=1.83; 95% CI: 1.25–2.69). Nevertheless there were almost no differences among the groups for current smoking or smoking history. Prevalence of overweight and obesity was slightly higher and levels of physical activity lower among women in remote areas.

Conclusion: There is little evidence that differences in mortality are due to the risk factors considered. Alternative explanations such as inequities in health services and environmental hazards should be considered.

Implications: People in rural areas may suffer from a double disadvantage of poorer health services and exposure to health hazards that are less common in urban areas.
© 2010 The Authors. ANZJPH © 2010 Public Health Association of Australia.

Keyword Women's health
Rural health
Mortality
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
 
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Created: Sun, 09 Jan 2011, 00:11:33 EST