Medicos numb to ‘stunning difference in life expectancy’ in bush

Published 22 November 2016

The medical sector has become numb to the ‘stunning difference in life expectancy and quality of life between city and bush, University of New England PhD Candidate and CEO of the Royal Flying Doctor Service, Martin Laverty, has told the National Press Club in Canberra.

Mr. Laverty was speaking on the topic ‘Fixing Rural and Remote Health’ when he told the Press Club that heart attack rates are much higher in the bush than in the city.

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“Heart Foundation research reveals remote areas in the Northern Territory have the highest rates of hospital admission for heart attack across the country, at 161 per ten thousand people.”

In the northern and eastern suburbs of Sydney, there are only 33 per ten thousand people. That’s roughly a fifth the rate of the Northern Territory.

“Pick a statistic. Any statistic. Health outcomes and health access is worse in the bush than city. Remote Australians die on average two and a half years earlier than people in the city. Type two-diabetes rates are 3.7 times higher. You are four times more likely to die in a car accident on a country road than a city road.”

Mr. Laverty says suicide rates are seven times as high in the bush than the city and that social factors such as poverty, education and housing are key determinants to these disparities.

People in regional and remote Australia see doctors at half the rate of people in the city, medical specialists and dentists at a third the rate and mental health professionals at a fifth the rate, according to Mr. Laverty.

“Why do we accept these disparities? Why do country people not complain? How have we let decision makers avoid accountability for worse outcomes and less access? We, in the rural health sector have become numb to the stunning difference in life expectancy and quality of life between city and bush. We’ve been tired into passive acceptance.”

But Mr. Laverty says the disparity can be addressed and in the 1990’s country South Australia reversed the poor heart attack survival rates for those in the bush.

“In the decade commencing 2000, an integrated Cardiovascular Clinical Network was established to work across South and Central Australia where survival rates from heart attacks were 1.7 times worse than in the cities. The network supported country doctors and nurses to treat emergency cardiovascular patients earlier by linking country clinicians with Adelaide specialists. Patients receive drug interventions earlier, and are transported to city hospitals sooner.”

By better linking and coordination, and with no new money, the mortality difference between city and bush has been equalised. 30-day survival rates from heart attack across country SA are as good as those in metropolitan Adelaide. The findings were published in the Medical Journal of Australia in 2014.

Mr. Laverty has called for the Commonwealth’s Rural Health Commission to be set up to succeed and for the acceptance and complacency on health disparities between city and bush to end.

“The Commissioner will be tasked to enhance training and opportunities for doctors to become more skilled rural generalists, but the success of the Commissioner should also be judged on better health outcomes for people in the bush.”

To achieve this, Mr. Laverty says the Commissioner will need to identify new flexibility for primary care access, technology and funding certainty.

The Commissioner will also need to come to terms with why chronic illness prevention programs so often fail in remote and country areas.

“The best means of treating illness is to prevent it. Yet there are pockets of country Australia where health prevention has failed.”