Does relative remoteness affect chronic disease outcomes? Geographic variation in chronic disease mortality in Australia, 2002-2006

Abstract

Objective: To examine the variation of chronic disease mortality by remoteness areas of Australia, including states and territories. Methods: Australian Bureau of Statistics (ABS) death registration data, by Statistical Local Area (SLA), were used to identify chronic disease mortality by remoteness category for states and territories and Australia. The analysis used multiple cause of death for six common chronic diseases: diabetes, ischaemic heart disease, stroke, hypertension, chronic obstructive pulmonary disease and renal disease. ABS correspondence files were used to adjust the SLA level death records and population. Results: The chronic disease mortality rate for Australian residents living in a very remote area (512 per 100,000 persons) was respectively 1.3, 1.4, 1.5, and 1.6 times higher than Remote, Outer Regional, Inner Regional and Major Cities categories. This pattern was consistent for the two age groups of 35-64 years and 65 years and over, all six chronic diseases and all states and territories except Victoria. Conclusion and implications: This study shows that chronic disease mortality increases with increasing relative remoteness. The results highlight the importance and opportunity to redress poorer health outcomes for rural and remote area populations. The study is limited by absence of reliable Indigenous identification in national death data. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.