The Australia Institute, media release, 14 February 2023:
New analysis reveals residents born in Far West NSW are suffering substantially worse health outcomes than residents in Sydney.
People in Far West NSW are dying earlier than they should, from avoidable causes, and while suicide rates have steadied in Sydney, they are on the rise in the most remote parts of the state.
The report warns of serious and growing inequality in health outcomes between city and country residents and recommends immediate investment in the sector.
Key points:
Life expectancy: People born in the Far West have a life expectancy 5.7 years less than those in Sydney, with the divide worsening
Premature death: Residents in Far Western NSW are 2x more likely to die prematurely than those in Sydney
Avoidable death: ‘Potentially avoidable deaths’ are 2.5x more likely in the Far West than in Sydney
Suicide: Residents in the NSW Far West are 2x as likely to commit suicide than those in Sydney, with a clear upwards trend in suicide rates
“Far West NSW is in serious need of medical attention. Where you live shouldn’t dictate how long you’ll live, but unfortunately in NSW it does” said Kate McBride, Researcher at The Australia Institute.
“Those in the Far West have significantly poorer health outcomes, inferior access to health services and face substantial financial challenges to access services.
“Life expectancy, premature deaths, and ‘potentially avoidable’ deaths are key statistical indicators of whether our health system is working. It is clear from the analysis in this report, sirens should be sounding from the Far West of the state.
“There’s a compelling case for significant investment across the continuum of care, from disease prevention to rehabilitation and ongoing care, in regional NSW.
“The first release in a series, this report reflects a wider national trend: That the health system is failing those living in regional and remote Australia” said Kate McBride.
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RELATED RESEARCH
Kate McBride, The Unlucky Country: Life expectancy and health in regional and remote Australia. Part 1: NSW, February 2023.
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Excerpts from the McBride report:
“Australia has the world’s third highest life expectancy at 84.3 years. However, this national average masks the fact that the ‘lucky country’ has some rather less lucky residents. In every state and territory, those in regional and remote areas have life expectancies several years lower than in the city.
New South Wales (NSW) is a stark example of this divide. Life expectancy in Far West NSW is 79.1 years compared to 84.5 years in Sydney. This more than five-year gap has grown from relative parity at the turn of the millennium to the current gap. Today, a person in far west NSW is more than twice as likely to die prematurely (under 75) than someone in Sydney.
While there are many possible reasons for this discrepancy, overall, people die of the same causes in urban and remote parts of NSW; a comparison of the top causes of death in each area reveals that the top 10 are almost identical. However, regional and remote people are dying younger and from preventable causes at much higher rates than those in Sydney. Deaths considered ‘potentially avoidable’ are more than two and a half times as common in the far west than in the state’s capital.
It has been known for years that there is a suicide issue in regional Australia. Suicide rates in far west NSW—already more than twice as high than those in Sydney—are continuing to rise, while those in urban areas remain steady. But while suicide is a significant problem, it is only the tenth leading cause of death in the region. Suicide tends to take people at a younger age than other causes and as a result can disproportionally skew life expectancy, having said this there are other factors likely at play.
In 2022, a NSW Parliamentary Inquiry into health outcomes and access to services in rural, regional, and remote NSW found that people outside urban areas had significantly poorer health outcomes, inferior access to health services, and faced substantial financial challenges to access services.
This divide between life expectancy in the cities and in the country is a problem that extends beyond far western NSW. The city/country divide exists across Australia, and it is growing. Inequity between Australians living in capitals and remote areas is a significant problem that demands government intervention, particularly concerning overwhelmed and under resourced health systems.”
NOTE: I draw to the attention of "North Coast Voices" readers, living in what is the Australian Bureau of Statistics' Coffs Harbour-Grafton Level 4 Statistical Area, the fact that the combined populations of Clarence Valley and Coffs Harbour City have a projected life expectancy at birth which is 3.9 years lower than that of the population of the Greater Sydney metropolitan area. Only the projected life expectancy at birth for the Far West and Orana region has a worse comparative figure.
The only differences are dehydration and suicide (more below) in the Far West being replaced by heart failure and breast cancer in Greater Sydney. The similarity in causes of death suggests that the factors driving lower life expectancy in the far west are not due to different physical conditions or different lifestyles, but to how causes of death are prevented and managed. [my yellow highlighting]
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Sadly, what the preceding paragraph is politely hinting at is that there is a culture within governments which tolerates and, perhaps even relies upon, inequality of access to health care along with an acceptance of delivery of poorer quality health care to those living in remote areas of New South Wales, as one of the tools which allows the provision of a much higher quality of health care to those living in metropolitan centres and inner regional areas on the fringes of major cities.
That is where the bulk of the state's electorates and voter numbers are concentrated and, it will come as no surprise that ahead of the March 2023 state election little electoral growth was expected in the western half of New South Wales [Report of the Electoral Districts Redistribution Panel on the draft determination of the names and boundaries of electoral districts of New South Wales, 9 Nov 2020].
