New South Wales trends in mortality differentials between small rural and urban communities over a 25-year period, 1970-1994

Abstract

Objective: To identify trends in premature mortality differences between urban and small rural communities in NSW over a 25-years period.

Design: A longitudinal population-based study. ABS population and death data by local government area, sex and age for the period 1970 to 1994, were used to derive mortality measures for urban and small rural communities in NSW.

Setting: NSW local government areas categorised by the Rural and Remote Metropolitan Area Classification system as 'capital city' (the Sydney Statistical Division) and 'other rural area' and 'other remote area'.

Subjects: All persons aged 0-74 years resident in the aforementioned NSW local government areas between 1970 and 1994 inclusive.

Main outcome measure: Whether premature mortality differentials have widened, narrowed or remained the same over the study period and the magnitude of any identified changes.

Result: There was a decrease in premature mortality rates for men and women in both urban and small rural communities. However, the decline was less in small rural communities, with the differential between small rural and urban areas increasing 2-3% every 5 years.

Conclusions: Differences in age structure, proportion of indigenous and migrant populations between small rural communities and urban NSW can not fully account for the increasing differential. Other possible explanatory factors include socioeconomic status and different exposures and practices in rural areas.