Mystery as rural death rates are 20% higher than urban deaths

Rural death rates, based on a new definition of what constitutes a rural place, appear to be more than 20% higher than in urban areas.

The very concerning and unexplained discovery is described in research published Friday, which has important implications for the agriculture-focused Waikato region.

New figures – based on the new way of measuring what constitutes a rural area – show 703 deaths per 100,000 people in urban areas, but that figure jumps 21% to 851 deaths in rural areas. The statistics cover all deaths from 2013 to 2017.

It is emphasized that this is an “unadjusted or raw” death rate and the reasons for the difference remain a mystery at this stage.

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The researchers who developed the new method of measuring death rates in rural communities say more work is needed to explain the big difference, but add that the issue is significant for Waikato regardless.

“The Waikato is a rural area, so it’s likely that the issues we raise will have a big impact,” said University of Waikato researcher Jesse Whitehead. Things.

However, the national statistics uncovered by him and his colleague Garry Nixon from the University of Otago have yet to be broken down regionally, Whitehead said.

“It’s something we plan to do.”

In a joint project, the couple claim that ‘rurality’ in the New Zealand health context was previously misclassified, with more than 30 different classifications used over the past two decades.

Their new five-level geographical classification for health (GCH) – discussed in Friday’s New Zealand Medical Journal – addresses concerns about this in a “technically robust” way.

When applied nationally, “the GCH shows that unadjusted mortality rates in rural areas are 21% higher than in urban areas – a difference not shown with generic classifications” , the couple said.

“Inaccurate grouping appears to have masked real differences in health outcomes between rural and urban communities,” Nixon said.

He expected that the data generated by the GCH could help guide national rural health strategy and policy.

In response to detailed questions from ThingsWhitehead said Statistics New Zealand’s most common definition of rurality was developed in 2004, but there were concerns about the “generic” approach of this method.

Of past practices, he said: “It paints a confusing and contradictory picture of rural health and, as our research shows, has likely masked the worst health outcomes in rural areas.

“Essentially,” Whitehead said, “we defined the rural-urban threshold so that similar communities are grouped together in a way that makes sense with respect to health.”

The GCH measure defining “urban” includes locations within a 25-minute drive of major centers like Hamilton or those within 20 minutes of major urban centers like Whangārei and New Plymouth.

On the importance of higher mortality rates for a number of medical conditions using GCH, Whitehead said: “This is an area of ​​work that we are currently undertaking and we hope to have more information on this soon. “

He said adopting the GCH measure “would mean that organizations and individuals look at the data in the same way and that there is a clear and consistent understanding of what is rural”.

“This means we can effectively identify rural health problems and start developing effective and appropriate solutions.”

The GCH had already been adopted and endorsed by the Ministry of Health’s Rural Health Alliance.

Whitehead said next year he and Nixon would explore the issues further. They would include: the intersecting impacts of rurality, ethnicity and socio-economic status; rural-urban relocation in the last years of people’s lives; and the variation in health care consumption and expenditure in urban and rural areas.