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Message from the CEO
We know that people living in rural and remote Australia experience poorer health outcomes than their metropolitan counterparts1. In a timely article published by Croakey this week, Tim Adair and Alan Lopez inform us that Australians living in socially disadvantaged areas and outside major cities are much more likely to die prematurely2 , and that disparities in health outcomes such as this are widening. The health of rural and remote Australians living with chronic disease is therefore likely to have been highly impacted due to the disruption to care during the lockdown, and those impacts will be longer-lasting due to poor access to health services in rural and remote areas. Alongside these sobering facts we also know that economic fallout from the pandemic is already being experienced disproportionately among poorer households, in poorer regions within countries, and in poorer countries in general3.
So it seems that social and economic recovery will not happen equitably for all Australians unless specific focus is given to supporting those living with socioeconomic disadvantage who have been most impacted by the lockdown. The consequences of a one-size-fits-all approach to recovery might include a prolonged economic downturn for rural and remote Australia, with a consequent drift of people away from rural towns in search of job security, as well as an acceleration in health disparities for people living in the bush.
Careful, rural-proofed strategies to rebuilding are required to ensure that all Australians can benefit from lessons learned from the pandemic.
If there are any silver linings to be gleaned from the COVID-19 pandemic, one shining example is the swift transition by health professionals everywhere to telehealth as an adjunct to face-to-face consultations. Feedback from physiotherapists working in primary health settings in rural NSW indicate that on the whole their clients like the medium, particularly those who live outside of regional centres, because it reduced the need to travel to access care. As we know, one of the central principles of primary health care is that which is delivered as close to the client’s home as possible. One of the most important decisions the government, private health insurers and third party payers might make would be to retain telehealth as one element of a suite of services that truly support equitable access to care for all Australians.
There are still problems to overcome to ensure telehealth is accessible to all, with reports that the user-end experience requires some improvement. We hear from AHPs providing services to Aboriginal communities in Western NSW that access to technology, both in terms of hardware/devices and internet connectivity/performance, continues to be an issue.
These persistent barriers to service access arising from gaps in basic infrastructure and wealth disparity point to the need for targeted strategies to support rural and remote Australia as we emerge from social and economic lockdown.
Stay well, everyone.
Cath
1 https://www.aihw.gov.au/reports-data/population-groups/rural-remote-australians/overview
2 https://croakey.org/the-poorest-australians-are-twice-as-likely-to-die-before-age-75-as-the-richest-and-the-gap-is-widening/?fbclid=IwAR2Gcm2rwATQ9w29L0cC2qKjhjL9uZzWTRulJRZ8FJI-p30rMMETNU-QJ-g
3 https://theconversation.com/rich-and-poor-dont-recover-equally-from-epidemics-rebuilding-fairly-will-be-a-global-challenge-138935
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