Non-communicable Disease and Injury-related Mortality in Rural and Urban Places of Residence: A Comparison between Canada and Australia

Abstract

Background: Few published studies looking at cross-national comparisons of rural-urban health status are available. As a first step towards addressing the lack of information on how rural populations in Canada compare with rural populations elsewhere in the world, this paper examines and contrasts Canadian mortality risks of selected diseases in rural and urban areas with those of Australia. Methods: Age-standardized mortality ratios for selected causes of deaths were calculated at the national level and broken down into place of residence categories using countryspecific definitions of rurality (Metropolitan Influence Zones in Canada and the Australian Standard Geographical Classification [ASGC] Remoteness in Australia). Results: Patterns of rural-urban mortality risk were mostly similar in both countries. However, depending on the causes of death examined, important differences were found. Mortality from motor vehicle accidents, suicide and a few cancer sites showed similar urban-rural gradients in both Canada and Australia. Notable differences were found for diabetes, all cancers combined, as well as lung and colorectal cancer. Rural Australians were at higher risk of dying from these diseases than their urban counterparts, whereas rural Canadians were at lower risk than urban Canadians. Discussion: Overall, the patterns that have emerged from this comparison of Canadian and Australian mortality risks suggest that health status disparities between rural and urban populations are not limited to a specific country or region of the world. However, there are also important differences between the two countries, as the geographic mortality patterns varied according to sex and according to disease category. This analysis is an initial step in promoting discussion of rural health in an international context. MeSH terms: Rural health; urban health; Canada; Australia; chronic disease; injury; mortality La traduction du résumé se trouve à la fin de l'article.

Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality: Part I—All Cancers and Lung Cancer and Part II—Colorectal, Prostate, Breast, and Cervical Cancers

“…Consistent with our study, excess lung cancer mortality in rural areas was found for Australia during 1997–1999 [60]. All-cancer and lung cancer mortality rates for Canadian men and women during the period 1986–1996 were lower in rural than in urban areas [60]. In many European countries (such as Denmark, Spain, Germany, and Italy) that have relatively high lung cancer mortality rates, smoking prevalence tends to be higher in urban than in rural areas, which may imply significantly higher lung cancer mortality risks among their urban residents [61].…”

“…Consistent with our study, excess lung cancer mortality in rural areas was found for Australia during 1997–1999 [60]. All-cancer and lung cancer mortality rates for Canadian men and women during the period 1986–1996 were lower in rural than in urban areas [60].…”

“…However, no significant rural-urban variations in colorectal cancer mortality were found for Canada and England [60, 81]. Like the US pattern, prostate cancer mortality rates were higher in rural than in urban areas of Australia, Canada, and England [60, 81, 82].…”

Neighbourhood income gradients in hospitalisations due to motor vehicle traffic incidents among Canadian children

“…Disparities in injury rates by income quintiles and by urban and rural areas suggest that motor vehicle traffic injuries are related to the environments in which children live. Similar to other international studies, rates of vehicle occupant injury were higher in rural than in urban areas 23 24 39. These higher rates may reflect greater travel distances, less safe driving conditions, and reduced access to emergency services in rural areas.…”

Cancer mortality in Yukon 1999–2013: elevated mortality rates and a unique cancer profile

“…Previous reports have also found that cancer mortality is worse among lung, prostate, and colorectal cancer patients residing in rural versus urban Canada [2,7]. Similar observations have been reported in the United States and Australia [7–9]. …”