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

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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 country-specific 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.

Résumé

Contexte

Rares sont les études publiées qui comparent l’état de santé des populations urbaines et rurales de différents pays. Pour aider à pallier le manque d’information sur les ressemblances et les différences entre les populations rurales du Canada et celles d’autres pays, nous avons analysé et comparé les risques de mortalité de certaines maladies en milieu rural et urbain au Canada et en Australie.

Méthode

Les taux de mortalité selon l’âge pour certaines causes de décès ont été calculés à l’échelle nationale, puis décomposés selon le lieu de résidence à l’aide des définitions de la ruralité utilisées dans chacun des deux pays (les « zones d’influence des régions métropolitaines » au Canada et la définition de l’éloignement de l’Australian Standard Geographical Classification [ASGC] en Australie).

Résultats

La répartition rurale-urbaine des risques de mortalité était généralement semblable dans les deux pays. Toutefois, nous avons relevé des écarts importants dans cette répartition selon les causes de décès examinées. La mortalité due aux accidents de la route, au suicide et à quelques cancers présentait un gradient rural-urbain semblable au Canada et en Australie, mais nous avons observé des différences notables en ce qui a trait aux décès dus au diabète, à tous les cancers combinés, au cancer du poumon et au cancer colorectal. Les Australiens vivant en milieu rural présentaient un plus grand risque de mourir de ces maladies que leurs concitoyens des milieux urbains, tandis qu’au Canada, le risque était moins élevé en milieu rural.

Interprétation

Dans l’ensemble, les tendances qui émergent de cette comparaison des risques de mortalité des Canadiens et des Australiens suggèrent que les disparités dans l’état de santé des populations rurales et urbaines ne se limitent pas à un pays ou à une région du monde en particulier. Il existe néanmoins d’importantes différences entre le Canada et l’Australie, car les structures géographiques de la mortalité varient selon le sexe et les catégories de maladies. Cette analyse est une première tentative d’ouvrir le débat sur la santé rurale dans un contexte international.

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Author information

Authors and Affiliations

  1. Surveillance Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada (PHAC), 120 Colonnade Rd, AL 6702A, Ottawa, Ontario, K1A 0K9, Canada

    Claudia Lagacé MSc MSc

  2. Evidence and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, PHAC, Canada

    Marie Desmeules MSc

  3. Centre for Rural and Northern Health Research, Laurentian University, Ontario, Canada

    Raymond W. Pong PhD & Denis Heng MSc

Authors
  1. Claudia Lagacé MSc MSc
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  2. Marie Desmeules MSc
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  3. Raymond W. Pong PhD
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  4. Denis Heng MSc
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Correspondence to Claudia Lagacé MSc MSc.

Additional information

The views expressed do not necessarily represent the official policy of the institutions represented by the relevant research team members (Laurentian University, Public Health Agency of Canada) or the project funding agency (Canadian Population Health Initiative/Canadian Institute for Health Information).

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Lagacé, C., Desmeules, M., Pong, R.W. et al. Non-communicable Disease and Injury-related Mortality in Rural and Urban Places of Residence: A Comparison between Canada and Australia. Can J Public Health 98 (Suppl 1), S62–S69 (2007). https://doi.org/10.1007/BF03403728

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