Wednesday, April 24, 2024

The rural-urban healthcare divide

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There has been enough talk about addressing the situation – it’s time for action, writes Craig Page.
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Those living in the country are already well aware of the rural-urban divide when it comes to accessing healthcare.

But research released last week by the University of Otago into covid-19 vaccination rates further highlights the gulf that exists between cities and those outside the main centres.

It is the first study to compare vaccination uptake in rural and urban areas during the peak period of New Zealand’s national vaccination rollout in 2021. 

It discovered different population groups had varying levels of vaccine uptake.

Lead author Tālis Liepiņš said the findings show improvements are needed in vaccination delivery for rural and urban communities, and further highlight the urban-rural divide when it comes to equitable healthcare.

“It i s important we advance general awareness around equity of access for rural populations and how health interactions for rural communities differ from urban communities,” he said.

By the end of the study, Liepiņš said, there was a clear urban-rural gradient for all ethnic groups. Those living in isolated areas had a lower level of vaccination uptake and “rurality” led to even lower vaccination rates for Māori.

The researchers also found “considerable variance” in uptake between rural older and rural younger people, with the rural-urban differences much more apparent in those younger than 45.

Co-author Professor Garry Nixon said the results further emphasised the importance of health policy responses tailored to meet the needs of rural populations.

Funded by the Ministry of Health Covid-19 and National Immunisation Programme, the study is the first of three exploring the covid-19 vaccine rollout in rural New Zealand. 

The difficulty in accessing  rural health services has long been talked about and last year this newspaper wrote at length about the significant chasm between health services in rural NZ and the main centres. 

The two biggest issues facing rural health are workforce capacity and equity of access to services.

Last year a new rural after-hours telehealth service was unveiled. It provides after-hours healthcare over the phone, and is being touted as improving access to primary health care for almost 900,000 New Zealanders. 

While there is no doubt it will help the cause of people living in insolated areas,  it is not seen by many as a long-term solution.

The new government has vowed to address rural health shortfalls.

National promised a third medical school with a focus on rural health and primary care and ACT said it would aim to deliver on a rural health strategy, which it proposed, to ensure greater access to healthcare. NZ First said it would attract new graduates to provincial areas with a bonding scheme that would see them have their student loans written off over five years’ service.  

Last week provided some movement when the University of Waikato signed a memorandum of understanding with the Ministry of Health to establish a third medical school.

The school will focus on training medical staff for rural practices and the university’s vice-chancellor, Professor Neil Quigley, said the signing is a step to addressing health workforce shortages and reducing NZ’s reliance on foreign doctors.

There has been plenty of talk about addressing the situation. It is time for some action.

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