A new system to redefine “rural” in New Zealand could lead to more accurate health data and improved services for rural communities, a new study has found.
The current definition of rural has been criticised for distorting the health outcomes and services available to rural communities, because it defines as rural those who live close to main urban centres and access medical services in those centres
“This means that the relatively good health outcomes of some of the wealthiest communities in the country have been masking the reality of poorer outcomes in many rural and remote areas,” Associate Professor Gerry Nixon of the University of Otago’s Department of General Practice and Rural Health said.
“Defining Rural in Aotearoa NZ” is a joint study by the universities of Otago and Waikato that will provide more accurate data of differences in health outcomes between rural and urban areas.
It creates a five-level Geographical Classification for Health (GCH), which the developers said addresses longstanding concerns about the way rural health outcomes have been measured in NZ.
It uses the same methodology and classification as Statistics NZ.
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“How rurality is defined matters for policy, service delivery, and for the communities that live in rural places,” University of Waikato Research Fellow Dr Jesse Whitehead said.
Nixon said he was surprised by how different the rural population as identified by the GCH is compared to the current definition.
“There is less overlap than we expected.”
Nixon said using the GCH definition, unadjusted mortality rates in rural areas, for example, are 21% higher than in urban areas – a difference that is not shown in the current generic classifications.
He said he hopes the GCH will provide a clearer picture of the health of rural New Zealanders, one that could ultimately improve rural healthcare.
The development of the GCH is the first component of a wider project funded by the Health Research Council of NZ.
The second phase will extend this work by analysing a range of health outcomes by rurality, identifying whether rural-urban differences have previously been masked by generic classifications.
“The GCH will be a useful tool in our research, and the research of others, to examine urban-rural differences in a range of health outcomes and access to health services,” said Nixon.
