Examining the implications of the COVID-19 pandemic through the lens of rural healthcare provides a unique and nuanced insight into the impacts of pandemics on at-risk populations. Currently, little academic evidence exists that interrogates the impact of COVID-19 on rural Australians. Analysing the gap between all-cause mortality and expected deaths in rural areas can provide crucial insight into how responsive the healthcare system is in relation to the changing needs of the population in a pandemic situation.
Understanding excess mortality poses a learning opportunity for Australian politicians, healthcare workers, and policy makers. Interrogating this data can provide an indication of social, economic, and systemic impacts on the health of the population and provide an insight into areas which may be under strain or experiencing shortages. This is imperative in cultivating change in the healthcare system and enabling positive outcomes for consumers.
The NRHA’s most significant finding was the lack of data that demonstrated the impacts and frequency of excess mortality in rural and remote areas. The absence of geographical data makes it impossible to fully understand the impacts of excess mortality on rural and remote consumers. NRHA strongly advocates for the creation of datasets demonstrating excess mortality in relation to remoteness. Currently, the ABS data only breaks down the impact of excess mortality on Aboriginal and Torres Strait Islander people by remoteness. The NRHA also notes the disproportionate rates of excess mortality in Australia’s First Nations population increasing from 1.9% in major cities, to 31.6% in remote areas. This is a significant increase in excess mortality in remoteness. Additionally, NRHA found that the
rural workforce shortages significantly impacted healthcare provision during COVID-19 and continue to impact healthcare access. Delays in preventative screening and access to early intervention led to an increase in priority one aeromedical retrievals, demonstrating the impact of missed early intervention care. These findings demonstrate the importance of investment in rural healthcare. Tailored datasets and rural specific models of care are imperative to addressing ongoing healthcare inequities.
The approximately 7 million Australians living in rural, remote and regional areas deal with the impacts of historical inequities in healthcare due to their geography daily. This has resulted in a lower life expectancy, a higher burden of disease, and an increased rate of potentially avoidable deaths. The impacts of events such as the COVID-19 pandemic have compounded these inequities due to inadequate health resourcing.
Understanding excess mortality during the COVID-19 pandemic will provide evidence of the direct and indirect impacts of the pandemic, observe the areas that our healthcare services lead the way, and recognise opportunities for adapting care models and providing stronger outcomes for consumers in the future. To fully understand the implications of the pandemic on the Australian population and prepare for the possibilities of future pandemics or events that will create further strain the healthcare system, it is important to review this data and implement actions to reduce instances of excess mortality in the future.