Indigenous adults living in very remote communities in the Northern Territory have lower death rates than those living in larger communities.
This surprise result of a research study published in the latest issue of the Medical Journal of Australia
is contrary to the widely held view that increasing remoteness is associated with poorer health.
The research, conducted by Dr Karen Andreasyan and Dr Wendy Hoy of the Centre for Chronic Disease at the University of Queensland, recorded age-adjusted rates of Indigenous mortality by remoteness of residence in Indigenous populations in the Northern Territory.
Although Indigenous death rates were lower in "very remote" communities than in "remote" towns or "outer regional" areas (such as the suburbs of Darwin), they were still higher than death rates in the general Australian population. Indigenous adults continued to be at far greater risk of death due to diabetes, cardiovascular and renal disease.
Compared with the general Australian population, age-standardised Indigenous death rates were up to nine times higher in remote areas, three times higher in outer regional areas, and two times higher in very remote communities.
The research also showed similar results for deaths caused by suicide, accidents or homicide, with death rates strikingly higher in remote areas, but lowest in very remote areas.
Authors were cautious in outlining the reasons for the difference, saying they were potentially "complex and speculative".
One potential reason is that people in poor health tend to move to population centres for better access to health services, including dialysis services.
Population centres also attract people seeking greater access to alcohol, and potentially other drugs, with flow-on effects on mortality.
Recent research also supports the possibility of better health in very remote communities due to factors such as better social environment, better family support, a healthier diet, more exercise and lower rates of substance misuse.