The mortality gap between urban and rural Canadians: a gendered analysis.

INTRODUCTION The primary purpose of this article is to demonstrate the role that age, gender, and place play in rural-urban differences in mortality, in order to better develop policy to reduce these differences. METHODS In 2006, the Canadian Institute for Health Research published a major epidemiological investigation into the morbidity and mortality experience of Canadians, using mortality data as well as the 2004 Canadian Community Health Survey. Using these data, gender differences in mortality across the rural-urban continuum were further explored. The proportion of excess deaths occurring in each of the four different types of rural places, relative to deaths in urban places, were calculated for different gender and age groups. RESULTS Differences in mortality across the urban-rural continuum are mainly driven by people under 45 years, and are particularly due to deaths caused by injury and poisoning, motor vehicle accident (MVA) and suicide. The proportion of excess deaths relative to urban places for those under 45 years increases with decreasing age. Remote places have the highest excess in mortality for suicide, MVA, injury and poisoning, relative to urban places. CONCLUSION The relative mortality for young girls living in rural compared with urban places is similar to the relative mortality for young rural boys. There is, therefore, a need for prevention policies targeted at both boys and girls to prevent suicide, injury/poisoning, and MVAs in rural, and especially in remote, places.