Comparison of injury-related hospitalised morbidity and mortality in urban and rural areas in Australia.

INTRODUCTION Rural residents generally experience a higher rate of injury than residents in urban settings. This article sought to identify and compare the pattern of injury mortality and hospitalised injury morbidity for urban and rural residents in New South Wales (NSW), Australia. METHOD Hospitalisation data for 1 July 2000 to 30 June 2005 and Australian Bureau of Statistics mortality data for 1 January 2000 to 31 December 2004 were obtained for NSW residents. The enhanced Accessibility/Remoteness Index of Australia (ARIA+) was used to define urban and rural locations. Standardised hospital admission ratios (SAR) and standardised mortality ratios (SMR) compared urban and rural injury hospitalised morbidity and mortality, respectively. RESULTS The rate of hospitalised injury (1755 vs 2482 per 100,000) and injury mortality (33.2 vs 48.1 per 100,000) was 1.5 times as high for rural compared with urban residents. Rural males aged 70 years and over and 20-34 years had particularly high injury mortality rates. There was variation in the ratio of injury mortality and hospitalised injury between rural and urban residents by injury mechanism, with rural residents experiencing higher SMRs for machinery (4.84), firearms (4.20), struck by/struck against (3.52), fire and burns (2.08), natural and environmental factors (1.91), motor vehicle crashes (1.88), interpersonal violence (1.58), suffocation (1.51) and self-harm (1.36) injuries and higher SARs for all mechanisms, except drowning-related admissions. CONCLUSIONS Differences exist in the injury hospitalisation and mortality rates between rural and urban residents, with rural injury rates higher than urban injury rates. Mechanisms of injury that have demonstrably higher SMRs and SARs in rural compared with urban locations should be targeted for injury prevention activity in NSW.