What does the project involve?
Using a co-design process with Stats NZ and members of the National Rural Health Advisory Group, we will generate an Geographical Classification for Health (GCH) based on the new Stats NZ generic Urban Accessibility Classification (UAC). This will involve agreeing a set of attributes of communities and their attendant health services that will define appropriate ‘cut points’ in the UAC. Part of this process will also involve identifying anomalies and reclassifying appropriately.
Primary Health Organisation enrolment data and geospatial modelling will be used to validate the GCH. The GCH and the most commonly used existing Stats NZ classification (Urban/rural experimental profile; UREP) will be used to analyse routinely collected data from the Ministry of Health to quantify current levels of urban/rural inequity in health service access and outcomes and the extent to which older classifications may have been masking disparities.
What impact do we expect it to have?
A fit for purpose process of classifying small areas in which people live as either urban or rural for health research will generate a much needed better understanding of health outcomes and healthcare access for rural NZers. The GCH will be made available so that it can be used in all future urban-rural analyses conducted in NZ. Of particular importance will be the health status of those most vulnerable to the additional burden of distance; those with high levels of deprivation, the elderly and those with disabilities.
Being able to monitor such disparity will make it possible to benchmark and compare how well each of the District Health Boards (DHBs) in NZ are serving their rural populations. A conscious effort to build knowledge and capacity in the undeveloped field of rural health research will be an investment in rural NZers and the rural industries that contribute to the national economy.
This knowledge will lead to better informed health policy which can then drive the innovation needed to deliver an effective and equitable health service for all NZers, regardless of where they live.
A higher proportion of the Māori population live in rural towns (16% c.f. 10% of non-Māori population) and rural areas (16% c.f. 14% of non-Māori population). Rural Māori experience even greater socioeconomic deprivation than non-Māori, and have poorer health outcomes than urban Māori and thus represent a particularly vulnerable group with poorer health status. Evaluating the health status of rural Māori will be a priority for the project.