Today the Royal Flying Doctor Service (RFDS) is releasing our first Best for the Bush ‘In-Focus’ report looking at heart, stroke and vascular disease and the disproportional impacts for rural and remote Australia.

This follows the release of our first Best for the Bush ‘Baseline’ report in February which again showed the most common reason for an RFDS aeromedical retrieval is in response to heart, stroke and vascular disease. This consistently accounts for almost a quarter of all RFDS aeromedical retrievals.

Our ‘In Focus’ report finds that:

• Heart, stroke and vascular disease is a significant issue throughout Australia – more than 1.2 million people are living with one or more of these diseases, which contribute to a quarter of all deaths.
• Hospitalisation rates for heart, stroke and vascular disease were 1.4 times higher for remote and very remote populations. People living in remote and very remote areas overall were 1.4 times as likely to die from heart, stroke and vascular disease.
• Ischaemic heart disease, also known as coronary heart disease, is currently the leading cause of death in Australia and costs the Australian health system almost $12 billion a year. Deaths from ischaemic heart disease were up to 10 times higher in rural and remotes areas.
• Indigenous Australians, more than half of whom live outside major cities, experience heart, stroke and vascular disease at higher rates and at younger ages. Indigenous peoples were 1.8 times as likely to be hospitalised and 1.8 times as likely to die from heart, stroke and vascular disease as non-Indigenous Australians.
• For stroke care, only 3% of Australians who live in rural and remote areas received care in a specialist stroke unit in 2021, compared to 77% of people who live in major cities.
• With the exception of nurses, the distribution of the primary healthcare workforce (per 100,000 head of population) is significantly lacking in rural and remote areas.

There is strong evidence that acute heart, stroke and vascular disease events are largely preventable, especially with early diagnosis and treatment. Primary healthcare is at the forefront of services to identify, prevent, and manage heart, stroke and vascular disease risk. Modifiable risk factors associated with heart, stroke and vascular disease are found at higher rates in rural and remote areas. These include high blood pressure and cholesterol; poorer diets; lower rates of physical activity; overweight and obesity; and, higher rates of tobacco smoking and alcohol intake. These risk factors can be effectively managed through primary healthcare initiatives.

The RFDS provides around 35,000 aeromedical retrievals every year, on behalf of the Commonwealth and our state retrieval partners — transporting those living, working and travelling in rural and remote Australia to the urgent hospital care they need.

This report shows that areas with the highest prevalence of risk factors and the poorest access to comprehensive and targeted services for preventing and managing heart, stroke and vascular disease correlate to areas where RFDS aeromedical retrievals are required to urgently transport people to necessary hospital care.

The latest data revealed in an independent Nous Group report, commissioned by the National Rural Health Alliance, also shows that for every person living in rural and remote parts of our country, there is an annual deficit in health care spending of $850 per year, equating to a total annual rural health spending deficit of $6.5 billion as compared to our major cities. And we know that the further you are from our major cities the harder it is to access comprehensive primary healthcare.

Based on the findings of this report, the RFDS is recommending:

1. More equitable access to comprehensive primary healthcare services in rural and remote areas, including cardiac care. This includes primary prevention, secondary prevention and targeted management plans;
2. Support for funding and service models for heart, stroke and vascular disease prevention and management that are appropriate for the rural and remote context
3.  Better data collection and linkages to further understand the need in these areas.

“We know that access to adequate or comprehensive primary health care is poor in many parts of rural, and particularly remote, Australia,” says Federation Executive Director of the Royal Flying Doctor Service of Australia, Frank Quinlan. “And this impacts the prevention and management of heart, stroke and vascular disease for people living in these areas.

“Heart, stroke and vascular disease rates worsen by remoteness and socioeconomic status and most aeromedical retrievals for heart, stroke and vascular disease came from areas without healthcare service provision, including lack of cardiac services and chronic disease management.

“As this report recognises “rural and remote communities need rural and remote solutions” that are designed with local communities to respond to need.”

The RFDS Best for the Bush In-Focus report seeks to provide the evidence for governments, service partners and communities to work together to deliver innovative, patient-centered solutions to solve these problems and ensure better health outcomes for our rural and remote communities.

This will only be achieved through the availability of adequate, equitable and appropriately targeted primary healthcare.

You can access the Best for the Bush InFocus report here. You can access the Best for the Bush state-by-state Appendices here.