Rural Remote Health
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Rural Remote Health · Apr 2008
Comparative StudyMyocardial infarction and heart failure hospitalization rates in Maine, USA - variability along the urban-rural continuum.
Cardiovascular disease, including myocardial infarction (MI) and heart failure (HF), remains the leading cause of death in wealthy countries and is of increasing concern in low- and middle-income countries as risk factors such as smoking and obesity become more common around the globe. Within each country the health burden of MI and HF generally falls more heavily on those who live in rural areas and on those who live in communities with lower average socioeconomic status (SES). Hospitalization rates are an important measure of community health because high rates may indicate a high burden of poor health, while inappropriately low rates (low hospitalization rates absent evidence of average good health) may indicate underutilization of health services. The objective of this study was to determine the predictors of MI and HF hospitalization rates at town level in the State of Maine, USA. Maine has large variations in wealth and along the urban-rural continuum at town level. Because our results shed light on variations in health and health-seeking behavior for different Maine populations (such as those living closer vs further from hospitals) they may be of interest to providers of healthcare to people who live in areas remote from healthcare, and to people who face other barriers to good cardiovascular health. ⋯ Our finding that higher MI and HF hospitalization rates were predicted for towns that had lower SES is in agreement with many previous studies and shows the importance of these variables to health, even in a setting such as Maine with large variability in rurality. The negative relationship between the distance to a hospital and hospitalization rates likely does not represent better health in those living remotely from healthcare. Rather, it may indicate that people who live in communities distant from hospitals are less likely to seek hospitalization. This suggests that patient behavior as well as socioeconomic status may impact heart-related hospitalization in Maine. It highlights the importance of patient and provider education to ensure that people who live remotely from health care are hospitalized appropriately.
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Rural Remote Health · Apr 2008
Alcohol harm and cost at a community level: data from police and health.
The Australian National Alcohol Strategy 2006-2009 recommends strengthening data collection at the local level, gathering information from emergency department (ED) attendees and, by integrating data sources, to develop a better understanding of alcohol- related harm. We piloted a method to estimate the number of alcohol-related presentations to ED and alcohol-related police incidents in a remote regional centre. We explore the practicality and benefits of integrating such alcohol related police and health data. ⋯ Future research would benefit from the use of project officers in ED and in the police force, to improve compliance and data completeness. A more comprehensive local picture would also include data from other agencies dealing with alcohol. A longer study is necessary to confirm the preliminary data on seasonal variation. Key words: alcohol, emergency department, injury prevention/ early intervention, intoxication, police incidents/crime.
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Rural Remote Health · Apr 2008
Water safety in the bush: strategies for addressing training needs in remote areas.
This article describes a unique, remote, water safety-training program delivered to 11 remote Australian communities during 2006-2007. The program, known as 'Water Safety in the Bush', was developed by Combined Universities Centre for Rural Health in Geraldton Western Australia in consultation with the Commonwealth Government Department of Health and Ageing, and the Royal Life Saving Society of Australia. ⋯ Remote and isolated communities have a pressing need to gain the knowledge and skills necessary for water safety and survival. Standard training programs, which in the case of swimming and water safety instruction are generally run in two-week blocks, are often not feasible. Models for delivering training, which give resources and power to local organisations to find innovative ways to meet their priorities, build capacity and ensure high participation rates.