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What is Rural Proofing & Why is it Important?. Martin Gorringe Rural Communities Policy Unit Defra. Rural Urban Definition. Rural-urban definition Rural-urban definition is a statistical tooI based on population not land use or sector
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What is Rural Proofing & Why is it Important? Martin Gorringe Rural Communities Policy Unit Defra
Rural Urban Definition Rural-urban definition Rural-urban definition is a statistical tooI based on population not land use or sector • http://www.defra.gov.uk/statistics/files/rural-urban-guidance-notes.pdf Classify each Output Area (OA) by:- • Settlement type: • Urban (population is 10,000 or more at Census 2001) • Rural town and fringe • Rural village • Rural hamlets and isolated dwellings • Context: • Less sparse • Sparse (very low residential density for 30km around)
Rural Proofing and Government • Rural proofing – Government commitment Defra acting as Rural Champion/ centre of expertise • Local Level guidelines for local authorities • National level guidelines • Lord Cameron independent review of rural proofing
The Rural USP • 86% of England’s land is rural; • 20% of the population live in rural areas; • Nearly 10m people in settlements with populations < 10,000 • Nearly a quarter of all older people live in rural areas (55+) • Rural areas are ageing at a faster rate than urban areas. Fastest rate of growth is amongst the oldest old (age 85+). • In 2009, 15% of all older people in rural areas lived below the poverty threshold. • Around 23% of rural households are in fuel poverty vs 18% of urban households (2009) • 38% of rural households are off the gas grid vs 9% of urban households
The Rural USP • Road fuel is around 2 pence per litre more expensive in sparse rural areas than the national average. • Only 50% of households in villages and hamlets have an hourly or better bus service within 13 minutes walk (compared with 96% of households in urban areas) • Public transport is more limited in rural places. In 2009 42% of households in the most rural areas had a regular bus service close by, compared to 96% of urban households • Residents in villages and hamlets spend 20 - 30% more on transport than those in urban areas
Rural Health – No Problem? Overall health outcomes more favourable in rural areas : • Life expectancy is higher, • Infant mortality rate is lower and • PYLL from common causes of premature death is lower Average life expectancy is highest in Rural 80 areas (80% of area classified rural) • 2009-11, male life expectancy was two years longer than urban areas and • Females born in Rural-80 areas in life expectancy is one and a half years longer than urban areas. Infant mortality is lower in rural areas: • In 2011, the infant mortality rate in rural areas was 3.7 deaths per 1,000 live births, compared with the England average of 4.3 deaths
Rural Health – no problem? PYLL from common causes of death is lower in rural areas. • PYLL from cancer in predominantly rural areas was 134.7 years per 10,000 people - over 15 years lower than the 150.6 per 1,000 in urban areas • PYLL from stroke or related diseases in predominantly rural areas was 12.5 years per 10,000 people, lower than the 16.6 PYLL per 10,000 people in predominantly urban areas • PYLL from Coronary Heart Disease in predominantly rural areas was 36 years per 10,000 people - lower than the 51.2 years per 10,000 people in urban areas • This means that fewer people living in rural areas are dying prematurely than those living in urban areas.
Why Rural Proof Health ? • Positive health outcomes for rural areas = health equity • Significant inequalities around access to services • Access to GP’s - • Travel distance – acute centres and specialist treatment = further away • Distance decay – patients access services less the further away they are. • Cost of service provision – Community care, economies of scale, staff retention
Why Rural Proof Health ? • 80% of rural residents live within 4km of a GP Surgery, compared with 98% of urban population • 57% of rural residents live within 4km of an NHS Dentist, compared with 98% of urban population • around one-sixth of Primary Care Trusts (PCTs) with the worst health and deprivation indicators were located in rural or significantly rural areas. • www.defra.gov.uk/statistics/rural • www.gov.uk/government/publications/national-rural-proofing-guidelines
Help is at hand • Rural proofing for health toolkit http://www.ruralproofingforhealth.org.uk/