Accessibility Skip to Global Navigation Skip to Local Navigation Skip to Content Skip to Search Skip to Site Map Menu

Rural and urban health care disparity

Uncovering inequalities: A fit for purpose definition of rural for health research and policy in New Zealand

This project builds on work previously published by this team:

Fearnley D, Lawrenson R, Nixon G. “Poorly defined” – unknown unknowns in NZ rural health. New Zealand Medical Journal 129 (1439) 77 – 81, 2016

The limited urban / rural analyses of routinely-collected data undertaken in Aotearoa New Zealand (NZ) has failed to demonstrate the health inequalities that are evident in similar countries. This is at odds with evidence of disparities in access to individual health services and the observed poor health status of residents of rural towns. It is possible that the apparent lack of effect of rurality on health outcomes in NZ is an artifact arising from the definition of 'rural' used in health statistics.

See further details of this project

Urban versus rural disparities in access to CT services

In April 2008 Oamaru Hospital became the smallest public hospital in New Zealand to install a computed tomography (CT) scanner. CT scanners are still uncommon outside urban centres in New Zealand. This project has found that:

  • Large rural versus urban disparities exist in CT utilisation in southern New Zealand
  • A rural CT can eliminate these disparities without apparent overservicing
  • CT can be introduced in a rural hospital with minimal logistical problems


Nixon, G., Samaranayaka, A., de Graaf, B., McKechnie, R., Rodwell, P., & Blattner, K. (2015). The impact of a rural scanner in overcoming urban versus rural disparities in the utilisation of computed tomography. Australian Journal of Rural Health, 23, 150-154. doi: 10.1111/ajr.12125
Nixon, G., Samaranayaka, A., de Graaf, B., McKechnie, R., Blattner, K., & Dovey, S. (2014). Geographic disparities in the utilisation of computed tomography scanning services in southern New Zealand. Health Policy, 118(2), 222-228. doi: 10.1016/j.healthpol.2014.05.002

Costs in attending specialist appointments

Fearnley, D., Kerse, N., & Nixon, G. (2016). The price of ‘free’: Quantifying the costs incurred by rural residents attending publically funded outpatient clinics in rural and base hospitals. Journal of Primary Health Care, 8(3), 204-209. doi: 10.1071/HC16014