In 2007-08, 4 per cent of Australians reported having diabetes, a condition that is largely
preventable through lifestyle changes. In a country as affluent as Australia, greater equality of
opportunity for low socio-economic groups would turn around the situation in which further
increases in diabetes are expected over the next decade.
Geographically, the burden of disease from diabetes increases with remoteness. People in
‘Remote’ and ‘Very remote’ areas have two and three times the rate of hospitalisation and two
and four times the rate of death from diabetes as people living in Australia’s major cities.
Aboriginal and Torres Strait Islander people are three times more likely to develop Type 2
Diabetes than non-Indigenous people. The prevalence of the condition among people in the
highest socioeconomic bracket is 2.3 per cent, while among those in the lowest it is twice that.
A large part of these differences can be attributed to obesity, tobacco and alcohol use – the initial
targets of the National Preventive Health Strategy. National programs to combat these risk factors
have in the past been more successful in urban than in rural and remote areas.
So in some respects the gap between rural areas and the capital cities is widening. For example,
rates of smoking in the major cities decreased by more than 15 per cent between 1995 and 2004-
05, whereas the rates in regional and remote areas appear not to have changed. Similarly the
incidence of a sedentary lifestyle decreased by 5 per cent in the major cities, but increased by
about 5 per cent in rural and remote areas.
Initiatives directed at groups at risk, including people in rural and remote communities, need to be
well-targeted and designed fit for purpose. Apparently simple challenges like ensuring that fresh
fruit and vegetables are available in rural and remote areas are important. And in more remote
areas there is likely to be special need to develop safe and appropriate amenities for physical
Diabetes management is also more challenging in rural and remote communities where access to
health care is not as good – meaning that complications of diabetes are more likely to occur.
These include cardiovascular, eye and kidney disease; nerve damage; foot complications; poor
oral health; and complications in pregnancy.