# Growing Inequities in Median Age of Death and Obesity Prevalence Between Australian Major Cities and Remote Areas: A National, Longitudinal, Spatial Analysis

## TL;DR

Health disparities in Australia have grown between major cities and remote areas, with remote residents dying younger and having higher obesity rates.

## Contribution

This study reveals increasing geographic health inequities in Australia using longitudinal data on median age of death and obesity prevalence.

## Key findings

- Remote areas had a lower median age of death and higher obesity prevalence compared to major cities.
- Obesity prevalence increased more in outer regional areas than in major cities, worsening geographic disparities.
- The Slope Index of Inequality showed widening inequities in both median age of death and obesity prevalence over time.

## Abstract

Obesity significantly contributes to longevity, with 25‐year‐old Australians experiencing reduced life expectancy of 8.3 years (men) and 6.1 years (women) compared to healthy‐weight peers. Given Australia's diverse geographical composition, this study examined trends in median age of death and obesity prevalence by remoteness over time.

Median age of death and modelled obesity prevalence data were obtained from the Public Health Information Development Unit (PHIDU) Social Health Atlas at Population Health Area level for six time points (2010–2022) and four time points (2011–2022), respectively. Data were linked to state (n = 8), Remoteness Area (n = 5) and Socio‐Economic Indexes for Areas (SEIFA) deciles. Mixed‐effect linear regression models examined differences by remoteness while adjusting for state/territory and area‐level deprivation. Temporal inequities were assessed using the Slope Index of Inequality (SII).

Persistent and widening inequities in median age of death (2018–2022: male SII −3.6, 95% CI −4.9 to −2.3; female SII −2.5, 95% CI −3.8 to −1.2) and obesity (2022: male SII 11.7, 95% CI 10.4–12.9; female SII 12.5, 95% CI 11.1–13.9) were observed between major cities and remote areas. Obesity prevalence increased across all Australian areas, with smallest increases in major cities (men 3, women 0.5 percentage points) but substantially greater increases in outer regional areas (men 11, women 7 percentage points), creating a clear divergence in geographic inequity. Marked disparities in obesity prevalence existed across major cities, regional and remote areas.

Geographic disparities were apparent in obesity prevalence and median age of death, as well as increasing inequities in both median age of death and obesity prevalence among Australian major cities, regional and remote areas. These findings highlight the urgent need for targeted public health interventions, particularly in regional and remote areas, to address Australia's growing health inequities.

Geographic health inequities in median age of death and obesity prevalence widened across Australia between 2010 and 2022. Individuals living in remote areas of Australia exhibited lower median age of death and greater obesity prevalence compared to those residing in major cities.