2023-04-21 18:13:59
To live old, live urban. This adaptation of the saying could be the conclusion of a study by the Association of Rural Mayors of France (AMRF), entrusted to the geographer Emmanuel Vigneron. “Update” of a previous study published in 2020, which revealed a difference in life expectancy of up to 2.2 years in favor of men living in very rural areas compared to those in the center of large cities, it shows a worsening of this gap for 30 years, despite a “cyclical” improvement linked to the high lethality of Covid-19 in denser areas.
While rural and urban “were equal in 1990, the situation observed in rural departments in 2022 is comparable to that measured before 2010 in urban areas: i.e. a delay of 15 years”. This means that over the past 30 years, life expectancy “has improved twice as fast in the city as in the countryside”. Access to care, facilitated in cities compared to medical deserts, is one of the ways to explain this gap.
Strong regional disparities
Thus in Puy-de-Dôme, the comparative mortality index (ICM), of 91 in Clermont-Ferrand, continues to increase as one moves away from the city. The study also highlights “marked differences between rural departments and urban departments”. On the scale of the 1,666 living areas, the main mortality risk factor in France remains the regional geography, the north registering an ICM and a risk much higher than the national average.
The study also reveals “edge effects” with areas of excess mortality located “at the boundaries of the departments and very often at the margins of the regions straddling two or three departments”, areas qualified as “neglected”. The AMRF, which regularly warns of medical deserts, makes several proposals, such as facilitating the installation of health professionals with a view to their better geographical distribution. In total, the study counts “14,216 more deaths per year in rural areas than would be expected if life expectancy there were identical to that of cities”.
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