2023-04-21 17:24:50
Life expectancy is higher in the city than in the countryside, and the gap between rural and urban areas is getting worse, according to a study by the Association of Rural Mayors of France published Thursday, April 20.
Rural and urban dwellers were equal in 1990. But, over the last thirty years, life expectancy has improved twice as fast in towns as in the countryside. The gap fell to 1.4 years between 1990 and 2021 in men, and to 0.8 in women, against 2.2 and 0.9 between 1990 and 2019. amounts to 14,216 additional annual deaths.
Regional geography, the main mortality risk factor
In 2020-2021, the average number of deaths in rural living areas which have a total population of 20.3 million inhabitants was 236,943. In urban living areas (48 million inhabitants), it is stood at 425,531 deaths. The study established a comparative mortality index (ICM) according to living areas. At equal age and gender, the ICM of rural living areas (104) is thus six points higher than that of urban living areas (98).
According to a map of the ICM at the scale of the 1,666 living areas, the main factor of mortality risk in France remains the regional geography, the North registering a risk much higher than the national average. The largest differences are thus between the north and the east of France, in the center of the country, at the tip of Brittany and in the overseas departments and territories.
“Border Effects”
The comparative mortality index can however vary completely depending on whether one is in the city center, generally a prefecture which concentrates health services, or in a very rural area, underlines the study. Thus in Puy-de-Dôme, the ICM, from 91 to Clermont-Ferrand, continues to increase as one moves away from the city.
The study also reveals “edge effects” with areas of excess mortality located “at the borders of departments and very often at the margins of regions straddling two or three departments”areas qualified as “abandoned”.
The Association of Rural Mayors of France, which regularly warns of medical deserts, calls for a “refounding health democracy” and proposes four concrete solutions to improve these gaps: giving health students the means to do internships outside the place of initial training, setting up coordinated care teams around the patient, facilitating the installation of health professionals for a better distribution and develop the sharing of skills and mixed exercises.
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