New health statistics show residents of regional NSW are dying as a result of car crashes, falls and intentional self-harm at far higher rates than residents of the state's cities.
But Tamworth GP and Director of the University of Newcastle's Department of Rural Health, Professor Jenny May, said the new statistics from the Australian Institute of Health and Welfare (AIHW) aren't all bad.
At least we know the problem clinicians experience in the community is real, she said.
"Shining a light on things to cause positive change is really important. We can't devise solutions to problems we don't know we have," she said.
"I think it's very clear that there is an ongoing, evolving pandemic of poor mental health in rural areas."
The AIHW data shows a strong correlation between a person's remoteness and their risk of hospitalisation or death in a transport accident, or by assault, or homicide, nationwide.
The state's major cities recorded just 185.8 crash hospitalisations per 100,000 people, and 3.5 deaths.
Inner regional areas like Tamworth, in NSW north east, recorded 269.7 hospitalisations and 8.8 deaths per 100,000 people.
The statistic means that a person is more likely to die after a car crash in a rural area, even though there are more crashes.
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Outer regional areas like Gunnedah, also in the state's north east, are even worse off, with 345.2 transport crash hospitalisations per 100,000 people and 13.8 fatalities, nearly four times the number of deaths.
Professor May said the road toll was partly a result of the risky lifestyles of rural people, plus higher speed limits, but also a shortfall in health resources.
The stats reinforce the importance of funding retrieval services like the Westpac Helicopter and the Rural Flying Doctors Service, she said.
"It is fair to say that the number of older people, certainly in very remote areas, is likely to reduce as the impacts of poorer access to health services and poorer access to a range of health services as people age [take effect]. Many people make the decision to move to more population areas when their health needs increase," she said.
The burden of suicide is also far heavier in rural NSW.
About 87.2 residents of metropolitan NSW are hospitalised as a result of intentional self-harm, and 9.5 die for every 100,000 people.
Inner regional areas have the highest rates of all, with 124.6 hospitalisations and 13.8 deaths per 100,000 people.
Rural people also report far higher rates of death by falls, even though the injury rate is not drastically higher.
In the state's major cities, there were 841.6 fall hospitalisations per 100k people, and 18.6 deaths.
In inner regional areas the rate was 914.6, and 25.4 deaths.
In outer regional areas it was 845.8 and 30.9 deaths.
The AIHW report measures data from 2017 to 2018.
Professor May said solutions ought to look to building up the sort of community resilience within rural communities that was already such an important force.
"I can't imagine what these stats would look like without the volunteerism, without the social connection that I see in rural community. In fact, as we look at these I suspect they would be a lot worse were it not for those very protective and important qualities and elements of many rural communities," she said.