The inhabitants of the countryside continue to live less long than those of the cities. This is the finding of a new study by the Association of Rural Mayors of France (AMRF), published this month of April. Worse: the differences in life expectancy have been worsening for the past thirty years, with rural areas registering an average of 14,216 additional deaths per year.
Produced by geographer Emmanuel Vigneron, the report is actually an update of a 2020 study. The updated data shows that life expectancy “has improved twice as fast in the city as in the countryside” . In detail: men born in hyper-rural areas have a life expectancy of 78.8 years in 2021, compared to 80.2 years for men born in hyper-urban areas. For women, these figures rise to 84.9 years for the hyper-rural environment, and 85.7 years for the hyper-urban environment.
Unequal access to care
If life expectancy is shorter in the countryside, it is no coincidence. Access to care is much more difficult there. In another study dating from 2021, the AMRF claims that rural residents consume 20% less hospital care than those in cities, at the same age and sex. Inequalities in access to care concern “in particular chemotherapy and dialysis sessions”, notes the report. He adds that 96% of urban dwellers can get to the emergency room in less than thirty minutes, compared to 79% of rural dwellers.
According to a map of the comparative mortality index (ICM) on the scale of the 1,666 living areas, the main mortality risk factor in France remains regional geography. The North registers a risk much higher than the national average. But on the scale of the same department, this ICM can vary, depending on whether the person lives in the prefecture, which concentrates the health services, or in a very rural area.
The trend is not improving. Still according to the AMRF, half of the doctors in rural areas are now over 55 years old. “A concentration of young doctors in urban departments” is also observed, notes the study. Progress has nevertheless been made during the pandemic: the gap in life expectancy has narrowed to 1.4 years for men and 0.8 years for women compared to 2.2 years and 0.9 years. In fact, many studies “have shown that Covid-19 has been more lethal in dense environments”. However, this is a balance “more cyclical than structural”, and the differences between urban and rural areas remain “marked”.
In addition to the study, the AMRF made several proposals. Firstly, it indicates that it wants to diversify the internship sites for health students, in particular by developing transport aid and territorial accommodation for health students (HTES). Always to better distribute the practitioners on the territory, it also militates in favor of the creation of a one-stop shop for each department, which would centralize the needs, the financial aids and the administrative support for the installation of a new professional of health.