Bridging the Distance: Equity in Dementia Care Across Rural Australia
Published in Social Sciences and General & Internal Medicine
Why place matters in dementia care
Dementia care is evolving rapidly, with advancements in diagnostics, treatments, and personalised care models. Yet, these innovations risk deepening existing inequities if access is not addressed. Our study focuses on geographic equity, examining how rurality impacts access to dementia diagnosis, management, and care across Australia.
Australia presents a unique challenge in this space. It is one of the most geographically vast countries in the world, yet its population is relatively small and heavily concentrated in metropolitan areas. This means that large portions of the country are sparsely populated, with communities often located hundreds of kilometres from major health services. These geographic realities create significant barriers to timely and equitable dementia care, particularly in regional and remote areas.
Historically, rural communities have faced systemic disadvantages in healthcare access due to under-resourcing, workforce shortages, and geographic isolation. These challenges are particularly acute in dementia care, where timely diagnosis and coordinated management are essential. Our research highlights the urgent need for targeted, place-based strategies to ensure rural populations are not left behind.
What we heard from rural communities
We conducted a qualitative study involving semi-structured interviews with individuals who had experienced the dementia diagnosis process either as patients, family members or friends. Participants were drawn from metropolitan, inner regional, and outer regional areas, allowing us to compare experiences across geographic contexts.
These classifications are based on the Australian Statistical Geography Standard, which defines areas by how far people must travel to access services. Metropolitan areas have the highest access, inner regional areas have moderate access, and outer regional areas are more remote with limited services. This framework helps illustrate how geography influences access to dementia care.
While some challenges were universal, such as long wait times and complex care pathways, rural participants consistently faced more obstacles. These included limited availability of specialists, long travel distances, and fragmented service delivery.
“We live rurally and were like three hours from anywhere.”
— Eleanor, Daughter, Small rural town, Outer Regional Australia
“There’s no specialists here. You have to wait weeks to see people. A geriatrician came over who I thought was terrific. He’s the only person that I found in the whole experience who was useful and sensible… But he’s three hours away. He only came over occasionally.”
— Abigail, Daughter, Medium rural town, Outer Regional Australia
Other participants echoed similar frustrations, pointing to the need to “make do” with limited local resources. In addition to geography, the study also revealed how factors such as affordability, availability, and acceptability shaped people’s experiences, often in overlapping and intersecting ways that influenced how, when, and whether they accessed dementia-related care.
Looking ahead: bridging the gap
Our findings reinforce the idea that significant health inequities persist between rural and metropolitan communities, and these must be prioritised in efforts to promote equitable dementia care. As clinical practice evolves, rural communities’ risk being excluded unless deliberate action is taken.
There are promising opportunities to improve access, including telehealth and outreach services. These approaches must be thoughtfully designed with rural users in mind, taking into account infrastructure, digital literacy, and cultural appropriateness. Strengthening the rural health workforce and developing localised service models are also essential steps toward building sustainable and responsive care systems.
This study contributes to a growing recognition that rurality is a social determinant of health. Addressing geographic inequity is not just a logistical challenge — it’s a matter of justice.
What we hope happens next
We hope this research helps bring rural voices to the forefront of dementia policy and service design. As new diagnostics, treatments, technologies and care models emerge, they must be developed with, not just for, rural communities. Equity in dementia care will only be achieved when access is no longer determined by postcode, and when every person, regardless of where they live, can receive timely, appropriate, and compassionate support.
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International Journal for Equity in Health
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