Abstract
Rural New Zealanders are more likely to die of a preventable cause than their urban peers. One in four Māori live in rural areas compounding already stark health inequities. The medical workforce remains geographically maldistributed, favouring large urban centres. Similar patterns are observed in comparable counties, but what is different, and unexplained in Aotearoa New Zealand (NZ), is that despite poorer health outcomes, rural dwellers have significantly lower hospitalisation rates than those living in urban areas. Relative urban and rural primary care utilisation rates are unknown.