Background and aims Remoteness of residence has been found to be a factor influencing health. Appropriate prevention strategies to prevent future injuries in rural and remote Australia are required.

The purpose of this epidemiological study was to examine the incidence and patterns of injury in Australia by remoteness area, to inform targeted injury prevention strategies.

Methods Cause of Death data from the Australian Bureau of Statistics for the period 2006 to 2014 was used to assess cause of death and remoteness of residence. Injury deaths were defined using the International Statistical Classification of Disease and Related Health Problems Tenth revision, Australian Modification (ICD-10-AM) with an external cause coding between V00 to Y34. Remoteness areas were classified as: Major Cities (MC), Inner Regional (IR), Outer Regional (OR), Remote (R) and Very Remote (VR). Ethics approval was obtained (JCU HREC Approval # H6136).

Results There were 77 615 (6% of all deaths) injury-related death. While the majority occurred in MC (n=47699, 62%), differences in crude rates increased with remoteness (34.4 MC compared to 68.8 per 1 00 000 in R areas respectively). The leading causes of injury fatalities, regardless of remoteness were intentional self-harm (n=21,849; 28%), falls (n=14,508; 19%) and transport (n=14,271; 18%). For R and VR locations the highest and second highest injury fatality cause are the same: transport accounting for 32% and 37%; and intentional self-harm 30% respectively.

Discussion and conclusions Remote-dwelling residents are more likely to die as a result of external injury mechanisms than their urban counterparts and have different patterns of injury. Rural areas have different industries, larger distances to transverse, dispersed populations, limited availability of medical facility infrastructure and associated emergency responding thus making prevention challenging.

Policy implication Evidence-based strategies and programs targeting rural and remote residents with a focus on transport safety and mental health are required.