This article analyses three broad questions: how is ‘remote’ different from ‘rural’; how do these differences affect the provision of health care and health outcomes, positively and negatively; and what is needed to address these issues and systematise solutions in order to deliver parity of health outcomes.

It finds that the characteristics that differentiate ‘remote’ communities from ‘rural’ centres are noteworthy contributors to several significant differences in the health status of their inhabitants and the nature and adequacy of the health care services available to meet their needs. Compared with metropolitan, regional and rural centres, Australians living in remote and very remote areas exhibit different and greater morbidity, higher avoidable mortality and lower uptake of preventive care programs.

There is evidence about what works, where it works and why. However, there is a failure to translate current knowledge into policy. The article calls for a remote health strategy based on full community engagement and government commitment that addresses systemic issues rather than an ad hoc approach.

The distinguishing characteristics of remote areas warrant a strategic approach to health care that takes account of their impact on health status and the delivery of services.