TORONTO — A new report on the health of women in rural and remote settings paints a picture of inequity, with spotty availability of the health services expected by women living in urban centres.

Rural women are more likely to be living on low incomes, to experience domestic violence and have to travel long distances to obtain the care they need, said the report by the Centres of Excellence for Women's Health released Tuesday.

"They are the 'invisible women' of health policy," said Margaret Haworth-Brockman, lead author of the report, titled Rural, Remote and Northern Women's Health.

"This study demonstrates that including rural and remote women in the policy decision-making process that directly affects their health, and the health of their families, is an essential first step."

The study found one in five Canadian women lives in a rural setting.

Rural women were more likely to be poor and have more children, and less likely to have access to full-time work, it suggests. They were more likely to die in a motor vehicle accident or by poisoning, suicide, diabetes or cancer, it adds.

The study notes that rural women, particularly aboriginals and older Canadians, were also at greater risk of being victims of violence.

Rural women also had greater family responsibilities and bore the brunt of the economic and familial costs when they or a member of their family needed to travel to another community to seek medical help, it found.

The report also said women in remote communities also complained of having limited access to health care provided by a female health professional and their confidentiality was easily compromised in small communities.

It noted many rural women said they do not bother to seek care until they are very sick and rarely seek help for preventive care.

The report, the largest examination to date of the health concerns of rural and northern women, was based on focus groups help across the country and on a national consultation meeting held last year in Saskatoon.

It was funded by the women's health bureau of Health Canada as well as the Canadian Institutes of Health Research's institute for gender and health.