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Assessing the Mediating Role of Internal Migration in Bushfire‐Related Changes in the Distribution of Australia's Medical Practitioners

Year: 2026

Type: article

Abstract: Background: Climate-driven bushfires increasingly shape community health needs and challenge medical workforce capacity in Australia. Although population mobility can influence practitioner availability, it is unclear whether bushfires indirectly affect medical practitioner workforce distribution by prompting internal migration. Understanding these dynamics is critical for informing climate-resilient health-workforce policies. Methods: We analysed a longitudinal panel of regional and remote Australian Local Government Areas (LGAs) from 2013 to 2021 using generalised estimating equations (GEEs) causal mediation analysis. Bushfire exposure was assessed using three complementary measures: (i) binary (any occurrence), (ii) cumulative (repeated events) and (iii) severity-based (intensity of exposure). Outcomes were full-time equivalent (FTE) medical practitioner, adjusted for remoteness and socio-economic conditions. Internal migration was included as a potential mediator. Results: = 0.04). Although internal migration was positively associated with FTE rates, it did not significantly mediate the relationship between bushfire exposure and workforce supply. Conclusions: Bushfire exposure is associated with higher medical practitioner FTE rates in affected LGAs. However, internal migration does not appear to meaningfully mediate this relationship for our study region. For extreme and consecutive bushfires, defined as bushfire occurrence in at least five of the past 10 years, the evidence for mediation through population movement is limited. These findings suggest that changes in the medical workforce following bushfires are more likely driven by direct health system policies rather than by broader internal migration patterns. Planning for future climate-related disasters should consider mechanisms that support responsive allocation and retention of medical practitioners, particularly in regional and remote areas with historically lower workforce levels.

Source: Public Health Challenges

DOI: 10.1002/puh2.70436

Authors: Xin Lin, Ross Bailie, Peter Radchenko, Geoffrey Morgan, Anirban Chakraborti, K. Shuvo Bakar

Institutions: The University of Sydney, Jawaharlal Nehru University

Language: English

Topic: Global Health Workforce Issues

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Decent work and economic growth, Reduced inequalities

Open Access status: gold

Estimated APC paid: $2,650