Assessing the Mediating Role of Internal Migration in Bushfire‐Related Changes in the Distribution of Australia's Medical Practitioners
4 affiliations
- 1School of Public Health The University of Sydney Camperdown Australia
- 2Sydney Business School The University of Sydney Darlington Australia
- 3School of Computational & Integrative Sciences Jawaharlal Nehru University New Delhi India
- 4Institute for Interdisciplinary Research New Delhi India
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: Across all exposure metrics, bushfire‐affected LGAs exhibited significantly higher medical practitioner FTE rates. Cumulative exposure showed a positive association (0.29, p = 0.02), with severity‐weighted exposure yielding a similar directional effect (1.32, p = 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.
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BibTeX
@article{lin2026assessing,
title = {{Assessing the Mediating Role of Internal Migration in Bushfire‐Related Changes in the Distribution of Australia's Medical Practitioners}},
author = {Xin Lin and Ross Bailie and Peter Radchenko and Geoffrey Morgan and Anirban Chakraborti and K. Shuvo Bakar},
journal = {Public Health Challenges},
year = {2026},
month = nov,
doi = {10.1002/puh2.70436},
url = {https://doi.org/10.1002/puh2.70436},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Assessing the Mediating Role of Internal Migration in Bushfire‐Related Changes in the Distribution of Australia's Medical Practitioners
AU - Xin Lin
AU - Ross Bailie
AU - Peter Radchenko
AU - Geoffrey Morgan
AU - Anirban Chakraborti
AU - K. Shuvo Bakar
PY - 2026
DA - 2026/11/03
JO - Public Health Challenges
DO - 10.1002/puh2.70436
UR - https://doi.org/10.1002/puh2.70436
AB - 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: Across all exposure metrics, bushfire‐affected LGAs exhibited significantly higher medical practitioner FTE rates. Cumulative exposure showed a positive association (0.29, p = 0.02), with severity‐weighted exposure yielding a similar directional effect (1.32, p = 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.
SN - 2769-2450
ER -