The inaugural Women's Survey by the NSW Country Women's Association (CWA) had more than 1600 responses, with 80 per cent coming from women who live outside the state's major cities.
More than 60 per cent of the survey respondents said limited access to primary and specialised healthcare providers was of most concern when it came to healthcare.
Almost 70 per cent said the high cost of housing and a shortage of housing stock was the most worrying aspect.
On the issue of safety, 34 per cent said an insufficient law enforcement presence was of most concern, while 30 per cent cited gender-based violence and harassment.
Women also said a lack of protective infrastructure like street lighting was of the greatest concern to them when it came to safety.
The survey would now be held annually and was an opportunity to focus CWA's areas of advocacy, NSW president Joy Beames told AAP.
"I knew safety was an issue but I was surprised by how big a response there was, it comes to light more and more that people really are frightened," she said.
"Women talked about gender-based violence and lack of police presence but they also mentioned going home after evening shifts and being worried about the lack of street lights."
The majority of the respondents were aged 45 years and over, a group Ms Beames said was often overlooked in government policy.
"We're certainly hoping politicians take note of this survey and about what women are saying and improve their policies based on that," she said.
When it came to the issue of finance and economic challenges for women, 51 per cent said access to affordable childcare and flexible work arrangements was of most concern.
Meanwhile, 26 per cent believed pay inequality and lack of opportunities for career advancement was the biggest challenge.
Reliable telecommunications services were also on the priority list for 24 per cent of respondents.
"As we see more responses coming in each year, that will start to show whether some of these issues are becoming more or less of a concern, and will help fine tune our advocacy efforts even further," Ms Beames said.
Gender equality could not be achieved in a vacuum and required all aspects of government to work together, NSW Minister for Women Jodie Harrison said.
"The NSW government is committed to promoting gender equality, and is continuing work to create a safer, fairer state," she said.
"(We) will continue to work with the community, experts and advocates, including the CWA, to advance opportunities for women across the state."
The state's 2024/25 budget included a $245.6 million domestic violence package for prevention, early intervention, crisis and legislative responses.
This included funding for specialist workers and to expand men's behaviour change programs.
Meanwhile, $34.3 million has been allocated to establishing an additional 20 Women's Health Centres across the state and $37.35 million to establish and run four menopause hubs.
"All members of the government, across all portfolios from housing, to education, police and health are working to create a more equal New South Wales," Ms Harrison said.
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