2015...Figure 26: HACC Service Profile: Canada Bay LGA, IWS and NSW, 201213- ..... 32 Figure 27: : General Practitioners and General Practice Services by LGA and IWS, 2015.. 35 Figure

Canada Bay Local Government Area

Health Profile

2015

Copies of this document can be downloaded from the SLHD website at: http://www.slhd.nsw.gov.au/planning/profiles.html

Prepared by the Planning Unit, Sydney Local Health District in collaboration with the Central and Eastern Sydney PHN. Chapters three and four of this document were revised and updated by the SLHD Health Observatory. Chapter five of this document is revised and updated by the SLHD Public Health Unit.

Enquires in relation to this profile should be directed to: Dr Pamela Garrett

Director, Planning

SLHD Planning Unit

Telephone: 02 9515 9517

Email: [email protected]

Date of Publication: December 2015

http://www.slhd.nsw.gov.au/planning/profiles.html

mailto:[email protected]

Canada Bay Local Government Area Health Profile

TABLE OF CONTENTS EXECUTIVE SUMMARY ...................................................................................................... 4 1 INTRODUCTION ............................................................................................................... 5 2 POPULATION AND COMMUNITY CHARACTERISTICS ................................................. 5

2.1 POPULATION CHARACTERISTICS ........................................................................................... 5 2.2 BIRTHS AND MATERNAL HEALTH ............................................................................................ 7 2.3 ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE ...................................................... 8 2.4 PEOPLE FROM CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS .............. 8 2.5 HUMANITARIAN ARRIVALS ....................................................................................................... 9 2.6 EDUCATION LEVELS.................................................................................................................. 9 2.7 SOCIO-ECONOMIC CHARACTERISTICS.................................................................................. 9 2.8 HOMELESSNESS ...................................................................................................................... 11

3 HEALTH RISKS OF THE POPULATION ........................................................................ 13 4 LONG TERM CONDITIONS AND CHRONIC DISEASE .................................................. 15

4.1 PREVALENCE OF CHRONIC DISEASE ................................................................................... 15 4.2 CANCER ..................................................................................................................................... 17 4.3 MORTALITY ............................................................................................................................... 19

5 INFECTIOUS DISEASES ................................................................................................ 20 5.1 HIV.. ............................................................................................................................................ 20 5.2 CHLAMYDIA ............................................................................................................................... 21 5.3 GONORRHOEA ......................................................................................................................... 22 5.4 INFECTIOUS SYPHILIS ............................................................................................................. 23 5.5 HEPATITIS B .............................................................................................................................. 24 5.6 HEPATITIS C .............................................................................................................................. 25

6 HEALTH SERVICE UTILISATION ................................................................................... 26 6.1 PRIMARY CARE UTILISATION ................................................................................................. 26 6.2 EMERGENCY DEPARTMENT PRESENTATIONS ................................................................... 27 6.3 HOSPITAL SEPARATIONS ....................................................................................................... 28

6.3.1 DAY-ONLY HOSPITAL SEPARATIONS ............................................................................ 28 6.3.2 OVERNIGHT HOSPITAL SEPARATIONS ......................................................................... 29

6.4 AMBULATORY CASE SENSITIVE ADMISSIONS..................................................................... 30 6.5 HOME AND COMMUNITY CARE .............................................................................................. 31

7 HEALTH SERVICE PROVISION ..................................................................................... 33 7.1 HOSPITALS AND DAY SURGERY ............................................................................................ 33 7.2 COMMUNITY HEALTH SERVICES ........................................................................................... 34 7.3 GENERAL PRACTICE ............................................................................................................... 35 7.4 ALLIED HEALTH ........................................................................................................................ 36 7.5 AGED CARE ............................................................................................................................... 37

APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES ................................. 38 APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS ............................................... 39

Page 1 of 40


List of Tables Table 1: Projected population: Canada Bay LGA 2006, 2011, 2016, 2021 and 2031 ............ 6 Table 2: Births to Canada Bay LGA residents and fertility rate 2006 – 2013 ......................... 7 Table 3: Child immunisation rates by age group; Canada Bay SA3 and IWS, 2012-2013 ..... 7 Table 4: Preventive maternal indicators, Canada Bay LGA and NSW 2011-2013 ................. 8 Table 5: Humanitarian migration stream, settlers arriving 2009–2014 ................................... 9 Table 6: IRSD by SLA, and rank within IWS, 2011 .............................................................. 10 Table 7: IRSD by suburbs within Canada Bay LGA, and rank within IWS, 2011 .................. 10 Table 8: Estimates of homelessness: Canada Bay LGA and NSW, 2011............................ 12 Table 9: Modelled estimates of health risk factors, 2011-13 ................................................ 13 Table 10: Health behaviour related hospitalisations, 2012-13 to 2013-14............................ 14 Table 11: Health behaviors of residents, IWS and NSW, 2013 ............................................ 14 Table 12: Modelled estimates of chronic conditions prevalenc, 2011-13 ............................. 15 Table 13: Estimates of chronic disease burden; Canada Bay, 2011-13 ............................... 16 Table 14: Burden of disease - hospital separations by cause: Canada Bay LGA ................ 16 Table 15: High body mass index, alcohol and smoking attributable deaths ......................... 16 Table 16: Age standardised cancer incidence rates by cancer site, 2004 to 2008 ............... 18 Table 17: Age standardised mortality rates by cancer site: Canada Bay LGA ..................... 19 Table 18: Deaths from all causes and potentially preventable deaths, 2010-2011 .............. 19 Table 19: HIV notification rate, by LGA, IWS, 2005-2014 .................................................... 20 Table 20: Chlamydia notification rate, by LGA, 2005 to 2014 .............................................. 21 Table 21: Gonorrhoea notification rate, by LGA, IWS, 2005-2014 ....................................... 22 Table 22: Infectious syphilis notification rate, by LGA, IWS, 2005 – 2014 ........................... 23 Table 23: Hepatitis B age-standardised notification rate, by LGA, IWS, 2005 – 2014 ......... 24 Table 24: Hepatitis C age-standardised notification rate, by LGA, IWS, 2005 – 2014......... 25 Table 25: Primary care services, age standardised rate, 2010 ............................................ 26 Table 26: Emergency department presentations (%) by hospital: Canada Bay LGA, 2013 . 27 Table 27: Emergency department presentations by triage category, 2013 ......................... 27 Table 28: Day-only hospital separations for Canada Bay LGA residents, 2013-14 ............. 28 Table 29: Overnight hospital separations for Canada Bay LGA residents, 2013-14 ............ 29 Table 30: Potentially preventable hospitalisation separations for ACSCs by LGA, 2011-13 30 Table 31: HACC Client Profile: Canada Bay LGA, IWS and NSW, 2012-13 ........................ 31 Table 32: HACC Service Profile: Canada Bay LGA, IWS and NSW, 2012-13 ..................... 32 Table 33: Health care facilities in Canada Bay LGA, HERO Database, 2015 ...................... 34 Table 34: Community health facilities in Canada Bay LGA, HERO Database, 2015 ............ 35 Table 35: Total aged care places and ratios, IWS and NSW, 2014 ..................................... 37 Table 36: Aged care facilities in Canada Bay LGA, HERO Database, 2015 ........................ 37

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List of Figures Figure 1: Population profile by age, Canada Bay LGA and NSW, 2014 ................................ 5 Figure 2: Population forecasts: Canada Bay LGA and NSW by age and gender, 2031 ......... 6 Figure 3: Canada Bay LGA population age groups 2011, 2016, 2021, 2026 and 2031 ......... 7 Figure 4: Language spoken at home: Canada Bay LGA, IWS and NSW 2011 ...................... 9 Figure 5: Comparison of SEIFA Disadvantage percentiles within Canada Bay LGA, 2011 .. 11 Figure 6: Type of Homelessness: Canada Bay LGA and NSW, 2011 ................................. 12 Figure 7: Modelled estimates of health risk factors, 2011-13 ............................................... 13 Figure 8: Modelled estimates of chronic conditions prevalence, 2011-13 ............................ 15 Figure 9: Age-standardised incidence of selected cancers, 2004 to 2008 ........................... 17 Figure 10: Number and rate of notifications of newly diagnosed HIV infection, 2005-2014 .. 20 Figure 11: HIV notification rate, by LGA, IWS 2005-2014 .................................................... 20 Figure 12: Chlamydia notification rate, by IWS and NSW, 2010 to 2014 ............................. 21 Figure 13: Gonorrhoea notificationrate, by IWS and NSW, 2010 to 2014 ............................ 22 Figure 14: Gonorrhoea notification rate, by LGA, 2005-2014 .............................................. 22 Figure 15: Infectious syphilis notification rate, by IWS and NSW, 2010-2014 ..................... 23 Figure 16:Infectious Syphilis notification rate by LGA and IWS, 2005 – 2014 ...................... 23 Figure 17: Hepatitis B notification rate, by IWS and NSW 2005-2014 ................................. 24 Figure 18: Hepatitis B notification rate by LGA and IWS, 2005 – 2014 ............................... 24 Figure 19: Hepatitis C notification rate, by IWS and NSW, 2005-2014 ................................ 25 Figure 20: Hepatitis C notification rate by LGA and IWS, 2005 – 2014 ............................... 25 Figure 21: Primary care services age standardised rati, 2010 ............................................. 26 Figure 22: Day-only hospital separations for Canada Bay LGA residents, 2013-14 ............. 28 Figure 23: Overnight hospital separations for Canada Bay LGA residents, 2013-14 ........... 29 Figure 24: Potentially preventable hospitalisations for ACSCs, by LGA, 2011-13 ................ 30 Figure 25: HACC Client Profile: Canada Bay LGA, IWS and NSW, 2012-13 ....................... 31 Figure 26: HACC Service Profile: Canada Bay LGA, IWS and NSW, 2012-13 .................... 32 Figure 27: : General Practitioners and General Practice Services by LGA and IWS, 2015 .. 35 Figure 28: Private allied health practitioners: Canada Bay LGA and IWS, 2014 .................. 36

Page 3 of 40


EXECUTIVE SUMMARY Canada Bay is a rapidly growing LGA. Thirty-five per cent of Canada Bay LGA residents report being born overseas and 28.6% in non-English speaking countries. Fifty-eight per cent of Canada Bay LGA residents identify as speaking only English at home, with notable proportions of the residents primary language being Italian (9%), followed by Mandarin (5%) and Cantonese (4%).

Canada Bay LGA has a greater proportion of residents aged 25 to 44 years compared to NSW. The index score for socio-economic disadvantage in Canada Bay – Concord Statistical Local Area (SLA) is 1,066 and Canada Bay – Drummoyne SLA is 1,068, indicating a relatively higher socioeconomic status of its residents.

Health Risks and Chronic Disease in Canada Bay LGA

Compared to NSW, Canada Bay LGA residents have a comparable prevalence rate of risky alcohol consumption, overweight and psychological distress, while the prevalence of smokers (11.7%) and obesity (19.5%) in Canada Bay LGA is lower compared to NSW (16.2% and 26.4% respectively).

The population is healthy overall with the prevalence of chronic disease generally lower than that of NSW. Respiratory system and musculoskeletal diseases are the most prevalent chronic conditions in Canada Bay LGA, matching the patterns observed in NSW. Type 2 diabetes, circulatory system diseases, mental and behavioural disorders in residents of Canada Bay LGA are not significantly different to NSW.

The incidence of most types of cancer is lower in Canada Bay LGA than the IWS catchment. The rates of breast, stomach and Non-Hodgkin's lymphoma cancers are significantly higher in Canada Bay LGA relative to NSW in 2004-2008. There is also a trend for an increased rate of mesothelioma in Canada Bay LGA compared to NSW.

Canada Bay LGA residents also have significantly fewer hospital separations compared to the state. Similarly, mortality from preventable causes is lower in Canada Bay LGA relative to NSW.

Infectious Diseases in Canada Bay LGA

Residents of the IWS catchment have higher rates of newly diagnosed HIV infections, hepatitis B, infectious syphilis, chlamydia and gonorrhoea than the state. However, Canada Bay LGA residents have one of the lowest prevalence rates of infectious disease in the IWS catchment.

Health Service Utilisation in Canada Bay LGA

The number of General Practitioners (GPs) in Canada Bay LGA is one of the lowest in the IWS catchment. The majority of Canada Bay LGA resident emergency department presentations (55.1%) and hospital separations are provided by Concord hospital.

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1 INTRODUCTION The Canada Bay Local Government Area (LGA) Health Profile describes the characteristics of the Canada Bay LGA population and compares it with the Inner West Sydney (IWS) catchment. The IWS catchment comprises the LGAs of Ashfield, Burwood, Canada Bay, Canterbury, Leichhardt, Marrickville, Strathfield and Statistical Local Areas (SLAs) of Sydney South and West.

Canada Bay LGA has a population of 87,4801 and occupies 20 sq. kilometres. The LGA includes the statistical local areas of Concord (pop: 39,203) and Drummoyne (pop: 36,558). The Canada Bay LGA includes the suburbs of Burwood North (postcode 2135), Breakfast Point (postcode 2137), Cabarita (postcode 2137), Concord (postcode 2137), Mortlake (postcode 2137), North Strathfield (postcode 2137), Concord West (postcode 2138), Liberty Grove (postcode 2138), Rhodes (postcode 2138), Abbotsford (postcode 2046), Canada Bay (postcode2046), Chiswick (postcode2046), Five Dock (postcode2046), Rodd Point (postcode2046), Russell Lea (postcode2046), Wareemba (postcode 2046) and Drummoyne (postcode 2047).

2 POPULATION AND COMMUNITY CHARACTERISTICS 2.1 Population Characteristics

Figure 1 shows that in 2014, the population age profile of the Canada Bay LGA had a greater proportion of residents aged 25 to 44 years compared to NSW.

Figure 1: Population profile by age, Canada Bay LGA and NSW, 2014

Source: Population by age and sex, regions of Australia. Australian Bureau of Statistics. Cat. No. 3235

Across all age groups combined, population growth in the Canada Bay LGA is expected to be 39% between 2011 and 2031, which is greater than the forecasted population growth across both the IWS catchment (32.7%) and NSW (27.8%).

Users of this information are strongly advised to refer to the source data to ensure accuracy, and to take note of the data explanations which accompany the profile. 1 Australian Bureau of Statistics ERP 2014

14% 12% 10% 8% 6% 4% 2% 0% 2% 4% 6% 8% 10% 12% 14%

0-45-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84

85+Canada Bay Females 2014 NSW Females 2014 Canada Bay Males 2014 NSW Males 2014

Page 5 of 40


Figure 2 further illustrates the significant growth above the catchment and NSW average in persons aged between 25 to 55 years.

Figure 2: Population forecasts: Canada Bay LGA and NSW by age and gender, 2031

Source: NSW State and LGA Population Projections, 2011-2031: 2014 release. Department of Planning & Environment

Major housing developments are anticipated in Rhodes and Breakfast Point, with significant urban consolidation and renewal occurring along the Parramatta Road corridor. Concurrent with population growth are proposed increases in the number of local homes and dwellings. The NSW Household and Implied Dwelling Projections 2011 – 2031 (2014) project an additional 13,900 dwellings from 2011 to 2031 in Canada Bay LGA. Of these dwellings it is expected that 8,850 will be family households and 3,700 will be lone person households2.

Table 1 and Figure 3 further illustrate the projected changes in population numbers and the number of people in different age groups in the Canada Bay LGA from 2011 – 2031. These numbers are based on the estimated resident population numbers released by the NSW Department of Planning and Environment in 2014.

Table 1: Projected population: Canada Bay LGA and IWS Catchment 2006, 2011, 2016, 2021 and 2031

Canada Bay LGA IWS Catchment

2011 2016 2021 2026 2031 2011 2016 2021 2026 2031

Total population

80,065 90,250 98,145 105,265 111,347 581,936 628,537 681,493 728,193 772,368

0 4 years 5,419 5,870 6,512 6,711 6,739 36,373 41,391 44,652 46,838 47,689 5 - 14

7,671 9,402 10,607 11,418 11,991 51,476 58,228 66,702 72,778 76,748

15 - 24

9,640 9,614 10,185 11,347 12,268 77,887 73,294 76,692 82,112 89,093 25 - 44

27,225 31,069 32,186 32,825 32,815 218,353 235,564 249,104 256,808 260,590

45 - 64

18,975 21,267 23,770 25,718 27,808 129,929 140,960 153,144 164,527 178,495 65 - 84

9,603 11,144 12,860 14,946 16,917 59,207 68,272 78,747 90,820 102,430

85 years + 1,532 1,885 2,024 2,300 2,808 8,711 10,829 12,453 14,309 17,323 Source: NSW State and LGA Population Projections, 2011-2031: 2014 release. Department of Planning & Environment

2 New South Wales State and Local Government Area Household and Implied Dwelling Projections: 2014 Final. Department Planning and Environment.

14% 12% 10% 8% 6% 4% 2% 0% 2% 4% 6% 8% 10% 12% 14%

0-45-9

10-1415-1920-2425-2930-3435-3940-4445-4950-5455-5960-6465-6970-7475-7980-84

85+CANADA BAY Females NSW Females 2031 CANADA BAY Males 2031 NSW Males 2031

Page 6 of 40


Figure 3: Canada Bay LGA projected population age groups 2011, 2016, 2021, 2026 and 2031

Source: NSW State and LGA Population Projections, 2011-2031: 2014 release. Department of Planning & Environment

2.2 Births and Maternal Health Table 2 shows the number of births to Canada Bay LGA residents in the period 2006 - 2013. Across this period, the fertility rate in the LGA has been consistently below the NSW rate, however it has increased from 2006. Canada Bay LGA ranked third within the IWS catchment for number of births (1,340) in 2013.

2014 ABS Births Data has not been referred to in this document secondary to a lag in processing the 2014 Births data due to a new system introduced by the NSW registrar. The ABS has committed to revising the 2014 numbers when the 2015 data is released in October 2016.

Table 2: Births to Canada Bay LGA Residents and Fertility Rate 2006 – 2013 Year Canada Bay LGA

estimated resident population

Canada Bay LGA births

Canada Bay LGA total fertility rate

NSW total fertility rate

2006 68,309 1,027 1.59 1.93 2007 70,196 1,054 1.66 1.99 2008 72,320 1,195 1.74 2.05 2009 75,332 1,128 1.76 1.98 2010 77,709 1,261 1.82 2.02 2011 80,065 1,237 1.79 1.96 2012 82,201 1,299 1.82 1.93 2013 84,906 1,340 1.8 1.94

Source: ABS Births, Australia, 2013 Catalogue No. 3301.0

Table 3 shows the immunisation coverage rates for children aged 0 to 5 years calculated for Canada Bay (SA3)3, the rates across the 1 year and 5 year age groups in the SA3 are higher than the IWS catchment and national figures.

Table 3: Child Immunisation Rates by Age Group; Canada Bay SA3 and IWS, 2012-2013 Canada Bay LGA Inner West Sydney National

Age Group % Fully Immunised 1 year 92.5% 90.5% 91.2% 2 years 90.6% 91.4% 92.5% 5 years 91.8% 89.6% 91.5%

Source: NHPA Analysis of Dept of Human Services, Australian Childhood Immunisation register (2012-13)

3 The NHPA data for 2012-13 combine Ashfield, Strathfield & Burwood in its estimates for Statistical Area Level 3 child immunisation estimates15 and the results are illustrated in table 4.

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

2011 2016 2021 2026 2031

0 4 years5 - 14 years15 - 24 years25 - 44 years45 - 64 years65 - 84 years85 years +Pr

ojec

ted

Popu

latio

n

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Table 4 shows that between 2011 and 2013 the rate of smoking during pregnancy in Canada Bay LGA was significantly lower than the state average, with a smoothed prevalence ratio between 27.2 and 38 at 95% confidence interval4 (NSW = 100). For the same period, the smoothed prevalence ratio of attendance for antenatal care prior to 14 weeks gestation ranged between 89.5 and 93.5 at 95% confidence interval4, which was significantly below the NSW smoothed prevalence ratio of 100.

Table 4: Preventive maternal indicators, Canada Bay LGA and NSW 2011-2013 Maternal Indicator Canada Bay LGA NSW

Smoking in pregnancy

Smoothed estimate of prevalence ratio

95% confidence interval for smoothed ratio

32.4 (27.2 – 38.0) (--) 100

First antenatal visit before 14 weeks of

gestation

No. of mothers per year 95% confidence interval for smoothed ratio 926 (89.5 -93.5) (--) 100

Source: NSW Perinatal Data Collection (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health, -- significantly lower than the state at 1% significance.

2.3 Aboriginal and Torres Strait Islander People

The traditional owners of the land encompassed by Canada Bay LGA are the Wangal people of the Eora Nation. Aboriginal and Torres Strait Islander people make up a total of 0.4% of the total population of the Canada Bay LGA, which is below the average for both the catchment (0.9%) and NSW (2.5%). Across all LGAs within the IWS catchment, Canada Bay LGA is home to the second-lowest proportion of Aboriginal and Torres Strait Islander people, just ahead of Strathfield LGA (0.3%).5

2.4 People from Culturally and Linguistically Diverse Backgrounds

As illustrated in Figure 4, based on the 2011 ABS Census 58% (44,186) of Canada Bay LGA residents reported speaking only English at home, notable proportions of the population identified their primary language as being Italian (9%; 6,671), followed by Mandarin (5%, 3,832) and Cantonese (4%, 2,803). Approximately 6% of residents indicated that they spoke another language and did not speak English well or did not speak English at all. Of note, the population of Drummoyne was predominantly English-speaking (72%), when compared to Concord residents (54%).

4 A confidence interval is a range around a measurement that conveys how precise the measurement is. 5 Australian Bureau of Statistics (2011)

Page 8 of 40


Figure 4: Language spoken (excludes English) at home: Canada Bay LGA, IWS and NSW 2011

Source: Australian Bureau of Statistics (2011) 2.5 Humanitarian Arrivals

Table 5 provides local and state data relating to humanitarian settlers during the period 1 January 2009 - 1 December 2014. Humanitarian arrivals settling in Canada Bay LGA came from 15 different countries, with the largest number being from Iran.

Table 5: Humanitarian migration stream, settlers arriving 2009–2014: Canada Bay LGA and NSW

Population characteristics Canada Bay LGA

NSW

Humanitarian Stream-number of settlers arriving from 2009 - 2014

53 27,450

Top 3 countries of birth for humanitarian migration stream, number of settlers arriving 2009 – 2014 Iran 29 Iraq 10,157

Peoples Republic of China 5 Iran 2,913 Iraq 5 Afghanistan 2,502

Source: Department of Immigration and Citizenship Settlement Database. Accessed Feb. 2015 2.6 Education Levels Secondary school participation data, from the 2011 census showed that within the Canada Bay LGA 62.5% of people aged over 15 years had completed Year 12 schooling (or equivalent). Full-time participation in secondary school at age 16 years was higher in Canada Bay LGA (84.4%) than the IWS catchment overall (82.3%). In 2013 the proportion of school leavers from Canada Bay LGA that undertook higher education qualifications (50.7%) was ranked third in the IWS catchment after, Strathfield LGA and Burwood LGA.

2.7 Socio-Economic Characteristics The Socio-Economic Indexes For Areas (SEIFA) are used to rank geographic areas across Australia according to their socio-economic characteristics. The Index of Relative Socioeconomic Disadvantage (IRSD) contains indicators of disadvantage such as low income, high unemployment and low levels of education. Relative disadvantage is associated with a low number. The average across Australia is 1,000. A number below 1,000 indicates lower socioeconomic status. Table 6 shows that in 2011 the index score for socio-economic disadvantage in Canada Bay - Concord was 1,066 and Canada Bay – Drummoyne was 1,068, the only Statistical Local Areas in SLHD with an overall score under 1,000 in 2011 were Canterbury LGA and Burwood LGA.

0%

2%

4%

6%

8%

10%

12%CANADA BAY

IWS

NSW

% o

f tot

al p

opul

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n

Page 9 of 40


Table 6: IRSD by SLA, and rank within IWS, 2011 Statistical Local Area Index score

(based on Australian average

of 1000)

Minimum score for SA1s in area

Maximum score for SA1s in area

Rank (SLAs within IWS)

Ashfield (A) 1,015 856 1112 8 Burwood (A) 996 870 1073 9 Canada Bay (A) - Concord 1,066 948 1140 3 Canada Bay (A) - Drummoyne

1,068 819 1138 2

Canterbury (C) 922 413 1081 10 Leichhardt (A) 1,079 733 1150 1 Marrickville (A) 1,022 498 1135 6 Strathfield (A) 1,022 749 1134 5 Sydney (C) - South 1,017 435 1138 7 Sydney (C) - West 1,022 615 1138 4 Inner West Sydney 1,006 413 1150 Source: Australian Bureau of Statistics (2011)

Table 7 and Figure 5 show the variance of the index score for socio-economic disadvantage across the suburbs that make up Canada Bay LGA. The suburb of Canada Bay had the lowest index score for socio-economic disadvantage (1,039) in Canada Bay LGA, indicating a lower level of advantage in the suburb when compared to Cabarita (1,117). Not one suburb in Canada Bay LGA, listed in the table below had a score below 1,000.

Table 7: IRSD by Suburbs within Canada Bay LGA, and rank within IWS, 2011 State Suburbs within Canada Bay

LGA Score Rank within IWS* Rank within Australia

Most disadvantaged to Least disadvantaged Canada Bay 1039 37

5580

Five Dock 1042 40 5746 Wareemba 1050 44 6060 Abbotsford (NSW) 1052 47 6151 Concord 1055 49 6293 North Strathfield 1056 52 6342 Russell Lea 1063 56 6623 Concord West 1065 57 6708 Rhodes 1075 60 7107 Liberty Grove 1082 62 7322 Rodd Point 1089 67 7560 Drummoyne 1093 69 7644 Mortlake (NSW) 1094 70 7678 Chiswick 1099 73 7785 Breakfast Point 1115 75 8058 Cabarita (NSW) 1119 76 8107 Source: 2033.0.55.001-SEIFA,2011. *77 suburbs within the IWS catchment were allocated an index score for socio-economic

disadvantage.

Page 10 of 40


Figure 5: Comparison of SEIFA Disadvantage percentiles within Canada Bay LGA, 2011

Source: 2033.0.55.001-SEIFA, 2011.

In 2011, the proportion of households in Canada Bay LGA with incomes above $130,000 per annum was higher in both Concord and Drummoyne compared to the IWS catchment area and NSW. Unemployment in Canada Bay LGA (3.5%) was significantly lower than the catchment (5.5%).

2.8 Homelessness

In SLHD in 2011, there were an estimated 4,068 people living with homelessness. This constituted 14% of NSW homelessness. Census data indicated that in SLHD in 2011:

• 25% were in severely overcrowded dwellings6 • 1% were sleeping rough • 57% of homeless people were living in boarding houses • There were less rough sleepers and more people in boarding houses than in

SESLHD.

In addition to Census data, a survey of mental health inpatients in SLHD and South Western Sydney LHD indicated that 20% were affected by unstable housing, and over a quarter of these people reported rough sleeping7.

6 Severely crowded dwellings in the Census are defined as a dwelling which requires 4 or more extra bedrooms to accommodate the people who usually live there. 7 Homelessness in SLHD. Public Health Observatory. Population Health. SLHD. 2014

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Table 8: Estimates of homelessness: Canada Bay LGA and NSW, 2011 Type of homelessness Number of people Persons in supported accommodation for the homeless 19 Persons staying in boarding houses 66 Persons in other temporary lodging 0 Persons living in ‘severely’ crowded dwellings 46 All homeless persons 171

Source: Australian Bureau of Statistics (2011)

Figure 6: Type of Homelessness: Canada Bay LGA and NSW, 2011

Source: Australian Bureau of Statistics (2011)

Table 8 and Figure 6 show that the statistical area of Canada Bay LGA had the lowest number of homeless people (171) within the IWS catchment, whilst the percentage of the total homeless population that reside in a boarding house (39%) in Canada Bay LGA was higher than the State (21%). The Canada Bay LGA also had the second lowest number of boarding houses (19) in the IWS catchment, above Strathfield LGA (6)8.

8 NSW Fair Trading: Boarding House Register. http://parkspr.fairtrading.nsw.gov.au/BoardingHouse.aspx. Accessed 29.01.2015

11%

39%

27%

17% 21%

33%

0%

10%

20%

30%

40%

50%

Persons in supportedaccommodation for the

homeless

Persons staying inboarding houses

Persons living in'severely' crowded

dwellings

Canada Bay

NSW

% o

f tot

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omel

ess p

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http://parkspr.fairtrading.nsw.gov.au/BoardingHouse.aspx


3 HEALTH RISKS OF THE POPULATION

3.1 Health Risk Factors Figure 7 and 9 show that modelled estimates of the prevalence of health risk factors including risky alcohol consumption, psychological distress and overweight in Canada Bay LGA were similar to IWS and NSW levels. The estimated prevalence of current smoking and obesity were similar in Canada Bay LGA compared to the IWS catchment, but lower compared to NSW.

Figure 7: Modelled estimates of health risk factors; Canada Bay LGA, IWS and NSW, 2011-13

Source: PHIDU - 2011-2013 National Health Survey. Refer to Appendix B 1.3 for definitions of Health Risk Factors

Table 9: Modelled estimates of health risk factors; Canada Bay LGA, IWS and NSW, 2011-13 Indicator Canada Bay LGA Inner West Sydney New South Wales Current Smokers 11.7 [10.5-12.8] 12.9 [12.4-13.4] 16.2 [16.1-16.4] Risk Alcohol Consumption 4.5 [3.3-5.7] 4.6 [4.2-5.0] 4.8 [4.7-4.9] Psychologically Distressed 9.4 [7.7-11.1] 10.2 [9.5-10.8] 10.5 [10.3-10.7] Overweight 34.7 [31.4-37.9] 33.4 [32.3-34.5] 34.6 [34.3-34.9] Obese 19.5 [17.6-21.5] 20.1 [19.4-20.8] 26.4 [26.2-26.6] Source: Public Health Information Development Unit - 2011-2013 National Health Survey

Overall, Canada Bay LGA residents had significantly fewer health behaviour related hospital separations per capita compared to the state (Table 10).

Page 13 of 40


Table 10: Health behaviour related hospitalisations, Canada Bay LGA, 2012-13 to 2013-14 Indicator Year Smoothed

number separations /

year

Smoothed rate/

100,000

sSSR9 [95% CI

Smoking attributable

2012-14 351.5 435.1 69.5 [64.7-74.4] Significantly lower than the state

High body mass index attributable

2012-14 311.6 393.7 75.2 [69.6-81.3] Significantly lower than the state

High blood pressure attributable

2012-14 482.8 996.7 75.7 [71-80.3] Significantly lower than the state

Alcohol attributable 2012-14 512.2 598.9 83.8 [78.7-89.1] Significantly lower than the state

Fall-related injury 2012-14 632 770 92 [87.1-97.2] Significantly lower than the state

Source: Health Statistics NSW Centre for Epidemiology and Evidence, NSW Ministry of Health. sSSR: Smoothed estimate of standardised separation ratio; CI: Confidence interval

Data on other health behaviours included in Table 11 are not available for LGAs. However, health behaviours of residents living in the IWS catchment were similar to the entire population of NSW. On average, less than 1 in 10 persons consumed the recommended vegetable intake, whereas approximately 50% of persons achieved the recommended fruit consumption. An estimated 51.5% of persons in NSW aged 16 years or more engaged in adequate levels of physical activity, whereas IWS residents performed slightly better, with an estimated 58.1% of persons having achieved recommended levels.

Table 11: Health behaviors of residents, IWS and NSW (% [95% CI]), 2013 Indicator IWS NSW

Consumes more than 2 standard alcoholic drinks per day (16 years and over

29.3 [25.6-33 1]

26.6 [25.5-27.8]

Adequate physical activity (16 years and over) 58.1 [54.0-62 1]

51.5 [50.2-52.7]

Recommended vegetable consumption (16 years and over) 9.9 [7.2-12.5] 9.4 [8.7-10.1]

Recommended fruit consumption (16 years and over) 52.1 [48.0-56 2]

51.8 [50.6-53.1]

Vaccinated against influenza in the last 12 months (65+ years) 64.5 [55.7-73 4]

71.0 [68.9-73.0]

Vaccinated against pneumococcal disease (65 years and over) 44.6 [34.6-54 5]

49.9 [47.5-52.2]

Source: 2013 NSW Adult Population Health Survey (SAPHaRI); Centre for Epidemiology and Evidence, NSW Ministry of Health. CI: Confidence interval

9 The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100.

Page 14 of 40


4 LONG TERM CONDITIONS AND CHRONIC DISEASE 4.1 Prevalence of Chronic Disease Figure 8 shows the estimated prevalence of chronic diseases in Canada Bay LGA, IWS and NSW. The most prevalent chronic conditions in Canada Bay LGA were respiratory system diseases and musculoskeletal diseases, matching the patterns observed in IWS and NSW. The estimated prevalence of type 2 diabetes and circulatory system diseases in residents of Canada Bay LGA were not significantly different to IWS and NSW. Likewise, the estimated prevalence of mental and behavioural disorders, respiratory system diseases and musculoskeletal system diseases were similar in Canada Bay LGA relative to IWS and NSW (Figure 8 and Table 12).

Figure 8: Modelled estimates of chronic conditions prevalence; Canada Bay LGA, IWS and NSW, 2011-13

Source: Public Health Information Development Unit - 2011-2013 National Health Survey

Table 12: Modelled estimates of chronic conditions prevalence; Canada Bay LGA, IWS and NSW, 2011-13

Indicator Canada Bay LGA Inner West Sydney New South Wales

Type 2 Diabetes 6.7 [5.0-8.5] 7.4 [6.7-8.1] 5.8 [5.6-5.9] Mental and Behavioural Disorders 11.6 [10.1-13.0] 12.4 [11.8-12.9] 13.1 [13.0-13.3] Circulatory System Diseases 17.1 [15.2-19.0] 17.8 [17.1-18.5] 17.8 [17.6-17.9] Respiratory System Diseases 24.8 [21.5-28.0] 24.4 [23.3-25.5] 27.4 [27.1-27.7] Musculoskeletal Diseases 27.2 [23.6-30.8] 26.1 [24.8-27.3] 28.1 [27.8-28.5] Source: Public Health Information Development Unit - 2011-2013 National Health Survey In terms of chronic disease burden, Table 13 shows that Canada Bay LGA residents had similar estimated prevalence of chronic obstructive pulmonary disease and hypertension (18+ years) compared to the IWS catchment and NSW. On the other hand, Canada Bay LGA residents had lower estimated prevalence of fair or poor self-assessed health compared to both the IWS catchment and NSW, and also had lower estimated prevalence of asthma and arthritis compared to NSW.

Page 15 of 40


Table 13: Estimates of chronic disease burden (ASR per 100 [95% CI]); Canada Bay, IWS and NSW 2011-13

Indicator Canada Bay LGA IWS catchment NSW

Fair or poor self-assessed health, > 15 yrs 11.5 [10.1-13] 14.3 [13.7-14.9] 14.3 [14.2-14.5] Asthma 7.7 [6.5-8.8] 7.2 [6.8-7.6] 9.6 [9.5-9.7] Chronic Obstructive Pulmonary Disease 2.2 [1.6-2.9] 2.3 [2-2.5] 2.6 [2.6-2.7] Hypertension, > 18 years 11.6 [9.6-13.6] 10.7 [10.1-11.4] 10.5 [10.4-10.7] Arthritis 13.8 [12.4-15.3] 13.9 [13.3-14.4] 15.3 [15.1-15.4] Source: Public Health Information Development Unit - 2011-13 National Health Survey. ASR: Age standardised rate; CI: Confidence interval

Overall, Canada Bay LGA residents have significantly fewer hospital separations per capita compared to the state, potentially driven by lower hospitalisation rates for chronic conditions such as chronic obstructive pulmonary disease, influenza and pneumonia and coronary heart disease (Table 14).

Table 14: Indicators of burden of disease - hospital separations by cause: Canada Bay LGA Indicator Year Smoothed

number separations/ year

Smoothed rate/ 100,000

sSSR[95% CI]10

Potentially preventable 2012-14

1,475 1,787 73.4 [70.7-76] Significantly lower than the state

Chronic obstructive pulmonary disease

2012-14

126 1,029 68.9 [60.7-77.4]

Significantly lower than the state

Coronary heart disease 2012-14

302 381 57.2 [53-62] Significantly lower than the state

Circulatory disease 2012-14

1,269 1,573 76 [73-79.1] Significantly lower than the state

Stroke 2012-14

103 126.7 73.3 [64-83] Significantly lower than the state

Asthma 2012-14

97 117 67.2 [58-76.5] Significantly lower than the state

Influenza and pnuemonia

2012-14

180 216.6 65.1[58.5-72] Significantly lower than the state

Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSSR: Smoothed estimate of standardised separation ratio; CI: Confidence interval

On the other hand, the rates of high body mass index, alcohol and smoking attributable deaths in Canada Bay LGA were not significantly different to state levels (Table 15).

Table 15: High body mass index, alcohol and smoking attributable deaths: Canada Bay LGA Indicator Year Smoothed

number/year Smoothed rate/

100,000 sSMR[95% CI]8

High body mass index

2011 28 36.1 92.7 [77-108.6] Not significantly different to the state

Alcohol 2011-12 11.2 14.2 81.9 [64.3-101.1] Not significantly different to the state

Smoking 2012 49 62.2 85.8 [70.3-103.3] Not significantly different to the state

Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSMR: Smoothed estimate of standardised mortality ratio; CI: Confidence interval

10 The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100.

Page 16 of 40


4.2 Cancer Information on the incidence and age-standardised rates of cancer over the period 2004 to 2008 is presented in Figure 9 and Table 16.

Figure 9: Age-standardised incidence of selected cancers per 100,000 persons: Canada Bay LGA, IWS and NSW, 2004 to 2008

Source: NSW Central Cancer Registry, Cancer Institute NSW

Prostate, breast, colon, lung and melanoma cancer were the most common cancers in Canada Bay LGA over this period. When compared to the state, there was a trend for lower overall age-standardised rate of cancer in Canada Bay LGA residents, with significantly lower rates observed for lung, melanoma and prostate cancer. There was also a trend for lower incidence of colon, and head and neck cancers in LGA relative to NSW. In contrast, the rates of breast, stomach and Non-Hodgkin's lymphoma cancers were significantly higher in Canada Bay LGA relative to NSW. There was also a trend for increased rate of mesothelioma in Canada Bay LGA compared to NSW (Table 16).

Page 17 of 40


Table 16: Age standardised cancer incidence rates (per 100,000) by cancer site: Canada Bay LGA, IWS and NSW, 2004 to 2008

Cancer Site Canada Bay LGA IWS Catchment NSW Count Rate Count Rate Count Rate All types 1,747 464.0 [442.4-

486.4] 11,397 449.1 [440.8-

457.4] 177,519 483.2 [481.0-

485.5] Bladder 37 9.7 [6.8-13.3] 243 9.7 [8.5-11.0] 3,631 9.7 [9.3-10.0] Brain 24 6.3 [4.0-9.3] 166 6.3 [5.4-7.3] 2,356 6.6 [6.3-6.8] Breast 248 67.8 [59.6-76.8] 1,447 56.2 [53.3-59.1] 21,102 58.2 [57.5-59.0] Cervix 8 2.1 [0.9-4.1] 92 3.3 [2.7-4.1] 1,228 3.5 [3.3-3.7] Colon 133 35.1 [29.3-41.6] 988 39.5 [37.1-42.0] 15,072 40.6 [39.9-41.2] Head and neck 36 9.6 [6.7-13.3] 370 14.6 [13.1-16.1] 4,686 12.8 [12.5-13.2] Kidney 46 12.3 [9.0-16.4] 321 12.8 [11.4-14.3] 4,857 13.2 [12.9-13.6] Leukaemia 51 14.2 [10.6-18.7] 314 12.5 [11.1-13.9] 4,605 12.6 [12.3-13.0] Lip 10 2.7 [1.3-4.9] 44 1.8 [1.3-2.4] 1,203 3.3 [3.1-3.5] Liver 27 7.1 [4.7-10.3] 224 8.9 [7.8-10.1] 2,088 5.7 [5.4-5.9] Lung 133 34.9 [29.2-41.4] 1,157 46.5 [43.9-49.3] 15,905 43.0 [42.3-43.7] Skin melanoma 133 34.8 [29.1-41.2] 726 27.8 [25.8-29.9] 17,716 48.8 [48.1-49.5] Mesothelioma 20 5.3 [3.2-8.2] 56 2.2 [1.7-2.9] 1,047 2.8 [2.6-3.0] Myelodysplasia 25 6.4 [4.1-9.4] 195 7.8 [6.7-8.9] 2,817 7.5 [7.2-7.8] Non-Hodgkin’s lymphoma

91 24.5 [19.7-30.1] 485 18.9 [17.2-20.7] 6,828 18.6 [18.2-19.1]

Oesophagus 14 3.5 [1.9-5.9] 108 4.3 [3.5-5.1] 2,024 5.4 [5.2-5.7] Ovary 24 6.3 [4.0-9.5] 195 7.6 [6.6-8.8] 2,191 6.0 [5.8-6.3] Pancreas 39 10.0 [7.1-13.7] 275 11.0 [9.7-12.3] 4,062 10.9 [10.5-11.2] Prostate 279 74.3 [65.8-83.5] 1,647 66.3 [63.1-69.6] 31,321 84.4 [83.4-85.3] Rectal 83 21.5 [17.1-26.7] 501 19.9 [18.2-21.8] 8,338 22.6 [22.1-23.1] Stomach 57 15.0 [11.4-19.5] 285 11.4 [10.1-12.8] 3,275 8.8 [8.5-9.1] Testis 17 4.6 [2.7-7.4] 80 2.6 [2.1-3.2] 1,084 3.2 [3.0-3.4] Thyroid 42 11.5 [8.3-15.5] 316 11.7 [10.4-13.1] 3,301 9.4 [9.1-9.8] Unspecified 56 14.2 [10.7-18.5] 364 14.4 [13.0-16.0] 6,014 16.0 [15.6-16.4] Uterus(body) 27 7.1 [4.7-10.4] 190 7.5 [6.5-8.6] 3,043 8.3 [8.0-8.6] All Others 87 23.3 [18.6-28.8] 608 23.7 [21.8-25.7] 7,725 21.3 [20.8-21.7] Source: NSW Central Cancer Registry, Cancer Institute NSW. Cell counts less than 5 are left blank

Cancer-related mortality for Canada Bay LGA, IWS and NSW is presented in Table 17. Between 2004 and 2008, cancer was the primary cause of death for 655 persons in Canada Bay LGA, with lung, colon, breast and prostate cancers being the leading types. The overall age-standardised rate of cancer-related deaths in Canada Bay LGA (168.2 per 100,000) was not significantly different to state levels (176.9 per 100,000). However, the age-standardised rate of death from lung cancer was significantly lower in Canada Bay LGA relative to NSW, and there was also a trend for a lower rate of death from colon cancer (Table 17). In contrast, there was a trend for significantly higher rate of death from mesothelioma in Canada Bay LGA compared to NSW.

Page 18 of 40


Table 17: Age standardised mortality rates (per 100,000) by cancer site: Canada Bay LGA, IWS and NSW, 2004 - 2008

Cancer Site Canada Bay LGA IWS Catchment NSW Count Rate Count Rate Count Rate All types 655 168.2 [155.5-181.6] 4,547 181.0 [175.7-

66,228 176.9 [175.5-178.2]

Bladder 13 3.1 [1.6-5.3] 106 4.2 [3.4-5.1] 1,644 4.3 [4.1-4.5] Brain 12 3.2 [1.7-5.7] 126 4.9 [4.1-5.8] 1,716 4.7 [4.5-5.0] Breast 42 11.0 [7.9-14.9] 296 11.7 [10.4-13.1] 4,693 12.6 [12.3-13.0] Cervix 5 1.2 [0.4-2.8] 28 1.1 [0.7-1.5] 415 1.1 [1.0-1.2] Colon 43 10.9 [7.8-14.6] 365 14.5 [13.0-16.0] 5,511 14.6 [14.3-15.0] Head and neck 14 3.8 [2.0-6.3] 154 6.1 [5.2-7.2] 1,762 4.7 [4.5-5.0] Kidney 11 2.9 [1.4-5.1] 87 3.4 [2.8-4.3] 1,605 4.3 [4.1-4.5] Leukaemia 20 5.2 [3.2-8.1] 148 5.9 [5.0-6.9] 2,248 6.0 [5.8-6.3] Liver 22 5.8 [3.7-8.9] 162 6.5 [5.5-7.6] 1,527 4.1 [3.9-4.3] Lung 102 26.5 [21.6-32.2] 937 37.7 [35.3-40.2] 12,781 34.4 [33.8-35.0] Non-Hodgkin’s lymphoma

24 6.1 [3.9-9.1] 176 6.9 [5.9-8.0] 2,569 6.8 [6.6-7.1]

Skin melanoma 23 5.9 [3.7-8.8] 125 5.0 [4.1-5.9] 2,314 6.2 [6.0-6.5] Mesothelioma 20 5.3 [3.2-8.2] 56 2.3 [1.7-3.0] 947 2.5 [2.4-2.7] Myelodysplasia 14 3.5 [1.9-5.8] 74 2.9 [2.3-3.7] 1,036 2.7 [2.5-2.9] Oesophagus 12 3.0 [1.6-5.3] 92 3.6 [2.9-4.4] 1,590 4.2 [4.0-4.4] Ovary 19 5.0 [3.0-7.9] 104 4.2 [3.4-5.1] 1,394 3.7 [3.5-3.9] Pancreas 38 9.7 [6.9-13.3] 240 9.6 [8.4-10.9] 3,611 9.6 [9.3-9.9] Prostate 51 12.7 [9.4-16.7] 287 11.4 [10.1-12.8] 4,904 12.8 [12.4-13.1] Rectum,

29 7.5 [5.0-10.8] 194 7.7 [6.7-8.9] 3,018 8.1 [7.8-8.4] Stomach 30 7.6 [5.1-10.9] 182 7.3 [6.2-8.4] 2,232 6.0 [5.7-6.2] Thyroid ** ** 12 0.5 [0.3-0.9] 168 0.4 [0.4-0.5] Unspecified 57 14.4 [10.9-18.7] 287 11.4 [10.1-12.8] 4,473 11.8 [11.5-12.2] Uterus(body) 8 2.0 [0.9-4.0] 43 1.7 [1.2-2.3] 614 1.6 [1.5-1.8] All Others 46 11.8 [8.6-15.7] 263 10.5 [9.2-11.8] 3,375 9.1 [8.8-9.4] Source: NSW Central Cancer Registry, Cancer Institute NSW. **Cell counts less than 5 are left blank

4.3 Mortality In 2007, life expectancy at birth for males and females in Canada Bay LGA was 82.7 and 86.9 years, respectively, which is higher than NSW (80 and 85 years for males and females, respectively). In 2010-2011 the standardised mortality from all causes in Canada Bay LGA was lower compared to the state. Similarly, mortality from amenable and preventable causes was lower in Canada Bay LGA relative to NSW (Table 18).

Table 18: Deaths from all causes and potentially preventable deaths: Canada Bay LGA, 2010-2011

Indicator Deaths per year sSMR [95% CI]11 Deaths from all causes 405 75.9 [70.8-81.0] Amenable to health care 38 87.0 [71.8-104.3] Preventable causes 49 71.6 [59.6-85.5] Amenable and preventable causes 85 75.5 [65.3-86.4] Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSMR: Smoothed standardised mortality ratio; CI: Confidence interval12

11 The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100. 12 A confidence interval is a range around a measurement that conveys how precise the measurement is.

Page 19 of 40


5 INFECTIOUS DISEASES 5.1 HIV The rate of newly diagnosed HIV infections in NSW in 2014 was 5 cases per 100,000 population. In 2014, there were 82 new HIV infections diagnosed in the IWS catchment. The IWS catchment had the highest rates of newly diagnosed HIV infections in the state at 13.4 cases per 100,000 population (Figure 10). Sydney City (South and West) and Marrickville LGA had the highest notification rates, at 45 and 19 cases per 100,000 population, respectively (Figure 11 and Table 19). Figure 10: Number and rate of notifications of newly diagnosed HIV infection in IWS, 2005-2014

Source: NSW HIV/AIDS database. (Accessed 21/04/2015)

Figure 11: HIV notification rate (per 100,000 of population), by LGA, IWS 2005-2014

Source: NSW HIV/AIDS database. (Accessed 21/04/2015)

Table 19: HIV notification rate (per 100,000 of population), by LGA, IWS, 2005-2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Ashfield 15 5 8 3 7 7 5 5 2 1 Burwood 10 5 6 5 4 5 2 11 0 5 Canada Bay 9 9 3 6 4 5 1 6 2 4 Canterbury 2 5 11 2 4 5 4 3 7 5 Leichhardt 14 6 4 15 7 7 13 11 5 0 Marrickville 32 28 26 24 28 16 27 28 27 19 Strathfield 5 7 10 3 0 3 3 10 0 2 Sydney City* 54 38 46 42 51 41 43 59 47 45 * Sydney City (South and West SLAs). Source: NSW HIV/AIDS database. (Accessed 18/05/2015)

0.0

5.0

10.0

15.0

20.0

25.0

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100

120

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014Total notifications Notification rate/100,000 population

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2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney*

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Page 20 of 40


In 2014, the average age of newly diagnosed HIV cases in the IWS catchment was 37 years, and 94% of the cases were male. This has remained constant since 2004. In 2014, 48% of all HIV notifications were in Australian born residents. Of the total notifications (50%) in Australian residents born overseas, 39% were born in a high prevalence country and 11% were born in a low prevalence country. In 2014, 59% of newly diagnosed HIV infections were defined as at an early stage of infection and there was a 13% increase in notifications classified as early between 2013 and 2014. For the period 2005 to 2014, on average, greater than 88% of all notifications were homosexually acquired, 6% heterosexually acquired and 2% acquired through injecting drug use (IDU).

5.2 Chlamydia Between 2010 and 2014, notification rates for chlamydia remained higher in the IWS catchment compared to NSW. In 2014, the IWS catchment had 1.5 times the rate of chlamydia notifications compared to NSW i.e. 36.8 versus 26.4 cases/100,000 population (Figure 12). Around half of all cases from 2010 to 2014 occurred in the 20-29 year age group. In 2014, 54% of cases were male, with males continuing to have slightly higher rates of chlamydia in the IWS catchment compared to females.

Figure 12: Chlamydia notifications (per 100,000 population) for IWS and NSW, 2010 to 2014

Source: NSW NCIMS database. (Accessed 26/02/2015) Table 20 shows that Sydney and Marrickville LGAs had the highest chlamydia notification rates of all LGAs in IWS. During the period from 2009 to 2014 there was almost a doubling of the notification rate for Sydney from 529 to 1009 cases/100,000 population.

Table 20: Chlamydia notifications (per 100,000 population), by LGA, 2005 to 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 173.9 143.0 188.5 180.1 177.7 213.8 218.2 244.6 244.5 259.9 Burwood 183.0 127.3 182.4 251.9 225.5 195.1 266.3 270.8 221.0 310.5 Canada Bay 124.0 143.5 128.2 178.4 161.9 212.3 219.8 254.0 242.6 268.7 Canterbury 126.3 148.4 114.0 134.5 152.8 164.7 202.6 187.3 209.6 208.2 Leichhardt 261.2 253.7 243.8 235.3 216.2 238.3 316.3 271.6 284.8 318.5 Marrickville 302.4 338.3 338.7 346.0 323.1 362.0 457.3 496.8 561.1 629.1 Strathfield 152.4 136.2 175.3 189.6 136.6 181.1 244.4 244.3 273.7 257.4 Sydney City* 542.8 490.9 556.4 573.0 529.0 636.3 703.7 762.3 732.8 1009.2 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

051015202530354045

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01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11

2010 2011 2012 2013 2014

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Tota

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Total notifications IWS IWS notification rate/100,000 population NSW notification rate/100,000 population

Page 21 of 40


5.3 Gonorrhoea The IWS catchment continues to have notification rates of gonorrhoea that are 2-3 times greater than NSW. In 2014, the average annual notification rate per 100,000 was 14.4 for IWS versus 5.3 for all of NSW (Figure 13). In 2014, the notification rate for males was almost 10 times higher than for females. Greater than 50% of all cases occured in the 20-39 age group for both sexes. Marrickville LGA and Sydney City (South and West) SLA’s continue to have the highest notification rates in the IWS catchment (Figure 14 and Table 21).

Figure 13: Gonorrhoea notifications (per 100,000 population), by IWS and NSW, 2010 to 2014

Source: NSW NCIMS database. (Accessed 26/02/2015)

Figure 14: Gonorrhoea notification rate (per 100,000 population), by LGA, 2005-2014


Table 21: Gonorrhoea notification rate (per 100,000 population) LGA, IWS, 2005-2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 24.5 29.1 16.7 16.6 30.4 30.2 36.8 57.1 77.0 96.3 Burwood 18.9 21.7 9.1 30.0 23.7 35.5 58.5 72.0 59.5 119.2 Canada Bay 28.4 24.9 21.4 22.1 23.9 23.2 47.5 59.6 67.1 54.0 Canterbury 24.7 27.4 19.0 12.2 28.2 29.2 44.1 56.5 41.6 59.9 Leichhardt 35.4 37.1 46.1 28.2 35.1 65.5 59.3 87.0 108.3 91.8 Marrickville 143.2 131.8 90.2 66.6 70.7 129.4 150.4 288.8 266.6 315.2 Strathfield 37.3 21.2 32.1 25.5 27.3 35.1 34.9 39.8 73.0 38.6 Sydney* 196.7 225.8 160.0 136.2 164.5 243.3 274.2 374.7 471.9 460.7 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

02468101214161820

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01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11

2010 2011 2012 2013 2014IWS total notifications IWS notification rate/100,000 population

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2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydneyRa

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Page 22 of 40


5.4 Infectious Syphilis Figure 15 shows the infectious syphilis notification rate remained relatively stable between 2010 and 2012 for the IWS catchment, but increased between 2013 and 2014 to almost three times the average annual notification rate in NSW. Males comprised the vast majority (98%) of cases of infectious syphilis in 2014. The highest proportion of cases occured in the 40-49 year age group. Marrickville LGA and Sydney City (South and West) SLA’a continue to have the highest notification rates (Figure 16 and Table 22).

Figure 15: Infectious syphilis notification rate (per 100,000 population), by IWS and NSW, 2010-2014


Figure 16:Infectious Syphilis notification rate (per 100,000) by LGA and IWS, 2005 – 2014


Table 22: Infectious syphilis notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 0.0 9.7 7.2 2.4 4.7 18.6 4.6 6.9 13.6 13.4 Burwood 0.0 6.2 3.0 12.0 5.9 8.9 11.7 5.8 8.5 27.7 Canada

4.5 1.5 2.8 2.8 1.3 1.3 5.0 3.6 8.2 14.9

Canterbury 3.7 2.2 4.4 6.4 2.1 3.5 1.4 5.4 9.4 8.6 Leichhardt 11.8 9.8 21.1 11.3 18.5 9.1 14.4 10.6 10.5 32.9 Marrickville 14.7 13.3 26.2 32.0 56.8 29.9 29.6 34.3 58.2 69.5 Strathfield 6.2 6.1 0.0 5.7 5.5 2.7 0.0 0.0 7.8 0.0 Sydney* 30.8 44.5 79.5 68.6 83.7 74.3 54.3 65.1 116.4 150.9 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

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01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11 01 03 05 07 09 11

2010 2011 2012 2013 2014

IWS total notifications IWS notification rate/100,000 population NSW notification rate/100,000 population

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2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney

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Page 23 of 40


5.5 Hepatitis B For the IWS catchment, the hepatitis B notification rate has remained relatively stable between 2010 and 2014. However, notification rates were consistently higher in the IWS catchment relative to NSW, and in 2014, was almost twice the rate of NSW (Figure 17).

Figure 17: Hepatitis B notification rate (per 100,000 population), by IWS and NSW 2005-2014


Males continue to have higher rates of hepatitis B infection (69.7 notifications/100 000 population) compared to females (56.8 notifications/100 000 population). In 2014 the 20-39 year age group had the highest number of notifications for both males and females. The LGAs with the highest notification rates for 2014 were (in decreasing order): Strathfield, Burwood, Canterbury and Ashfield LGA’s (Figure 18 and Table 23).

Figure 18: Hepatitis B notification rate (per 100,000) by LGA and IWS, 2005 – 2014


Table 23: Hepatitis B age-standardised notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 92.2 78.0 99.4 91.5 101.8 66.2 74.1 106.3 73.7 73.8 Burwood 126.3 117.1 99.0 76.5 95.5 84.7 68.6 83.5 99.2 88.5 Canada Bay 46.5 37.1 36.9 30.4 43.7 50.4 38.8 35.4 49.8 45.8 Canterbury 109.3 102.6 90.0 87.2 85.4 75.2 80.0 71.4 80.9 82.9 Leichhardt 14.1 9.4 25.3 16.0 17.2 10.8 14.0 9.6 17.6 15.3 Marrickville 73.0 75.2 60.5 55.6 54.2 44.1 51.0 41.0 41.4 37.1 Strathfield 130.3 92.6 67.6 88.4 75.4 81.1 70.6 89.2 68.1 89.3 Sydney* 84.0 56.6 62.3 51.5 48.5 50.6 48.8 54.3 47.3 45.6 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

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Page 24 of 40


5.6 Hepatitis C The hepatitis C notification rate has decreased over time in the IWS catchment, and in 2014 was the same as the NSW notification rate (Figure 19). In 2014, notifications in males occurred at more than twice the rate (68.7 notifications/100 000 population) as those in females (33.3 notifications/100,000 population). The highest numbers of notifications were in the 20-39 year age group for females and in the 30-49 year age group for males. The LGAs with the highest notification rates for 2014 were (in decreasing order): Sydney City (South and West) SLA’s, Ashfield LGA, Leichhardt LGA and Marrickville LGA (Figure 20).

Figure 19: Hepatitis C notification rate (per 100,000 population), by IWS and NSW, 2005-2014


Figure 20: Hepatitis C notification rate (per 100,000) by LGA and IWS, 2005 – 2014


Table 24: Hepatitis C age-standardised notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 65.4 61.7 62.8 43.8 41.6 35.0 37.6 32.4 27.9 59.9 Burwood 57.8 58.0 36.1 21.5 27.6 34.1 40.3 33.0 15.9 18.5 Canada Bay 29.5 31.8 23.3 18.9 30.9 30.5 25.8 21.3 12.6 16.4 Canterbury 56.8 41.0 41.1 41.4 40.5 38.4 39.5 35.0 44.1 29.7 Leichhardt 46.7 54.1 38.1 31.2 75.2 65.3 50.5 62.2 75.1 47.9 Marrickville 113.1 87.8 83.5 66.2 83.4 66.2 66.6 66.3 63.3 47.9 Strathfield 38.6 40.8 47.7 21.6 25.6 39.9 20.0 20.9 26.6 18.3 Sydney* 120.1 128.0 108.2 85.7 102.8 117.9 87.4 72.6 85.9 117.9 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

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Page 25 of 40


6 HEALTH SERVICE UTILISATION 6.1 Primary Care Utilisation

The age standardised rate of primary care services (per 100,000) is presented in Table 25, with age-standardised ratios and statistical comparisons to national levels displayed in Figure 21. The rate of 45 year old health checks in Canada Bay LGA were markedly higher than IWS and state levels. The rates of general practitioner (GP) health assessments (75 years or more) and GP enhanced primary care in Canada Bay LGA were higher relative to IWS, but comparable to NSW. The age-standardised rates of GP practice nurse services and GP mental health plans in Canada Bay LGA were lower than state levels, but similar to IWS.

Table 25: Primary care services, age standardised rate per 100,000: Canada Bay LGA, IWS and NSW, 2010

Indicator Canada Bay LGA IWS Catchment NSW 45 year old health checks^ 6,101.0 4,796.6 4,627.8 GP health assessment (75+) 21,602.9 17,377.5 20,867.4 GP enhanced primary care 2,543.7 2,147.8 2,618.4 GP practice nurse services 17,773.8 16,320.0 29,844.9 GP Mental Health care plans 7,813.8 7,625.4 8,222.3 Source: Public Health Information Development Unit and Department of Health and Ageing (2014) ^For persons aged between 45-49 years

Figure 21: Primary care services age standardised ratio: Canada Bay LGA, IWs and NSW, 2010

Source: Public Health Information Development Unit and Department of Health and Ageing (2014)

Dashed line: National reference level; * Significantly different to state at 95% confidence level; ** Significantly different to state at 99% confidence level. ^For persons aged between 45-49 years

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6.2 Emergency Department Presentations

The distribution of emergency department presentations by Canada Bay LGA residents across hospitals in the IWS catchment, and all other NSW hospitals is presented in Table 26. The majority of Canada Bay LGA resident emergency department presentations were serviced by the Concord Repatriation General Hospital (Concord Hospital) (55.1%), constituting 28.6% of all emergency department presentations at Concord Hospital.

Table 26: Emergency department presentations (%) by hospital: Canada Bay LGA, 2013 Indicator Canterbury

hospital Concord hospital

RPA hospital

Other NSW hospitals

Total

LGA Presentations 259 (1.4) 10,478 (55.1) 3,850 (20.2) 4,428 (23.3) 19,015 (100) All Presentations 38,397 (1.5) 36,662 (1.4) 71,576 (2.8) 2,410,994 (94.3) 2,557,629 (100) % of total 0.7% 28.6% 5.4% 0.2% 0.7% Source: NSW Admitted Patient Data Collection, Centre for Epidemiology and Evidence, NSW Ministry of Health

The rates of emergency department presentations (per 1,000 persons) by triage category are shown in Table 27. The age-standardised rates of non-urgent, urgent and emergency triage category emergency department presentations were lower in Canada Bay LGA residents compared to IWS. On the other hand, the rate of semi-urgent emergency department presentations was higher in Canada Bay LGA relative to the IWS catchment.

Table 27: Emergency department presentations (per 1,000 persons) by triage category: Canada Bay LGA, 2013

LGA Non-urgent Semi Urgent Urgent Emergency Resuscitation Ashfield 16.5 [15.3-17.7] 82.6 [80.0-85.2] 88.3 [85.7-90.9] 31.4 [29.8-33.0] 1.7 [1.3-2.0] Burwood 15.0 [13.7-16.3] 100.2 [97.0-103.5] 80.9 [78.0-83.8] 26.1 [24.4-27.7] 2.2 [1.8-2.7] Canada Bay 15.1 [14.3-15.9] 105.6 [103.5-107.7] 75.2 [73.4-77.0] 23.0 [22.0-24.0] 1.7 [1.4-2.0] Canterbury 22.0 [21.2-22.7] 110.0 [108.4-111.6] 115.2 [113.7-

116.8] 41.7 [40.7-42.7] 2.4 [2.2-2.7]

Leichhardt 17.4 [16.3-18.6] 71.5 [69.2-73.7] 92.5 [90.0-94.9] 35.0 [33.5-36.6] 1.3 [1.0-1.7] Marrickville 21.8 [20.8-22.9] 101.9 [99.7-104.1] 114.8 [112.5-

117.1] 43.4 [42.0-44.8] 2.0 [1.7-2.3]

Strathfield 16.4 [15.1-17.7] 114.1 [110.9-117.4] 74.4 [71.7-77.0] 23.5 [21.9-25.0] 2.2 [1.7-2.6] Sydney City 10.4 [9.7-11.0] 36.2 [34.9-37.5] 40.3 [38.9-41.7] 15.6 [14.7-16.5] 0.7 [0.5-0.8] IWS 17.4 [17.1-17.7] 90.3 [89.6-91.1] 88.6 [87.9-89.3] 31.3 [30.9-31.8] 1.8 [1.7-1.9] NSW 52.0 [51.8-52.1] 148.6 [148.3-148.8] 103.8 [103.6-

104.0] 33.6 [33.5-33.7] 2.0 [2.0-2.0]

Source: NSW Admitted Patient Data Collection, Centre for Epidemiology and Evidence, NSW Ministry of Health

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6.3 Hospital Separations

6.3.1 Day-only Hospital Separations Canada Bay LGA resident separations from hospital on a day-only13 basis are shown in Table 28. In 2013/2014, 38% (7,107) of all day-only separations were provided by private hospitals followed by 37% (7,007 separations) by Sydney Local Health District (SLHD) hospitals and 18% by private day procedure centers (3,426 separations).

Table 28: Day-only hospital separations for Canada Bay LGA residents, 2013-14 Day-only

Hospitals/Day Procedure Centres No. of Separations Per cent of total Separations Private Hospitals 7,107 38% SLHD Hospitals 7,007 37% Private Day Procedure Centres 3,426 18% Other LHD Hospitals 1,412 7% Total 18,952 100% Source Flow-Info v 5.0

As shown in Figure 22, 37% (7,007 separations) of Canada Bay LGA resident day-only separations occurred in SLHD hospitals. Concord Hospital provided for 72% of the total separations within SLHD (5,080 separations), followed by RPA Hospital at 26% (1,796 separations).

Figure 22: Day-only hospital separations for Canada Bay LGA residents, by LHD, 2013-14

Source Flow-Info v 5.0

13 Day-only Separations: A person who is admitted to hospital and leaves on the same calendar day

Private Hospitals 38% (n=7107)

Private Day Procedure Centres

18% (n=3426)

Other LHDs 7% (n=1412)

Concord 72% (n=5080)

Royal Prince Alfred 26% (n=1796)

Other SLHD Hospitals

2% (n=131)

Sydney LHD 37% (n=7007)

Page 28 of 40


6.3.2 Overnight Hospital Separations

The breakdown of Canada Bay LGA resident overnight14 hospitalisations is shown in Table 29. In 2013/14 SLHD hospitals (57%; 7,501 separations) provided the majority of overnight hospital separations for Canada Bay LGA residents, followed by private hospitals at 32% (4,145 separations) and other LHD Hospitals at 11%( 1,498 separations).

Table 29: Overnight hospital separations for Canada Bay LGA residents, 2013-14 Overnight(s)

Hospitals No. of Separations Per cent of total Separations SLHD Hospitals 7,501 57% Private Hospitals 4,145 32% Other LHD Hospitals 1,498 11% Total 13,144 100% Source Flow-Info v 5.0

As shown in Figure 23, SLHD hospitals provided for 57% (7,501 separations) of all Canada Bay LGA resident overnight separations. Concord Hospital provided 3,951 or 53% of the total overnight separations within SLHD, followed by RPA Hospital at 41% (3,095 separations).

Figure 23: Overnight hospital separations for Canada Bay LGA residents, by LHD, 2013-14

Source Flow-Info v 5.0

14 Overnight Separations: A person who is admitted to hospital and leaves on a different calendar day.

Private Hospitals 32% (n=4145)

Other LHDs 11% (n=1498)

Concord 53% (n=3951)

Royal Prince Alfred 41%(n=3095)

Balmain 2% (n=182)

Tresillian (P/W) 2% (n=115)

Canterbury 1% (n=101)

Sydney LHD 57% (n=7501)

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6.4 Ambulatory Case Sensitive Admissions

The numbers and rates of potentially preventable hospital separations classified as Ambulatory Care Sensitive Conditions (ACSCs) by IWS LGAs are presented in Table 30 and Figure 24. ACSC admissions are those in which the resulting hospitalisation is thought to be largely preventable via the application of public health interventions that are usually provided in an ambulatory setting such as primary care.

Higher rates of ACSC hospitalisations may reflect indirect evidence of problems with the provision of healthcare such as difficulties in accessing primary health-care services and a lack of appropriate skills and resources. ACSCs include vaccine-preventable conditions, selected acute conditions and selected chronic conditions that are amenable to behaviour modification and lifestyle change. The rate of ACSC separations was 1869.0 per 100,000 persons in Canada Bay LGA in 2011-13 and was significantly lower than the state level.

Table 30: Potentially preventable hospitalisation separations for ACSCs by LGA, 2011-13 LGA Separations per year Separations per 100,000 sSSR* relationship to state

levels Ashfield 837 1,882.5 Significantly lower than the state Burwood 631 1,847.5 Significantly lower than the state Canada Bay 1,507 1,869.0 Significantly lower than the state Canterbury 3,255 2,288.4 Significantly lower than the state Leichhardt 953 1,944.6 Significantly lower than the state Marrickville 1,488 2,124.9 Significantly lower than the state

Strathfield 593 1,749.5 Significantly lower than the state Sydney 3,010 2,222.1 Significantly lower than the state Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health Note: *sSSR: The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100.

Figure 24: Potentially preventable hospitalisations for ACSCs, by LGA, 2011-13

Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health . sSSR: Smoothed estimate of standardised separation ratio; CI: Confidence interval

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6.5 Home And Community Care Figure 25 and Table 31 shows the profile of Home and Community Care (HACC) clients in Canada Bay LGA compared to the IWS catchment and NSW. During this period, there were no Indigenous clients in Canada Bay LGA. However, the proportion of clients that did not speak English in Canada Bay LGA (33%) was higher relative to NSW (11%), but lower than IWS (39%). The proportion of clients with a carer (28%) was greater than both the overall catchment (23%) and NSW (21%), and the proportion of clients that live alone (37%) was slightly lower than both the IWS catchment (39%) and NSW (39%).

Figure 25: HACC Client Profile: Canada Bay LGA, IWS and NSW, 2012-13

Source: Public Health Information Development Unit (2014)

Table 31: HACC Client Profile: Canada Bay LGA, IWS and NSW, 2012-13 Indicator Canada Bay LGA Inner West Sydney New South Wales

Living alone 37.3 (791) 39.1 (6499) 39.0 (106308) Living with carer 27.5 (584) 23.0 (3825) 20.7 (56385) Indigenous NA (NA) 1.4 (230) 3.8 (10268) Non-english speaking 33.3 (706) 39.0 (6484) 11.2 (30469)


Figure 26 and Table 32 provides a graphical comparison of selected HACC services in Canada Bay LGA LGA, IWS and NSW. HACC clients located in Canada Bay LGA received a lower number of care counselling, centre-based day care and transport instances of care per 1,000 persons, compared to the IWS catchment and state levels. However, the number of care coordination services provided to Canada Bay LGA residents per-capita were higher than across the IWS catchment and NSW.

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Figure 26: HACC Service Profile: Canada Bay LGA, IWS and NSW, 2012-13


Table 32: HACC Service Profile: Canada Bay LGA, IWS and NSW, 2012-13 Indicator Canada Bay LGA Inner West Sydney New South Wales

Allied health care 3.8 (319) 3.5 (1822) 2.3 (17549) Care counselling 1.5 (125) 2.8 (1476) 3.5 (26863) Case management 2.0 (165) 3.0 (1580) 2.0 (15261) Centre-based daycare 2.1 (182) 4.7 (2446) 2.8 (21907) Care coordination 4.8 (408) 4.1 (2096) 4.0 (30940) Domestic assistance 6.0 (515) 5.8 (2979) 7.1 (54720) Transport 4.7 (402) 8.0 (4120) 9.4 (72274) Source: Public Health Information Development Unit (2014)

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7 HEALTH SERVICE PROVISION 7.1 Hospitals and Day Surgery Canada Bay LGA residents access public hospital services at the Royal Prince Alfred Hospital, the Concord Hospital, the Canterbury Hospital, and the Balmain Hospital.

The Royal Prince Alfred Hospital (RPA) is a principle referral hospital, providing tertiary and quaternary referral acute services to its IWS catchment, rural and other metropolitan residents, interstate and overseas patients. Examples of RPA’s tertiary and quaternary medical, surgical and diagnostic services include Liver and Kidney Transplantation, Open Heart Surgery, Cardiology, Neurology, Respiratory, Immunology, Maternity, Gynaecology, Neo-natal Intensive Care, Colorectal and Upper GI surgery, Emergency and Critical Care and Trauma services.

The Institute of Orthopaedics and Rheumatology and the Professor Marie Bashir Mental Health Centre are located at RPA. Cancer care, including Haematology and Neurosurgery is provided at the highest level at RPA with other selected cancer services provided in collaboration with the Chris O’Brien Lifehouse, a not-for-profit hospital located on the RPA campus. RPA provides a wide range of non-inpatient services across all medical and surgical specialties, including Hospital-in-the Home. A defining attribute of RPA is its world class research and teaching. The SLHD, in collaboration with the University of Sydney, and thirteen affiliated Medical Research Institutes forms Sydney Research. The SLHD is part of the Sydney Health Partners which is an Advanced Health Research and Translation Centre of the NHMRC.

Concord Repatriation General Hospital (CRGH or Concord Hospital) is a principle referral hospital, providing tertiary and quaternary referral acute services to its IWS catchment, rural and other metropolitan residents, interstate and overseas patients. Examples of the tertiary and quaternary medical and surgical services at Concord Hospital include the state-wide Burns service, Andrology, Bariatric surgery, Neurology and Stroke, Cardiology, Aged Care, Medical Rehabilitation, Ophthalmology, Urology, Immunology, Upper GI, Colorectal, Orthopaedics, Plastic surgery, integrated Cancer care, Emergency Medicine and Critical Care. Inpatient Maternity and Paediatric services are not available at Concord Hospital. Concord provides a wide range of non-inpatient services across all medical and surgical specialties, including Hospital-in-the Home. The Concord Centre for Mental Health is located at Concord Hospital. The Concord Hospital provides world class research and teaching in collaboration with the University of Sydney and its affiliated Medical Research Institutes.

The Canterbury Hospital is a major metropolitan hospital that provides district level hospital care to its local community. Canterbury provides emergency services, maternity, paediatrics, aged care, medical and surgical services and a range of non-inpatient services including Hospital-in-the Home.

The Balmain Hospital is a specialist Aged Care and Rehabilitation Hospital. It provides a General Practice Casualty service through a consortium of local General Practitioners. The hospital provides a range of outpatient services including Hospital-in-the Home.

The direct Canada Bay LGA catchment area includes a 38 bed private acute surgical facility (Westside Private Hospital) and the 174 bed public psychiatric hospital (Concord Centre for Mental Health). An oral health clinic is also available in Concord Hospital.

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Table 33: Health care facilities in Canada Bay LGA, HERO Database, 2015 Health Service Name Service Type Location

Concord General and Repatriation Hospital Public Hospitals Concord

Concord Oral Health Clinic Oral Health Services Concord

Centre for Digestive Diseases Day Surgery Five Dock

Drummoyne Eye Surgery Centre Day Surgery Drummoyne

Westside Private Hospital Private Hospitals Concord Source: NSW Health Establishment Registration Online (HERO) database (2012)

7.2 Community Health Services The Sydney Local Health District provides a comprehensive range of community health and community based health services providing prevention, early intervention, assessment, treatment, health maintenance and continuing care services. Community based services include:

• Community Health Services (see below) • Health Promotion • Aboriginal Health Services • Community Mental Health Services • Community Aged Care, Chronic Care and Rehabilitation Services • Community Oral Health Services • Community Drug Health Services

The services provided by Community Health include:

• Sydney District Nursing Service

• Community Development

• Sexual Health /Community HIV services

• Early Childhood Health

• Palliative Care Nursing

• Women’s Health

• Multicultural Health • Youth Health • Child and Family Health

• Sexual Assault Services

• Counseling

• Community Nutrition • Child Protection

Community based health services are located in numerous facilities including community health centres, community clinics, schools and outreach centres. Large multidisciplinary Community Health Centres are located at Croydon, Marrickvillle, Canterbury and Redfern. Community health services located within Canada Bay LGA, that are currently registered on the NSW Health Establishment Registration Online Database (HERO) include early childhood, and mental health services (Table 34).

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Table 34: Community health facilities in Canada Bay LGA, HERO Database, 2015 Health Service Name Service Type Location

Concord Day Centre Mental Health Services Concord

Concord Outpatient Clinic - Concord Hospital Mental Health Services Concord

Rivendell Child, Adolescent and Family Unit Mental Health Services Concord West

Rivendell Day Program Mental Health Services Concord West

Rivendell Outpatient clinic Mental Health Services Concord West

Concord Early Childhood Health Centre Community Health Centre Concord Concord Early Childhood Health Centre Community Nursing Service Child and Family Health

Early Childhood Services Concord

Five Dock Early Childhood Health Centre Community Health Centre Five Dock Source: NSW Health Establishment Registration Online (HERO) database (2012)

7.3 General Practice Figure 27 shows that the number of GPs per 100,000 persons in Canada Bay LGA was one of the lowest in the catchment, although the number of GPs providing services in an aged care setting and under the Access to Allied Psychological Services (ATAPS) scheme was broadly consistent with the IWS catchment.

Figure 27: : General Practitioners and General Practice Services by LGA and IWS, 2015

Source: Central and Eastern Sydney PHN (2015).

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7.4 Allied Health

The availability of most types of allied health practitioner in Canada Bay LGA is approximately at or above the rate across the entire catchment. Compared to the broader area, the most notable examples of practitioners that were less readily available in Canada Bay LGA include Occupation Therapists, Physiotherapists and Psychologists.

Figure 28: Private Allied Health Practitioners: Canada Bay LGA and IWS, 2014

Source: Central and Eastern Sydney PHN (2014). Rates reported are crude (not age standardised).

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7.5 Aged Care Aged care reforms are being progressively implemented over the next ten years. The reform moves aged care towards consumer-directed care that is sustainable and affordable. In 2013-14 new Home Care Packages and supplements in both home care and residential care were released.

Table 35 shows that at 30 June 2014 the total number of aged care places and ratios (places per 1,000 people aged 70 years and over)in the Inner West catchment 126.2 was higher than the state (111.2 per 1,000 people over 70 years). Under the Government framework a national provision level of 125 residential and home care packages for every 1,000 people aged over 70 years or over, is to be achieved by 2021-22.

Table 35: Total Aged Care Places and Ratios (per 1,000 aged over 70 yrs), IWS and NSW, 2014 Total Operational Places Total Operational Ratios Residential IWS NSW IWS NSW Low care 1,488 32,205 33.7 40.7 High care 2,910 34,575 65.8 43.7 Total residential 4,398 66,780 99.5 84.5 Home Care IWS NSW IWS NSW Low care 995 17,307 22.5 21.9 High care 187 3,826 4.2 4.8 Total home care 1,182 21,133 26.7 26.7 Grand total Residential + Home care

5,580 87,913 126.2 111.2

Source: Stocktake of Australian Government subsidised aged care places and ratios, Department of Social Services, Australian Government, June 2014

Much of the health-related care delivered to older people is delivered directly by the Aged Care and Rehabilitation (AC&R) service, a core part of the Sydney Local Health District. Other religious, charitable and community organisations also provide services throughout the IWS catchment area. Aged Care services located within Canada Bay LGA, that are currently registered on the NSW Health Establishment Registration Online Database (HERO) are identified in Table 36.

Table 36: Aged care facilities in Canada Bay LGA, HERO Database, 2015 Aged Care Facilities Location SLHD Aged, Chronic Care and Rehabilitation Service Concord West

Concord Residential Aged Care Facility Concord

Kurmala Nursing Home Concord West

Minnamurra Drummoyne

Parkview Nursing Home Five Dock

Redleaf Manor Concord

Russell Lea Nursing Home Five Dock

St Mary's Villa Residential Aged Care Facility Concord

Scalabrini Village Residential Aged Care Drummoyne Source: NSW Health Establishment Registration Online (HERO) database

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APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES In a number of cases, data was only available at the postcode level, rather than an LGA or SLA level. Where this occurred, the data at the postcode level was mapped to the LGA or SLA according to the correspondences shown in Table A1. The correspondences are based upon published data sourced from the Australian Bureau of Statistics regarding postcode to SLA or LGA mappings detemined under the Australian Standard Geographical Classification.

In some cases, a single postcode spans a number of LGAs or SLAs. These postcodes are only included when more than 10% are within an LGA or SLA boundary.

Table A1: Postcode to SLA / LGA correspondences

LGA / SLA POSTCODE % WITHIN

LGA BOUNDARY

LGA / SLA POSTCODE

% WITHIN LGA

BOUNDARY

Ashfield

2045 99.62

Leichhardt

2038 98.95 2130 99.97 2039 100.00 2131 100.00 2040 99.99 2132 40.71 2041 100.00

Burwood

2132 59.29

Marrickville

2042 60.98 2133 51.54 2044 99.74 2134 100.00 2048 99.95 2135 20.33 2049 100.00 2136 52.34 2050 40.17

Canterbury

2133 40.35 2203 100.00 2191 78.20 2204 99.96 2192 100.00

Strathfield

2129 100.00 2193 95.86 2135 72.70 2194 100.00 2136 47.66 2195 100.00 2140 100.00 2196 74.57 2191 21.80 2206 100.00

Sydney City South

2008 33.62 2208 50.22 2015 100.00 2209 32.92 2016 100.00 2210 17.78 2017 100.00

Canada Bay

2046 100.00 2018 37.02 2047 100.00 2042 39.02 2137 100.00 2043 100.00 2138 100.00

Sydney City West

2006 100.00 2139 100.00 2007 92.59

2008 66.38 2009 100.00 2037 100.00 2050 59.83

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APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS B.1 Background to the LGA Health Profiles

The LGA Health Profiles were initially published in 2010 by the Sydney Local Health District. This version of the LGA Health Profiles 2015 was a collaborative project with the Central and Eastern Sydney PHN and the Sydney Local Health District.

Unfortunately the breadth of detail required to inform the LGA/SLA profiles is not available within a single data source. Accordingly, data has been sourced on a range of relevant indicators using the most appropriate, recently available source for each indicator. In some cases, the absence of complete data consistency across all indicators may require consumers of the LGA/SLA profiles to interpret some findings with caution, and this document aims to identify those areas where this is most likely to be the case. Source references are identified and should be used in conjunction with this document when interpreting the LGA/SLA profiles.

B.1.1 PHIDU Social Health Atlas of Australia

In some cases data has been sourced from the October 2014 release of the Social Health Atlas of Australia, which is compiled by the Public Health Information Development Unit (PHIDU), which is under the auspices of the University of Adelaide.

The data obtained from PHIDU is provided at the LGA/SLA, Medicare Local, state and national levels and includes a broad number of indicators that are relevant to population health needs. However, in a number of cases the data collections that underpin these indicators have been compiled by different organisations that use different sampling techniques and assumptions. Furthermore, the range of indicators presented in PHIDU’s Social Health Atlas use data collected over different years. The breadth of data sources, collection techniques and collection timeframes used in PHIDU’s Social Health Atlas should therefore be taken into consideration when interpreting the data and readers should be cautious about drawing direct comparisons between indicators that are based upon data that has been collected at different timeframes, by different organisations, or using different assumptions.

Some indicators presented within PHIDU’s Social Health Atlas of Australia are ‘synthetic predictions’ that have been derived by PHIDU at the LGA or SLA level, based upon various different data collections. As a result, these predictions do not represent data collected in administrative or other data sets, should be used with caution, and be treated as indicative of the prevalence of the health condition or risk factor in an area with these demographic and socioeconomic characteristics. Synthetic predictions within the PHIDU dataset have been made for indicators relating to the prevalence of chronic disease, private health insurance coverage and health risk factors.

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B.1.2 Other Data Sources

The need to obtain data from a range of sources introduces the possibility of misalignment of populations and assumptions when comparing data across time periods, or from different data sources. Nonetheless, it has been necessary as part of the development of the LGA/SLA profiles to draw conclusions between indicators that are based upon different data collections. Although the LGA/SLA profiles have been constructed in such a way that the most relevant, recently available data has been used for each indicator, it is important to recognise the limitations in comparing data sourced from different collections, and over different timeframes.

Considering the diversity of data sources used to construct the LGA/SLA profiles, data was not always available for all indicators at the state, PHN or LGA/SLA level. As a result, some indicators have been derived in order to provide comparisons between indicators at these different levels. Consumers should exercise caution when making comparisons between derived benchmarks and reported results. The PHN provided workforce data on private allied health provider for this report.

B.1.3 Health Risk Factors – Definitions

The data in Figure 7 are self-reported data, reported to interviewers in the 2011–13 National Health Survey. A current smoker is an adult (over 18 years of age) who reported at the time of interview that they smoked cigarettes, cigars or pipes at least once a week.

Risky alcohol consumption was based on estimated alcohol consumption in the seven days prior to interview using two components – the number of days on which the respondent reported consuming alcohol in the previous week; and the quantity consumed in the most recent days on which they consumed alcohol. For people who drank on no more than three days in the last week, their daily consumption was simply the total consumed divided by seven. Harmful use of alcohol is defined as average daily consumption of more than 75 ml (three standard drinks) for males and 50 ml (two standard drinks) for females.

Physical inactivity is defined as those aged 15 years and over who did not exercise in the two weeks prior to interview for the 2011-13 NHS, through sport, recreation or fitness (including walking).

Psychological Distress: This data is derived from the Kessler Psychological Distress Scale (K-10), which is a scale of non-specific psychological distress based on 10 questions asked of respondents about negative emotional states in the 4 weeks prior to interview. 'High' and ‘Very High’ distress are the two highest levels of distress categories (of a total of four categories).

Overweight and Obesity: The BMI was calculated from self-reported height and weight information and grouped as follows to allow reporting against both World Health Organization and National Health & Medical Research Council guidelines – normal range: 18.5 to less than 20.0 and 20.0 to less than 25.0; overweight: 25.0 to less than 30.0; obese: 30.0 and greater.

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