Murrumbidgee Local Health District

Socio-economic Disadvantage in MLHD

A discussion of ABS Socio-economic Indicators for Areas (SEIFA) from 2011 Census

Kim GilchristEpidemiologist, Public Health21 May 2013

Copies of this document, data files and maps available from: www.mlhd.health.nsw.gov.au/about/health-statistics/reports

Murrumbidgee Local Health DistrictABN 71 172 428 618

Locked Bag 10, Wagga Wagga NSW 2650Tel 02 6933 9100 Fax 02 6933 9188

Website www.mlhd.health.nsw.gov.au

CONTENTS

Social Determinants of Health.......................................................................................................................3

Executive Summary........................................................................................................................................3

Socio Economic Indexes For Areas (SEIFA).....................................................................................................3

Disadvantage in MLHD...............................................................................................................................4

Other SEIFA indexes.................................................................................................................................12

How to Use SEIFA.....................................................................................................................................17

Relationship between Socioeconomic status and health outcomes........................................................18

Appendix 1...................................................................................................................................................27

References and Links...................................................................................................................................28

LIST OF FIGURES

Figure 1 - SEIFA disadvantage index score for local government areas in MLHD, 2011.................................4

Figure 2 - Map of relative disadvantage by LGA, MLHD, 2011.......................................................................5

Figure 3 - SEIFA Index of Relative Socio-economic Disadvantage by SA1, MLHD 2011..................................6

Figure 4 - Population proportion and number living in highly disadvantaged SA1s by LGA, 2011.................7

Figure 5 - SEIFA index of Advantage and Disadvantage by SA1 in MLHD, 2011...........................................14

Figure 6 - SEIFA index of Economic Resources by SA1 in MLHD, 2011.........................................................15

Figure 7 -SEIFA index of Education and Occupation by SA1 in MLHD, 2011.................................................16

Figure 8 - Health Promotion Falls program indicator map...........................................................................17

Figure 9 to ...................................................................................................................................................18

Figure 25 - Scatter Plots of Disadvantage versus health outcomes..............................................................26

LIST OF TABLES

Table 1 - Index of Relative Disadvantage by LGA in MLHD, ABS 2011............................................................8

Table 2 – SEIFA Index of Relative Disadvantage – population distribution by decile bands for LGAs in MLHD, 2011...................................................................................................................................................9

Table 3 - Highest percentage of LGA population living in disadvantaged SA1s............................................10

Table 4- Highest population number in disadvantaged SA1s by LGA in MLHD............................................11

Table 5 - All SEIFA scores by LGA, score and decile ranking in Australia......................................................13

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SOCIAL DETERMINANTS OF HEALTH

Even in the most affluent countries, people who are less “well-off” have substantially shorter life expectancies and more illness than the rich. Not only are these differences in health an important social injustice, they have led in particular to a growing understanding of the sensitivity of health to the social environment and to what has become known as the social determinants of health (Wilkinson and Marmot 2003).

According to the World Health Organisation, the social determinants of health are conditions in which people are born, grow, live, work and age, including the health system. The circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

The health sector has a role to play by providing health services that are fair and equitable based on need. Health, often working in partnership with other agencies, plays a role in advocating for conditions which promote and support good health. It is important for health care providers to know their local communities in terms of their socio-economic status.

The population Census provides us with data on the income, housing, education, employment, family structure, disability, transport, age, gender and ethnicity of people all over Australia. The Australian Bureau of Statistics has combined these in a set of indicators called the Socio-economic Indexes for Areas (SEIFA) which give a summary measure of socio-economic status for people living in specific geographic regions in Australia. This document explores the latest socio-economic indicator data from the 2011 Census for the people living in the Murrumbidgee Health District.

EXECUTIVE SUMMARY

In general LGAs in the MLHD are more disadvantaged than the average for all LGAs in Australia.

In MLHD approximately 12.5 per cent of people live in highly disadvantaged areas, compared to 10 per cent in Australia and 11.7 per cent in NSW.

Only 4.2 per cent of the MLHD live in areas with the least disadvantage compared to 12.1 per cent in Australia and 13.9 per cent in NSW.

Narrandera, Hay and Murrumbidgee Shire are ranked in the 30 most highly disadvantaged LGAs in NSW and Narrandera ranks 100th among all LGAs in Australia.

The highest levels of disadvantage (i.e. ranking in the top 10 per cent of all areas) are seen in suburbs of larger urban centres as well as the rural townships.

High proportions of the LGA population living in disadvantaged areas were seen in Narrandera, Harden Jerilderie and Urana where over 25 per cent of the population lived in highly disadvantaged areas.

LGAs with large numbers of people living in highly disadvantaged areas included Wagga Wagga (6597) Albury (6301), Griffith (3671) and Young (3003).

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SOCIO ECONOMIC INDEXES FOR AREAS (SEIFA)

What is SEIFA?

The 2011 Census of Population and Housing provides information on a broad range of social and economic aspects of the Australian population. People using census data are often interested in an overview or summary measure of Census data, rather than looking at individual items. Socio Economic Indexes for Areas (SEIFA) is one such summary measure.

SEIFA is a set of four indexes that have been created from social and economic Census information. Each index ranks geographic areas across Australia in terms of their relative socio-economic advantage and disadvantage. The four indexes each summarise a slightly different aspect of the socio-economic conditions in an area.

The indexes can be used for a number of different purposes, including targeting areas for business and services, strategic planning and social and economic research. For each index, every geographic area in Australia is given a SEIFA score which measures how relatively ‘advantaged’ or ‘disadvantaged’ that area is compared with other areas in Australia.

The four indexes in SEIFA 2011 are:

Index of Relative Socio-Economic Disadvantage (IRSD)

Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD)

Index of Economic Resources (IER) Index of Education and Occupation (IEO)

(Source: 2033.0.55.001 - Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011)

Indicator of Disadvantage

The Index of Relative Socio-economic Disadvantage (IRSD) is a general socio-economic index that summarises a range of information about the economic and social conditions of people and households within an area. Unlike the other indexes, this index includes only measures of relative disadvantage.

A low score indicates relatively greater disadvantage in general. For example, an area could have a low score if there are (among other things): - many households with low income, many people with no qualifications, or many people in low skill occupations.

A high score indicates a relative lack of disadvantage in general. For example, an area may have a high score if there are (among other things):- few households with low incomes, few people with no qualifications, and few people in low skilled occupations.

See Appendix 1 for a list of included variables and their weightings in the score. Note that Aboriginality is no longer included in this index as a measure of disadvantage.

Australian Bureau of Statistics (ABS) Standard Geographic Areas

For the 2011 Census the ABS developed a new set of geographic standards based on land use. The smallest geography on which Census data are based is called the Statistical Area 1 (SA1) – these areas are small in population size and geography (except in very sparsely populated areas) and are similar to the Collection Districts used in previous Censuses.

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DISADVANTAGE IN MLHD

At Local Government Area (LGA) level

Local government area SEIFA scores are produced based on a population-weighted average of the constituent SA1 scores. For comparison, the scores for all areas are ranked (ordered) across Australia and given a quantile banding (usually in decile/ 10% bands). As this is a measure of relative disadvantage it is not the actual score which is of interest but where the geographic area is ranked among others in Australia, NSW or the LHD. The SEIFA score of 1000 is the national mean, scores below 1000 show higher disadvantage than the average and scores above 1000 show less disadvantage. A score of 500 does not indicate twice as much disadvantage as a score of 1000, a decile band of 1 indicates the top 10 per cent most disadvantaged areas. SEIFA scores and ranks cannot be compared over time as SEIFA components may change from one Census to the next. The indexes are designed to compare the relative socio-economic characteristics of areas at a given point in time, not to compare individual areas across time (longitudinal analysis).

Figure 1 shows the scores for disadvantage for the LGAs – the blue dot is the average score for the SA1s in the LGA, and the vertical blue line shows the range of scores within the LGA. Griffith, Wagga Wagga, Albury and Murray Shires have the widest range of scores indicating a broad social gradient of high levels of disadvantage to relatively low levels.

The line at 1000 shows the average for Australia and the average for NSW at 994 and rural NSW at 958. Thirteen LGAs are below the rural NSW average and only four LGAs are above the NSW average.

The twenty-nine LGAs in MLHD are listed in Table 1 giving their score for the relative disadvantage index plus their ranking among all LGAs in Australia and separately in NSW. Narrandera, Hay and Murrumbidgee are the LGAs with the greatest average disadvantage within MLHD (Figure 2). These LGAs are among the top 20 per cent of disadvantaged LGAs in Australia and rank 24th, 26th and 28th respectively of the 153 LGAs in NSW. Averaging scores to LGA level may mask pockets of disadvantage at the smaller SA1 level.

Smaller area SEIFA

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Figure 2 - Map of relative disadvantage by LGA, MLHD, 2011

Figure 1 - SEIFA disadvantage index score for local government areas in MLHD, 2011

Another more detailed way to look at the index is to look at the population distribution of LGAs by constituent SA1 SEIFA decile bands (Table 2). Where the LGA SEIFA scores in MLHD were not ranked among the “worst in Australia” some of the SA1s in MLHD are. Ten per cent of the Australian population (11.7 per cent of NSW) lives in SA1s in the highest disadvantage level (Decile 1), in MLHD 12.5 per cent (34,458 people) live in relative disadvantage. Figure 3 shows the areas of highest disadvantage in MLHD as the darkest shading, they are generally associated with urban areas and particular suburb areas of Wagga Wagga, Albury, Griffith and Deniliquin, although each of the major towns in the District appear to have an area of disadvantage.

Table 3 lists the MLHD LGAs in order of proportion of the population living in Decile 1 ranked SA1s. Narrandera, Harden, Jerilderie and Urana all have more than a quarter of the LGA

population living in highly disadvantaged SA1s and Young and Murrumbidgee over one-fifth. In terms of population size - the larger urban areas of Wagga Wagga, Albury, Griffith and Young have the highest numbers of people living in disadvantaged SA1s, equating to 57 per cent of all people living in highly disadvantaged areas in MLHD (Table 4). combines the two concepts of the size of the disadvantaged population and the proportion of an LGA population that are living in disadvantaged areas. The dark shading of an LGA indicates that there is a high percentage of the LGA population who are disadvantaged. Each SA1 within MLHD which is in the highest disadvantage decile is represented by a dot on the map – the size of the dot is determined by the number of people living in that SA1. Where in Figure 3 some of the SA1s are geographically very small and difficult to see, highlights the location and size of the disadvantaged populations.

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Figure 3 - SEIFA Index of Relative Socio-economic Disadvantage by SA1, MLHD 2011

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Figure 4 - Population proportion and number living in highly disadvantaged SA1s by LGA, 2011

Table 1 - Index of Relative Disadvantage by LGA in MLHD, ABS 2011

2011 Local Government Area Name (LGA)

Usual Resident Population

Ranking within Australia Ranking within State or Territory Minimum score for SA1s in area

Maximum score for SA1s

in area

% Usual Resident Population without

a SA1 level scoreScore Rank Decile Percentile State Rank Decile Percentile

Albury 47851 979 289 6 52 NSW 91 6 60 565 1156 0%Berrigan 8067 954 198 4 35 NSW 59 4 39 850 1049 0%Bland 5868 975 270 5 48 NSW 83 6 54 799 1055 0%Boorowa 2397 964 236 5 42 NSW 73 5 48 901 1083 0%Carrathool 2580 969 254 5 45 NSW 80 6 52 895 1041 0%Conargo 1535 1040 489 9 87 NSW 129 9 84 1006 1068 0%Coolamon 4107 975 272 5 49 NSW 84 6 55 838 1081 0%Cootamundra 7344 942 142 3 26 NSW 38 3 25 777 1081 0%Corowa Shire 10997 968 246 5 44 NSW 75 5 49 820 1060 0%Deniliquin 7125 942 143 3 26 NSW 39 3 26 662 1093 0%Greater Hume Shire 9814 989 341 7 61 NSW 102 7 67 884 1089 0%Griffith 24380 964 235 5 42 NSW 72 5 47 478 1122 0%Gundagai 3656 962 229 5 41 NSW 71 5 47 887 1054 0%Harden 3574 942 146 3 26 NSW 41 3 27 828 1060 0%Hay 2940 927 105 2 19 NSW 26 2 17 846 1057 0%Jerilderie 1492 998 378 7 67 NSW 112 8 73 869 1095 0%Junee 5881 942 145 3 26 NSW 40 3 26 851 1106 13%Leeton 11014 954 201 4 36 NSW 61 4 40 703 1076 1%Lockhart 3006 999 384 7 68 NSW 113 8 74 917 1069 0%Murray 6966 988 332 6 59 NSW 99 7 65 559 1083 0%Murrumbidgee 2262 928 109 2 20 NSW 28 2 19 817 1054 0%Narrandera 5897 925 100 2 18 NSW 24 2 16 772 1067 0%Temora 5758 956 205 4 37 NSW 63 5 41 834 1073 0%Tumbarumba 3364 954 199 4 36 NSW 60 4 39 878 1061 0%Tumut Shire 10938 951 184 4 33 NSW 53 4 35 804 1081 0%Urana 1149 937 130 3 23 NSW 34 3 23 864 1010 0%Wagga Wagga 59460 998 377 7 67 NSW 111 8 73 494 1144 2%Wakool 3953 976 276 5 49 NSW 86 6 56 865 1074 0%Young 12238 947 168 3 30 NSW 49 4 32 737 1091 1%

Source: Australian Bureau of Statistics, 2033.0.55.001 - Socio-economic Indexes for Areas (SEIFA), Australia, 2011

Note: Prison populations and other residential care facilities are included in overall population counts but excluded from household statistics in the Census and therefore not included in SEIFA scores.

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Table 2 – SEIFA Index of Relative Disadvantage – population distribution by decile bands for LGAs in MLHD, 2011.

Most disadvantagedLowest SEIFA scores

Decile 1 score below 875875 to <1100Deciles 2 to 9

Least disadvantaged1100 to >1300

Decile 10Total

populationTotal

population Per centTotal Usual

ResidentPopulation Per cent Population Per cent Population Per cent in included

SA1sin excluded

SA1sexcluded Population Disadvantage

score for LGADecile(AUS)

Albury 6,301 13.2% 38,277 80.0% 3,250 6.8% 47,828 23 0.0% 47,851 979 6Berrigan 1,444 17.9% 6,623 82.1% 0 0.0% 8,067 0 0.0% 8,067 954 4Bland 535 9.1% 5,333 90.9% 0 0.0% 5,868 0 0.0% 5,868 975 5Boorowa 0 0.0% 2,397 100.0% 0 0.0% 2,397 0 0.0% 2,397 964 5Carrathool 0 0.0% 2,580 100.0% 0 0.0% 2,580 0 0.0% 2,580 969 5Conargo 0 0.0% 1,535 100.0% 0 0.0% 1,535 0 0.0% 1,535 1040 9Coolamon 748 18.2% 3,359 81.8% 0 0.0% 4,107 0 0.0% 4,107 975 5Cootamundra 849 11.6% 6,495 88.4% 0 0.0% 7,344 0 0.0% 7,344 942 3Corowa 155 1.4% 10,826 98.4% 0 0.0% 10,981 16 0.1% 10,997 968 5Deniliquin 565 7.9% 6,555 92.0% 0 0.0% 7,120 5 0.1% 7,125 942 3Greater Hume 0 0.0% 9,799 99.8% 0 0.0% 9,799 15 0.2% 9,814 989 7Griffith 3,671 15.1% 20,463 83.9% 219 0.9% 24,353 27 0.1% 24,380 964 5Gundagai 0 0.0% 3,656 100.0% 0 0.0% 3,656 0 0.0% 3,656 962 5Harden 1,149 32.2% 2,425 67.8% 0 0.0% 3,574 0 0.0% 3,574 942 3Hay 265 9.0% 2,675 91.0% 0 0.0% 2,940 0 0.0% 2,940 927 2Jerilderie 400 26.8% 1,092 73.2% 0 0.0% 1,492 0 0.0% 1,492 998 7Junee 1,140 19.4% 3,779 64.3% 177 3.0% 5,096 785 13.3% 5,881 942 3Leeton 1,571 14.3% 9,378 85.1% 0 0.0% 10,949 65 0.6% 11,014 954 4Lockhart 0 0.0% 3,003 99.9% 0 0.0% 3,003 3 0.1% 3,006 999 7Murray 691 9.9% 6,275 90.1% 0 0.0% 6,966 0 0.0% 6,966 988 6Murrumbidgee 512 22.6% 1,750 77.4% 0 0.0% 2,262 0 0.0% 2,262 928 2Narrandera 1,988 33.7% 3,909 66.3% 0 0.0% 5,897 0 0.0% 5,897 925 2Temora 1,027 17.8% 4,731 82.2% 0 0.0% 5,758 0 0.0% 5,758 956 4Tumbarumba 0 0.0% 3,351 99.6% 0 0.0% 3,351 13 0.4% 3,364 954 4Tumut 1,035 9.5% 9,892 90.4% 0 0.0% 10,927 11 0.1% 10,938 951 4Urana 299 26.0% 850 74.0% 0 0.0% 1,149 0 0.0% 1,149 937 3Wagga Wagga 6,597 11.1% 43,891 73.8% 7,817 13.1% 58,305 1,155 1.9% 59,460 998 7Wakool 513 13.0% 3,440 87.0% 0 0.0% 3,953 0 0.0% 3,953 976 5Young 3,003 24.5% 9,069 74.1% 0 0.0% 12,072 166 1.4% 12,238 947 3MLHD total 34,458 12.5% 227,409 82.5% 11,463 4.2% 273,330 2,284 0.8% 275,614NSW 804,803 11.7% 5,110,011 74.0% 960,815 13.9% 6,875,629 29,018 0.40% 6,904,647

Australia 2,079,320 9.7% 16,673,918 77.5% 2,599,368 12.1% 21,352,606 155,109 0.70% 21,507,715

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Table 3 - Highest percentage of LGA population living in disadvantaged SA1s

LGA

Most disadvantagedLowest SEIFA scores

Decile 1 score below 875875 to <1100Deciles 2 to 9

Least disadvantaged1100 to >1300

Decile 10Total

populationTotal

population PercentageTotal Usual

ResidentPopulation Per cent Population Per cent Population Per cent in included

SA1sin excluded

SA1sexcluded Population

Narrandera 1,988 33.7% 3,909 66.3% 0 0.0% 5,897 0 0.0% 5,897Harden 1,149 32.2% 2,425 67.8% 0 0.0% 3,574 0 0.0% 3,574Jerilderie 400 26.8% 1,092 73.2% 0 0.0% 1,492 0 0.0% 1,492Urana 299 26.0% 850 74.0% 0 0.0% 1,149 0 0.0% 1,149Young 3,003 24.5% 9,069 74.1% 0 0.0% 12,072 166 1.4% 12,238Murrumbidgee 512 22.6% 1,750 77.4% 0 0.0% 2,262 0 0.0% 2,262Junee 1,140 19.4% 3,779 64.3% 177 3.0% 5,096 785 13.3% 5,881Coolamon 748 18.2% 3,359 81.8% 0 0.0% 4,107 0 0.0% 4,107Berrigan 1,444 17.9% 6,623 82.1% 0 0.0% 8,067 0 0.0% 8,067Temora 1,027 17.8% 4,731 82.2% 0 0.0% 5,758 0 0.0% 5,758Griffith 3,671 15.1% 20,463 83.9% 219 0.9% 24,353 27 0.1% 24,380Leeton 1,571 14.3% 9,378 85.1% 0 0.0% 10,949 65 0.6% 11,014Albury 6,301 13.2% 38,277 80.0% 3,250 6.8% 47,828 23 0.0% 47,851Wakool 513 13.0% 3,440 87.0% 0 0.0% 3,953 0 0.0% 3,953Cootamundra 849 11.6% 6,495 88.4% 0 0.0% 7,344 0 0.0% 7,344Wagga Wagga 6,597 11.1% 43,891 73.8% 7,817 13.1% 58,305 1,155 1.9% 59,460Murray 691 9.9% 6,275 90.1% 0 0.0% 6,966 0 0.0% 6,966Tumut 1,035 9.5% 9,892 90.4% 0 0.0% 10,927 11 0.1% 10,938Bland 535 9.1% 5,333 90.9% 0 0.0% 5,868 0 0.0% 5,868Hay 265 9.0% 2,675 91.0% 0 0.0% 2,940 0 0.0% 2,940Deniliquin 565 7.9% 6,555 92.0% 0 0.0% 7,120 5 0.1% 7,125Corowa 155 1.4% 10,826 98.4% 0 0.0% 10,981 16 0.1% 10,997Boorowa 0 0.0% 2,397 100.0% 0 0.0% 2,397 0 0.0% 2,397Carrathool 0 0.0% 2,580 100.0% 0 0.0% 2,580 0 0.0% 2,580Conargo 0 0.0% 1,535 100.0% 0 0.0% 1,535 0 0.0% 1,535Greater Hume 0 0.0% 9,799 99.8% 0 0.0% 9,799 15 0.2% 9,814Gundagai 0 0.0% 3,656 100.0% 0 0.0% 3,656 0 0.0% 3,656Lockhart 0 0.0% 3,003 99.9% 0 0.0% 3,003 3 0.1% 3,006Tumbarumba 0 0.0% 3,351 99.6% 0 0.0% 3,351 13 0.4% 3,364MLHD total 34,458 12.5% 227,409 82.5% 11,463 4.2% 273,330 2,284 0.8% 275,614NSW 804,803 11.7% 5,110,011 74.0% 960,815 13.9% 6,875,629 29,018 0.40% 6,904,647

Australia 2,079,320 9.7% 16,673,918 77.5% 2,599,368 12.1% 21,352,606 155,109 0.70% 21,507,715

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Table 4- Highest population number in disadvantaged SA1s by LGA in MLHD

Most disadvantagedLowest SEIFA scores

Decile 1 score below 875875 to <1100Deciles 2 to 9

Least disadvantaged1100 to >1300

Decile 10Total

populationTotal

population PercentageTotal Usual

ResidentPopulation Per cent Population Per cent Population Per cent in included

SA1sin excluded

SA1sexcluded Population

2011Wagga Wagga 6,597 11.1% 43,891 73.8% 7,817 13.1% 58,305 1,155 1.9% 59,460Albury 6,301 13.2% 38,277 80.0% 3,250 6.8% 47,828 23 0.0% 47,851Griffith 3,671 15.1% 20,463 83.9% 219 0.9% 24,353 27 0.1% 24,380Young 3,003 24.5% 9,069 74.1% 0 0.0% 12,072 166 1.4% 12,238Narrandera 1,988 33.7% 3,909 66.3% 0 0.0% 5,897 0 0.0% 5,897Leeton 1,571 14.3% 9,378 85.1% 0 0.0% 10,949 65 0.6% 11,014Berrigan 1,444 17.9% 6,623 82.1% 0 0.0% 8,067 0 0.0% 8,067Harden 1,149 32.2% 2,425 67.8% 0 0.0% 3,574 0 0.0% 3,574Junee 1,140 19.4% 3,779 64.3% 177 3.0% 5,096 785 13.3% 5,881Tumut 1,035 9.5% 9,892 90.4% 0 0.0% 10,927 11 0.1% 10,938Temora 1,027 17.8% 4,731 82.2% 0 0.0% 5,758 0 0.0% 5,758Cootamundra 849 11.6% 6,495 88.4% 0 0.0% 7,344 0 0.0% 7,344Coolamon 748 18.2% 3,359 81.8% 0 0.0% 4,107 0 0.0% 4,107Murray 691 9.9% 6,275 90.1% 0 0.0% 6,966 0 0.0% 6,966Deniliquin 565 7.9% 6,555 92.0% 0 0.0% 7,120 5 0.1% 7,125Bland 535 9.1% 5,333 90.9% 0 0.0% 5,868 0 0.0% 5,868Wakool 513 13.0% 3,440 87.0% 0 0.0% 3,953 0 0.0% 3,953Murrumbidgee 512 22.6% 1,750 77.4% 0 0.0% 2,262 0 0.0% 2,262Jerilderie 400 26.8% 1,092 73.2% 0 0.0% 1,492 0 0.0% 1,492Urana 299 26.0% 850 74.0% 0 0.0% 1,149 0 0.0% 1,149Hay 265 9.0% 2,675 91.0% 0 0.0% 2,940 0 0.0% 2,940Corowa 155 1.4% 10,826 98.4% 0 0.0% 10,981 16 0.1% 10,997Boorowa 0 0.0% 2,397 100.0% 0 0.0% 2,397 0 0.0% 2,397Carrathool 0 0.0% 2,580 100.0% 0 0.0% 2,580 0 0.0% 2,580Conargo 0 0.0% 1,535 100.0% 0 0.0% 1,535 0 0.0% 1,535Greater Hume 0 0.0% 9,799 99.8% 0 0.0% 9,799 15 0.2% 9,814Gundagai 0 0.0% 3,656 100.0% 0 0.0% 3,656 0 0.0% 3,656Lockhart 0 0.0% 3,003 99.9% 0 0.0% 3,003 3 0.1% 3,006Tumbarumba 0 0.0% 3,351 99.6% 0 0.0% 3,351 13 0.4% 3,364MLHD total 34,458 12.5% 227,409 82.5% 11,463 4.2% 273,330 2,284 0.8% 275,614NSW 804,803 11.7% 5,110,011 74.0% 960,815 13.9% 6,875,629 29,018 0.40% 6,904,647

Australia 2,079,320 9.7% 16,673,918 77.5% 2,599,368 12.1% 21,352,606 155,109 0.70% 21,507,715

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OTHER SEIFA INDEXES

The SEIFA score for advantage and disadvantage is a two sided scale looking at both advantage and disadvantage – so that a high score indicates high levels of advantaged households and low scores indicate high levels of disadvantage (Table 5, Figure 5). There are some areas of highly advantaged SA1s in Albury, Wagga Wagga and a small area in Griffith – however the LGA scores for advantage show no LGAs in MLHD in the top 10 per cent of Australian LGAs, and only Conargo in the top 20 per cent.

The Index of Economic Resources (IER) focuses on the financial aspects of relative socio-economic advantage and disadvantage by summarising variables related to income and wealth and excludes education and occupation – so a low score indicates a lack of economic resources in general (perhaps many households with low income, low rent, high unemployment, and few households with high income or home ownership) and a high score indicates relatively greater access to economic resources, higher incomes larger homes, homes fully owned, fewer low income households. Conargo shire again is the only

shire to show advantage being in the top 10 per cent of LGAs for access to economic resources and Greater Hume and Lockhart in the top 30 per cent (Table 5, Figure 6). Hay shire ranked lowest among LGAs in MLHD being in the bottom 20 per cent of all LGAs showing relatively poor access to economic resources, with Deniliquin, Murrumbidgee and Narrandera ranking in the bottom 30 per cent of all LGAs in Australia. Again pockets of disadvantage were most notable in urban areas of Albury, Griffith and Wagga Wagga, as well as rural towns (Figure 6).

The index of Education and Occupation looks at the percentage of skilled occupations, higher education, tertiary students as well as low skilled jobs, unemployment and low high school completion. Tumut, Narrandera, Leeton, Hay and Corowa ranked the lowest of MLHD Shires in terms of education levels and skilled occupations (Table 5 Figure 7), whereas Conargo shire ranked highest (top 20% of LGAs), indicating proportionally more skilled employment and/or management positions as well as higher educational attainment.

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Table 5 - All SEIFA scores by LGA, score and decile ranking in Australia

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2011 Local Government Area Name (LGA)

Index of Relative Socio-economic Advantage and

Disadvantage

Index of Relative Socio-economic Disadvantage

Index of Economic Resources

Index of Education and Occupation

Usual Resident Population

Score Decile Score Decile Score Decile Score Decile

Albury (C) 967 6 979 6 964 4 962 6 47851Berrigan (A) 938 4 954 4 965 4 942 4 8067Bland (A) 959 5 975 5 997 7 953 5 5868Boorowa (A) 954 5 964 5 985 6 976 7 2397Carrathool (A) 959 5 969 5 984 6 954 5 2580Conargo (A) 1039 9 1040 9 1053 10 1076 9 1535Coolamon (A) 960 5 975 5 1000 7 968 6 4107Cootamundra (A) 928 3 942 3 965 4 923 3 7344Corowa Shire (A) 943 4 968 5 978 5 912 2 10997Deniliquin (A) 926 3 942 3 948 3 928 3 7125Greater Hume Shire (A) 976 6 989 7 1010 8 966 6 9814Griffith (C) 951 5 964 5 977 5 923 3 24380Gundagai (A) 945 4 962 5 992 6 928 3 3656Harden (A) 933 3 942 3 967 4 949 5 3574Hay (A) 915 2 927 2 945 2 920 2 2940Jerilderie (A) 983 7 998 7 1005 7 996 8 1492Junee (A) 932 3 942 3 974 5 922 3 5881Leeton (A) 938 4 954 4 976 5 918 2 11014Lockhart (A) 983 7 999 7 1018 8 981 7 3006Murray (A) 967 6 988 6 995 7 950 5 6966Murrumbidgee (A) 919 2 928 2 959 3 930 3 2262Narrandera (A) 912 2 925 2 948 3 920 2 5897Temora (A) 937 3 956 4 969 4 933 4 5758Tumbarumba (A) 944 4 954 4 980 5 934 4 3364Tumut Shire (A) 936 3 951 4 970 4 912 2 10938Urana (A) 925 3 937 3 985 6 943 4 1149Wagga Wagga (C) 987 7 998 7 991 6 975 7 59460Wakool (A) 962 5 976 5 985 6 974 7 3953Young (A) 936 3 947 3 964 4 928 3 12238

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Source: Australian Bureau of Statistics, 2033.0.55.001 - Socio-economic Indexes for Areas (SEIFA), Australia, 2011

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Figure 5 - SEIFA index of Advantage and Disadvantage by SA1 in MLHD, 2011.

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Figure 6 - SEIFA index of Economic Resources by SA1 in MLHD, 2011.

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Figure 7 -SEIFA index of Education and Occupation by SA1 in MLHD, 2011.

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Why does Conargo stand out?

Conargo had a population of 1535 counted as usual residents in the August 2011 Census, with a median age of 41 years, very few people were born overseas and very few people over 15 years were unemployed (1.2%). Fifty-two per cent of employed people in Conargo stated they were “managers” (potentially farm managers) compared to 13 per cent in NSW and Australia, and a further 10 per cent were “professionals” so that over 60 per cent of the workforce are in the highest “skilled” categories in

terms of the SEIFA indexes, join this with low unemployment; few one parent families; a majority of houses with 4 or more bedrooms; home ownership 10 per cent higher than NSW and Australian averages; and you get a Shire that shows very low levels of disadvantage. Conargo however still has lower median income levels than NSW and Australia at $100 less per week for personal income and more than $450 less per week for a family.

HOW TO USE SEIFA

In general, in terms of health planning we are mainly interested in disadvantaged populations. The Health Promotion team in MLHD have used the Index of Relative Disadvantage in combination with other health and/or behavioural risk factor indicators and existing services information to determine priority

locations for prevention programs. For example the priority area of falls in the elderly shown in Figure 8 highlights where the hospitalisation for falls is high (red cross), where there are no physical activity leaders (red star) and the relative disadvantage of LGAs in MLHD (2006 data shown).

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Figure 8 - Health Promotion Falls program indicator map

RELATIONSHIP BETWEEN SOCIOECONOMIC STATUS AND HEALTH OUTCOMES

SEIFA indexes can also be analysed in conjunction with other data to determine if a relationship exists between disadvantage and certain health characteristics. However it should be reiterated that a SEIFA score is given to an area based on percentages of people with certain characteristics not an individual – so it is not looking at direct relationships for actual people – but a population perspective. The following charts explore the relationship between the SEIFA score for Relative Disadvantage of LGAs in MLHD and the rate of particular health indicators.

THE SCATTER PLOTS: The SEIFA disadvantage score for an LGA (the horizontal axis) has been plotted against the rate of hospitalisation/death (the vertical axis) for that LGA. Each chart has 29 dots, one for each LGA. A “line of best fit” has been added to each chart

to demonstrate a linear relationship between disadvantage and the health indicator.

INTERPRETATION: An LGA will appear towards the left of the chart if it is relatively disadvantaged and towards the top of the chart if there are high rates of the indicator. A slope in the line of best fit running down from high left to low right shows that LGAs with higher disadvantage have higher rates of the poor health outcome

DATA TABLES: Microsoft Excel Spreadsheets of the data for the following charts can be downloaded with this document at:

www.mlhd.health.nsw.gov.au/about/health-statistics/reports

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Figure 9

A gradient can be seen where LGAs with higher levels of disadvantage experience higher rates of hospitalisation for all causes (Figure 9).

Figure 10

A gradient can be seen where LGAs with higher levels of disadvantage experience higher rates of potentially preventable hospitalisation (Figure 10). These are hospitalisations occurring where the type of hospitalisation is considered to be avoidable through appropriate primary or ambulatory care services.

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Figure 11

A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of diabetes hospitalisation (Figure 11).

Figure 12

A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of coronary heart disease hospitalisation, although there is a high level of variation (Figure 12).

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Figure 13

A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of coronary heart disease hospitalisation, although there is a high level of variation (Figure 13).

Figure 14

A slight gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of avoidable death (Figure 14). These are deaths in those aged less than 75 years which are considered avoidable through prevention or treatment.

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Figure 15

A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of avoidable deaths from preventable causes (Figure 15). These are deaths in those aged less than 75 years which are considered avoidable through prevention.

Figure 16

There is no clear gradient seen, LGAs with higher levels of disadvantage tend to experience similar rates of avoidable deaths from amenable causes as those of less disadvantage (Figure 16Figure 11), possibly indicating equal access to

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available services in MLHD. These are deaths in those aged less than 75 years which are considered avoidable through effective treatment.

Figure 17

A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of fall related hospitalisations in older people (Figure 17).

Figure 18

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A slight gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of deaths attributable to alcohol; however there is a high level of variation indicating the relationship is not strong in MLHD (Figure 18).

Figure 19

A slight positive gradient can be seen where LGAs with higher levels of disadvantage tend to experience lower rates of hospitalisation attributable to alcohol; however there is little variation in rates across LGAs indicating the relationship is not strong in MLHD (Figure 19).

Figure 20

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A gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of death attributable to high body mass (Figure 20).

Figure 21

A slight gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of hospitalisation attributable to high body mass (Figure 21).

Figure 22

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A slight gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of deaths attributable to smoking related illness (Figure 22).

Figure 23

A clear gradient can be seen where LGAs with higher levels of disadvantage tend to experience higher rates of hospitalisation attributable to smoking related illness (Figure 23).

Figure 24

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A clear gradient can be seen where LGAs with higher levels of disadvantage have a higher percentage of mothers who smoke during pregnancy (Figure 24). Albury LGA has been omitted as most births occur in Victorian hospitals and are therefore not included in the NSW Midwives Data Collection.

Figure 25

A slight gradient can be seen where LGAs with higher levels of disadvantage have a lower percentage of mothers who have antenatal visits by 14 weeks gestation (Figure 25). Albury LGA has been omitted as most births occur in Victorian hospitals and are therefore not included in the NSW Midwives Data Collection.

APPENDIX 1

Index of Relative Socio-Economic Disadvantage - Final IRSD variables and loadings

Variable mnemonic Variable loading Variable description

INC_LOW -0.90 % People with stated annual household equivalised income between $1 and $20,799 (approx. 1st and 2nd deciles)

CHILDJOBLESS -0.85 % Families with children under 15 years of age who live with jobless parents

NONET -0.81 % Occupied private dwellings with no internet connectionOCC_LABOUR -0.75 % Employed people classified as 'labourers'NOYR12ORHIGHER -0.75 % People aged 15 years and over whose highest level of education is

Year 11 or lower. Includes Certificate I and IIUNEMPLOYED -0.74 % People (in the labour force) unemployedLOWRENT -0.73 % Occupied private dwellings paying rent less than $166 per week

(excluding $0 per week)ONEPARENT -0.71 % One parent families with dependent offspring onlyDISABILITYU70 -0.66 % People aged under 70 who have a long–term health condition or

disability and need assistance with core activitiesNOCAR -0.56 % Occupied private dwellings with no carsSEP_DIVORCED -0.54 % People aged 15 and over who are separated or divorced

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OVERCROWD -0.52 % Occupied private dwellings requiring one or more extra bedrooms (based on Canadian National Occupancy Standard)

OCC_DRIVERS -0.52 % Employed people classified as Machinery Operators and DriversOCC_SERVICE_L -0.50 % Employed people classified as Low Skill Community and Personal

Service WorkersNOEDU -0.44 % People aged 15 years and over who have no educational attainmentENGLISHPOOR -0.34 % People who do not speak English well

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REFERENCES AND LINKS

Social determinants of health: the solid facts. 2nd edition / edited by Richard Wilkinson and Michael Marmot, World Health Organisation, 2003.

www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf

Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2011 (cat. no. 2033.0.55.001).

www.abs.gov.au/ausstats/abs@.nsf/mf/2033.0.55.001)

SEIFA 2011 Data – Download full data www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/2033.0.55.0012011?OpenDocument

Technical Paper - A comprehensive guide to SEIFA 2011 (PDF) www.abs.gov.au/ausstats/Subscriber.nsf/LookupAttach/2033.0.55.001Publication28.03.131/$File/

2033.0.55.001 SEIFA 2011 Technical Paper.pdf

SEIFA Basics - A simpler guide on the basics of SEIFA (web based) www.abs.gov.au/ausstats/abs@.nsf/Lookup/by Subject/2033.0.55.001~2011~Main Features~SEIFA Basics~3

Copies of this document, data files and maps available from: www.mlhd.health.nsw.gov.au/about/health-statistics/reports

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