Sydney City...population of the Sydney City South and 1.4% of the Sydney City - West, which is th- e...

Sydney City (South and West)

Statistical Local 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]

Sydney City (South and West Statistical Local Areas) Health Profile

CONTENTS EXECUTIVE SUMMARY ...................................................................................................... 4 1 INTRODUCTION ............................................................................................................... 5 2 POPULATION AND COMMUNITY CHARACTERISTICS ................................................. 6

2.1 POPULATION CHARACTERISTICS ........................................................................................... 6 2.2 BIRTHS AND MATERNAL HEALTH ............................................................................................ 8 2.3 ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE ....................................................... 9 2.4 PEOPLE WITH CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS................ 9 2.5 HUMANITARIAN ARRIVALS........................................................................................................ 9 2.6 EDUCATION LEVELS ................................................................................................................ 10 2.7 SOCIO-ECONOMIC CHARACTERISTICS ................................................................................ 10 2.8 HOMELESSNESS ...................................................................................................................... 12

3 HEALTH RISKS OF THE POPULATION ........................................................................ 14 4 LONG TERM CONDITIONS AND CHRONIC DISEASE .................................................. 16

4.1 PREVALENCE OF CHRONIC DISEASE ................................................................................... 16 4.2 CANCER ..................................................................................................................................... 18 4.3 MORTALITY ............................................................................................................................... 20

5 INFECTIOUS DISEASE ................................................................................................... 21 5.1 HIV .............................................................................................................................................. 21 5.2 CHLAMYDIA ............................................................................................................................... 22 5.3 GONORRHOEA ......................................................................................................................... 23 5.4 INFECTIOUS SYPHILIS ............................................................................................................. 24 5.5 HEPATITIS B .............................................................................................................................. 25 5.6 HEPATITIS C .............................................................................................................................. 26

6 HEALTH SERVICE UTILISATION ................................................................................... 27 6.1 PRIMARY CARE UTILISATION ................................................................................................. 27 6.2 EMERGENCY DEPARTMENT PRESENTATIONS ................................................................... 28 6.2 Hospital Separations ............................................................................................... 29

6.2.1 DAY-ONLY HOSPITAL SEPARATIONS ............................................................................ 29 6.2.2 OVERNIGHT HOSPITAL SEPARATIONS ......................................................................... 30

6.3 AMBULATORY CARE SENSITIVE ADMISSIONS .................................................................... 31 6.4 HOME AND COMMUNITY CARE .............................................................................................. 32

7 HEALTH SERVICE PROVISION ..................................................................................... 34 7.1 HOSPITALS AND DAY SURGERY ............................................................................................ 34 7.2 COMMUNITY HEALTH SERVICES ........................................................................................... 35 7.3 GENERAL PRACTICE ............................................................................................................... 36 7.4 ALLIED HEALTH ........................................................................................................................ 37 7.5 AGED CARE ............................................................................................................................... 38

APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES ................................. 39 APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS ............................................... 40

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List of Tables Table 1: Projected population: Sydney City and IWS 2006, 2011, 2016, 2021 and 2031 ...... 7

Table 2: Births to Sydney City LGA residents and fertility rates, 2006 – 2013 ....................... 8

Table 3: Child Immunisation Rates by age group; Sydney Inner City SA3, 2012-2013 .......... 8 Table 4: Preventive maternal indicators, Sydney City LGA and NSW 2011-2013 .................. 8

Table 5: Humanitarian migration stream, settlers arriving 2009–2014: Sydney City LGA 9

Table 6: IRSD by SLA, and rank within IWS, 2011 .............................................................. 10

Table 7: IRSD by Suburbs within Sydney City, and rank within IWS, 2011 .......................... 11 Table 8: Estimates of homelessness: Sydney Inner City (SA3), 2011 ................................. 13

Table 9: Modelled estimates of health risk factors: Sydney City, IWS and NSW, 2011-13 .. 14

Table 10: Health behaviours of residents, IWS and NSW (% [95% CI]), 2013 ..................... 15

Table 11: Modelled estimates of prevalence of chronic conditions, age standardised % ..... 16 Table 12: Modelled estimates of chronic disease, Sydney City, IWS and NSW, 2011-13 .... 17

Table 13: Burden of disease - hospital separations by cause, Sydney City, 2009- 2013 ..... 17

Table 14: High BMI, alcohol and smoking attributable deaths, Sydney City, 2011 .............. 17

Table 15: Age standardised cancer incidence ratesby cancer site, 2004-2008 ................... 19 Table 16: Age standardised mortality rates (per 100,000) by cancer site, 2004-2008.......... 20

Table 17: All causes and potentially preventable deaths, Sydney City LGA, 2010-2011 ..... 20

Table 18: HIV notification rate (per 100,000 of population), by LGA, IWS, 2005-2014 ......... 21 Table 19: Chlamydia notification rate (per 100,000 population), by LGA, 2005 to 2014 ....... 22

Table 20: Gonorrhoea notification rate (per 100,000 population) LGA, IWS, 2005-2014 ..... 23

Table 21: Infectious syphilis notification rate (per 100,000) by LGA, IWS, 2005 – 2014 ...... 24

Table 22: Hepatitis B age-standardised notification rate by LGA, IWS, 2005 – 2014 ........... 25 Table 23: Hepatitis C age-standardised notification rate by LGA, IWS, 2005 – 2014 .......... 26

Table 24: Primary care services, Sydney City, IWS and NSW, 2010 ................................... 27

Table 25: Emergency department presentations (%) by hospital, Sydney City, 2013 .......... 28

Table 26: Emergency department presentations by triage, by LGA, IWS and NSW, 2013 . 28 Table 27: Day-only hospital separations for Sydney City residents 2013/2014 .................... 29

Table 28: Overnight hospital separations for Sydney City residents 2013/2014 .................. 30

Table 29: Potentially preventable hospitalisation separations for ACSCs, 2011-13 ............ 31

Table 30: HACC Client Profile, 2012-13; % of HACC clients (number) ................................ 32 Table 31: HACC Service Profile, 2012-13; Instances of care per 1,000 (number) ............... 33

Table 32: Health care facilities in Sydney City (South and West), HERO Database, 2015 .. 35

Table 33: Community health facilities in Sydney City, HERO Database, 2015 .................... 36

Table 34: Aged care facilities in Sydney City (South and West), HERO Database, 2015 .... 38

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List of Figures Figure 1: Population profile: Sydney City LGA and NSW by age and gender, 2014 .............. 6 Figure 2: Population forecasts: Sydney Cityand NSW by age and gender, 2031................... 6 Figure 3: Sydney City projected population age groups 2011, 2016, 2021, 2026 and 2031 .. 7 Figure 4: Language spoken at home: Sydney City LGA, IWS and NSW, 2011..................... 9 Figure 5: SEIFA Disadvantage percentiles in Sydney City SLA (South), 2011 .................... 11 Figure 6: SEIFA Disadvantage percentiles within Sydney City SLA (West), 2011 ............... 12 Figure 7: Type of Homelessness: Sydney Inner City (SA3) and NSW, 2011 ....................... 13 Figure 8: Modelled estimates of health risk factors, 2011-13 ............................................... 14 Figure 9: Modelled estimates of prevalence of chronic conditions, 2011-13 ........................ 16 Figure 10: Age-standardised incidence of selected cancers, 2004 to 2008 ......................... 18 Figure 11: Number and rate of notifications of newly diagnosed HIV infection, 2005-2014 .. 21 Figure 12: HIV notification rate (per 100,000 of population), by LGA, IWS 2005-2014 ........ 21 Figure 13: Chlamydia notification rate for IWS and NSW, 2010 to 2014 .............................. 22 Figure 14: Gonorrhoea notification rate, by IWS and NSW, 2010 to 2014 ........................... 23 Figure 15: Gonorrhoea notification rate (per 100,000 population), by LGA, 2005-2014 ....... 23 Figure 16: Infectious syphilis notification rate, by IWS and NSW, 2010-2014 ..................... 24 Figure 17:Infectious Syphilis notification rate (per 100,000) by LGA and IWS, 2005 – 2014 24 Figure 18: Hepatitis B notification rate, by IWS and NSW 2005-2014 ................................. 25 Figure 19: Hepatitis B notification rate (per 100,000) by LGA and IWS, 2005 – 2014 .......... 25 Figure 20: Hepatitis C notification rate, by IWS and NSW, 2005-2014 ................................ 26 Figure 21: Hepatitis C notification rate (per 100,000) by LGA and IWS, 2005 – 2014 ......... 26 Figure 22: Primary care services, Sydney City (South and West), IWS and NSW, 2010 ..... 27 Figure 23: Day-only hospital separations for Sydney City LGA residents, 2013-14 ............ 29 Figure 24: Overnight hospital separations for Sydney City LGA residents, 2013-14 ............ 30 Figure 25: Potentially preventable hospitalisations for ACSCs, by LGA, 2011-13 ................ 31 Figure 26: HACC Client Profile, by Sydney City, IWS and NSW) 2012-13 .......................... 32 Figure 27: HACC Service Profile, by Sydney City, IWS and NSW, 2012-13 ........................ 33 Figure 28: General Practitioners and General Practice Services, by LGA and IWS, 2015 ... 36 Figure 29: Allied Health Practitioners, Sydney City and IWS, 2014 .................................... 37

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EXECUTIVE SUMMARY Approximately 57% of Sydney City Local Government Area (LGA) residents speak English as a primary language, while smaller proportions of residents identify their primary language as being Mandarin (15%, 5,212), followed by Cantonese (9%, 3,321) and Greek (5%, 1,639). Aboriginal and Torres Strait Islander people make up a total of 2.0% of the total population of the Sydney City - South and 1.4% of the Sydney City - West, which is the highest proportion of any LGA across the Inner West Sydney (IWS) catchment. Sydney City South and West Statistical Local Areas (SLA) have a high concentration of residents aged between 20 and 39 years, relative to NSW. The population of the Sydney City (South and West SLA’s) is expected to grow by 50% to 2031, which is the highest growth rate of any LGA across the catchment, and, according to the 2014 population projecitons,will add approximately 64,000 additional residents. The index score for socio-economic disadvantage in Sydney City - South is 1,017 and Sydney City – West is 1,022. Five suburbs within Sydney City LGA; Waterloo, Eveleigh, Redfern, Ultimo and Glebe have scores for socioeconomic disadvantage which fall below the national average of 1,000 indicating relatively lower socioeconomic status. The percentage of the total homeless population that reside in a boarding house (45%) in the Sydney Inner City is notably higher than the state (21%).

Health Risks and Chronic Disease in Sydney City LGA The estimated prevalence of smoking (13.6%) and obesity (15.6%) in Sydney City LGA residents is significantly lower than the state (16% and 26% respectively). In contrast, the estimated prevalence of risky alcohol consumption, psychological distress and overweight are similar to NSW levels.

When compared to the state, the overall age-standardised rate of cancer is not significantly different in Sydney City (South and West SLA’s) residents. However, there is significantly higher rates of head and neck, liver, myelodysplasia and lung cancers in Sydney City (South and West SLA’s).

Overall, Sydney City LGA residents have significantly fewer hospital separations compared to the state, however, the rates of alcohol-attributable and fall-related injury hospitalisations are higher in Sydney City LGA compared to the state. The standardised mortality from all causes in Sydney City LGA is similar compared to the state; however, mortality from amenable and preventable causes in Sydney City LGA is significantly higher than the state.

Infectious Diseases in Sydney city LGA The IWS catchment has higher rates of newly diagnosed HIV infections, hepatitis B, infectious syphilis, chlamydia and gonorrhoea than the state. In 2014, Sydney City (South and West) had the highest notification rates for all infectious diseases except Hepatitis B.

Health Service Utilisation in Sydney city LGA The per-capita availability of General Practitioners (GPs) and Practice Nurses in Sydney City (South and West SLA’s) is similar to the IWS catchment overall, while the availability of allied health appears to be limited across the Sydney City (South and West SLA).

RPA Hospital provided the majority of emergency department presentations (60.6%) and hospital separations for Sydney City (South and West SLA) residents. The age-standardised rates of emergency department presentations for all triage categories were lower in Sydney City (South and West SLA’s) compared to the IWS catchment.

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1 INTRODUCTION The Sydney City Local Government Area – South and West Statistical Local Areas (SLA) Health Profile describes the characteristics of the Sydney City (South and West) population and compares it with the Inner West Sydney (IWS) catchment and NSW populations.1 The IWS catchment comprises the LGAs of Ashfield, Burwood, Canada Bay, Canterbury, Leichhardt, Marrickville, Strathfield and the SLAs of Sydney City South and Sydney City West. The Sydney City LGA is divided into four statistical local areas (SLAs): Inner, East, South and West. Responsibility for the health of communities living in these SLAs is shared by two local health districts. SLHD is responsible for Sydney - West SLA and Sydney – South SLA and South Eastern Sydney Local Health District (SESLHD) is responsible for Sydney – Inner SLA and Sydney – East SLA. Due to differing data collection methods and boundaries used by the various agencies, the information provided in this profile will be either specific to the residents of the SLAs of Sydney - South and Sydney – West or, in some cases, will refer to the whole of the Sydney City LGA. The Sydney City (South and West) has a population of 93,3542 and covers 16.5 square kilometres. The two SLAs include the suburbs of Chippendale and Darlington (postcode 2008), Alexandria, Beaconsfield and Eveleigh (postcode 2015), Redfern (postcode 2016), Waterloo and Zetland (postcode 2017), Rosebery (postcode 2018), Newtown (postcode 2042) and Erskineville (postcode 2043), the University of Sydney (postcode 2006), Ultimo (postcode 2007), Chippendale and Darlington (postcode 2008), Pyrmont (postcode 2009), Forest Lodge and Glebe (postcode 2037), and Camperdown (postcode 2050) .

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. 2 Australian Bureau of Statistics ERP 2014

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2 POPULATION AND COMMUNITY CHARACTERISTICS 2.1 Population Characteristics Figure 1, the 2014 age profile of Sydney City (South and West) had a high concentration of persons aged between 20 and 39 years, relative to NSW. Conversely, there were lower proportions of persons aged 19 years and below, and 45 years and above, compared to the NSW population.

Figure 1: Population profile: Sydney City LGA and NSW by age and gender, 2014

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

Population estimates to 2031 provided in Figure 2 , shows that the growth in persons aged 20 to 44 years is expected to be well in excess of that expected across NSW. In total, the population of the Sydney City (South and West SLA’s) is forecast to grow by 50% to 2031, which is the highest growth rate of any LGA / SLA across the IWS catchment, and will add approximately 64,000 additional residents to its current population of 93,354.

Figure 2: Population forecasts: Sydney City (South and West SLA’s) and NSW by age and gender, 2031

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+

Sydney City LGA Females 2014 NSW Females 2014 Sydney City LGA Males 2014 NSW Males 2014

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

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

Sydney City Females NSW Females 2031 Sydney City Males 2031 NSW Males 2031

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

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 31,150 dwellings from 2011 to 2031 in Sydney City LGA. Of these dwellings it is projected that 11,140 will be family households and 14,500 will be lone person households3. The greatest population growth is anticipated in Green Square, Beaconsfield, Ultimo (the Carlton United Brewery site) and Redfern/Waterloo.

Table 1 and Figure 3 further illustrate the projected changes in population numbers and the number of people in different age groups in the Sydney City (South and West) 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: Sydney City (South and West SLA’s) and IWS 2006, 2011, 2016, 2021 and 2031

Sydney City (South and West) IWS Catchment 2011 2016 2021 2026 2031 2011 2016 2021 2026 2031

Total population

105,066 118,848 133,537 145,669 157,498 581,936 628,537 681,493 728,193 772,368

0 - 4 years 4,297 5,611 6,647 7,307 7,573 36,373 41,391 44,652 46,838 47,689 5 - 14 years 4,420 5,593 7,203 8,579 9,592 51,476 58,228 66,702 72,778 76,748

15 - 24 years 17,950 16,315 17,147 18,108 19,697 77,887 73,294 76,692 82,112 89,093 25 - 44 years 50,992 58,506 63,563 66,067 67,840 218,353 235,564 249,104 256,808 260,590 45 - 64 years 19,466 22,512 26,147 30,020 34,343 129,929 140,960 153,144 164,527 178,495 65 - 84 years 7,311 9,503 11,829 14,308 16,721 59,207 68,272 78,747 90,820 102,430

85 years + 630 808 1,001 1,281 1,732 8,711 10,829 12,453 14,309 17,323


Across all age groups combined, population growth in the Sydney City (South and West) is expected to be 50% between 2011 and 2031, which is greater than the forecasted population growth across both the IWS catchment (32.7%) and NSW (27.8%).

Figure 3: Sydney City (South and West SLA’s) projected population age groups 2011, 2016, 2021, 2026 and 2031


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

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

2011 2016 2021 2026 2031

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

Proj

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d

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2.2 Births and Maternal Health Table 2 shows the number of births to Sydney City LGA residents in the period 2006 - 2013. Across this period, the fertility rate in Sydney City LGA has been below the NSW rate; however it has increased from 2006. In 2013, approximately 1,542 of the births in Sydney City LGA came from residents of the South and West SLA’s that make up part of the IWS catchment population.

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 Sydney City LGA Residents and Fertility Rate, 2006 – 2013 Year Sydney City LGA

resident population Sydney City LGA births Sydney City LGA total

fertility rate NSW total

fertility rate 2006 164,597 1,677 0.93 1.93 2007 169,056 1,904 0.99 1.99 2008 172,985 1,936 1.02 2.05 2009 177,150 2,017 1.06 1.98 2010 180,748 2,119 1.08 2.02 2011 183,281 2,185 1.10 1.96 2012 187,561 2,276 1.10 1.93 2013 191,918 2,301 1.09 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 the Sydney Inner City (SA3), the rates for all age groups in the SA3 were lower than the IWS catchment and national figures.

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

Age Group % Fully Immunised 1 year 87.1% 90.5% 91.2% 2 years 87.7% 91.4% 92.5% 5 years 83.3% 89.6% 91.5%

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

Table 4 shows that between 2011 and 2013 the rate of smoking during pregnancy in Sydney City LGA was significantly lower than the state average, with a smoothed prevalence ratio between 47.8 and 58.1 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 88.3 and 91.3 at 95% confidence interval4, which was significantly below the NSW smoothed prevalence ratio of 100.

Table 4: Preventive maternal indicators, Sydney City LGA and NSW 2011-2013 Maternal Indicator Sydney City LGA NSW

Smoking in pregnancy

Smoothed estimate of prevalence ratio

95% confidence interval for smoothed ratio

52.9 (47.8 – 58.1) (--) 100

First antenatal visit before 14 weeks of

gestation

No. of mothers per year 95% confidence interval for smoothed ratio 1388 (88.3 – 91.3) (--) 100

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

4 A confidence interval is a range around a measurement that conveys how precise the measurement is.

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2.3 Aboriginal And Torres Strait Islander People

The Sydney City (South and West) was originally home to the Cadigal and Wangal people of the Eora Nation. Aboriginal and Torres Strait Islander people made up a total of 2.0% of the total population of the Sydney City South SLA and 1.4% of the Sydney City West SLA, which was the highest proportion of any LGA/SLA across the catchment IWS catchment. The population of Aboriginal and Torres Strait Islander persons in the Sydney (South) SLA was generally older than the total Indigenous population in the IWS catchment overall.

2.4 People with Culturally and Linguistically Diverse Backgrounds

Based on the 2011 ABS Census, approximately 57% of Sydney City LGA residents spoke English as a primary language, while notable proportions of residents identified their primary language as being Mandarin (15%, 5,212), followed by Cantonese (9%, 3,321) and Greek (5%, 1,639). 4.9% of residents from the Sydney City LGA indicated that they spoke another language and did not speak English well or did not speak English at all.

Figure 4: Language spoken (excludes English) at home: Sydney City 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 Sydney City LGA came from 44 different countries, with the largest number being from Iran and Turkey.

Table 5: Humanitarian migration stream, settlers arriving 2009–2014: Sydney City LGA and NSW

Population characteristics Sydney City LGA NSW Humanitarian Stream-number of settlers arriving from 2009 -14 249 27,450

Top 3 countries of birth for humanitarian migration stream, number of settlers arriving 2009 – 2014 Iran 78 Iraq 10157

Turkey 24 Iran 2913 China 20 Afghanistan 2502

Source: Department of Immigration and Citizenship Settlement Database. Accessed Feb. 2015

0%

2%

4%

6%

8%

10%

12%

14%

16%CITY OF SYDNEY(SOUTH ANDWEST)IWS

NSW

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2.6 Education Levels

Within the Sydney City - South and West SLA’s, approximately 73% of people aged over 15 years completed Year 12 schooling (or equivalent). Of particular note, lower rates of completion were reported for Redfern (63.9%), Waterloo (69.9%) and Rosebery (62.2%). Each of these suburbs falls well-below the average completion rate within the Sydney City SLA.

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. The average across Australia is 1,000. A number below 1,000 indicates lower socioeconomic status. Table 6 shows the index score for socio-economic disadvantage in Sydney - South was 1,017 and Sydney – West was 1,022, the only Statistical Local Areas in SLHD with an overall score under 1,000 in 2011 were Canterbury LGA and Burwood LGA.

Table 6: IRSD by SLA, and rank within IWS, 2011

Statistical Local Area Index score (based on average of 1000)

Minimum score for SA1s in

area

Maximum score for SA1s

in area

Rank (SLAs

within IWS) Ashfield (A) 1015 856 1112 8 Burwood (A) 996 870 1073 9 Canada Bay (A) - Concord 1066 948 1140 3 Canada Bay (A) - Drummoyne 1068 819 1138 2 Canterbury (C) 922 413 1081 10 Leichhardt (A) 1079 733 1150 1 Marrickville (A) 1022 498 1135 6 Strathfield (A) 1022 749 1134 5 Sydney (C) - South 1017 435 1138 7 Sydney (C) - West 1022 615 1138 4 Sydney 1006 413 1150 Source: Australian Bureau of Statistics (2011)

Table 7, Figure 5 and Figure 6 show the marked variance of the index score for socio-economic disadvantage across the suburbs that make up Sydney City (South and West SLA’s). The suburb of Waterloo had the lowest index score for socio-economic disadvantage (889) in Sydney City (South and West SLA’s), indicating a greater level of disadvantage in the suburb when compared to Alexandria (1098). Ultimo (974) and Glebe (986) had the lowest index score for socio-economic disadvantage in the City West SLA.

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Table 7: IRSD by Suburbs within Sydney City (South and West), and rank within IWS, 2011

State Suburbs within Sydney City-South

Score Rank within IWS* Rank within Australia Most disadvantaged to Least disadvantaged

Waterloo 889 5 779 Eveleigh 932 9 1503 Redfern 973 17 2671 Chippendale 1020 30 4669 Rosebery 1023 33 4804 Darlington 1034 35 5304 Newtown 1067 58 6824 Beaconsfield 1087 65 7496 Zetland 1089 66 7551 Erskineville 1090 68 7572 Alexandria 1098 71 7757

State Suburbs within Sydney

City-West Score Rank within IWS* Rank within Australia

Most disadvantaged to Least disadvantaged Ultimo 974 18 2710 Glebe 986 20 3156 Chippendale 1020 30 4669 Darlington 1034 35 5304 Pyrmont 1055 50 6308 Forest Lodge 1061 54 6541 Camperdown 1086 63 7457

Source: 2033.0.55.001-SEIFA, 2011. *77 suburbs within the IWS catchment were allocated an IRSD

Figure 5: Comparison of SEIFA Disadvantage percentiles within Sydney City SLA (South), 2011

Source: 2033.0.55.001-SEIFA, 2011.

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Figure 6: Comparison of SEIFA Disadvantage percentiles within Sydney City SLA (West), 2011

Source: 2033.0.55.001-SEIFA, 2011.

Unemployment in the Sydney City (West) SLA (4.5%) and the Sydney City (South) SLA (6.1%) differ from the IWS catchment average of 5.5%. In the 2011 Census, median weekly household incomes across the Sydney City LGA were approximately $1,639, well above the NSW average of $1,237.

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 dwellings5 • 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 sleeping6.

The ABS census data for 2011 combined Sydney Inner City in its estimates for ‘Statistical Area Level 3 homelessness estimates’, therefore the entire population within this statistical area does not fall within the IWS catchment and the results are illustrated in Table 8.

5 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. 6 Homelessness in SLHD. Public Health Observatory. Population Health. SLHD. 2014

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Table 8: Estimates of homelessness: Sydney Inner City (SA3), 2011 Type of homelessness Number of people Persons in supported accommodation for the homeless 677 Persons staying in boarding houses 1,486 Persons in other temporary lodging 31 Persons living in ‘severely’ crowded dwellings* 458 Persons living in other crowded dwellings 1,263 All homeless persons 3,307


Figure 7: Type of Homelessness: Sydney Inner City (SA3) and NSW, 2011


The statistical area of Sydney Inner City (SA3), had the highest number of homeless people (3,307) when compared to the IWS catchment overall (Table 8). The percentage of the total homeless population that reside in a boarding house (45%) in the Sydney Inner City (SA3) was notably higher than the state (21%). The Sydney City (South and West) also had the highest number of boarding houses (106) in the IWS catchment7.

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

20%

45%

14% 17%

21%

33%

0%

10%

20%

30%

40%

50%

Persons in supportedaccommodation for the

homeless

Persons staying in boardinghouses

Persons living in 'severely'crowded dwellings

Sydney InnerCity

NSW

% o

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ess

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http://parkspr.fairtrading.nsw.gov.au/BoardingHouse.aspx.%20Accessed%2029.01.2015


3 HEALTH RISKS OF THE POPULATION 3.1 Health Risk Factors

Figure 8 and Table 9 show that modelled estimates of the prevalence of smoking in Sydney City (South and West) were lower compared to NSW, but similar to IWS. The estimated prevalence of obesity in Sydney City (South and West) was lower compared to both IWS and NSW. In contrast, the estimated prevalence of risky alcohol consumption, psychological distress and overweight in Sydney City (South and West) were similar to IWS and NSW levels.

Figure 8: Modelled estimates of health risk factors: Sydney City (South and West), IWS and NSW, 2011-13

Source: Public Health Information Development Unit - 2011-2013 National Health Survey Refer to Appendix B 1.3 for definitions of Health Risk Factors described above * Estimates reported for the IWS part of Sydney LGA

Table 9: Modelled estimates of health risk factors: Sydney City (South and West), IWS and NSW, 2011-13

Risk indicator Sydney City* IWS NSW Current Smokers 11.8 [10.0-13.5] 12.9 [12.4-13.4] 16.2 [16.1-16.4] Risk Alcohol Consumption 4.8 [2.9-6.6] 4.6 [4.2-5.0] 4.8 [4.7-4.9] Psychologically Distressed 8.1 [5.9-10.3] 10.2 [9.5-10.8] 10.5 [10.3-10.7] Overweight 33.5 [28.9-38.1] 33.4 [32.3-34.5] 34.6 [34.3-34.9] Obese 14.8 [12.3-17.4] 20.1 [19.4-20.8] 26.4 [26.2-26.6] Source: Public Health Information Development Unit - 2011-2013 National Health Survey Refer to Appendix B 1.3 for definitions of Health Risk Factors described above * Estimates reported for the IWS part of Sydney LGA

Overall, Sydney City LGA residents had significantly fewer health behaviour related hospital separations per capita compared to the state. However, the rates of alcohol and fall-related injury related hospitalisations were higher in Sydney City LGA compared to NSW (Table 10).

Page 14 of 41


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

number separations /

year

Smoothed rate/

100,000

sSSR8 [95% CI]

Smoking attributable 2012-14 794.9 620.5 99.1 [94-104.2]

Not significantly different to the state

High body mass index attributable

2012-14 551.2 429.4 82.1 [77-86.8] Significantly lower than the state

High blood pressure attributable

2012-14 819 1,176.6 89.3 [85-93.6] Significantly lower than the state

Alcohol attributable 2012-14 1,616.5 847.6 118.5 [114.5-122.6]

Significantly higher than the

Fall-related injury 2012-14 1,133 910.5 108.8 [104.6-113.1]

Significantly higher than the

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 behaviours of residents, IWS and NSW (% [95% CI]), 2013 Indicator IWS NSW

Consumes more than 2 standard drinks per day when drinking alcohol, persons aged 16 years and over

29.3 [25.6-33.1]

26.6 [25.5-27.8]

Adequate physical activity, persons aged 16 years and over 58.1 [54.0-62.1]

51.5 [50.2-52.7]

Recommended vegetable consumption, persons aged 16+ years 9.9 [7.2-12.5] 9.4 [8.7-10.1] Recommended fruit consumption, persons aged 16+ years 52.1 [48.0-

56.2] 51.8 [50.6-53.1]

Vaccinated against influenza in the last 12 months, persons aged 65 +

64.5 [55.7-73.4]

71.0 [68.9-73.0]

Vaccinated against pneumococcal disease, persons aged 65 years+

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 interval9

8 The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100. 9 A confidence interval is a range around a measurement that conveys how precise the measurement is.

Page 15 of 41


4 LONG TERM CONDITIONS AND CHRONIC DISEASE 4.1 Prevalence of Chronic Disease Figure 9 and Table 12 displays the estimated prevalence of a number of chronic diseases in Sydney City (South and West), the IWS catchment and NSW. The most prevalent chronic conditions across Sydney City (South and West), IWS and NSW are respiratory system and musculoskeletal diseases. The estimated age-standardised prevalence of type 2 diabetes, mental and behavioural disorders and circulatory system diseases were similar in Sydney City (South and West) compared to both IWS and NSW. Likewise, the estimated prevalence of respiratory and musculoskeletal diseases in Sydney City (South and West) were not significantly different to IWS and NSW.

Figure 9: Modelled estimates of prevalence of chronic conditions, Sydney City (South and West) , 2011-13

Source: Public Health Information Development Unit - 2011-2013 National Health Survey* Estimates are for the IWS part of Sydney LGA

Table 12: Modelled estimates of prevalence of selected chronic conditions, Age standardised % [95% CI]

Indicator Sydney City (South and West)

Inner West Sydney New South Wales

Type 2 Diabetes 5.8 [3.5-8.1] 7.4 [6.7-8.1] 5.8 [5.6-5.9] Mental and Behavioural Disorders

13.1 [10.7-15.5] 12.4 [11.8-12.9] 13.1 [13.0-13.3]

Circulatory System Diseases 18.1 [14.8-21.4] 17.8 [17.1-18.5] 17.8 [17.6-17.9] Respiratory System Diseases 26.0 [21.3-30.7] 24.4 [23.3-25.5] 27.4 [27.1-27.7] Musculoskeletal Diseases 27.2 [21.5-32.9] 26.1 [24.8-27.3] 28.1 [27.8-28.5] Source: PHIDU - 2011-2013 National Health Survey (NHS)* Estimates reported for the IWS part of Sydney LGA

In terms of chronic disease burden, Table 13 shows that the estimated prevalence of fair or poor self-assessed health in Sydney City (South and West) residents was lower relative to IWS and NSW. On the other hand, the estimate prevalence of asthma, chronic obstructive pulmonary disease, hypertension (18+ years) and arthritis in Sydney City (South and West) were similar to IWS and NSW.

Page 16 of 41


Table 13: Modelled estimates of chronic disease, Sydney City (South and West) (ASR per 100 [95% CI]), 2011-13

Indicator Sydney City * IWS NSW Fair or poor self-assessed health, > 15 years

9.7 [7.8-11.5] 14.3 [13.7-14.9] 14.3 [14.2-14.5]

Asthma 8.0 [6.3-9.8] 7.2 [6.8-7.6] 9.6 [9.5-9.7] Chronic Obstructive Pulmonary Disease

2.2 [1.3-3.2] 2.3 [2.0-2.5] 2.6 [2.6-2.7]

Hypertension, > 18 years 11.0 [8.1-14.0] 10.7 [10.1-11.4] 10.5 [10.4-10.7] Arthritis 12.9 [10.7-15.2] 13.9 [13.3-14.4] 15.3 [15.1-15.4] Source: PHIDU - 2011-13 NHS. ASR: Age standardised rate; CI: Confidence interval10. * Estimates are for the IWS part of Sydney LGA

Overall, Sydney City LGA residents had significantly fewer hospital separations per capita compared to the state. (Table 14).

Table 14: Indicators of burden of disease - hospital separations by cause, Sydney City LGA, 2009- 2013

Indicator Year Smoothed number

separations/ year

Smoothed rate/

100,000

sSSR11[95% CI]

Potentially preventable 2012-14 3,099 2,223 91.3 [89.1-93.6]

Significantly lower than the state

Chronic obstructive pulmonary disease

2012-14 195 1,299.7 86.9 [78.7-95.8]


Coronary heart disease 2012-14 585 477.5 71.6 [67.8-75.7]


Circulatory disease 2012-14 2,498 1,804 97.2 [84.7-89.5]


Stroke 2012-14 209 184 106.5 [97.2-116.6]

Not significantly different to the

state Asthma 2012-14 142 109.3 62.8 [55.9-

70.1] Significantly lower

than the state Influenza and

pneumonia 2012-14 329 265.2 79.7 [74-86] 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 interval12

The rates of high body mass index, alcohol- and smoking-attributable deaths in Sydney City LGA were not significantly different to state levels (Table 15).

Table 15: High BMI, alcohol and smoking attributable deaths, Sydney City LGA, 2011 Indicator Year Smoothed number

of deaths/ year Smoothed

rate/ 100,000 sSMR9[95% CI]

High body mass index

2011 38 36.7 94.3 [79.3-111.0]


Alcohol 2011-12

25.9 17.1 99 [82.3-118.9]


Smoking 2011 77 101.3 73.5 [85.4-120.4]


Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSMR: Smoothed estimate of standardised mortality ratio; CI: Confidence interval10

11 The smoothed estimate of standardised separation 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 17 of 41


4.2 Cancer Information on the incidence and age-standardised rates of cancer over the period 2004 to 2008 is presented in Figure 10 and Table 16.

Figure 10: Age-standardised incidence of selected cancers/100,000 persons, Sydney City, IWS and NSW, 2004 to 2008

Source: NSW Central Cancer Registry, Cancer Institute NSW

Prostate, breast, lung and colon cancer were the most common cancers in Sydney City (South and West SLA’s) over this period. When compared to the state, the overall age-standardised rate of cancer was not significantly different in Sydney City (South and West SLA’s) residents. However, there were significantly higher rates of head and neck, liver, myelodysplasia and lung cancers in Sydney City (South and West SLA’s) relative to NSW. In contrast, the rates of melanoma and prostate cancers were significantly lower in Sydney City (South and West SLA’s) compared to state levels.

.

Page 18 of 41


Table 16: Age standardised cancer incidence rates (per 100,000) by cancer site, 2004-2008 Cancer Site Sydney City IWS NSW

Count Rate Count Rate Count Rate All types 1617 479.9 [456.1-

504.6] 11397 449.1 [440.8-

457.4] 177519 483.2 [481.0-

485.5] Bladder 26 8.5 [5.6-12.5] 243 9.7 [8.5-11.0] 3631 9.7 [9.3-10.0] Brain 20 4.9 [2.8-7.7] 166 6.3 [5.4-7.3] 2356 6.6 [6.3-6.8] Breast 207 57.0 [49.2-65.6] 1447 56.2 [53.3-59.1] 21102 58.2 [57.5-59.0] Cervix 13 2.6 [1.3-4.6] 92 3.3 [2.7-4.1] 1228 3.5 [3.3-3.7] Colon 120 39.0 [32.2-46.8] 988 39.5 [37.1-42.0] 15072 40.6 [39.9-41.2] Head and neck 83 24.7 [19.6-30.8] 370 14.6 [13.1-16.1] 4686 12.8 [12.5-13.2] Kidney 44 12.9 [9.2-17.4] 321 12.8 [11.4-14.3] 4857 13.2 [12.9-13.6] Leukaemia 47 14.8 [10.7-19.9] 314 12.5 [11.1-13.9] 4605 12.6 [12.3-13.0] Lip 5 1.6 [0.5-3.7] 44 1.8 [1.3-2.4] 1203 3.3 [3.1-3.5] Liver 32 9.9 [6.7-14.1] 224 8.9 [7.8-10.1] 2088 5.7 [5.4-5.9] Lung 170 54.7 [46.7-63.7] 1157 46.5 [43.9-49.3] 15905 43.0 [42.3-43.7] Melanoma of skin 118 31.3 [25.6-37.8] 726 27.8 [25.8-29.9] 17716 48.8 [48.1-49.5] Mesothelioma 6 1.8 [0.6-4.0] 56 2.2 [1.7-2.9] 1047 2.8 [2.6-3.0] Myelodysplasia 35 11.5 [8.0-16.0] 195 7.8 [6.7-8.9] 2817 7.5 [7.2-7.8] Non-Hodgkin’s lymphoma

65 18.6 [14.1-23.9] 485 18.9 [17.2-20.7] 6828 18.6 [18.2-19.1]

Oesophagus 21 6.3 [3.9-9.6] 108 4.3 [3.5-5.1] 2024 5.4 [5.2-5.7] Ovary 27 7.6 [4.9-11.2] 195 7.6 [6.6-8.8] 2191 6.0 [5.8-6.3] Pancreas 32 10.5 [7.1-14.9] 275 11.0 [9.7-12.3] 4062 10.9 [10.5-11.2] Prostate 223 69.3 [60.4-79.2] 1647 66.3 [63.1-69.6] 31321 84.4 [83.4-85.3] Rectal 79 23.9 [18.8-29.9] 501 19.9 [18.2-21.8] 8338 22.6 [22.1-23.1] Stomach 31 10.6 [7.1-15.0] 285 11.4 [10.1-12.8] 3275 8.8 [8.5-9.1] Testis 16 2.8 [1.5-4.8] 80 2.6 [2.1-3.2] 1084 3.2 [3.0-3.4] Thyroid 34 8.1 [5.4-11.4] 316 11.7 [10.4-13.1] 3301 9.4 [9.1-9.8] Unspecified site 45 15.6 [11.4-21.0] 364 14.4 [13.0-16.0] 6014 16.0 [15.6-16.4] Uterus(body) 24 7.0 [4.4-10.4] 190 7.5 [6.5-8.6] 3043 8.3 [8.0-8.6] All Others 94 24.5 [19.4-30.4] 608 23.7 [21.8-25.7] 7725 21.3 [20.8-21.7] Source: NSW Central Cancer Registry, Cancer Institute NSW. **Cell counts less than 5 are left blank * Estimates reported for the IWS part of Sydney LGA

Cancer-related mortality for Sydney City (South and West SLA’s), IWS and NSW is presented in Table 17. Between 2004 and 2008, cancer was the primary cause of death for 565 persons in Sydney City (South and West SLA’s), with lung, colon, prostate and liver cancers the leading types. The overall age-standardised rate of cancer-related deaths in Sydney City (South and West SLA’s) (183.5 per 100,000) was not significantly different than the state (176.9 per 100,000). However, a significantly higher rate of mortality was observed for head and neck, liver and lung cancers, while a trend for significantly decreased mortality from bladder cancer was observed in Sydney City (South and West) compared to NSW.

Page 19 of 41


Table 17: Age standardised mortality rates (per 100,000) by cancer site, 2004-2008 Cancer Site Sydney IWS NSW Count Rate Count Rate Count Rate All types 565 183.5 [168.4-199.5] 4547 181.0 [175.7-186.3] 66228 176.9 [175.5-

178.2] Bladder 6 1.9 [0.7-4.3] 106 4.2 [3.4-5.1] 1644 4.3 [4.1-4.5] Brain 14 4.0 [2.1-6.8] 126 4.9 [4.1-5.8] 1716 4.7 [4.5-5.0] Breast 29 9.1 [6.0-13.2] 296 11.7 [10.4-13.1] 4693 12.6 [12.3-13.0] Cervix ** ** 28 1.1 [0.7-1.5] 415 1.1 [1.0-1.2] Colon 47 15.2 [11.1-20.3] 365 14.5 [13.0-16.0] 5511 14.6 [14.3-15.0] Head and neck 28 8.8 [5.8-12.7] 154 6.1 [5.2-7.2] 1762 4.7 [4.5-5.0] Kidney 6 2.2 [0.8-4.9] 87 3.4 [2.8-4.3] 1605 4.3 [4.1-4.5] Leukaemia 16 5.4 [3.0-8.8] 148 5.9 [5.0-6.9] 2248 6.0 [5.8-6.3] Liver 29 8.8 [5.9-12.7] 162 6.5 [5.5-7.6] 1527 4.1 [3.9-4.3] Lung 135 43.7 [36.6-51.8] 937 37.7 [35.3-40.2] 12781 34.4 [33.8-35.0] Non-Hodgkin’s lymphoma

23 7.5 [4.7-11.3] 176 6.9 [5.9-8.0] 2569 6.8 [6.6-7.1]

Skin melanoma

19 5.7 [3.4-9.0] 125 5.0 [4.1-5.9] 2314 6.2 [6.0-6.5]

Mesothelioma 7 2.3 [0.9-4.9] 56 2.3 [1.7-3.0] 947 2.5 [2.4-2.7] Myelodysplasia 9 3.2 [1.4-6.1] 74 2.9 [2.3-3.7] 1036 2.7 [2.5-2.9] Oesophagus 20 5.8 [3.5-9.0] 92 3.6 [2.9-4.4] 1590 4.2 [4.0-4.4] Ovary 10 3.2 [1.5-5.9] 104 4.2 [3.4-5.1] 1394 3.7 [3.5-3.9] Pancreas 25 8.7 [5.6-12.9] 240 9.6 [8.4-10.9] 3611 9.6 [9.3-9.9] Prostate 30 11.0 [7.4-15.8] 287 11.4 [10.1-12.8] 4904 12.8 [12.4-13.1] Rectal 25 7.8 [5.0-11.5] 194 7.7 [6.7-8.9] 3018 8.1 [7.8-8.4] Stomach 20 6.7 [4.0-10.4] 182 7.3 [6.2-8.4] 2232 6.0 [5.7-6.2] Thyroid ** ** 12 0.5 [0.3-0.9] 168 0.4 [0.4-0.5] Unspecified 29 10.5 [7.0-15.1] 287 11.4 [10.1-12.8] 4473 11.8 [11.5-12.2] Uterus(body) ** ** 43 1.7 [1.2-2.3] 614 1.6 [1.5-1.8] All Others 31 9.8 [6.6-14.0] 263 10.5 [9.2-11.8] 3375 9.1 [8.8-9.4] Source: NSW Central Cancer Registry, Cancer Institute NSW.** Cell counts less than 5 are left blank * Estimates reported for the IWS part of Sydney LGA

4.3 Mortality In 2007, life expectancy at birth for males and females in Sydney City LGA was 80.1 and 85.0 years, respectively, which were very similar to the state (80 and 85 years for males and females, respectively). Consistently, the standardised mortality from all causes in Sydney City LGA was similar compared to the state (smoothed standardised mortality ratio (sSMR) 97.8; Table 18). However, mortality from amenable and preventable causes in Sydney City LGA was significantly higher than state levels (Table 18).

Table 18: Deaths from all causes and potentially preventable deaths, Sydney City LGA, 2010-11 Indicator Deaths per year sSMR13 [95% CI] Deaths from all causes 685 97.8 [92.6-102.8] Amenable to health care 79 103.6 [89.9-117.7] Preventable causes 161 116.3 [104.0-128.6] Amenable and preventable causes 245 113.8 [104.5-124.1] Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSMR: Smoothed standardised mortality ratio; CI: Confidence interval14

13 The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100. 14 A confidence interval is a range around a measurement that conveys how precise the measurement is.

Page 20 of 41


5 INFECTIOUS DISEASE 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 11). Sydney City (South and West SLA’s) and Marrickville LGA had the highest notification rates, at 45 and 19 cases per 100,000 population, respectively (Figure 12 and Table 19). Figure 11: Number and rate of notifications of newly diagnosed HIV infection in IWS, 2005-2014

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

Figure 12: 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

0

20

40

60

80

100

120

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

Tota

l not

ifica

tions

Rate

/100

,000

pop

ulat

ion

0

10

20

30

40

50

60

70

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney*

Ra

te/1

00,0

00 p

erso

ns

Page 21 of 41


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 13). 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 13: 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 (South and West SLA’s) and Marrickville LGA 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

0

50

100

150

200

250

300

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

Rate

/100

,000

pop

ulat

ion

Tota

l Not

ifica

tions

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

Page 22 of 41


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 14). 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 15 and Table 21).

Figure 14: Gonorrhoea notifications (per 100,000 population), by IWS and NSW, 2010 to 2014

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

Figure 15: 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 City*

196.7 225.8 160.0 136.2 164.5 243.3 274.2 374.7 471.9 460.7


02468101214161820

0

20

40

60

80

100

120

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 NSW notification rate/100,000 population

Tota

l not

ifica

tions

Rate

/100

,000

pop

ulat

ion

050

100150200250300350400450500

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydneyRa

te/1

00,0

00 p

opul

atio

n

Page 23 of 41


5.4 Infectious Syphilis Figure 16 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 and Sydney City (South and West SLA’s) continue to have the highest notification rates (Figure 17 and Table 22).

Figure 16: Infectious syphilis notification rate (per 100,000 population), by IWS and NSW, 2010-2014


Figure 17: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 B

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 City*

30.8 44.5 79.5 68.6 83.7 74.3 54.3 65.1 116.4 150.9


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Page 24 of 41


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 18).

Figure 18: 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 LGAs (Figure 19 and Table 23).

Figure 19: 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 City*

84.0 56.6 62.3 51.5 48.5 50.6 48.8 54.3 47.3 45.6


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Page 25 of 41


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 20). 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, Leichhardt and Marrickville (Figure 21).

Figure 20: Hepatitis C notification rate (per 100,000 population), by IWS and NSW, 2005-2014


Figure 21: 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 City*

120.1 128.0 108.2 85.7 102.8 117.9 87.4 72.6 85.9 117.9


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Page 26 of 41


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 22. The rate of 45 year old health checks in Sydney City (South and West SLA’s) was lower than both IWS and NSW. The rates of general practitioner (GP) health assessments (75 years or more), GP enhanced primary care, and GP practice nurse services in Sydney was similar to IWS, but lower compared to the state levels. In contrast, the rate of GP mental health care plans was slightly higher in Sydney City (South and West SLA’s) compared to IWS and NSW rates.

Table 25: Primary care services, age standardised rate per 100,000, Sydney City (South and West SLA’s),

IWS and NSW, 2010 Indicator Sydney IWS Catchment New South Wales 45 year old health checks^ 3637.9 4796.6 4627.8 GP health assessment (75+) 17244.2 17377.5 20867.4 GP enhanced primary care 1968.1 2147.8 2618.4 GP practice nurse services 16782.0 16320.0 29844.9 GP Mental Health care plans 8519.5 7625.4 8222.3 Source: Public Health Information Development Unit and Department of Health and Ageing (2014). ^For persons aged between 45-49 years. * Estimates reported for the IWS part of Sydney LGA

Figure 22: Primary care services (age standardised ratio), Sydney City (South and West), 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* Estimates reported for the IWS part of Sydney LGA

Page 27 of 41


6.2 Emergency Department Presentations The distribution of emergency department presentations by Sydney City (South and West) residents across hospitals in the IWS catchment and all other NSW hospitals is presented in Table 26. RPA Hospital provided the largest percentage of emergency department presentations by Sydney City (South and West SLA’s) residents (60.6%), constituting 8.7% of all emergency department visits at RPA Hospital.

Table 26: Emergency department presentations (%) by hospital, Sydney City (South and West), 2013

Indicator Canterbury hospital

Concord hospital

RPA hospital

Other NSW hospitals

Total

LGA Presentations

43 (0.4) 71 (0.7) 6,192 (60.6)

3,915 (38.3) 10,221 (100)

All Presentations

38,397 (1.5) 36,662 (1.4) 71,576 (2.8)

2,410,994 (94.3) 2,557,629 (100)

Sydney % of total

0.1 0.2 8.7 0.2 0.4

Source: NSW Admitted Patient Data Collection, Centre for Epidemiology and Evidence, NSW Ministry of Health * Estimates reported for the IWS part of Sydney LGA

The rates of emergency department presentations (per 1,000 persons) by triage category are displayed in Table 27. The age-standardised rates of emergency department presentations for all triage categories were lower in Sydney City (South and West) compared to IWS (Table 27).

Table 27: Emergency department presentations (per 1,000) by triage category, by LGA, IWS and NSW, 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 * Estimates reported for the IWS part of Sydney LGA

Page 28 of 41


6.2 Hospital Separations

6.2.1 Day-only Hospital Separations Sydney City LGA resident separations from hospital on a day-only15 basis are shown in Table 28. In 2013-14, 30% (5,828 separations) of all day-only separations were provided by SLHD hospital, followed by private hospitals at 24% (4,611 separations) and private day procedure centres at 18% (3,529 separations).

Table 28: Day-only hospital separations for Sydney City LGA residents, 2013-14

Hospital/LHD No. of Hospital Separations Percent of Total Separations SLHD Hospitals 5,828 30% Private Hospitals 4,611 24% Private Day Procedure Centres 3,529 18% St. Vincent's Network 2,696 14% South Eastern Sydney 1,912 10% Other LHD Hospitals 673 3% Total 19,249 100% Source Flow-Info v 5.0

As shown in Figure 23, 30% (5,828 separations) of Sydney City LGA resident day-only separations occurred in SLHD hospitals. RPA Hospital provided for 95% of the total separations within SLHD (5,563 separations).

Figure 23: Day-only hospital separations for Sydney City LGA residents, 2013-14

Source Flow-Info v 5.0

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

Private Hospitals 24% (n=4611)

Private Day Procedure Centres

18% (n=3529)

St. Vincent's Network

14% (n=2696)

South Eastern Sydney

10% (n=1912) Other LHDs 4% (n=673)

Royal Prince Alfred 95% (n=5563)

Other SLHD Hospitals

5% (n=265)

Sydney LHD 30% (n=5828)

Page 29 of 41


6.2.2 Overnight Hospital Separations The breakdown of Sydney City LGA resident overnight16 hospitalisations is shown in Table 29. In 2013-14, the majority (47%; 6,716) of all overnight separations were provided by SLHD hospitals, followed by private hospitals at 20% (2,777 separations).

Table 29: Overnight hospital separations for Sydney City LGA residents, 2013-14 Hospital/LHD No. of Hospital Separations Percent of Total Separations SLHD Hospitals 6,716 47% Private Hospitals 2,777 20% South Eastern Sydney 1,998 14% St. Vincent's Network 1,822 13% Other LHD Hospitals 914 6% Total 14,227 100% Source Flow-Info v 5.0

As shown in Figure 24, SLHD hospitals provided for 47% (6,716 separations) of all Sydney City LGA resident overnight separations. RPA Hospital provided 5,843 or 87% of the total overnight separations within SLHD.

Figure 24: Overnight hospital separations for Sydney City LGA residents, 2013-14

Source Flow-Info v 5.0

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

Private Hospitals

20% (n=2777)

St. Vincent's Network

13% (n=1822)

South Eastern Sydney

14% (n=1998)

Other LHDs 6% (n=914)

Royal Prince Alfred 87% (n=5843)

Concord 5% (n=330)

Other SLHD Hospitals

8% (n=543)

Sydney LHD 47% (n=6716)

Page 30 of 41


6.3 Ambulatory Care 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 25. 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 health care 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 2222.1 per 100,000 persons in Sydney City LGA and was significantly lower than the state level. However, the rate of ACSC separations in Sydney City LGA, in 2011-13 was the second highest among the constituent LGAs of the IWS catchment.

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 City 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 25: 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

Page 31 of 41


6.4 Home and Community Care Figure 26 and Table 31 shows the profile of Home and Community Care (HACC) clients in Sydney City (South and West SLA’s) compared to the IWS catchment and NSW. During this reporting period, there were 115 Indigenous HACC clients in Sydney. The proportion of HACC clients living alone in Sydney City (South and West SLA’s) (52%) was higher compared to both the IWS catchment (39%) and NSW (39%). In contrast, the proportion living with a carer in Sydney City (South and West SLA’s) (12%) was lower compared to IWS (23%) and NSW (21%). The proportion of clients that were non-English speaking in Sydney City (South and West SLA’s) (38%) was markedly higher than NSW (11%), but similar to IWS (39%).

Figure 26: HACC Client Profile, by Sydney City (South and West SLA’s), IWS and NSW) 2012-13

Source: Public Health Information Development Unit (2014) * Estimates reported for the IWS part of Sydney LGA

Table 31: HACC Client Profile, % of HACC clients (actual number), 2012-13 Indicator Sydney Inner West Sydney New South Wales

Living alone 51.5 (1617) 39.1 (6499) 39.0 (106308) Living with carer 12.2 (383) 23.0 (3825) 20.7 (56385) Indigenous 3.7 (115) 1.4 (230) 3.8 (10268) Non-english speaking 38.0 (1194) 39.0 (6484) 11.2 (30469)


Page 32 of 41


Figure 27 and Table 32 provides a graphical comparison of selected HACC services in Sydney City (South and West SLA’s), the IWS catchment and NSW. The rates of centre-based day care, care coordination and transport services were higher in Sydney City (South and West SLA’s) compared to IWS and NSW. The instances of domestic assistance services per 1,000 were higher in Sydney City (South and West SLA’s) compared to IWS, but similar to NSW. The rates of allied health care, care counselling and case management were largely similar across Sydney City (South and West SLA’s), the IWS catchment and NSW.

Figure 27: HACC Service Profile, by Sydney City (South and West SLA’s), IWS and NSW, 2012-13


Table 32: HACC Service Profile, Instances of care per 1,000 (actual number),2012-13 Indicator Sydney City (South and

West) Inner West Sydney New South Wales

Allied health care 2.6 (104) 3.5 (1822) 2.3 (17549) Care counselling 2.2 (104) 2.8 (1476) 3.5 (26863) Case management 3.6 (158) 3.0 (1580) 2.0 (15261) Centre-based daycare

13.3 (560) 4.7 (2446) 2.8 (21907)

Care coordination 9.0 (414) 4.1 (2096) 4.0 (30940) Domestic assistance 7.6 (286) 5.8 (2979) 7.1 (54720) Transport 16.1 (724) 8.0 (4120) 9.4 (72274) Source: Public Health Information Development Unit (2014) * Estimates reported for the IWS part of Sydney LGA

Page 33 of 41


7 HEALTH SERVICE PROVISION 7.1 Hospitals and Day Surgery Sydney City (South and West SLA’s) 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 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 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, with strong affiliations to the University of Sydney, 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 CRGH 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 CRGH. Concord Hospital 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 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 Sydney City (South and West SLA’s) catchment area includes a public hospital, community oral health clinics and private day surgery and hospital facilities, that are currently registered on the NSW Health Establishment Registration Online Database (HERO) are outlined in Table 33.

Page 34 of 41


Table 33: Health care facilities in Sydney City (South and West SLA’s), HERO Database, 2015 Health Care Facility Service Type Location

Royal Prince Alfred Hospital Public Hospitals Camperdown Community Oral Health Clinic – Sydney Dental Hospital Oral Health Services Surry Hills RPA Oral Health Clinic Oral Health Services Camperdown Drummoyne Eye Surgery Centre Day Surgery Drummoyne Westside Private Hospital Private Hospitals Concord Roseberry Day Surgery Private Hospitals Roseberry

Source: NSW Health Establishment Registration Online (HERO) database (2015)

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 Sydney City (South and West), that are currently registered on the NSW Health Establishment Registration Online Database (HERO) include early childhood services (Table 34).

Page 35 of 41


Table 34: Community health facilities in Sydney City (South and West), HERO Database, 2015 Community Health Facility Service Type Location

Redfern Early Childhood Health Centre Child Health Services Redfern Redfern Community Health Centre Community Health Service Redfern Redfern Community Mental Health Centre Mental Health Services Redfern Redfern Psychiatric Rehabilitation Association Mental Health Services Redfern Muralappi, The Settlement Neighbourhood Centre

Youth Health Service Strawberry Hills

Australian Red Cross Society Blood & Tissue Collection Sydney Glebe Early Childhood Health Centre Child Health Services Glebe Ultimo Early Childhood Health Centre Child Health Services Ultimo Broadway Child, Adolescent & Family Health Centre

Community Health Services

Broadway

Cellblock Youth Health Service Mental Health Services Chippendale Glebe Community Clinic Mental Health Services Glebe Glebe Community Mental Health Centre Mental Health Services Glebe Glebe/Redfern/Newtown Community Health Centre

Mental Health Services Glebe

Professor Marie Bashir Mental Health Service Mental Health Services Camperdown RPA Cognitive Behaviour Clinic Mental Health Services Camperdown RPA Consultation Liaison Ambulant Clinic Mental Health Services Camperdown RPA Consultation Liaison Inpatient Service Mental Health Services Camperdown

Source: NSW Health Establishment Registration Online (HERO) database (2012)

7.3 General Practice Figure 28 shows that the number of GPs per 100,000 persons in Sydney City (South and West SLA’s) was similar to the IWS catchment average, although the number of GPs providing services in an aged care setting and under the Access to Allied Psychological Services (ATAPS) scheme was higher than the IWS catchment overall.

Figure 28: General Practitioners and General Practice Services, by LGA and IWS, 2015

Source: PHN (2015).

Page 36 of 41


7.4 Allied Health The availability of most types of allied health practitioners in Sydney City (South and West SLA’s) was below the rate across the entire IWS catchment. Compared to the broader area, the most notable examples of practitioners that were less readily available in Sydney City (South and West) included Chiropractors, Dentists, Exercise Physiologists Optometrists, Occupation Therapists, Physiotherapists, Speech Pathologists and Podiatrists.

Figure 29: Allied Health Practitioners, Sydney City (South and West SLA’s) and IWS, 2014

Source: PHN (2014). Rates reported are crude (not age standardised).

Page 37 of 41


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 IWS 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 provided 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 Sydney City (South and West SLA’s), that are currently registered on the NSW Health Establishment Registration Online Database (HERO) are identified in Table 36.

Table 36: Aged care facilities in Sydney City (South and West), HERO Database, 2015 Health Service Name Service Type Location

Eastern Sector Aged Care Services Aged Care Glebe Campbell House Nursing Home Public and Private Nursing Homes Surry HIlls Mission Holme Nursing Home Public and Private Nursing Homes Redfern Source: NSW Health Establishment Registration Online (HERO) database

Page 38 of 41


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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