Leichhardt - Sydney Local Health District€¦ · Enquires in relation to this profile should be...

Leichhardt Local Government Area

Health Profile

2015

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

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

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

Director, Planning

SLHD Planning Unit

Telephone: 02 9515 9517

Email: [email protected]

Date of Publication: December 2015

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

mailto:[email protected]

Leichhardt Local Government Area Health Profile

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

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

3 HEALTH RISKS OF THE POPULATION ........................................................................ 12 4 LONG TERM CONDITIONS AND CHRONIC DISEASE .................................................. 14

4.1 PREVALENCE OF CHRONIC DISEASE ............................................................................. 14 4.2 CANCER ............................................................................................................................... 16 4.3 MORTALITY ......................................................................................................................... 18

5 INFECTIOUS DISEASE ................................................................................................... 19 5.1 HIV………………………………………………………………………………… ……………….19 5.2 CHLAMYDIA ......................................................................................................................... 20 5.3 GONORRHOEA .................................................................................................................... 21 5.4 INFECTIOUS SYPHILIS ....................................................................................................... 22 5.5 HEPATITIS B ........................................................................................................................ 23 5.6 HEPATITIS C ........................................................................................................................ 24

6 HEALTH SERVICE UTILISATION ................................................................................... 25 6.1 PRIMARY CARE UTILISATION ............................................................................................ 25 6.2 EMERGENCY DEPARTMENT PRESENTATIONS .............................................................. 26 6.3 HOSPITAL SEPARATIONS ................................................................................................. 27 6.3.1 DAY-ONLY HOSPITAL SEPARATIONS ................................................................... 27 6.3.2 OVERNIGHT HOSPITAL SEPARATIONS ................................................................ 28 6.4 AMBULATORY CARE SENSITIVE ADMISSIONS ............................................................... 29 6.5 HOME AND COMMUNITY CARE......................................................................................... 30

7 HEALTH SERVICE PROVISION ..................................................................................... 32 7.1 HOSPITALS AND DAY SURGERY ...................................................................................... 32 7.2 COMMUNITY HEALTH SERVICES...................................................................................... 33 7.3 GENERAL PRACTICE .......................................................................................................... 34 7.4 ALLIED HEALTH ................................................................................................................... 35 7.5 AGED CARE ......................................................................................................................... 36

APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES ................................. 37 APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS ............................................... 38

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List of Tables Table 1: Projected population: Leichhardt LGA 2006, 2011, 2016, 2021 and 2031 ............... 6 Table 2: Births to Leichhardt LGA residents and fertility rate 2006 – 2013 ............................ 7 Table 3: Child Immunisation rates by age group: Leichhardt (SA3) and National, 2012-2013 7 Table 4: Preventive maternal indicators, Leichhardt LGA and NSW, 2011-13 ....................... 8 Table 5: Humanitarian migration stream, settlers arriving 2009–2014 ................................... 9 Table 6: IRSD by SLA, and rank within IWS, 2011 ................................................................ 9 Table 7: IRSD by suburbs within Leichhardt LGA, and rank within IWS, 2011 .................... 10 Table 8: Estimates of homelessness: Leichhardt LGA and NSW, 2011 .............................. 11 Table 9: Modelled estimates of health risk factors: Leichhardt LGA, IWS and NSW, 2011-2013 .................................................................................................................................... 12 Table 10: Health behaviour related hospitalisations, Leichhardt LGA, 2012-13 to 2013-14 . 12 Table 11: Health behaviours of residents: IWS and NSW, 2013 .......................................... 13 Table 12: Modelled estimates of prevalence of selected chronic conditions ........................ 14 Table 13: Modelled estimates of chronic disease: Leichhardt LGA, 2011-13 ....................... 14 Table 14: Indicators of burden of disease - hospital separations by cause, 2012-14 ........... 15 Table 15: High body mass index, alcohol and smoking attributable deaths, 2011 ............... 15 Table 16: Age standardised cancer incidence rates by cancer site, 2004 to 2008 ............... 17 Table 17: Age standardised mortality rates by cancer site, 2004 - 2008 ............................. 18 Table 18: Deaths from all causes and potentially preventable deaths, 2010-2011 .............. 18 Table 19: HIV notification rate, by LGA, IWS, 2005-2014 .................................................... 19 Table 20: Chlamydia notification rate, by LGA, 2005 to 2014 .............................................. 20 Table 21: Gonorrhoea notification rate, by LGA, IWS, 2005-2014 ....................................... 21 Table 22: Infectious syphilis notification rate, by LGA, IWS, 2005 – 2014 .......................... 22 Table 23: Hepatitis B age-standardised notification rate, by LGA, IWS, 2005 – 2014 .......... 23 Table 24: Hepatitis C age-standardised notification rate, by LGA, IWS, 2005 – 2014.......... 24 Table 25: Primary care services, age standardised rate: Leichhardt LGA, IWS and NSW, 2010 .................................................................................................................................... 25 Table 26: Emergency department presentations, by hospital: Leichhardt LGA, 2013 .......... 26 Table 27: Emergency department presentations, by triage category: Leichhardt LGA, 201326 Table 28: Day-only hospital separations for Leichhardt LGA residents, 2011-13 ................. 27 Table 29: Overnight hospital separations for Leichhardt LGA residents 2013-2014 ............ 28 Table 30: Potentially preventable hospitalisation separations for ACSCs by LGA 2011-13 . 29 Table 31: HACC Client Profile, 2012-13; % of HACC clients .............................................. 30 Table 32: HACC Service Profile; Instances of care per 1,000, 2012-13 .............................. 31 Table 33: Acute and day surgery facilities in Leichhardt LGA, HERO Database, 2015 ........ 32 Table 34: Community health facilities in Leichhardt LGA, HERO Database, 2015 ............... 33 Table 35: Total Aged Care Places and Ratios, IWS and NSW, 2014 .................................. 36 Table 36: Aged care facilities in Leichhardt LGA, HERO Database, 2015 ........................... 36

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List of Figures Figure 1: Population profile by age, Leichhardt LGA and NSW, 2014 ................................... 5 Figure 2: Population forecasts: Leichhardt LGA and NSW by age and gender, 2031 ............ 6 Figure 3: Leichhardt LGA projected population age groups 2011, 2016, 2021, 2026 and 2031 ............................................................................................................................................. 7 Figure 4: Language spoken at home: Leichhardt LGA, IWS and NSW, 2011 ........................ 8 Figure 5: Comparison of SEIFA Disadvantage percentiles within Leichhardt LGA, 2011 ..... 10 Figure 6: Type of Homelessness: Leichhardt LGA and NSW, 2011 .................................... 11 Figure 7: Modelled estimates of health risk factors, 2011-2013 ........................................... 12 Figure 8: Modelled estimates of prevalence of chronic conditions, 2011-2013 .................... 14 Figure 9: Age-standardised incidence of selected cancers, 2004 to 2008 ........................... 16 Figure 10: Number and rate of notifications of newly diagnosed HIV infection, 2005-2014 .. 19 Figure 11: HIV notification rate, by LGA, IWS 2005-2014 .................................................... 19 Figure 12: Chlamydia notification rate, by IWS and NSW, 2010 to 2014 ............................. 20 Figure 13: Gonorrhoea notification rate, by IWS and NSW, 2010 to 2014 ........................... 21 Figure 14: Gonorrhoea notification rate, by LGA, 2005-2014 .............................................. 21 Figure 15: Infectious syphilis notification rate, by IWS and NSW, 2010-2014 ..................... 22 Figure 16:Infectious Syphilis notification rate, by LGA and IWS, 2005 – 2014 .................... 22 Figure 17: Hepatitis B notification rate, by IWS and NSW 2005-2014 ................................. 23 Figure 18: Hepatitis B notification rate by LGA and IWS, 2005 – 2014 ................................ 23 Figure 19: Hepatitis C notification rate, by IWS and NSW, 2005-2014 ................................ 24 Figure 20: Hepatitis C notification rate, by LGA and IWS, 2005 – 2014 ............................... 24 Figure 21: Primary care services: Leichhardt LGA, IWS and NSW, 2010 ............................ 25 Figure 22: Day-only hospital separations for Leichhardt LGA residents, 2011-13 ................ 27 Figure 23: Overnight hospital separations for Leichhardt LGA residents, 2013-14 .............. 28 Figure 24: Potentially preventable hospitalisations for ACSCs by LGA, 2011-13 ................. 29 Figure 25: HACC Client Profile by Leichhardt LGA, IWS and NSW, 2012-2013 .................. 30 Figure 26:HACC Service Profile by Leichhardt LGA, IWS and NSW, 2012-13 .................... 31 Figure 27: General Practitioners and General Practice Services by LGA and IWS, 2015. ... 34 Figure 28: Private Allied Health Practitioners: Leichhardt LGA and IWS, 2014 ................... 35

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EXECUTIVE SUMMARY Approximately 28% of Leichhardt LGA residents report being born overseas and 13% in non -English speaking countries. A high proportion of Leichhardt LGA residents (79.4%) identify as speaking only English at home, followed by Italian (3%; 1,586), Greek (1%, 728) and Spanish (1%, 534). Aboriginal and Torres Strait Islander people make up 1.0% of the total population of Leichhardt LGA, which is marginally above the average for the Inner West Sydney (IWS) catchment (0.9%).

The population age profile of the Leichhardt LGA shows a much higher concentration of middle-aged residents (between 25 and 44 years) and young children (aged 0 to 4 years), compared to the NSW population. The fertility rate in Leichhardt LGA remains below the NSW rate. The population growth in the Leichhardt LGA is expected to be 22% between 2011 and 2031, which is lower than the forecasted population growth for NSW (28%)

The index score for socio-economic disadvantage in Leichhardt LGA is 1,079. Average annual household incomes within the Leichhardt LGA are the highest of any LGA within the IWS catchment, and significantly greater than the average of NSW overall.

Health Risks and Chronic Disease in Leichhardt LGA

Leichhardt LGA residents have a comparable prevalence rate of risky alcohol consumption, overweight and psychological distress, while the estimated prevalence of smokers and obesity in Leichhardt LGA and IWS are significantly lower compared to NSW.

The most prevalent chronic conditions in Leichhardt LGA, and NSW are respiratory system and musculoskeletal diseases. The estimated prevalence of type 2 diabetes in Leichhardt LGA is also lower compared to the IWS catchment. When compared to the state, the age-standardised rate of cancer is not significantly different for Leichhardt LGA residents.

Prostate, breast, lung and melanoma cancer are the most common cancers, and significantly higher rates of liver and lung cancer were observed in Leichhardt LGA compared to NSW in 2004-2008. The overall age-standardised rate of cancer-related deaths in Leichhardt LGA (198.1 per 100,000) is significantly higher than the state (176.9 per 100,000), with a higher rate of mortality observed for leukaemia, and a trend for increased mortality observed for lung cancer.

Overall, Leichhardt LGA residents had significantly fewer health behaviour related hospital separations compared to the state. However, the separation ratio of alcohol (123) and fall-related injury attributable (121) hospitalisations was significantly higher in Leichhardt LGA compared to NSW (100).

Infectious Diseases in Leichhardt LGA

The IWS catchment has higher rates of newly diagnosed HIV infections, hepatitis B, infectious syphilis, chlamydia and gonorrhoea than the state. Leichhardt LGA has the third highest notification rate for Hepatitis C within the IWS catchment area.

Health Service Utilisation in Leichhardt LGA

The number of General Practitioners (GPs) per-capita is one of the highest within the IWS catchment. Allied Health Professionals vary in availability across professions, while Practice Nurses are below the IWS catchment average. RPA Hospital provides the majority (67.6%) of emergency department presentations and hospital separations by Leichhardt LGA residents.

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

Leichhardt LGA has a population of 58,1361 and occupies 11 square kilometres. Leichhardt LGA includes the suburbs of Annandale (postcode 2038), Rozelle (postcode 2039), Lilyfield and Leichhardt (postcode 2040), Balmain, Balmain East and Birchgrove (postcode 2041).

2 POPULATION AND COMMUNITY CHARACTERISTICS 2.1 Population Characteristics

Figure 1 shows that in 2014 the age profile of the Leichhardt LGA residents had a much higher concentration of middle-aged residents (between 25 and 44 years) and young children (aged 0 to 4 years), compared to the NSW population.

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

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

Across all age groups combined, population growth in the Leichhardt LGA is expected to be 22% between 2011 and 2031, which is lower than the forecasted population growth across both the IWS catchment (32.7%) and NSW (27.8%). Concurrent with population growth are

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. 1Estimated Resident Population. ABS 2014.

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

0-45-9

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

85+

Leichhardt Females 2014 NSW Females 2014 Leichhardt Males 2014 NSW Males 2014

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proposed increases in the number of local homes and dwellings. The NSW Household and Implied Dwelling Projections 2011 – 2031 (2014) project an additional 5,950 dwellings from 2011 to 2031 in Leichhardt LGA. Of these dwellings it is projected that 3,450 will be family households and 2,500 will be lone person households2.

Figure 2 further illustrates that the Leichhardt LGA population will experience higher growth for persons aged between 25 to 49 years.

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

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

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

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

Leichhardt LGA IWS Catchment 2011 2016 2021 2026 2031 2011 2016 2021 2026 2031

Total population

55,642

58,152

61,311

64,400

67,543

581,936

628,537

681,493

728,193

772,368

0 4 years 4,471 4,338 4,313 4,447 4,542 36,373 41,391 44,652 46,838 47,689 5 - 14 years 4,603 5,703 6,067 6,097 6,256 51,476 58,228 66,702 72,778 76,748

15 - 24 years 4,715 4,540 5,055 5,730 6,123 77,887 73,294 76,692 82,112 89,093 25 - 44 years 22,57

1 22,250

22,568

23,158

23,730

218,353

235,564

249,104

256,808

260,590 45 - 64 years 13,68

9 14,421

15,226

15,871

16,682

129,929

140,960

153,144

164,527

178,495 65 - 84 years 4,964 6,193 7,275 8,170 8,958 59,207 68,272 78,747 90,820 102,430 85 years + 629 706 807 927 1,252 8,711 10,829 12,453 14,309 17,323


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

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

0-45-9

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

85+

LEICHHARDT Females NSW Females 2031 LEICHHARDT Males 2031 NSW Males 2031

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


Leichhardt LGA has a number of Urban Growth NSW Urban redevelopment projects within its boundaries that may increase the projected population and number of dwellings within the LGA. These include the Bays Precinct and Parramatta Road Urban Renewal Projects.

2.2 Births and Maternal Health Table 2 shows the number of births to Leichhardt LGA residents in the period 2006 - 2013. Across this period, the fertility rate in Leichhardt LGA has been below the NSW rate, but has increased from 2006. Leichhardt LGA ranked fifth highest within the IWS catchment for number of births in 2013 (1,100). 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 Leichhardt LGA residents and fertility rate 2006 – 2013 Year Leichhardt LGA estimated

resident population Leichhardt LGA births Leichhardt LGA total

fertility rate NSW total

fertility rate

2006 51,243 991 1.57 1.93 2007 52,095 1,050 1.65 1.99 2008 53,133 1,112 1.73 2.05 2009 54,115 1,140 1.82 1.98 2010 54,969 1,121 1.86 2.02 2011 55,642 1,126 1.87 1.96 2012 56,307 1,020 1.79 1.93 2013 57,266 1,100 1.78 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 Leichhardt (SA3), the rates across all age groups in the SA3 were higher or similar to the IWS catchment and national figures.

Table 3: Child Immunisation rates by age group: Leichhardt (SA3) and National, 2012-2013 Leichhardt IWS Catchment National

Age Group % Fully Immunised 1 year 91.2% 90.5% 91.2% 2 years 93.3% 91.4% 92.5% 5 years 88.2% 89.6% 91.5%

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

0

5,000

10,000

15,000

20,000

25,000

2011 2016 2021 2026 2031

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

ojec

ted

Popu

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Table 4 shows that between 2011 and 2013 the rate of smoking during pregnancy in Leichhardt LGA was significantly lower than the state average, with a smoothed prevalence ratio between 38.1 and 51.4 at 95% confidence interval3 (NSW = 100). For the same period, the smoothed prevalence ratio of attendance for antenatal care prior to 14 weeks gestation ranged between 87.4 and 91.5 at 95% confidence interval3, which was significantly below the NSW smoothed prevalence ratio of 100.

Table 4: Preventive maternal indicators, Leichhardt LGA and NSW, 2011-13 Maternal Indicator Leichhardt LGA NSW

Smoking in pregnancy

Smoothed estimate of prevalence ratio

95% confidence interval for smoothed ratio

44.3 (38.1 – 51.4) (--) 100 First antenatal visit before 14

weeks of gestation

No. of mothers per year 95% confidence interval for smoothed ratio 725 (87.4 – 91.5) (--) 100

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

2.3 Aboriginal and Torres Strait Islander People The traditional owners of the land are the Wangal people of the Eora Nation. Aboriginal and Torres Strait Islander people made up a total of 1.0% of the total population of the Leichhardt LGA, which was marginally above the average for the catchment (0.9%), but well below NSW overall (2.5%). Across all LGAs within the IWS catchment, Leichhardt LGA was home to the fourth highest proportion of Aboriginal and Torres Strait Islander people.

2.4 People from Culturally and Linguistically Diverse Backgrounds As illustrated in Figure 4, based on the 2011 ABS Census approximately 79% (41,456) of Leichhardt LGA residents identified as speaking only English at home, notable proportions of the population identified their primary language as being Italian (3%; 1,586), followed by Greek (1%,728) and Spanish (1%, 534). Only 2.1% of residents indicated that they spoke another language and do not speak English well or do not speak English at all.

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

Source: Australian Bureau of Statistics (2011)

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

0%

2%

4%

6%

8%

10%

12%LEICHHARDTIWSNSW

% o

f tot

al

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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 Leichhardt LGA came from 11 different countries, with the largest number being from Iran.

Table 5: Humanitarian migration stream, settlers arriving 2009–2014: Leichhardt LGA and NSW Population characteristics Leichhard

t LGA NSW

Humanitarian Stream-number of settlers arriving from 2009 - 2014 31 27,450

Top 3 countries of birth for humanitarian migration stream, number of settlers arriving 2009 – 2014 Iran 16 Iraq 10,157

Burma 2 Iran 2,913 China 2 Afghanistan 2,502

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

2.6 Education Levels Secondary school participation data from the 2011 census, showed that within the Leichhardt LGA 70% of people aged over 15 years had completed Year 12 schooling (or equivalent). Full-time participation in secondary school at age 16 years was higher in Leichhardt LGA (89.3%) than the IWS catchment overall (82.3%). In 2013 the proportion of school leavers from Leichhardt LGA that undertook higher education qualifications (48.8%) was ranked equal fourth highest with Ashfield across the IWS catchment.

2.7 Socio-Economic Characteristics The Socio-Economic Indexes For Areas (SEIFA) are used to rank geographic areas across Australia according to their socio-economic characteristics. The Index of Relative Socioeconomic Disadvantage (IRSD) contains indicators of disadvantage such as low income, high unemployment and low levels of education. Relative disadvantage is associated with a low number. The average across Australia is 1,000. A number below 1,000 indicates lower socioeconomic status.

Table 6 shows the index score for socio-economic disadvantage in Leichhardt LGA was 1,079, indicating the highest socioeconomic status of any LGA within the IWS. The only Statistical Local Areas in the IWS catchment 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 IWS 1006 413 1150 Source: Australian Bureau of Statistics (2011)

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Table 7 and Figure 5 show the variance of the index score for socio-economic disadvantage across the suburbs that make up Leichhardt LGA. No suburbs in Leichhardt LGA had a score below 1,000.

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

LGA Score Rank within IWS* Rank within Australia

Most disadvantaged to Least disadvantaged

Lilyfield 1044 41

5815

Leichhardt (NSW) 1062 55 6620

Balmain 1079 61 7234

Annandale (NSW) 1087 64 7479

Balmain East 1099 72 7777

Rozelle 1108 74

7943

Birchgrove 1124 77 8158

Source: 2033.0.55.001-SEIFA, 2011. *77 suburbs within the IWS catchment were allocated an index score for socio-economic

disadvantage.

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

Source: 2033.0.55.001-SEIFA, 2011.

Based on the 2011 ABS Census, average annual household incomes within the Leichhardt LGA were the highest of any LGA within the IWS catchment, and were also significantly greater than NSW overall. In particular, the proportion of households with incomes in excess of $130,000 was far greater than NSW averages. Unemployment in Leichhardt LGA was the lowest of any LGA within the IWS catchment at 2.7%.

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2.8 Homelessness

In SLHD in 2011, there were an estimated 4068 people living with homelessness. This constituted 14% of NSW homelessness. Census data indicated that in SLHD in 2011:

• 25% were in severely overcrowded dwellings4 • 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 sleeping5.

Table 8: Estimates of homelessness: Leichhardt LGA and NSW, 2011 Type of homelessness Number of people

Persons in supported accommodation for the homeless 44 Persons staying in boarding houses 231 Persons in other temporary lodging 0 Persons living in ‘severely’ crowded dwellings 13 All homeless persons 319 Source: Australian Bureau of Statistics (2011)

Figure 6: Type of Homelessness: Leichhardt LGA and NSW, 2011

Source: Australian Bureau of Statistics (2011)

The percentage of the total homeless population that reside in a boarding house (72%) in the Leichhardt LGA was notably higher than the State (21%) (Figure 6). The Leichhardt LGA had the fifth highest number of boarding houses (22) in the IWS catchment6.

4 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. 5 Homelessness in SLHD. Public Health Observatory. Population Health. SLHD. 2014 6 NSW Fair Trading: Boarding House Register. http://parkspr.fairtrading.nsw.gov.au/BoardingHouse.aspx. Accessed 29.01.2015

14%

72%

4% 17% 21% 33%

0%10%20%30%40%50%60%70%80%

Persons in supportedaccommodation for the homeless

Persons staying in boardinghouses

Persons living in 'severely'crowded dwellings

Leichhardt

NSW

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


3 HEALTH RISKS OF THE POPULATION 3.1 Health Risk Factors Figure 7 shows that modelled estimates of the prevalence of current smoking and obesity were lower in Leichhardt LGA compared to the IWS catchment and NSW. In contrast, the estimated prevalence of risky alcohol consumption, psychological distress and overweight in Leichhardt LGA were similar to both the IWS catchment and NSW levels.

Figure 7: Modelled estimates of health risk factors: Leichhardt LGA, IWS and NSW, 2011-2013

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

Table 9: Modelled estimates of health risk factors: Leichhardt LGA, IWS and NSW, 2011-2013 Indicator Leichhardt Inner West Sydney New South Wales Current Smokers 10.7 [9.6-11.8] 12.9 [12.4-13.4] 16.2 [16.1-16.4] Risk Alcohol C ti

4.6 [3.3-5.9] 4.6 [4.2-5.0] 4.8 [4.7-4.9] Psychologically Di t d

8.8 [7.1-10.4] 10.2 [9.5-10.8] 10.5 [10.3-10.7] Overweight 34.5 [31.3-37.8] 33.4 [32.3-34.5] 34.6 [34.3-34.9] Obese 15.8 [14.0-17.5] 20.1 [19.4-20.8] 26.4 [26.2-26.6] Source: Public Health Information Development Unit (PHIDU) - 2011-2013 National Health Survey.

Overall, Leichhardt LGA residents had significantly fewer health behaviour related hospital separations compared to the state. However, the rate of alcohol and fall-related injury attributable hospitalisations was significantly higher in Leichhardt LGA compared to NSW (Table 10).

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

number separations /

Smoothed rate/

100 000

sSSR7 [95% CI]

Smoking attributable 2012-14 251 518.2 82.8 [75.8-89.9]

Significantly lower than the state

High body mass index attributable

2012-14 181 371.9 71.1 [63.9-78.4]


High blood pressure attributable

2012-14 262.5 1,003.2 76.2 [70.3-82.5]


Alcohol attributable 2012-14 492.4 885.5 123 [116-132] Significantly higher than the

Fall-related injury 2012-14 452 1,013 121 [113-128] 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

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

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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 (% [95% CI]): IWS and NSW, 2013

Indicator IWS NSW Consumes more than 2 standard drinks per day when drinking alcohol, persons aged 16+ years

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 years and over

64.5 [55.7-73.4] 71.0 [68.9-73.0]

Vaccinated against pneumococcal disease, aged 65 years and o er

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 interval8


Page 13 of 39


4 LONG TERM CONDITIONS AND CHRONIC DISEASE 4.1 Prevalence of Chronic Disease The most prevalent chronic conditions across Leichhardt LGA, IWS and NSW were respiratory system diseases and musculoskeletal diseases (Figure 8). The estimated age-standardised prevalence of type 2 diabetes in Leichhardt LGA was lower compared to the IWS catchment and NSW. There was also a trend for lower estimated prevalence of mental and behavioural disorders in Leichhardt LGA compared to NSW.

Figure 8: Modelled estimates of prevalence of chronic conditions: Leichhardt LGA, IWS and NSW, 2011-2013

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

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

Indicator Leichhardt LGA

Inner West Sydney New South Wales

Type 2 Diabetes 4.2 [3.0-5.3] 7.4 [6.7-8.1] 5.8 [5.6-5.9] Mental and Behavioural Disorders 11.5 [10.0-13.0] 12.4 [11.8-12.9] 13.1 [13.0-13.3] Circulatory System Diseases 16.8 [14.8-18.9] 17.8 [17.1-18.5] 17.8 [17.6-17.9] Respiratory System Diseases 26.4 [23.0-29.8] 24.4 [23.3-25.5] 27.4 [27.1-27.7] Musculoskeletal Diseases 27.3 [23.5-31.1] 26.1 [24.8-27.3] 28.1 [27.8-28.5] Source: Public Health Information Development Unit - 2011-2013 National Health Survey

In terms of chronic disease burden, Table 13 shows that the estimated prevalence of asthma, chronic obstructive pulmonary disease and hypertension in Leichhardt LGA were similar to both the IWS catchment and NSW. However, Leichhardt LGA residents have lower estimated prevalence of fair or poor self-assessed health relative to the IWS catchment and NSW. The estimated prevalence of arthritis in Leichhardt LGA was similar to the IWS catchment, but lower relative to the state.

Table 13: Modelled estimates of chronic disease (ASR per 100 [95% CI]), 2011-13 Indicator Leichhardt LGA IWS NSW Fair or poor self-assessed health, > 15 years 9.5 [8.2-10.7] 14.3 [13.7-14.9] 14.3 [14.2-14.5] Asthma 8.4 [7.1-9.7] 7.2 [6.8-7.6] 9.6 [9.5-9.7] Chronic Obstructive Pulmonary Disease 2.4 [1.7-3.1] 2.3 [2-2.5] 2.6 [2.6-2.7] Hypertension, > 18 years 10.3 [8.4-12.2] 10.7 [10.1-11.4] 10.5 [10.4-10.7] Arthritis 13.0 [11.5-14.5] 13.9 [13.3-14.4] 15.3 [15.1-15.4] Source: Public Health Information Development Unit - 2011-13 National Health Survey ASR: Age standardised rate; CI: Confidence interval9


Page 14 of 39


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

Table 14: Indicators of burden of disease - hospital separations by cause: Leichhardt LGA, 2012-14

Indicator Year Smoothed number

separations/ year

Smoothed rate/

100,000

sSSR10[95% CI]

Potentially preventable 2012-14

992 2,008 82.5 [78.7.6-86]


Chronic obstructive pulmonary disease

2012-14

93 1,614 108 [93.2-123.8]

Not significantly different to the

state Coronary heart disease 2012-

14 150 331.6 49.7 [44.2-

55.7] Significantly lower

than the state Circulatory disease 2012-

14 690 1,538 74.3 [70.5-


than the state Stroke 2012-

14 58 138.4 80.1 [66.9-95] Significantly lower

than the state Asthma 2012-

14 78 134.1 77.1 [65.8-89] Significantly lower

than the state Influenza and

pneumonia 2012-

14 133 284.2 85.4 [75.5-


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 interval11

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

Table 15: High body mass index, alcohol and smoking attributable deaths: Leichhardt LGA, 2011

Indicator Year Smoothed number of

deaths/ year

Smoothed rate/

100,000

sSMR11 [95% CI]

High body mass index

2011 15 37.2 95.7 [78.7-114.7] Not significantly different to the state

Alcohol 2011-12

8.7 18 104.1 [82.2-131.8] Not significantly different to the state

Smoking 2011 29 99.7 72.3 [79.2-124.4] Not significantly different to the state

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

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

Page 15 of 39


4.2 Cancer

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

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

Source: NSW Central Cancer Registry, Cancer Institute NSW

Prostate, breast, lung and melanoma cancer were the most common cancers in Leichhardt LGA over this period. When compared to the State, the overall age-standardised rate of cancer was not significantly different in Leichhardt LGA residents. However, there were trends for significantly higher rates of liver and lung cancer in Leichhardt LGA compared to NSW. In contrast, there was a trend for lower age-standardised rate of pancreatic cancer in Leichhardt LGA compared to NSW (Table 16).

Page 16 of 39

Table 16: Age standardised cancer incidence rates (per 100,000) by cancer site, 2004 to 2008 Cancer Site Leichhardt LGA IWS Catchment NSW Count Rate Count Rate Count Rate All types 1159 503.7 [474.4-

534.2] 11397 449.1 [440.8-

457.4] 177519 483.2 [481.0-

485.5] Bladder 18 8.8 [5.2-14.1] 243 9.7 [8.5-11.0] 3631 9.7 [9.3-10.0] Brain 19 8.2 [4.8-13.1] 166 6.3 [5.4-7.3] 2356 6.6 [6.3-6.8] Breast 170 66.8 [57.0-77.8] 1447 56.2 [53.3-59.1] 21102 58.2 [57.5-59.0] Cervix 14 4.6 [2.4-7.8] 92 3.3 [2.7-4.1] 1228 3.5 [3.3-3.7] Colon 84 40.8 [32.4-50.7] 988 39.5 [37.1-42.0] 15072 40.6 [39.9-41.2] Head and neck 39 17.8 [12.6-24.5] 370 14.6 [13.1-16.1] 4686 12.8 [12.5-13.2] Kidney 25 11.7 [7.5-17.3] 321 12.8 [11.4-14.3] 4857 13.2 [12.9-13.6] Leukaemia 35 14.5 [9.9-20.3] 314 12.5 [11.1-13.9] 4605 12.6 [12.3-13.0] Lip ** ** 44 1.8 [1.3-2.4] 1203 3.3 [3.1-3.5] Liver 23 11.0 [6.9-16.6] 224 8.9 [7.8-10.1] 2088 5.7 [5.4-5.9] Lung 116 52.8 [43.5-63.5] 1157 46.5 [43.9-49.3] 15905 43.0 [42.3-43.7] Melanoma of skin

111 44.4 [36.3-53.8] 726 27.8 [25.8-29.9] 17716 48.8 [48.1-49.5]

Mesothelioma ** ** 56 2.2 [1.7-2.9] 1047 2.8 [2.6-3.0] Myelodysplasia 18 8.5 [5.0-13.6] 195 7.8 [6.7-8.9] 2817 7.5 [7.2-7.8] Non-Hodgkin’s lymphoma

48 21.3 [15.6-28.4] 485 18.9 [17.2-20.7] 6828 18.6 [18.2-19.1]

Oesophagus 15 7.3 [4.0-12.1] 108 4.3 [3.5-5.1] 2024 5.4 [5.2-5.7] Ovary 20 8.8 [5.3-13.6] 195 7.6 [6.6-8.8] 2191 6.0 [5.8-6.3] Pancreas 15 6.9 [3.8-11.5] 275 11.0 [9.7-12.3] 4062 10.9 [10.5-11.2] Prostate 176 79.4 [67.9-92.3] 1647 66.3 [63.1-69.6] 31321 84.4 [83.4-85.3] Rectal 48 20.7 [15.2-27.6] 501 19.9 [18.2-21.8] 8338 22.6 [22.1-23.1] Stomach 20 9.9 [6.0-15.4] 285 11.4 [10.1-12.8] 3275 8.8 [8.5-9.1] Testis 8 2.4 [1.0-4.8] 80 2.6 [2.1-3.2] 1084 3.2 [3.0-3.4] Thyroid 30 11.2 [7.4-16.1] 316 11.7 [10.4-13.1] 3301 9.4 [9.1-9.8] Unspecified site 23 10.0 [6.3-15.2] 364 14.4 [13.0-16.0] 6014 16.0 [15.6-16.4] Uterus(body) 15 6.5 [3.6-10.8] 190 7.5 [6.5-8.6] 3043 8.3 [8.0-8.6] All Others 64 27.0 [20.6-34.7] 608 23.7 [21.8-25.7] 7725 21.3 [20.8-21.7] Source: NSW Central Cancer Registry, Cancer Institute NSW **Cellcounts less than 5 are left blank Cancer-related mortality for Leichhardt LGA, the IWS catchment and NSW is presented in Table 17. Between 2004 and 2008, cancer was the primary cause of death for 426 persons in Leichhardt LGA, with lung, colon, leukaemia and breast cancers the leading types. The overall age-standardised rate of cancer-related deaths in Leichhardt LGA (198.1 per 100,000) was significantly higher than the state (176.9 per 100,000), with a higher rate of mortality observed for leukaemia, and a trend for increased mortality observed for lung cancers. In contrast, there was a significantly lower rate of mortality from prostate cancer in Leichhardt LGA relative to NSW.


Table 17: Age standardised mortality rates (per 100,000) by cancer site, 2004 - 2008 Cancer Site Leichhardt LGA IWS Catchment NSW Count Rate Count Rate Count Rate All types 426 198.1 [179.4-

218.2] 4547 181.0 [175.7-

186.3] 66228 176.9 [175.5-

178.2] Bladder 12 5.9 [3.0-10.4] 106 4.2 [3.4-5.1] 1644 4.3 [4.1-4.5] Brain 17 7.2 [4.0-11.7] 126 4.9 [4.1-5.8] 1716 4.7 [4.5-5.0] Breast 25 11.1 [7.1-16.6] 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 39 18.9 [13.3-25.9] 365 14.5 [13.0-16.0] 5511 14.6 [14.3-15.0] Head and neck 18 8.5 [5.0-13.5] 154 6.1 [5.2-7.2] 1762 4.7 [4.5-5.0] Kidney 7 3.7 [1.5-7.7] 87 3.4 [2.8-4.3] 1605 4.3 [4.1-4.5] Leukaemia 28 12.2 [8.0-17.8] 148 5.9 [5.0-6.9] 2248 6.0 [5.8-6.3] Liver 16 7.5 [4.2-12.3] 162 6.5 [5.5-7.6] 1527 4.1 [3.9-4.3] Lung 95 43.9 [35.4-53.8] 937 37.7 [35.3-40.2] 12781 34.4 [33.8-35.0] Non-Hodgkin’s lymphoma

20 9.2 [5.6-14.4] 176 6.9 [5.9-8.0] 2569 6.8 [6.6-7.1]

Skin melanoma

13 5.7 [3.0-9.8] 125 5.0 [4.1-5.9] 2314 6.2 [6.0-6.5]

Mesothelioma ** ** 56 2.3 [1.7-3.0] 947 2.5 [2.4-2.7] Myelodysplasia ** ** 74 2.9 [2.3-3.7] 1036 2.7 [2.5-2.9] Oesophagus 9 4.5 [2.0-8.5] 92 3.6 [2.9-4.4] 1590 4.2 [4.0-4.4] Ovary 7 3.4 [1.3-7.0] 104 4.2 [3.4-5.1] 1394 3.7 [3.5-3.9] Pancreas 13 6.2 [3.2-10.6] 240 9.6 [8.4-10.9] 3611 9.6 [9.3-9.9] Prostate 16 7.8 [4.4-12.7] 287 11.4 [10.1-12.8] 4904 12.8 [12.4-13.1] Rectal 16 7.2 [4.1-11.7] 194 7.7 [6.7-8.9] 3018 8.1 [7.8-8.4] Stomach 16 7.9 [4.5-12.9] 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 17 7.7 [4.4-12.5] 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 28 13.0 [8.6-19.0] 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

4.3 Mortality In 2007, life expectancy at birth for males and females in Leichhardt LGA was 79.7 and 84.6 years, respectively, which were similar to the state (80 and 85 years for males and females, respectively). Consistently, the standardised mortality from all causes in Leichhardt LGA was similar compared to the state. Mortality from amenable and preventable causes in Leichhardt LGA was also not significantly different to NSW levels (Table 18).

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

Indicator Deaths per year sSMR12 [95% CI] Deaths from all causes 268 99.6 [91.7-107.8] Amenable to health care 25 85.4 [69.0-104.4] Preventable causes 46 99.9 [82.2-119.0] Amenable and preventable causes 70 92.2 [78.7-106.8] Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health sSMR: Smoothed standardised mortality ratio; CI: Confidence interval13

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

Page 18 of 39


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 10). 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 11 and Table 19). Figure 10: Number and rate of notifications of newly diagnosed HIV infection in IWS, 2005-2014

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

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

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

Table 19: HIV notification rate (per 100,000 of population), by LGA, IWS, 2005-2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 15 5 8 3 7 7 5 5 2 1 Burwood 10 5 6 5 4 5 2 11 0 5 Canada Bay 9 9 3 6 4 5 1 6 2 4 Canterbury 2 5 11 2 4 5 4 3 7 5 Leichhardt 14 6 4 15 7 7 13 11 5 0 Marrickville 32 28 26 24 28 16 27 28 27 19 Strathfield 5 7 10 3 0 3 3 10 0 2 Sydney City* 54 38 46 42 51 41 43 59 47 45 * Sydney City (South and West SLAs). Source: NSW HIV/AIDS database. (Accessed 18/05/2015)

0.0

5.0

10.0

15.0

20.0

25.0

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 19 of 39


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

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

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

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

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

051015202530354045

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 20 of 39


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

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

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

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


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

02468101214161820

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 21 of 39


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

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


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


Table 22: Infectious syphilis notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 0.0 9.7 7.2 2.4 4.7 18.6 4.6 6.9 13.6 13.4 Burwood 0.0 6.2 3.0 12.0 5.9 8.9 11.7 5.8 8.5 27.7 Canada 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* 30.8 44.5 79.5 68.6 83.7 74.3 54.3 65.1 116.4 150.9 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

0

1

2

3

4

5

6

0

5

10

15

20

25

30

35

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

2010 2011 2012 2013 2014

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

Tota

l not

ifica

tions

Rate

/100

,000

pop

ulat

ion

020406080

100120140160

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney

Rate

/100

,000

pop

ulat

ion

Page 22 of 39


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

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


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

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


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

0

20

40

60

80

100

0

100

200

300

400

500

600

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014Total number of notifications IWS Age-standardised rate IWS Age-standardised rate NSW

Tota

l num

ber o

f not

ifica

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Rate

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0,00

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0

20

40

60

80

100

120

140

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014


Not

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Page 23 of 39


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

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


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


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

* Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

0102030405060708090

0

100

200

300

400

500

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2005 2006 2007 2008 2009 2010 2011 2012 2013 2014


Age-

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Page 24 of 39


6 HEALTH SERVICE UTILISATION 6.1 Primary Care Utilisation The age-standardised rate of primary care services (per 100,000) is presented in Table 25, with age-standardised ratios and statistical comparisons to national levels displayed in Figure 21. The rate of 45 year old health checks in Leichhardt LGA was considerably lower than both the IWS catchment and NSW. Likewise, the rates of general practitioner (GP) health assessments (75 years or more) and GP enhanced primary care in Leichhardt LGA were lower than NSW levels and also slightly lower relative to the IWS catchment. The rate of GP practice nurse services in Leichhardt LGA were similar to the IWS catchment, but lower compared to the state level. In contrast, the rate of GP mental health care plans in Leichhardt LGA was higher compared to the IWS catchment and NSW.

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

Indicator Leichhardt LGA

IWS NSW

45 year old health checks^ 3365.1 4796.6 4627.8

GP health assessment (75+) 15070.4 17377.5 20867.4

GP enhanced primary care 1962.6 2147.8 2618.4

GP practice nurse services 18362.7 16320.0 29844.9

GP Mental Health care plans 9515.8 7625.4 8222.3 Source: Public Health Information Development Unit and Department of Health and Ageing (2014) ^For persons aged between 45-49 years

Figure 21: Primary care services (age standardised ratio): Leichhardt LGA, IWS and NSW, 2010

Source: Public Health Information Development Unit and Department of Health and Ageing (2014) Dashed line: National reference level; * Significantly different to state at 95% confidence level; ** Significantly different to state at 99% confidence level ^For persons aged between 45-49 years

Page 25 of 39


6.2 Emergency Department Presentations The distribution of emergency department presentations by Leichhardt LGA 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 Leichhardt LGA residents (67.6%), constituting 11.3% of all emergency department visits at RPA Hospital.

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

hospital Concord hospital

RPA hospital Other NSW hospitals

Total

LGA Presentations

96 (0.8) 299 (2.5) 8064 (67.6) 3462 (29) 11921 (100)

All Presentations

38397 (1.5) 36662 (1.4) 71576 (2.8) 2410994 (94.3) 2557629 (100)

Leichhardt LGA % of total

0.3 0.8 11.3 0.1 0.5

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

The rates of emergency department presentations (per 1,000 persons) by triage category are displayed in Table 27. The age-standardised rates of emergency department presentations for urgent and emergency triage classifications were significantly higher for Leichhardt LGA residents compared to the IWS catchment. In contrast, there was a lower standardised rate of semi-urgent classified presentations compared to the IWS catchment.

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

LGA Non-urgent Semi Urgent Urgent Emergency Resuscitation Ashfield 16.5 [15.3-

17.7] 82.6 [80.0-85.2] 88.3 [85.7-90.9] 31.4 [29.8-

33.0] 1.7 [1.3-2.0]

Burwood 15.0 [13.7-16.3]

100.2 [97.0-103.5] 80.9 [78.0-83.8] 26.1 [24.4-27.7]

2.2 [1.8-2.7]

Canada Bay 15.1 [14.3-15.9]

105.6 [103.5-107.7]

75.2 [73.4-77.0] 23.0 [22.0-24.0]

1.7 [1.4-2.0]

Canterbury 22.0 [21.2-22.7]

110.0 [108.4-111.6]

115.2 [113.7-116.8]

41.7 [40.7-42.7]

2.4 [2.2-2.7]

Leichhardt 17.4 [16.3-18.6]

71.5 [69.2-73.7] 92.5 [90.0-94.9] 35.0 [33.5-36.6]

1.3 [1.0-1.7]

Marrickville 21.8 [20.8-22.9]

101.9 [99.7-104.1] 114.8 [112.5-117.1]

43.4 [42.0-44.8]

2.0 [1.7-2.3]

Strathfield 16.4 [15.1-17.7]

114.1 [110.9-117.4]

74.4 [71.7-77.0] 23.5 [21.9-25.0]

2.2 [1.7-2.6]

Sydney 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

Page 26 of 39


6.3 Hospital Separations 6.3.1 Day-only Hospital Separations Leichhardt LGA resident separations from hospital on a day-only14 basis are shown in Table 28. In 2013-14, 34% (3,764) of all day-only separations were provided by SLHD hospitals, followed by private hospitals at 33% (3,645) and private day procedure centers at 25% (2,777 separations).

Table 28: Day-only hospital separations for Leichhardt LGA residents, 2011-13

Hospital/LHD No. of Separations Per cent of Total Separations

SLHD Hospitals 3,764 34% Private Hospitals 3,645 33% Private Day Procedure Centres 2,777 25% Other LHD Hospitals 997 9% Total 11,183 100% Source Flow-Info v 5.0

As shown in Figure 22, 34% (3,764 separations) of Leichhardt LGA resident day-only separations occurred in SLHD hospitals. RPA Hospital provided for 80% of the total separations within SLHD (2,995 separations), followed by Concord Hospital at 10% (391 separations) and Balmain Hospital (322 separations).

Figure 22: Day-only hospital separations for Leichhardt LGA residents, 2011-13

Source Flow-Info v 5.0

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

Private Hospitals 33% (n=3645)

Private Day Procedure Centres

25% (n= 2777)

Other LHDs 9% (n=997)

Royal Prince Alfred 80% (n=2995)

Concord 10%

(n=391)

Balmain 9%

(n= 322) Other SLHD Hospitals 1% (n=56)

Sydney LHD 34% (n=3764)

Page 27 of 39


6.3.2 Overnight Hospital Separations

The breakdown of Leichhardt LGA resident overnight15 hospitalisations is shown in Table 29. In 2013-14, SLHD hospitals provided the majority (60%; 5,386 separations) of all overnight separations, followed by private hospitals at 27% (2,445 separations).

Table 29: Overnight hospital separations for Leichhardt LGA residents 2013-2014

Hospital/LHD No. of Separations Percent of Total Separations SLHD Hospitals 5,386 60% Private Hospitals 2,445 27% South Eastern Sydney 266 3% St. Vincent's Network 245 3% Sydney Children's Network 243 3% All Other LHD hospitals 382 4% Total 8,967 100% Source Flow-Info v 5.0

As shown in Figure 23, SLHD hospitals provided for 60% (5386 separations) of all Leichhardt LGA resident overnight separations. RPA Hospital provided 4,384 or 81% of the total overnight separations within SLHD, followed by Balmain Hospital at 8% (431 separations) and Concord Hospital at7% (351 separations)

Figure 23: Overnight hospital separations for Leichhardt LGA residents, 2013-14

Source Flow-Info v 5.0

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

Private Hospitals 27% (n= 2445)

South Eastern Sydney

3% (n=266)

St. Vincent's Network

3% (n= 245)

Sydney Children's Network 3% (243)

Other LHDs 4% (382)

Royal Prince Alfred 81%(4384)

Balmain 8% (n=431)

Concord 7% (n=351)

Other SLHD Hospitals

4% (n=220)

Sydney LHD 60% (n=5386)

Page 28 of 39


6.4 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 24. ACSC admissions are those in which the resulting hospitalisation is thought to be largely preventable via the application of public health interventions that are usually provided in an ambulatory setting such as primary care.

Higher rates of ACSC hospitalisations may reflect indirect evidence of problems with the provision of 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 1,944.6 per 100,000 persons in Leichhardt LGA in 2011-13, and was significantly lower than the state level.

Table 30: Potentially preventable hospitalisation separations for ACSCs by LGA 2011-13 LGA Separations per year Separations per 100,000 sSSR16 relationship to state

levels Ashfield 837 1,882.5 Significantly lower than the state Burwood 631 1,847.5 Significantly lower than the state Canada Bay 1,507 1,869.0 Significantly lower than the state Canterbury 3,255 2,288.4 Significantly lower than the state Leichhardt 953 1,944.6 Significantly lower than the state Marrickville 1,488 2,124.9 Significantly lower than the state Strathfield 593 1,749.5 Significantly lower than the state Sydney 3,010 2,222.1 Significantly lower than the state Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health

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

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

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

Page 29 of 39


6.5 Home and Community Care Figure 25 and Table 31 shows the profile of Home and Community Care (HACC) clients in Leichhardt LGA compared to the IWS catchment and NSW. During this reporting period, there were 27 Indigenous HACC clients in the Leichhardt LGA. The proportion of HACC clients living alone in Leichhardt LGA (43%) was higher than both the IWS catchment (39%) and NSW (39%). Likewise, the proportion living with a carer was higher in Leichhardt LGA (25%) compared to the IWS catchment (23%) and NSW (21%). The proportion of clients that were not English speaking in Leichhardt LGA (18%) was markedly lower than the IWS catchment (39%), but slightly higher than NSW (11%).

Figure 25: HACC Client Profile by Leichhardt LGA, IWS and NSW, 2012-2013

Source: Public Health Information Development Unit (2014)

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

Living alone 42.5 (524) 39.1 (6499) 39.0 (106308) Living with carer 25.2 (311) 23.0 (3825) 20.7 (56385) Indigenous 2.2 (27) 1.4 (230) 3.8 (10268) Non-english speaking 17.9 (221) 39.0 (6484) 11.2 (30469) Source: Public Health Information Development Unit (2014)

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Figure 26 and Table 32 provides a comparison of selected HACC services in Leichhardt LGA, the IWS catchment and NSW. The rate of allied health care and centre-based day care services received by HACC clients in Leichhardt LGA was lower compared to the IWS catchment, but similar to NSW. In contrast, the rates of care counselling and case management were higher in Leichhardt LGA compared to both the IWS catchment and NSW. The rate of care coordination received by Leichhardt LGA residents was lower compared to both the IWS catchment and NSW. The instances of domestic assistance and transport services per 1,000 in Leichhardt LGA were similar to the IWS catchment, but lower than NSW.

Figure 26:HACC Service Profile by Leichhardt LGA, IWS and NSW, 2012-13


Table 32: HACC Service Profile; Instances of care per 1,000 (actual number), 2012-13 Indicator Leichhardt LGA Inner West Sydney New South Wales

Allied health care 2.5 (107) 3.5 (1822) 2.3 (17549) Care counselling 4.3 (182) 2.8 (1476) 3.5 (26863) Case management 4.1 (180) 3.0 (1580) 2.0 (15261) Centre-based daycare 2.2 (93) 4.7 (2446) 2.8 (21907) Care coordination 2.4 (98) 4.1 (2096) 4.0 (30940) Domestic assistance 5.3 (217) 5.8 (2979) 7.1 (54720) Transport 7.8 (323) 8.0 (4120) 9.4 (72274)


Page 31 of 39


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

The Royal Prince Alfred Hospital (RPA) is a principle referral hospital providing tertiary and quaternary 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 Sydney Local Health District, 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 providing tertiary and quaternary acute services to its IWS catchment, rural and other metropolitan residents, interstate and overseas patients. Examples of the tertiary and quaternary medical and surgical services at Concord include the state-wide Burns service, Andrology, Bariatric surgery, Neurology and Stroke, Cardiology, Aged Care, Medical Rehabilitation, Ophthalmology, Urology, Immunology, Upper GI, Colorectal, Orthopaedics, Plastic surgery, integrated Cancer care, Emergency Medicine and Critical Care. Inpatient Maternity and Paediatric services are not available at Concord Hospital. Concord 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 Leichhardt LGA is home to the 75 bed Balmain Hospital, and also a Day Surgery (Table 33).

Table 33: Acute and day surgery facilities in Leichhardt LGA, HERO Database, 2015 Health Service Name Service Type Location

Camperdown Sleep Investigation Centre, The Day Surgery Annandale Balmain Hospital Public Hospitals Balmain

Source: NSW Health Establishments Registration Online (HERO) database

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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

• Child and Family Health

• Multicultural Health • Youth Health • Women’s Health • Sexual Assault

Services • Counseling

• Community Nutrition • Child Protection

Community based health services are located in numerous facilities across the IWS catchment 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 Leichhardt LGA, that are currently registered on the NSW Health Establishment Registration Online Database (HERO) include early childhood, youth and mental health services (Table 34).

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

Leichhardt Women's Community Health Centre Community Health Leichhardt Leichhardt Early Childhood Health Centre Child Health Services Leichhardt SLHD Foundation House Drug & Alcohol Lilyfield Aftercare Association of NSW Mental Health Services Leichhardt Balmain Early Childhood Centre Child Health Services Balmain Mental Health Coordinating Council Mental Health Services Rozelle MH Children & Young People Taskforce Mental Health Services Leichhardt NSW Consumer Advisory Group Mental Health Services Rozelle Rozelle Assertive Follow-up Mental Health Services Leichhardt Rozelle Boarding House Mental Health Services Leichhardt Rozelle GP Shared Care Mental Health Services Leichhardt Rozelle Psychogeriatric Services Mental Health Services Leichhardt

Source: NSW Health Establishments Registration Online (HERO) database

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7.3 General Practice Selected characteristics of General Practitioners currently practicing across the IWS catchment are shown in Figure 27. Currently the number of GPs per 100,000 persons in Leichhardt LGA was the highest in the IWS catchment. Leichhardt LGA also has the greatest number of GPs per capita that deliver services under the Access to Allied Psychological Services(ATAPS) GP psychological support scheme of any LGA across the IWS catchment.

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

Source: Central and Eastern Sydney PHN (2015).

Page 34 of 39


7.4 Allied Health Figure 28 shows the availability of various allied health practitioners in Leichhardt LGA on a per-capita basis, compared to the IWS catchment. Leichhardt LGA was well-served by most allied health services relative to the average across the IWS catchment; particularly Psychologists, Chiropractors, Pharmacists, Physiotherapists, Podiatrists, Osteopaths and Speech Pathologists. In fact, over all the disciplines, Leichhardt LGA had the greatest number of allied health practitioners per 100,000 persons of any LGA within IWS catchment.

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

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

Page 35 of 39


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

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

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

5,580 87,913 126.2 111.2

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

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

Table 36: Aged care facilities in Leichhardt LGA, HERO Database, 2015 Aged Care Facilities Facility Location

Opal Annandale Residential Aged Care Facility Annandale Sister Dorothea Residential Aged Care Facility Annandale Montrose Aged Care Plus Centre Residential Aged Care Facility Balmain UnitingCare Aldersgate House Residential Aged Care Facility Leichhardt UnitingCare The Marion Residential Aged Care Facility Leichhardt UnitingCare Annesley House Residential Aged Care Facility Lilyfield

Source: NSW Health Establishment Registration Online (HERO) database

Page 36 of 39


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 thepostcode 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

Page 37 of 39


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.

Page 38 of 39


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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