www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817 ABN 49 158 486 670
Company Name (ABN 000000000), trading as Name of Company’s Trading Name (if different from Company’s Name)
Page |2 FINAL
Acknowledgments The Eastern Sydney Medicare Local would like to acknowledge the Australian Government Department of Health for funding the preparation of this report.
We extend sincere thanks to those representatives that contributed to the preparation of this report specifically, the South Eastern Sydney Local Hospital District Planning and Population Health Unit.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |3 FINAL
Contents 1. Introduction ............................................................................................................. 6 2. Population and community characteristics .......................................................... 7 2.1. 2.2. 2.3. 2.4. 2.5. 2.6. 2.7.
Population characteristics ..............................................................................................................7 Birth rate .........................................................................................................................................8 Cultural characteristics ...................................................................................................................8 Aboriginal and Torres Strait islander community .........................................................................10 Family structure ............................................................................................................................11 Private health insurance coverage................................................................................................11 Broadband internet access ...........................................................................................................12
3. Social determinants of health .............................................................................. 13 3.1. 3.2. 3.3. 3.4. 3.5. 3.6. 3.7.
Socio-economic characteristics ....................................................................................................13 Income ..........................................................................................................................................13 Employment ..................................................................................................................................14 Education levels ...........................................................................................................................15 Homelessness ..............................................................................................................................16 Social cohesion / community strength ..........................................................................................17 Barriers to accessing services......................................................................................................17
4. Health characteristics and risk factors ............................................................... 18 4.1. 4.2. 4.3. 4.4. 4.5. 4.6. 4.7. 4.8. 4.9. 4.10. 4.11.
Self-reported health status ...........................................................................................................18 Health risk factors .........................................................................................................................18 Immunisation, infant mortality and wellbeing ...............................................................................19 Prevalence of chronic disease .....................................................................................................21 Cancer screening rates ................................................................................................................22 Prevalence of cancer ....................................................................................................................22 Disability .......................................................................................................................................23 Mortality ........................................................................................................................................24 Alcohol-related domestic violence incidences ..............................................................................25 STI Rates......................................................................................................................................25 Infectious diseases .......................................................................................................................28
5. Health service availability..................................................................................... 30 5.1. 5.2. 5.3. 5.4. 5.5. 5.6.
Hospitals .......................................................................................................................................30 General practitioners ....................................................................................................................30 Allied health ..................................................................................................................................31 Mental health services ..................................................................................................................32 Community health services ..........................................................................................................32 Aged care .....................................................................................................................................33
6. Health service utilisation ...................................................................................... 34 6.1. 6.2. 6.3. 6.4. 6.5. 6.6. 6.7. 6.8.
Primary care utilisation .................................................................................................................34 Hospital admission .......................................................................................................................35 Top 10 causes of hospital admission ...........................................................................................35 Ambulatory care sensitive admissions .........................................................................................36 Number of hospitalisations for conditions of interest....................................................................36 Hospitalisations resulting from risk factors ...................................................................................38 Mental health services ..................................................................................................................40 Home and Community Care (HACC) ...........................................................................................40
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |4 FINAL
List of figures Figure 1: Population profile ........................................................................................................................................... 7 Figure 2: Forecast population growth ............................................................................................................................. 8 Figure 3: Birth rates ........................................................................................................................................................ 8 Figure 4: Primary languages spoken at home ................................................................................................................ 9 Figure 5: Breakdown of South Asian Languages ............................................................................................................ 9 Figure 6: Breakdown of South East Asian (excl Thai) languages ................................................................................. 10 Figure 7: Indigenous persons population profile ........................................................................................................... 10 Figure 8: Family structure ............................................................................................................................................ 11 Figure 9: Private health insurance coverage ................................................................................................................ 11 Figure 10: Broadband internet access at home ............................................................................................................ 12 Figure 11: Comparison of SEIFA Advantage and Disadvantage .................................................................................. 13 Figure 12: Annual household income ........................................................................................................................... 13 Figure 13: Income support ............................................................................................................................................ 14 Figure 14: Top five Industry sectors of employment ..................................................................................................... 14 Figure 15: Unemployment ............................................................................................................................................ 15 Figure 16: Highest year of school completed ................................................................................................................ 15 Figure 17: Secondary school participation .................................................................................................................... 16 Figure 18: Homelessness ............................................................................................................................................. 16 Figure 19: Indicators of community strength ................................................................................................................. 17 Figure 20: Barriers to accessing service ....................................................................................................................... 17 Figure 21: Self assessed health ................................................................................................................................... 18 Figure 22 Health risk factors ......................................................................................................................................... 19 Figure 23: Percentage of children fully immunised ....................................................................................................... 19 Figure 24: Pertussis notifications .................................................................................................................................. 20 Figure 25: Pneumococcal presentations ....................................................................................................................... 20 Figure 26: Percentage of low birth weight babies and mothers who smoke whilst pregnant ....................................... 21 Figure 27: Prevalence of selected chronic conditions ................................................................................................... 21 Figure 29: Comparison of cancer screening outcomes................................................................................................. 22 Figure 30: Prevalence of selected cancers ................................................................................................................... 23 Figure 31: Proportion of people with profound or severe disabilities ............................................................................. 23 Figure 32: Proportion of people who have need for assistance with core activities ...................................................... 24 Figure 33: Premature mortality from chronic disease.................................................................................................... 24 Figure 34: Potentially avoidable deaths ..................................................................................................................... 25 Figure 35: Comparison of alcohol related domestic violence ....................................................................................... 25 Figure 36: HIV notifications ........................................................................................................................................... 26 Figure 37:Chlamydia notifications ................................................................................................................................. 26 Figure 38: Rectal chlamydia notifications ..................................................................................................................... 27 Figure 39: Gonorrhea notifications................................................................................................................................ 27 Figure 40: Syphilis notifications .................................................................................................................................... 28 Figure 41: Hepatitis B notifications ............................................................................................................................... 28 Figure 42: Hepatitis C notifications ............................................................................................................................... 29 Figure 43: GPs per 1000 population ............................................................................................................................ 30 Figure 44: After hours GP clinics .................................................................................................................................. 31 Figure 45: Allied health Practitioners ............................................................................................................................ 31 Figure 46: Number of ATAPS providers ....................................................................................................................... 32 Figure 47: Aged care availability ................................................................................................................................... 33 Figure 48: Selected primary care services .................................................................................................................... 34 Figure 49: MBS GP services per person ...................................................................................................................... 34 Figure 50: Hospitalisation rate ...................................................................................................................................... 35 Figure 51: Top 10 causes of hospitalisation ................................................................................................................. 35 Figure 52: Preventable hospitalisations ....................................................................................................................... 36 Figure 53: Stroke hospitalisations ................................................................................................................................. 36 Figure 55: Coronary heart disease hospitalisations ...................................................................................................... 37 Figure 55: Diabetes related hospitalisations ................................................................................................................. 37 Figure 56: Alcohol related hospitalisations .................................................................................................................. 38 Figure 57: Smoking related hospitalisation ................................................................................................................... 38 Figure 58: High body mass related hospitalisations ..................................................................................................... 39 Figure 59: Number of falls ............................................................................................................................................ 39 Figure 60: Percentage of ATAPS referral’s by sub region ............................................................................................ 40 Figure 61: Characteristics of HACC clients ................................................................................................................... 40 Figure 62: Utilisation of HACC services ........................................................................................................................ 41
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |5 FINAL
Glossary of Terms Term Eastern Sydney Medicare Local
Eastern Sydney ESML SLA LGA ML ABS PHIDU
Explanation Refers to an independent organization that coordinates primary health care delivery for residents living within the sub-regions of Sydney-Inner SLA, Sydney-East SLA, Waverley LGA, Woollahra LGA, Randwick LGA, Botany Bay LGA and Lord Howe Island Refers to data associated with Sydney LGA, Waverley LGA, Woollahra LGA, Randwick LGA, Botany Bay LGA, but excludes Sydney-North LGA, Sydney West LGA and Lord Howe Island LGA Eastern Sydney Medicare Local Statistical Local Area Local Government Area Medicare Local Australian Bureau of Statistics Population Health Information Development Unit
Data Data was gathered from a number of different sources including the Australian Bureau of Statistics (ABS), Public Health Information Development Unit (PHIDU), South East Sydney LHD, Health Statistics NSW and ESML. We have relied on the data provided wherever possible and have avoided carrying out extrapolations or making assumptions in interpreting the data. Data Limitations 1. Comparable data sets were not always available when comparing sub-regional information to the ML level. As such two points of comparison have been primarily used and presented against a NSW figure (where possible) - ESML and Eastern Sydney. 2. Large portions of respondents to certain data sets (e.g. in ABS census data) had either not responded or marked answers as ‘not applicable’. In all cases where this has occurred these responses have been excluded from the graphical representations presented in this report. As a result, some figures presented in this report do not always total 100%. 3. The Health Workforce Australia data used to present the levels of Allied Health practitioners does not take into consideration those disciplines that are self-regulated. 4. Due to a small population size of approximately 350 residents, data relating to residents on Lord Howe Island have not been included (where data is presented at the sub-regional and ML level) due to privacy reasons.
Disclaimer th This report is prepared solely for the purpose set out in our job arrangement letter dated 10 December 2013 and is not to be used for any other purpose. The information provided in this report is based on information supplied by Eastern Sydney Medicare Local and other publicly available data sources. Paxton Partners has not verified the detailed assumptions and has relied on the information and data as sourced. The scope of work for this project did not include procedures considered necessary under generally accepted auditing standards for the purposes of expressing an opinion on the data provided. Accordingly, Paxton Partners does not express such an opinion
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |6 FINAL
1. Introduction The Botany Bay Local Government Area (LGA) (2011 pop: 39,355) is a south eastern suburb of 1 metropolitan Sydney in New South Wales. Spanning 27 square kilometers, including significant foreshore areas, this LGA is bordered by the City of Sydney in the north, Randwick City in the east, Botany Bay in the south, and Rockdale City and the Marrickville Council areas in the west. Suburbs in this catchment include Daceyville, Eastlakes, Mascot, Pagewood and Rosebery. The Kameygal people are the traditional owners of these lands. Kingsford-Smith International Airport and Port Botany serve as strong industrial anchors in this region. Table 1.1 provides general characteristics of the Botany Bay sub-region at a glance. Table 1: Characteristics of the Botany Bay sub-region at a glance
Indicator Population Population growth forecast (2011 – 2025) % indigenous persons Average household income* Unemployment^ % Speak English in the home^ Private health insurance coverage
Value 39,355
Sub-region Rank within ML 5
Medicare local
NSW
383,014
7,211,486
2.6%
6
12.9%
15.3%
1.5% $64,740 3.5% 53.4% 42.6%
1 6 5 5 5
0.9% N/A 2.7% 69.8% 56.6%
2.5% $64,324 5.3% 76.5% 48.2%
Source: ^Australian Bureau of Statistics; *City profile (profile.id); (unmarked) Public Health Information Development Unit and Australian Bureau of Statistics.
1
http://profile.id.com.au/botany-bay/about; accessed 28 January 2014. www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |7 FINAL
2. Population and community characteristics Headlines
Higher proportion of 0-19 year olds as compared to the ESML average
Lower proportion of 20-39 year olds as compared to the ESML catchment average
Lowest population growth forecast across the Medicare Local region
5 lowest percentage of families who speak English in the home within the region
Lower levels of full time employment as compared to the ESML and NSW averages
th
2.1. Population characteristics Figure 1 shows that the population profile of Botany Bay sub-region is higher than the Medicare Local (ML) for age ranges 0 to 19 and 35 to 64. These age ranges account for 62.3% of the total population within the Botany Bay catchment area, compared to 55.3% across the ML catchment. In contrast, a smaller proportion of Botany Bay’s population is aged between 20 to 34 and 65 and above (33.4%) compared to the Eastern Sydney Medicare Local (ESML) average (41.0%). Figure 1: Population profile
Source: PHIDU and Australian Bureau of Statistics (2013)
Population growth forecasts for Botany Bay between 2011 and 2025 are provided in Figure 2. According to the Australian Bureau of Statistics (ABS), population growth is expected to be lower for the subregion (2.6%) compared to the ESML average (12.9%) from 2011 to 2025. There are negative population growth forecasts for most age groups under 60, as opposed to higher growth rates forecast in the population aged 85 or more, which is expected to increase by 65.8% between 2011 and 2025, when compared to the ESML average. Although these population growth estimates were released in 2011, several high development areas have either been approved or are under construction within this LGA including Mascot Station, the British American Tobacco location in Pagewood, Rosebery and the Banksmeadow precinct. Although not technically located within its boundaries, the bordering Green Square development is expected to attract 40,000 new residents and 22,000 new workers by 2030.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |8 FINAL
Figure 2: Forecast population growth
Source: PHIDU and Australian Bureau of Statistics (2013)
2.2. Birth rate The birth rate in Botany Bay is currently the highest among all sub-regions in the ML (1.73 children per female) but is lower than the average for NSW overall (1.80 births per female). Figure 3: Birth rates
Source: PHIDU and Australian Bureau of Statistics (2013)
2.3. Cultural characteristics The majority of the population identifies English as their primary language (53%). This is lower than the average for both the ESML (70%) and NSW (77%). The graph below shows the major primary languages spoken at home in Randwick, with the exception of English. Chinese (6.9%), Greek (6.2%), South Asian (6.1%) and Southeast Asian languages (5.7%) are the other most common primary languages spoken in Botany Bay residences.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
Page |9 FINAL
Figure 4: Primary languages spoken at home
Source: Australian Bureau of Statistics (2012)
A further breakdown of South Asian languages reveals that 3.84% of the population of Botany Bay speaks Bengali in the home compared with 0.65% of the population of ESML and 0.33% of the population of NSW. The second most common dialect spoken within the South Asian languages group was Hindi with 0.99% of the total Botany Bay population identifying themselves as Hindi speakers. Figure 5: Breakdown of South Asian Languages
Source: Australian Bureau of Statistics (2012)
A breakdown of the South East Asian (excluding Thai) languages shows that 3.37% of the Botany Bay population speaks Indonesian in the home compared with 1.83% of the ESML population and 0.38% of NSW. There are also higher percentages of Tagalog, Filipino and Malay speakers in the Botany Bay population compared with those of ESML and NSW.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 10 FINAL
Figure 6: Breakdown of South East Asian (excluding Thai) languages
Source: Australian Bureau of Statistics (2012)
2.4. Aboriginal and Torres Strait islander community Indigenous Australians comprise 1.5% of the total population of the Botany Bay sub-region, which is higher than for the ESML catchment (0.9%) but lower than NSW (2.4%). The Indigenous population is also proportionally larger within the younger age ranges from 0-19 within Botany Bay when compared to ESML. Figure 7: Indigenous persons population profile
Source: PHIDU and Australian Bureau of Statistics (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 11 FINAL
2.5. Family structure Figure 7 shows a breakdown of predominant family structures living within the catchment. The most common family type in Botany Bay is a ‘couple family with children’ (31%), which is broadly consistent with NSW overall, but is higher than the ESML catchment area (19%). Botany Bay also has higher levels of ‘one parent families’ (11.3%) compared to ESML (6.5%). Figure 8: Family structure
Source: Australian Bureau of Statistics (2012)
2.6. Private health insurance coverage Figure 9 shows that 38.2% of Botany Bay residents have private health insurance. This is lower than the figures for the ESML catchment (56.6%) and NSW as a whole (48%). Figure 9: Private health insurance coverage
Source: PHIDU and Australian Bureau of Statistics (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 12 FINAL
2.7. Broadband internet access Figure 10 shows that broadband internet penetration within households in Botany Bay (68.1%) is lower than both ESML (74.7%) and NSW (69.9%). Figure 10: Broadband internet access at home
Source: PHIDU and Australian Bureau of Statistics (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 13 FINAL
3. Social determinants of health Headlines
Botany Bay has the lowest SEIFA score in the ESML.
Above average levels of income support are required in Botany Bay compared to the rest of ESML.
Higher levels of the population cannot afford medical care and medication when compared to the ESML and NSW.
3.1. Socio-economic characteristics The Socio-Economic Indexes for Areas (SEIFA) index score for socio-economic advantage and disadvantage in Botany Bay is 985, which is the lowest among the six sub-regions within the ESML catchment. The graph below highlights the respective percentile rank for both socio economic advantage and disadvantage. Figure 11: Comparison of SEIFA Advantage and Disadvantage
Source: Australian Bureau of Statistics (2013)
3.2. Income Figure 12 shows that average household incomes for residents of Botany Bay are broadly in line with NSW overall. Compared to other residents in the ESML catchment, personal incomes in Botany Bay are lower on average, with a relatively higher proportion of the Botany Bay residents earning below $65,000 per year. Figure 12: Average household income
Source: Australian Bureau of Statistics (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 14 FINAL
Figure 13 shows that more people within Botany Bay receive income support than within the ESML catchment as a whole. However, when compared with NSW, the proportion of people receiving income support in Botany Bay is lower. Figure 13: Income support
Source: PHIDU and Centrelink (2013)
3.3. Employment Industry An analysis of the jobs held by residents of Botany Bay reveals that the top five industry sectors of employment are healthcare and social assistance (5.2%), retail trade (4.7%), transport, postal and warehousing (4.7%), accommodation and food services (3.4%) and manufacturing (3.4). Together, these five industries employ 22% of the population, which is higher when compared to the ML (18%) and NSW (19%). Figure 14: Top five Industry sectors of employment
Source: Australian Bureau of Statistics (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 15 FINAL
Employment status The percentage of people who are unemployed within the Botany Bay sub region is 3.53%, which is higher than ESML (2.72%) but lower than the NSW average (5.25%). Figure 15: Unemployment
Source: PHIDU and Australian Bureau of Statistics (2013)
3.4. Education levels Within the Botany Bay sub-region 44% of people aged over 15 years have completed Year 12 schooling/ or equivalent. This is lower than across the ESML (58%) but higher than the overall figure for NSW (38%). Figure 16: Highest year of school completed
Source: Australian Bureau of Statistics (2012)
Data available from PHIDU shows that secondary school participation at age 16 in Botany Bay (80%) is broadly in line with ESML (83%) and NSW (80%). The proportion of school leavers from Botany Bay that go on to pursue higher education qualifications ( 36%) is lower than ESML (41%) but greater than the NSW average (30%).
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 16 FINAL
Figure 17: Secondary school participation
Source: PHIDU and Australian Bureau of Statistics (2012)
3.5. Homelessness Figure 18 shows that the per-capita rate of homelessness in Botany Bay (0.70%) is lower than the level across the ESML (1.14%) and NSW (0.76%). Figure 18: Homelessness
Source: Australian Bureau of Statistics (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 17 FINAL
3.6. Social cohesion / community strength Figure 19 shows that Botany Bay is broadly in line with the ESML and NSW when it comes to indicators of community strength. All three demographics feel strongly that they can get support in a time of crisis (all over 80%) with only approx. 5% of the population disagreeing with the acceptance of foreign cultures. Figure 19: Indicators of community strength
Source: PHIDU and Australian Bureau of Statistics (2013)
3.7. Barriers to accessing services Figure 20 shows the major barriers to accessing services across Botany Bay. Affordability is evident as a predominant barrier to access, with a higher proportion of residents citing an inability to afford medical treatment (11.9%) and medications (9.1%) compared to the ESML catchment. The major barrier though was the proportion of people who did not access the internet (24.5%). Figure 20: Barriers to accessing services
Source: PHIDU and Australian Bureau of Statistics (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 18 FINAL
4. Health characteristics and risk factors Headlines
There is a high level of physically inactive persons in Botany Bay than the ESML and NSW averages (40%)
Levels of alcohol related violence are lower in Botany Bay (1.3 per 1000 of population) than ESML (1.5) and NSW (1.4)
High level of children fully immunised in Botany Bay (95.4%), compared to both ESML (87.4%) and NSW (91.4%)
Botany Bay has a higher percentage of low birth weight babies (7.2%) compared to the ESML (5.5%) and NSW (6.1%)
High prevalence of musculoskeletal and respiratory disease compared with ESML and NSW averages
Higher levels of potentially avoidable deaths and preventable hospitalisations than ESML and NSW
Above average levels of profound or severe disability in over 65 year olds compared to ESML and NSW
4.1. Self-reported health status Figure 21 shows that the levels for fair or poor self-assessed health in Botany Bay (17.8%) are higher than across the ESML (12.5%) and NSW (16.6%). It also illustrates that the levels of those with restricted core activities are higher in Botany Bay (10.9%) than the ESML (9.3%) but lower than NSW (11.5%). Figure 21: Self assessed health
Source: PHIDU and Australian Bureau of Statistics (2013)
4.2. Health risk factors Figure 22 shows that the health risk profile of Botany Bay varies across the categories captured when compared to the average across the ESML. For the proportion of smokers, obese persons, physically inactive persons and the psychologically distressed levels are higher in Botany Bay. However, the proportion of the population with risky alcohol consumption and overweight persons are below the ESML average.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 19 FINAL
Figure 22 Health risk factors
Source: PHIDU and Australian Bureau of Statistics (2013)
4.3. Immunisation, infant mortality and wellbeing Childhood immunisation Figure 23 shows the percentage of children that are fully immunised at one, two and five years of age. For all ages, immunisation rates in Botany Bay are broadly in line with NSW overall, and are greater than in the ESML catchment. Figure 23 also shows a gradual decline in the proportion of children fully immunized, which appears to be most pronounced between one and two years of age. Figure 23: Percentage of children fully immunised
Source: PHIDU and Australian Childhood Immunisation Register / Medicare Australia (2013)
Pertussis The graph below shows the number of pertussis notifications in Botany Bay each year from 2008-12, along with an overall figure for Eastern Sydney (comprising Botany Bay, Randwick, Sydney, Waverley and Woollahra LGA’s). The graph shows that the volume of notifications increased across Botany Bay from 2008-2011 but have subsequently declined and in 2012 were below the 2008 levels.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 20 FINAL
Figure 24: Pertussis notifications
Source: South East Sydney Local Health District
Pneumococcal The number of pneumococcal notifications has remained relatively stable in Botany Bay. In 2008 and 2012 the same number of notifications (6) occurred and there were no major fluctuations between those years. For the Eastern Sydney region the number of notifications has increased from 23 per annum to 31, representing an increase of 34%. This is shown in the graph below. Figure 25: Pneumococcal presentations
Source: South East Sydney Local Health District
Low birth weight babies Figure 26 shows the percentage of low birth weight babies and the percentage of mothers who smoke whilst pregnant within the Botany Bay sub region, ESML and NSW. Botany Bay has a higher rate of low birth weight babies (7.2%) than ESML (5.5%) and NSW (6.1%). The level of women who smoke whilst pregnant in Botany Bay is 5.5% compared with 2.5% in the ESML and 12.0% in NSW as a whole.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 21 FINAL
Figure 26: Percentage of low birth weight babies and mothers who smoke whilst pregnant
Source: PHIDU and NSW Ministry of Health (2013)
4.4. Prevalence of chronic disease Figure 27 shows that the prevalence rates for chronic diseases within the Botany Bay sub region are broadly in line with those shown for both the ESML and NSW for type 2 diabetes, high cholesterol, mood disorders and respiratory systems disease. The greatest variation is in the percentage of the population suffering from circulatory system diseases which is 14.5% in Botany Bay compared to 12.4% in the ESML and musculoskeletal diseases (28.6% in Botany Bay compared to 27.9% across ESML and 29.8% in NSW) Figure 27: Prevalence of selected chronic conditions
Source: PHIDU and Australian Bureau of Statistics (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 22 FINAL
4.5. Cancer screening rates Figure 28 shows the percentage of people who were eligible for, and participated in bowel and cervical cancer screening programs in 2010. 31% of those eligible in Botany Bay participated in the bowel cancer screening program which was higher than the ESML (30%) and lower than NSW (35%). 53% of those eligible for the cervical cancer screening program in Botany Bay took part compared with 60% in the ESML catchment and 56% across NSW. No data was available regarding breast cancer screening. Figure 28: Cancer screening rates
Sources: PHIDU and Department of Health and Ageing (2010). Formal publication and reporting of the NBCSP data is undertaken by the Australian Institute of Health and Welfare on behalf of the Department of Health and Ageing. NBCSP data included in this report provided by the Department of Health and Ageing is not part of the formal publication and reporting process for NBCSP data; PHIDU and NSW Central Cancer Registry (2009 and 2010).
Figure 29 shows the proportion of test results in relation to cancer screening programs that indicated some form of abnormality. The percentage of bowel cancer screening participants that showed some form of abnormality was 9.7% in Botany Bay which was higher than both in the ESML catchment (7.3%) and NSW (8.4%). The rate of low-grade abnormalities from the cervical cancer screening was 3.1% in Botany Bay compared with 4.6% in the ESML catchment and 3.2% in NSW. The rate of high-grade cervical screening abnormalities in Botany Bay was 0.7% compared with 0.8% in the ESML and 0.6% in NSW. Figure 29: Comparison of cancer screening outcomes
Sources: PHIDU and Department of Health and Ageing (2010). Formal publication and reporting of the NBCSP data is undertaken by the Australian Institute of Health and Welfare on behalf of the Department of Health and Ageing. NBCSP data included in this report provided by the Department of Health and Ageing is not part of the formal publication and reporting process for NBCSP data; PHIDU and NSW Central Cancer Registry (2009 and 2010).
4.6. Prevalence of cancer Figure 30 shows the prevalence of certain cancer types across the sub regions and NSW as a whole. No data at the Medicare Local level was available. Botany Bay has the highest prevalence of both cervical (0.059 per 1000 population) and stomach (0.139) cancer of any sub-region across the ESML catchment, www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 23 FINAL
but the lowest prevalence of breast (0.541) and prostate (0.688) cancers per 1000 persons. Figure 30: Prevalence of selected cancers
Source: Cancer Institute NSW (2010)
4.7. Disability Profound or severe disabilities 'People with Profound/severe disability are those who need some ongoing help or supervision with 2 communication, self-care and/or mobility for six months or more . Figure 31 shows the proportion of persons with profound or severe disability is within the Botany Bay sub region. The graph shows that levels of profound or severe disability are generally higher in Botany Bay, particularly for persons aged 65 or more. Figure 31: Proportion of people with profound or severe disabilities
Source: PHIDU and Australian Bureau of Statistics (2013)
2
Australian Bureau of Statistics, accessed from http://www.abs.gov.au/ausstats/abs@.nsf/Products/4367.0~20072008~Main+Features~Introduction?OpenDocument; on 5 Feb 2014 www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 24 FINAL
Need for assistance with core activities The proportion of people who require assistance with core activities is the same in Botany Bay (4.69%) as it is in NSW (4.69%). However this figure is lower within ESML where only 2.96% of people require assistance with core activities. Figure 32: Proportion of people who have need for assistance with core activities
Source: PHIDU and Australian Bureau of Statistics (2013)
4.8. Mortality Premature mortality refers to deaths among people aged less than 75 years. Figure 33 presents mortality rates from chronic conditions in Botany Bay for persons aged between 0 and 74. The data shows that premature mortality is higher in Botany Bay than the ESML average for cancer, circulatory system disease and respiratory system disease, whilst having lower rates of premature mortality related to external causes and suicide. Figure 33: Premature mortality from chronic disease (ages 0 to 74 years) and external causes
Source: PHIDU and Australian Bureau of Statistics (2013)
A potentially avoidable death is one that, theoretically, could have been avoided given an understanding of causation, the adoption of available disease prevention initiatives and the use of 3 available health care. Figure 34 below illustrates that the per-capita rate of avoidable mortality i n B o t a n y B a y (1.14 deaths per 1,000 persons) is 3 9 % higher than the ESML (0.82) and 25% higher than the NSW rate (0.91).
3
Australian Bureau of Statistics, accessed from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1370.0~2010~Chapter~Potentially%20avoidable%20deaths%20 on 5 February 2014 www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 25 FINAL
Figure 34: Potentially avoidable deaths per 1,000 persons
Source: Health Statistics NSW and NSW Ministry of Health
4.9. Alcohol-related domestic violence incidences The graph below illustrates that the alcohol-related domestic violence rates are lower in the Botany Bay sub region (1.2 incidences per 1000 population) than in both Eastern Sydney (1.5) and NSW (1.4). Figure 35: Comparison of alcohol related domestic violence incidence
Source: NSW Bureau of Crime Statistics and Research (2012)
4.10. Sexually Transmissible Infections HIV The graph below illustrates the volume of HIV notifications since 2011. The data is split between those notifications that occurred in Sydney LGA and those in the rest of the ESML catchment. The reason the data has been presented in this format is due to the sensitivities around providing it at an LGA level due to the low levels of notifications in certain LGA’s. The data shows that from 2011 to 2012 notifications increased in Sydney LGA by 31%, but decreased by 20% in the rest of the region resulting in a 15% overall increase. The data provided for 2013 only covered the period from January – September so has not been used for comparative purposes.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 26 FINAL
Figure 36: HIV notifications
Source: South Eastern Sydney Local Health District
Chlamydia The graph below shows the annual number of notifications of chlamydia in Botany Bay over the period from 2008-12. Alongside this the graph tracks the overall number of notifications across Eastern Sydney (comprising Botany Bay, Randwick, Sydney, Waverley and Woollahra LGA’s). The number of notifications has risen from 91 to 105 per annum in Botany Bay over the period representing an increase of 15%. The overall number of notifications for Eastern Sydney has increased from 1887 to 2556 per annum, representing an increase of 35%. Figure 37:Chlamydia notifications
Source: South Eastern Sydney Local Health District
Rectal Chlamydia in males The graph below shows the annual number of notifications of rectal chlamydia in males in Botany Bay over the period from 2008-12. Alongside this the graph tracks the overall number of notifications across Eastern Sydney (comprising Botany Bay, Randwick, Sydney, Waverley and Woollahra LGA’s). The number of notifications has risen from 7 to 15 per annum in Botany Bay over the period representing an increase of 114%. The overall number of notifications for Eastern Sydney has increased from 249 to 429 per annum, representing an increase of 72%.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 27 FINAL
Figure 38: Rectal chlamydia notifications
Source: South Eastern Sydney Local Health District
Gonorrhea The graph below shows the annual number of notifications of gonorrhea in Botany Bay over the period from 2008-12. Alongside this the graph tracks the overall number of notifications across Eastern Sydney (comprising Botany Bay, Randwick, Sydney, Waverley and Woollahra LGA’s). The number of notifications has risen from 11 to 52 per annum in Botany Bay over the period representing an increase of 373%. The overall number of notifications for Eastern Sydney has increased from 384 to 1114 per annum, representing an increase of 190%. Figure 39: Gonorrhea notifications
Source: South Eastern Sydney Local Health District
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 28 FINAL
Syphilis The graph below shows the annual number of notifications of syphilis in Botany Bay over the period from 2008-12. Alongside this the graph tracks the overall number of notifications across Eastern Sydney (comprising Botany Bay, Randwick, Sydney, Waverley and Woollahra LGA’s). The number of notifications has risen from 4 to 6 per annum in Botany Bay over the period. The overall number of notifications for Eastern Sydney has increased from 179 to 191 per annum, representing an increase of 6%. Figure 40: Syphilis notifications
Source: South Eastern Sydney Local Health District
4.11. Infectious diseases Hepatitis B From 2008 – 2012 there has been a downward trend in the number of notifications in both Botany Bay in the Eastern Sydney region. In Botany Bay notifications have gone from 30 in 2008 to 21 in 2012, a decrease of 30%. In Eastern Sydney they have decreased from 210 in 2008 to 137 in 2012, a decrease of 35%. This is illustrated on the graph below. Figure 41: Hepatitis B notifications
Source: South Eastern Sydney Local Health District
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 29 FINAL
Hepatitis C The graph below illustrates the number of Hepatitis C notifications in Botany Bay and the Eastern Sydney region annually from 2008 to 2012. The number of notifications in Botany Bay has remained relatively stable with 14 notifications in 2008 and 15 in 2012. The peak was 18 in 2011. The overall figure for the Eastern Sydney region has declined from256 notifications in 2008 to 179 in 2012, a decrease of 30%. This is shown on the graph below. Figure 42: Hepatitis C notifications
Source: South Eastern Sydney Local Health District
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 30 FINAL
5. Health service availability Headlines
Lower levels of aged care availability compared to ESML and NSW averages.
Botany Bay has the lowest rates of GPs and Allied Health Practitioners per 1000 of the population amongst the 6 sub regions of ESML.
5.1. Hospitals There are no public or private hospitals located within the Botany Bay sub region. The nearest public hospital /emergency department is Prince of Wales Randwick, which is located approximately 4.7km away from the suburb of Botany.
5.2. General practitioners The graph below shows that the number of GPs per 1000 population in Botany Bay (0.88 per 1000 population) is the lowest of the sub regions across the ESML catchment, as well as being below the Eastern Sydney average (1.77). However, the availability of GPs within Botany Bay meets the benchmark 4 of 1 GP for every 1133 residents (or the equivalent of 0.88 per 1,000 capita). Figure 43: GPs per 1000 population
Per 1000 population
2.50 2.00 1.50 1.00 0.50 0.00 Botany Bay Randwick
Sydney
GP's
Waverley
Woollahra
Eastern Sydney
Benchmark
Source: Health Workforce Australia (2013)
After hours GP services ‘After hours’ services are defined as any primary service that is open:
Before 8:00am and after 6pm weekdays;
Before 8:00am and after 12:00pm on Saturdays; and
All day Sundays and public holidays.
The data illustrated on the graph below details the number of general practices in the region registered with the ESML after hour’s program. The graph shows that there are 13 such practices in Botany Bay.
4
Benchmark figure is 1 GP per every 1133 people (0.88 per 1000) based on: May J, Jones et all, ‘GP perceptions of workforce shortage in a rural setting’ (2007); Wilkinson D. Inequitable distribution of general practitioners in Australia, Australian Journal of Rural Health (2000); May J, Morrissey et al ‘Supporting the rural GP workforce: impact of a managed care practice. In, Proceedings, General Practice & Primary Health Care Conference; 5-7July 2006; Perth, WA; (2006). www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 31 FINAL
Figure 44: After hours GP clinics
Source: Eastern Sydney Medicare Local
5.3. Allied health As shown in Figure 45, Botany Bay has below average levels of allied health providers across all areas covered in comparison to the other sub regions in ESML. This is partly due to the fact that there are significantly higher levels of allied health practitioners in the Randwick sub region which has increased the overall Eastern Sydney average. Figure 45: Allied health Practitioners per 1000 population
Source: Health Workforce Australia (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 32 FINAL
5.4. Mental health services The graph below shows the total number of ATAPS providers by sub region, as well as providing a calculation to show the number per 100,000 population. The graph shows that there are 5 ATAPS providers in Botany Bay equally 13 per 100,000 population. Figure 46: Number of ATAPS providers
Source: Eastern Sydney Medicare Local
The table below illustrates the volume of available mental health facilities within the ESML catchment area. Many of the facilities within the region will offer more than one of the types of services listed in the first column of the table below. However, in order to identify the number of facilities in the region we have only included each facility in the table below once. This means that they have been grouped under the classification that bests first their primary service offering. The table shows that Botany Bay has no facilities delivering mental health services out of the ESML total of 91 Table 2: Mental health providers Adolescent mental Health General mental health services General Mental Health Services Mental Health Advocacy Mental health assessment/triage/ crisis response Mental health case management/continuing care Mental health information/referral Mental health inpatient services (hospital psychiatric unit) Mental Health non-residential rehabilitation Mental health residential rehabilitation/community care unit Psychiatry (requires referral) Psychology
Botany Bay 0 0 0 0 0 0 0 0 0 0 0 0
ESML Total
0
Sydney (C) - Sydney (C) Inner East Randwick (c) Waverley (A) Woollahra (A) ESML Total 0 1 0 0 0 1 2 1 3 0 0 6 2 1 3 0 0 6 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 1 2 4 0 0 0 6 0 0 0 1 0 1 0 0 1 0 0 1 0 0 0 0 0 0 20 5 2 6 2 35 15 1 6 7 4 33
43
13
15
14
6
91
Source: Eastern Sydney Medicare Local / National Health Service Directory (2013
5.5. Community health services The table below illustrates the volume of available unique community health service facilities within the ESML catchment area. Many of the facilities within the region will offer more than one of the types of services listed in the first column of the table below. However, in order to identify the number of facilities in the region we have only included each facility in the table below once. This means that they have been grouped under the classification that bests first their primary service offering. The table shows that Botany Bay has no facilities delivering community care services out of the ESML total of 59.
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 33 FINAL
Table 3: Community health centers Botany Bay Aboriginal health Community cancer services Community health care Health advocacy/liaison services Health information /referral Immunisation Maternal and child health Nursing lead clinics Sexual health Social support Veterans services Women's health clinic Youth drop in/assistance/support
0 0 0 0 0 0 0 0 0 0 0 0 0
Total
0
Sydney (C) - Sydney (C) Inner East Randwick (c) Waverley (A) Woollahra (A) 1 1 0 0 0 2 1 1 0 1 4 2 2 2 2 1 1 0 0 0 8 4 2 0 0 1 0 1 0 1 1 0 1 0 0 0 0 1 0 0 5 4 0 0 0 0 0 0 0 0 1 1 0 0 0 2 0 2 0 0 2 0 0 1 0
28
14
10
3
4
Total
2 5 12 2 14 3 2 1 9 0 2 4 3
59
Source: South East Sydney Local Health District (2013) and National Health Services Directory (2013)
5.6. Aged care Figure 47 illustrates the availability of aged care services across the Botany Bay sub region, ESML and NSW broken down into high, low and community-based aged care. This shows that there are lower levels of high care facilities in Botany Bay (42 places per 1000 people over 70) compared to ESML (46) and NSW (45). The same is true of low care availability, with Botany Bay having the lowest number of low-care spaces per 1000 persons aged over 70 (14) of any sub-region in ESML. Figure 47 shows that the number of low care places in Botany Bay per-capita is 60% lower than the overall ML (35 places per 1000) and 67% lower than NSW (42 places per 1000). Figure 47: Aged care availability
Source: PHIDU and Department of Health and Ageing (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 34 FINAL
6. Health service utilisation Headlines
Botany Bay has the highest level of diabetes, coronary heart disease and smoking-related hospitalisations of any sub region within the ESML catchment.
Botany Bay has the lowest level of alcohol-related hospitalisations of any ESML subregion.
Botany Bay has the highest level of hospitalisations related to high body mass of any ESML sub-region.
6.1. Primary care utilisation Figure 48 shows the number of primary care services per-capita billed for Botany Bay residents to the MBS were generally higher than the E S ML with the exception of GP mental health care plans. The figures for Botany Bay were generally in line with the NSW average with the exception of practice nurse services which were lower in Botany Bay compared to NSW. Figure 48: Selected primary care services
Source: PHIDU and Department of Health and Ageing (2013)
Figure 49 shows that the level of General Practitioner (GP) MBS services delivered per person per year is higher in Botany Bay (6.3) than in Eastern Sydney (5.1) or NSW (5.8). Considering the relatively low availability of GPs within Botany Bay as presented in Figure 43, this suggests that residents of Botany Bay seek care from areas located outside of the Botany Bay LGA. Figure 49: MBS GP services per person
Source: PHIDU and Department of Health and Ageing (2013) www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 35 FINAL
6.2. Hospital admission Figure 50 illustrates that the hospitalisation rates for Botany Bay (422 per 1000 population) are 4.5% higher than the Eastern Sydney catchment (404) and 17.2% higher than NSW (360). Figure 50: Hospitalisation rate
Source: Health Statistics NSW and NSW Ministry of Health (2011)
6.3. Top 10 causes of hospital admission The graph below outlines the top 10 causes of hospitalisation within Botany Bay by DRG along with the number of separations. It shows that rehabilitation, same day (Z60C) is the largest cause of hospitalisation in the sub region. The graph below is based on data provided by the LHD using a postcode analysis. For the purposes of this exercise it was assumed that the following postcodes constitute the nearest available match to Botany Bay LGA: 2018, 2019, 2020, 2032, 2035 and 2036. Figure 51: Top 10 causes of hospitalisation
Source: South Eastern Sydney Local Health District
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 36 FINAL
6.4. Ambulatory care sensitive admissions Ambulatory care sensitive conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in the ambulatory setting. The graph below shows that the levels of preventable hospitalisation for ambulatory care sensitive conditions in Botany Bay (25.6 per 1000 population) are 24% higher than Eastern Sydney (20.7) catchment and 8% higher than NSW (23.8). Figure 52: Preventable hospitalisations for ambulatory-care sensitive conditions
Source: NSW Ministry of Health and Health Statistics NSW (2012)
6.5. Number of hospitalisations for conditions of interest This section presents data describing the number of hospitalisations per 1000 persons for stroke, coronary heart disease and diabetes. Stroke Figure 52 shows that Botany Bay's number of hospitalisations for stroke (1.37 per 1000 of the population) is marginally lower than the NSW average (1.43). No data is available for the overall ESML catchment; however, the available data indicates that Botany Bay is in the mid-range compared to other sub-regions within the ESML catchment. Figure 53: Stroke hospitalisations per 1000 population
Source: NSW Ministry of Health and Health Statistics NSW (2012) Note: * The data available for the Sydney LGA includes the east, inner, south and west but excludes Northern Sydney. This differs from the area covered by the ESML catchment which includes only Sydney (Inner) and Sydney (East).
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 37 FINAL
Coronary Heart Disease Figure 53 shows that hospitalisations for coronary heart disease are highest in Botany Bay (10.6per 1000 population) of any sub-region across the ESML catchment. CHD hospitalisations for Botany Bay residents are also 74% higher than the NSW average (6.1 per 1000 population). Figure 54: Coronary heart disease hospitalisations
Source: NSW Ministry of Health and Health Statistics NSW (2012)
Diabetes Figure 55 shows that the level of diabetes-related hospitalisations are the highest in Botany Bay (2.1per 1000 population) of any sub-region across the ESML catchment. Diabetes-related hospitalisations for Botany Bay residents are also 45% higher than the average across NSW (1.5). Figure 55: Diabetes related hospitalisations
Source: NSW Ministry of Health and Health Statistics NSW (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 38 FINAL
6.6. Hospitalisations resulting from risk factors This section presents data on hospitalisations arising from modifiable risk factors, including alcohol, smoking, high body mass and falls. Alcohol Figure 56 shows that Botany Bay (0.663 per 1000 population) has lower levels of alcohol-related hospitalisations compared to all other LGA’s in the ESML catchment. Figure 56: Alcohol related hospitalisations
Source: NSW Ministry of Health and Health Statistics NSW (2012) Note: * The data available for the Sydney LGA includes the east, inner, south and west but excludes Northern Sydney. This differs from the area covered by the ESML catchment which includes only Sydney (Inner) and Sydney (East).
Smoking Figure 57 shows that the levels of smoking-related hospitalisations are higher in Botany Bay (6.5 per 1000 population) the NSW average (5.7). Smoking-related hospitalisations are also the highest in Botany Bay of any sub-region within the ESML catchment. Figure 57: Smoking related hospitalisation
Source: NSW Ministry of Health and Health Statistics NSW (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 39 FINAL
High body mass Figure 58 illustrates that the levels of hospitalisation related to high body mass are 42% higher in Botany Bay (6.3 per 1000 population) than in NSW (4.4). The number of hospitalisations attributable to high body mass in Botany Bay are also the highest of any sub-region across the ESML catchment. Figure 58: High body mass related hospitalisations
Source: NSW Ministry of Health and Health Statistics NSW (2012)
Falls Botany Bay sub region has the second highest level of fall related hospitalisations for those aged 65 years and over in ESML catchment (38.13 per 1000 population), behind Randwick (39.89). Both of these sub regions have higher rates than the NSW average of 31.29. Figure 59: Number of falls per 1000 population 65 and over
Source: NSW Ministry of Health and Health Statistics NSW (2012)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 40 FINAL
6.7. Mental health services The graph below illustrates the correlation between the percentages of total ESML residents in each sub region compared to the percentage of total ATAPS referrals. The graph shows that Botany Bay has 11% of the residents in ESML but provides only 6% of the ATAPS referrals. Figure 60: Percentage of ATAPS referral’s by sub region
Source: Eastern Sydney Medicare Local
6.8. Home and Community Care (HACC) Figure 61 shows the characteristics of HACC consumers in Botany Bay, compared to the ESML catchment and NSW. Major differences in the profile of HACC consumers in Botany Bay relate to the proportion of non-English speaking clients (29.3%), which is 50.3% higher than ESML overall and almost three times as great as the proportion of non-English speaking HACC clients in NSW. Botany Bay also appears to have a greater number of HACC clients per 1000 population (41.2) compared to ESML (33.7) and NSW (36.1), as well as a greater proportion of its indigenous population as clients (8.1% compared to 6.6% across ESML and 5.5% in NSW). Figure 61: Characteristics of HACC clients
Source: PHIDU and Department of Health and Ageing (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817
P a g e | 41 FINAL
Figure 62 presents the number of instances of care for selected HACC services across Botany Bay, which shows that Botany Bay residents are more frequent consumers of most HACC services than both the overall ML and NSW. Notably, the greatest variances in HACC service utilisation relate to:
Centre-based day care services (7.5 instances per 1000 compared to 3.6 across ESML and 2.6 in NSW);
Care coordination services (7.5 instances per 1000 compared to 3.1 across ESML and 4.3 in NSW);
Transport services (11.9 instances per 1000 compared to 8.1 across ESML and 8.9 in NSW); and
Allied health care in the home (5.2 instances per 1000 compared to 4.2 across ESML and 2.6 in NSW). Figure 62: Utilisation of HACC services
Source: PHIDU and Department of Health and Ageing (2013)
www.esml.org.au Level 1, 5 Rosebery Avenue, Rosebery NSW 2018 t 02 9663 5958 f 02 9663 5817