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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

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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 ...........................................................................9 Family structure ..............................................................................................................................9 Private health insurance coverage................................................................................................10 Broadband internet access ...........................................................................................................10

3. Social determinants of health .............................................................................. 11 3.1. 3.2. 3.3. 3.4. 3.5. 3.6. 3.7.

Socio-economic characteristics ....................................................................................................11 Income ..........................................................................................................................................11 Employment ..................................................................................................................................12 Education levels ...........................................................................................................................13 Homelessness ..............................................................................................................................14 Social cohesion/community strength ............................................................................................15 Barriers to accessing services......................................................................................................15

4. Health characteristics and risk factors ............................................................... 16 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 ...........................................................................................................16 Health risk factors .........................................................................................................................16 Immunisation, infant mortality and wellbeing ...............................................................................17 Prevalence of chronic disease .....................................................................................................19 Cancer screening rates ................................................................................................................19 Prevalence of cancer ....................................................................................................................20 Disability .......................................................................................................................................20 Mortality ........................................................................................................................................22 Alcohol-related domestic violence ................................................................................................23 Sexually Transmissible Infections ................................................................................................23 Infectious diseases .......................................................................................................................26

5. Health service availability..................................................................................... 27 5.1. 5.2. 5.3. 5.4. 5.5. 5.6.

Hospitals .......................................................................................................................................27 General practitioners ....................................................................................................................27 Allied health ..................................................................................................................................28 Mental health services ..................................................................................................................29 Community health services ..........................................................................................................29 Aged care .....................................................................................................................................30

6. Health service utilisation ...................................................................................... 31 6.1. 6.2. 6.3. 6.4. 6.5. 6.6. 6.7. 6.8.

Primary care utilisation .................................................................................................................31 Hospital admission .......................................................................................................................32 Top 10 causes of hospital admission ...........................................................................................32 Ambulatory care sensitive admissions .........................................................................................33 Number of hospitalisations for conditions of interest....................................................................33 Hospitalisations resulting from risk factors ...................................................................................35 Mental health services ..................................................................................................................37 Home and Community Care (HACC) ...........................................................................................37

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List of figures Figure 1: Population profile ........................................................................................................................................... 7 Figure 2: Forecast population growth ............................................................................................................................ 7 Figure 3: Fertility rates ................................................................................................................................................... 8 Figure 4: Primary languages spoken at home ................................................................................................................ 8 Figure 5: Indigenous persons population profile ............................................................................................................. 9 Figure 6: Family structure Source: Australian Bureau of Statistics .................................................................................. 9 Figure 7: Private health insurance coverage ............................................................................................................... 10 Figure 8: Broadband internet access at home .............................................................................................................. 10 Figure 9: Comparison of SEIFA Advantage and Disadvantage .................................................................................... 11 Figure 10: Annual household income ........................................................................................................................... 11 Figure 11: Income support, ........................................................................................................................................... 12 Figure 12: Top five Industry sectors of employment ..................................................................................................... 12 Figure 13: Unemployment ............................................................................................................................................ 13 Figure 14: Highest year of school completed ................................................................................................................ 13 Figure 15: Secondary school participation .................................................................................................................... 14 Figure 16: Homelessness ............................................................................................................................................. 14 Figure 17: Indicators of community strength ................................................................................................................. 15 Figure 18: Barriers to accessing services ..................................................................................................................... 15 Figure 19: Self assessed health ................................................................................................................................... 16 Figure 20 Health risk factors ........................................................................................................................................ 16 Figure 21: Percentage of children fully immunised ....................................................................................................... 17 Figure 22: Pertussis notifications .................................................................................................................................. 17 Figure 23: Pneumococcal notifications ......................................................................................................................... 18 Figure 24: Percentage of low birth weight babies and mothers who smoke whilst pregnant ........................................ 18 Figure 25: Prevalence of selected chronic conditions ................................................................................................... 19 Figure 26: Cancer screening rates................................................................................................................................ 19 Figure 27: Comparison of cancer screening outcomes................................................................................................. 20 Figure 28: Prevalence of selected cancers ................................................................................................................... 20 Figure 29: Proportion of people with profound or severe disabilities............................................................................. 21 Figure 30: Proportion of people who have need for assistance with core activities ...................................................... 21 Figure 31: Premature mortality from chronic disease- .................................................................................................. 22 Figure 32: Potentially avoidable deaths .................................................................................................................... 22 Figure 33: Alcohol related domestic violence incidence, .............................................................................................. 23 Figure 34: HIV notifications ........................................................................................................................................... 23 Figure 35:Chlamydia notifications ................................................................................................................................. 24 Figure 36: Rectal chlamydia notifications ..................................................................................................................... 24 Figure 37: Gonorrhea notifications................................................................................................................................ 25 Figure 38: Syphilis notifications .................................................................................................................................... 25 Figure 39: Hepatitis B notifications ............................................................................................................................... 26 Figure 40: Hepatitis C notifications ............................................................................................................................... 26 Figure 41: GPs per 1000 population ............................................................................................................................. 27 Figure 42: After hours GP clinics .................................................................................................................................. 28 Figure 43: Allied health Practitioners ........................................................................................................................... 28 Figure 44: Number of ATAPS providers ....................................................................................................................... 29 Figure 45: Aged care availability .................................................................................................................................. 30 Figure 46: Selected primary care services .................................................................................................................... 31 Figure 47: MBS GP services per person .................................................................................................................... 31 Figure 49: Hospitalisation rate ..................................................................................................................................... 32 Figure 50 Top 10 causes of hospitalisation .................................................................................................................. 32 Figure 51: Preventable hospitalisations for ambulatory-care sensitive conditions ....................................................... 33 Figure 52: Stroke hospitalisations ................................................................................................................................ 33 Figure 53: Coronary heart disease hospitalisations .................................................................................................... 34 Figure 54: Diabetes related hospitalisations ................................................................................................................ 34 Figure 55: Alcohol related hospitalisations .................................................................................................................. 35 Figure 56: Smoking related hospitalisation ................................................................................................................... 35 Figure 57: High body mass related hospitalisations ..................................................................................................... 36 Figure 58: Number of falls ........................................................................................................................................... 36 Figure 59: Percentage of ATAPS referrals by sub region ............................................................................................. 37 Figure 60: Characteristics of HACC clients .................................................................................................................. 37 Figure 61: Utilisation of HACC services ........................................................................................................................ 38

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Glossary of Terms Term Eastern Sydney Medicare Local

Eastern Sydney ESML SLA LGA ML ABS PHIDU GPs OT’s

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 General Practitioners Occupational Therapists

Data Data was gathered from a number of different data sets and sources including the Australian Bureau of Statistics (ABS), Public Health Information Development Unit (PHIDU), South East Sydney LHD, NSW Health Stats and ESML. We have relied on the data wherever possible and have avoided carrying out an extrapolations or making assumptions around the data and how it can be interpreted. Data Limitations 1. Comparable data sets were not always available when comparing sub regional information to the Medicare Local level. As such two points of comparison have been primarily used and presented against a NSW figure (where possible); ESML catchment and Eastern Sydney. 2. Large portions of respondents to certain data sets (e.g. in ABS census data) had either not respondent or marked the question non applicable. In all cases where this has occurred these responses have been excluded from the graphical representations of the analysis undertaken. The result of this is that figures presented in certain graphs in this profile do not always total 100%. 3. The HWA 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 sub-regional 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

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1. Introduction The Woollahra Local Government Area (LGA) (2011 pop: 52,159) is a south eastern suburb of 1 metropolitan Sydney in New South Wales. Spanning 12 square kilometers, including substantial foreshore areas and beaches, this LGA is bordered by Port Jackson (Sydney Harbour) in the north, the Waverley Council area in the east, Randwick City in the south and the City of Sydney in the west. Suburbs in this catchment include Bellevue Hill, Darling Point, Double Bay, Edgecliff, Paddington (part), Point Piper, Rose Bay (part), Vaucluse (part), Watsons Bay and Woollahra. The Cadigal and Birrabirragal people are the traditional owners of these lands. The Woollahra Council area is predominantly residential, with the Sydney Harbour National Park, the Paddington retail area on Oxford Street, Rose Bay, Watson’s Bay and a military reserve as major features in this region. Table 1 provides general characteristics of the Woollahra sub-region at a glance. Table 1: Characteristics of the Woollahra 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

Sub-region Value Rank within ML 52,159 3

Medicare local

NSW

383,014

7,211,486

3.5%

5

12.9%

15.3%

0.2% $124,696 1.5% 85% 74%

6 1 1 1 1

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.

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2. Population and community characteristics Headlines 

Higher proportion of 60-84 years olds compared to the ESML and NSW averages.

High proportion of people who speak English in the home (85%) compared to other ESML sub regions.

High levels of private health insurance compared to ESML and NSW averages.

2.1. Population characteristics Figure 1 shows that the population profile of Woollahra sub-region is higher than the Medicare Local (ML) for age ranges 6 0 - 8 4 . These age ranges account for 19.5% of the total population within the Woollahra catchment area, compared to 15.2% across the ML catchment. There is a larger proportion of the population of Woollahra population (33%) aged between 20- 39 then the NSW average (28.1). Figure 1: Population profile (by age)

Source: PHIDU and Australian Bureau of Statistics (2013)

Population growth forecasts for Woollahra between 2011 and 2025 are provided in Figure 2. According to the Australian Bureau of Statistics (ABS) population growth is due to be 3.5% in Woollahra compared to 12.9% in the ESML catchment and 13.6% across NSW. There are only three age groups where higher growth rates are predicted in Woollahra than across the ESML and NSW; 10-14, 15-19, and 75-79. It is anticipated that new development will be limited in this region over the coming years. Figure 2: Forecast population growth (2011 to 2025, by age)

Source: PHIDU and Australian Bureau of Statistics (2013)

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2.2. Birth rate The birth rate in Woollahra is currently 1.36 children per female. This is 3% higher than the average birth rate across the ESML catchment (1.31), and 24% lower than the average for NSW (1.80 children per female). Figure 3: Fertility rates

Source: PHIDU and Australian Bureau of Statistics (2013)

2.3. Cultural characteristics Figure 4 shows the major non English primary languages spoken at home in Woollahra. The largest grouping of the population identifies English as their primary language (85%) after this the most spoken languages are Chinese (2.3%), Greek (1.5%), Iberian (1.3%) and French (1.2%). Figure 4: Primary languages spoken at home

Source: Australian Bureau of Statistics (2012)

Of the 604 people who identified Iberian as the language they speak at home, 423 (70%) spoke Spanish and the remaining 178 (30%) Portuguese.

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2.4. Aboriginal and Torres Strait islander community Indigenous Australians comprise 0.3% of the total population of the Woollahra sub-region, which is lower than for the ESML catchment (0.9%) and the NSW average (2.4%). As a result of this the graph below illustrates that the proportion of indigenous population is lower in Woollahra for all age groups when compared with the ESML and NSW. Figure 5: Indigenous persons population profile, by age

Source: PHIDU and Australian Bureau of Statistics (2013)

2.5. Family structure Figure 6 shows a breakdown of predominant family structures living within the catchment. The most common family type in Woollahra is a ‘couple family with no children’ (24%), which is higher than the ESML catchment (22%) and the same as the NSW average (24%). Woollahra also has lower percentages of one parent families and other family types when compared to the averages across the ESML and within NSW. Figure 6: Family structure

Source: Australian Bureau of Statistics (2012)

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2.6. Private health insurance coverage Figure 7 shows that 74% of Woollahra residents have private health insurance. This is higher than ESML catchments average (57%) and the NSW average (48%). Figure 7: Private health insurance coverage

Source: PHIDU and Australian Bureau of Statistics (2013)

2.7. Broadband internet access Figure 8 shows that broadband internet penetration within households in Woollahra (79%) is higher than the ESML catchment area (75%) and the NSW average (70%). Figure 8: Broadband internet access at home

Source: PHIDU and Australian Bureau of Statistics (2013)

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3. Social determinants of health Headlines 

Woollahra the highest Socio-Economic Indexes for Areas (SEIFA) score of the ESML sub regions.

22% of the population earns over $104,000 per annum.

Lower proportion of people on income support then the ESML and NSW averages.

Lower levels of unemployment and homelessness than the ESML and NSW averages.

3.1. Socio-economic characteristics The Socio-Economic Indexes for Areas (SEIFA) index score for socio-economic advantage and disadvantage in Woollahra is 1129, which ranks 1st out of the six sub regions. The graph below highlights the respective percentile rank for both socio economic advantage and disadvantage. Figure 9: Comparison of SEIFA Advantage and Disadvantage

Source: Australian Bureau of Statistics (2013)

3.2. Income Figure 10 shows that a higher proportion of the Woollahra population has a household income of more than $78,000 when compared with the ESML and NSW averages and that a lower percentage of the population within the sub region earn less than $42,000 compared to the ESML and NSW averages. Figure 10: Average household income

Source: Australian Bureau of Statistics (2012)

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Figure 11 shows that a lower proportion of people within Woollahra receive income support (8.9% in total), than within the ESML catchment as a whole (15.6%) and the NSW average (30.3%). Figure 11: Income support,

Source: PHIDU and Centrelink (2013)

3.3. Employment Industry An analysis of the occupations held by residents of Woollahra reveals that the top five industry sectors of employment are professional, scientific and technical services (9.5%), financial and insurance services (6.3%), health care and social assistance (5.3%), retail and trade (3.7%) and education and training (3.4%).Together, these five industries employ 28.2% of the population, which is higher when compared to ESML (25.6%) and NSW (19.4%). Figure 12: Top five Industry sectors of employment

Source: Australian Bureau of Statistics (2012)

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Employment status The percentage of people who are unemployed within the Woollahra sub region is 1.49%, which is lower than across ESML (2.72%) and NSW (5.25%). Figure 13: Unemployment

Source: PHIDU and Australian Bureau of Statistics (2013)

3.4. Education levels Within Woollahra 62% of people aged over 15 years have completed Year 12 schooling/ or equivalent. This is higher than the average within the ESML catchment area (58%) and the overall average across (NSW 38%). Figure 14: Highest year of school completed

Source: Australian Bureau of Statistics (2012)

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Data available from PHIDU shows that secondary school participation at age 16 in Woollahra (84%) is higher than across ESML (83%) and NSW (80%). The proportion of school leavers from Woollahra that go on to pursue higher education qualifications ( 35%) is lower the ESML catchment average (41%) but higher than the NSW figure (30%). Figure 15: Secondary school participation

Source: Australian Bureau of Statistics (2012)

3.5. Homelessness Figure 16 shows that the per-capita rate of homelessness in Woollahra (0.45%) is lower than the level across both the ESML catchment (1.14%) and NSW (0.76%). Figure 16: Homelessness

Source: Australian Bureau of Statistics (2012)

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3.6. Social cohesion/community strength Figure 17 shows that Woollahra is broadly in line with the ESML and NSW averages when it comes to indicators of community strength. Figure 17: Indicators of community strength

Source: PHIDU and Australian Bureau of Statistics (2013)

3.7. Barriers to accessing services Figure 18 shows the major barriers to accessing services across Woollahra. The highest proportionate barrier to accessing services within the sub region was not accessing the internet (15%) this compares to 21% within ESML catchment area and 28% of people in NSW who did not have access to the internet. The proportion of persons signaling barriers to accessing services were lower for all categories in Woollahra compared to ESML and NSW. Figure 18: Barriers to accessing services

Source: PHIDU and Australian Bureau of Statistics (2013)

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4. Health characteristics and risk factors Headlines 

Below ESML and NSW averages for health risk factors with the exception of overweight persons who are proportionately higher in Woollahra than ESML and NSW.

Lowe prevalence of chronic disease and premature death then ESML and NSW averages.

Woollahra has the highest proportionate levels of prostate, breast and melanoma cancers in the ESML.

4.1. Self-reported health status Figure 19 shows that the levels for fair or poor self-assessed health in Woollahra (9.7%) are lower than the ESML catchment (12.5%) and the NSW averages (16.6%). It also illustrates that the levels of those with restricted core activities are lower in Woollahra (7.7%) than the ESML (9.3%) and NSW (11.5%) averages. Figure 19: Self assessed health

Source: PHIDU and Australian Bureau of Statistics (2013)

4.2. Health risk factors Figure 20 shows that the health risk profile of Woollahra is lower than the ESML and NSW averages for all factors with the exception of the proportionate level of overweight persons. Figure 20 Health risk factors

Source: PHIDU and Australian Bureau of Statistics (2013)

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4.3. Immunisation, infant mortality and wellbeing Childhood immunisation Figure 21 shows the percentage of children that are fully immunised at one, two and five years of age. For all ages the percentage of children immunized in Woollahra are lower than those across the ESML and NSW. At 1 year the rates for Woollahra are 89% compared to 90% for ESML and 92% for NSW. At 2 years old the rate for Woollahra are 88% compared with 89% for ESML and 92% for NSW. Finally, at 5 years the rates for Woollahra are 83% compared to 84% for ESML and 90% for NSW. Figure 21: 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 Woollahra 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 Woollahra from 2008-2010 but have subsequently declined and in 2012 were broadly in line with 2008 levels. Figure 22: Pertussis notifications

Source: South Eastern Sydney Local Health District

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Pneumococcal The number of pneumococcal notifications in Woollahra has decreased from 2 in 2008 to 0 in 2012. 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 23: Pneumococcal notifications

Source: South Eastern Sydney Local Health District

Low birth weight babies Figure 24 shows the percentage of low birth weight babies and the percentage of mothers who smoke whilst pregnant within the Woollahra sub region, ESML and NSW. Woollahra has a lower rate of low birth weight babies (4.5%) than ESML (5.5%) and NSW (6.1%). The level of women who smoke whilst pregnant in Woollahra is 0.8% compared with 2.5% in the ESML and 12.0% in NSW as a whole. Figure 24: Percentage of low birth weight babies and mothers who smoke whilst pregnant

Source: PHIDU and NSW Ministry of Health (2013)

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4.4. Prevalence of chronic disease Figure 25 shows that the prevalence rates for the chronic diseases captured within Woollahra are favorable when compared to those shown for both the ESML and NSW. Figure 25: Prevalence of selected chronic conditions

Source: PHIDU and Australian Bureau of Statistics (2013)

4.5. Cancer screening rates Figure 26 shows the percentage of people who were eligible for, and participated in bowel and cervical cancer screening programs in 2010. 28% of those eligible in Woollahra participated in the bowel cancer screening program which was the below the ESML (30%) and NSW (35%) averages. 74% of those eligible for the cervical cancer screening program in Woollahra took part compared with 60% in the ESML catchment and 56% across NSW. No data was available regarding breast cancer screening. Figure 26: 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 27 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 7.4% in Woollahra which was higher than the ESML catchment (7.3%) and lower than NSW (8.4%). The rate of low-grade abnormalities from the cervical cancer screening was 5.0% in Woollahra compared with 4.6% in the ESML catchment and 3.2% in NSW. The rate of high-grade cervical screening abnormalities in Woollahra was 0.7% compared with 0.8% in the ESML and 0.6% in NSW.

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Figure 27: 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 28 shows the prevalence of certain cancer types across the sub regions comprising ESML and NSW as a whole. No data at the Medicare local level was available. The data suggests that the most common types of cancer in Woollahra are prostate (0.93 instances per 1000 population), breast (0.81) and melanoma (0.55). In the case of these three cancer types the levels of frequency recorded in Woollahra were the highest of all the ESML sub regions. Figure 28: 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 29 shows the proportion of persons with profound or severe disability within the Woollahra sub region, ESML and NSW. The graph shows that levels of profound or severe disability are lower in Woollahra across all categories.

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Figure 29: Proportion of people with profound or severe disabilities

Source: PHIDU and Australian Bureau of Statistics (2013)

Need for assistance with core activities The proportion of people who require assistance with core activities in Woollahra (2.21%) is lower than the average across the ESML catchment (2.96%), and the average across NSW (4.69%), as shown in Figure 30. Figure 30: Proportion of people who have need for assistance with core activities

Source: PHIDU and Australian Bureau of Statistics (2013)

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4.8. Mortality Premature mortality refers to deaths among people aged less than 75 years. Figure 31 presents mortality rates from chronic conditions in Woollahra for persons aged between 0 and 74. The data shows that premature mortality is lower in Woollahra for all factors noted. The prevalence of cancer is the most significant cause of mortality and is 16% lower in Woollahra than the ESML average. Figure 31: Premature mortality from chronic disease-

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. The graph below illustrates that the per-capita rate of avoidable mortality i n W o o l l a h r a (0.65 deaths per 1,000 persons) is 2 1 % lower than the ESML catchment (0.82 deaths per 1,000 persons) and 29% lower than the NSW rate (0.91 deaths per 1,000 persons). Figure 32: Potentially avoidable deaths per 1000 persons, 2006-07

Source: Health Statistics NSW and NSW Ministry of Health

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4.9. Alcohol-related domestic violence The graph below illustrates that the alcohol-related domestic violence rates are lower in Woollahra (0.6 incidences per 1000 population) than in both the ESML (1.5) and NSW (1.4). Figure 33: 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 and that this resulted in a 15% increase overall. The data provided for 2013 only covered the period from January – September so has not been used for comparative purposes. Figure 34: HIV notifications

Source: South Eastern Sydney Local Health District (2013)

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Chlamydia The graph below shows the annual number of notifications of chlamydia in Woollahra 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 179 to 268 per annum in Woollahra over the period representing an increase of 50%. The overall number of notifications for Eastern Sydney has increased from 1887 to 2556 per annum, representing an increase of 35%. Figure 35: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 Woollahra 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 increased from 23 to 40 per annum in Woollahra over the period representing an increase of 74%. The overall number of notifications for Eastern Sydney has increased from 249 to 429 per annum, representing an increase of 72%. Figure 36: Rectal chlamydia 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


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Gonorrhea The graph below shows the annual number of notifications of gonorrhea in Woollahra 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 24 to 104 per annum in Woollahra over the period representing an increase of 333%. The overall number of notifications for Eastern Sydney has increased from 384 to 1114 per annum, representing an increase of 190%. Figure 37: Gonorrhea notifications

Source: South Eastern Sydney Local Health District

Syphilis The graph below shows the annual number of notifications of syphilis in Woollahra 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 in Woollahra has decreased from 18 per annum in 2008, to 15 in 2012. The overall number of notifications for Eastern Sydney has increased from 179 to 191 per annum, representing an increase of 6%. Figure 38: Syphilis notifications

Source: South Eastern Sydney Local Health District

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4.11. Infectious diseases Hepatitis B From 2008 – 2012 there has been a downward trend in the number of notifications in both Woollahra and the Eastern Sydney region. In Woollahra the number of notifications has gone from 13 in 2008 to 6 in 2012, a decrease of 54%. 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 39: Hepatitis B notifications

Source: South Eastern Sydney Local Health District

Hepatitis C The graph below illustrates the number of Hepatitis C notifications in Woollahra and the Eastern Sydney region annually from 2008 to 2012. The number of notifications in Woollahra has decreased from 15 notifications in 2008 to 8 in 2012, a decrease of 46%. 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 40: Hepatitis C notifications

Source: South Eastern Sydney Local Health District

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5. Health service availability Headlines 

Woollahra had lower levels of available aged care beds then the ESML and NSW averages.

2 after hours facilities located on the sub region.

5.1. Hospitals There is one hospital located within the Woollahra; the Wolper Jewish Hospital which is located at 8 Trelawney Street, Woollahra, 2025 Hospital name Wolper Jewish Hospital

Hospital type Specialist medical and rehabilitation centre

No of beds 54

5.2. General practitioners The graph below shows that the number of GPs per 1000 population in Woollahra (2.1 per 1000 population) is the second highest of the sub regions across the ESML catchment. The availability of GPs is well above both the average across the ESML catchment (1.77) and is almost 240% higher the national 4 benchmark figure (0.88). Figure 41: GPs per 1000 population

Source: Health Workforce Australia (2013) Note: Sydney LGA includes other areas of the city besides Sydney East and Inner

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


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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 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 hours program. The graph shows that there are 23 such practices in Woollahra. Figure 42: After hours GP clinics

Source: Eastern Sydney Medicare Local (2013)

5.3. Allied health As shown in Figure 43, the per-capita availability of chiropractors (0.3 per 1000 population), dentists (1.6), OT’s (0.8), optometrists (0.4) pharmacists (1.95) and psychologists (2.58) is below the average across the ESML catchment. For all other disciplines Woollahra the per-capita availability of allied health providers are greater than the average across the ESML catchment. Figure 43: Allied health Practitioners

Source: Health Workforce Australia (2013) Note: Sydney LGA includes other areas of the city besides Sydney East and Inner SLA

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5.4. Mental health services Figure 44 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 17 ATAPS providers in Woollahra equally 33 per 100,000 population. Figure 44: Number of ATAPS providers

Source: Eastern Sydney Medicare Local (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 classifications that best first their primary service offering. The table shows that Woollahra has 4 facilities delivering community care services out of the ESML total of 59, or 7% of the total. Table 2: Community health care facilities

Source: South East Sydney Local Health District (2013) and National Health Services Directory (2013)

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5.6. Aged care Figure 45 illustrates the availability of aged care services across the Woollahra sub region, ESML and NSW broken down into high, low and community-based aged care. This shows that there are lower levels of availability for types of aged care captured within the sub region compared to the ESML and NSW averages and lower levels of low care places. In terms of comparison to ESML there are 61% fewer high care places per 1000 persons, 20% fewer low care places and no recorded community aged care facilities in Woollahra to compare to the ESML. Figure 45: Aged care availability

Source: PHIDU and Department of Health and Ageing (2013)

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6. Health service utilisation Headlines 

Woollahra has higher levels of hospitalisations per 1000 population compared to the ESML and NSW averages.



Lower than average levels of primary care services received in Woollahra.

6.1. Primary care utilisation Figure 46 shows the number of primary care services per-capita billed for Woollahra residents to the MBS were lower than the Eastern Sydney catchment and NSW for all services captured below. The largest variation were for GP health assessment for persons aged 75+ (93.2 per 1000 population) compared to Eastern Sydney (141.4) and NSW (207.7) and practice nurse services (90.4) which were higher in both Eastern Sydney (119.5) and NSW (296.2). Figure 46: Selected primary care services

Source: PHIDU and Department of Health and Ageing (2013)

Figure 47 shows that the level of General Practitioner (GP) MBS services delivered per person per year is lower in Woollahra (4.4) than in Eastern Sydney (5.1) or NSW (5.8). Figure 47: MBS GP services per person

Source: PHIDU and Department of Health and Ageing (2013)

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6.2. Hospital admission Figure 48 illustrates that the hospitalisation rates for Woollahra (445 per 1000 population) are 10% higher than the Eastern Sydney catchment (404) and 24% higher than NSW (360). Figure 48: 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 based using a postcode analysis. For the purposes of this exercise it was assumed that the following postcodes constitute the nearest available match to Woollahra LGA: 2022, 2024, 2026, 2029 and 2030. Figure 49 Top 10 causes of hospitalisation

Source: South East Sydney Local Health District (2013)

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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 the levels of preventable hospitalisation for ambulatory care sensitive conditions in Woollahra (19.3 per 1000 population) are 7% lower than Eastern Sydney (20.7) catchment and 19% lower than NSW (23.8). Figure 50: 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 50 shows that the number of hospitalisations from strokes in Woollahra (1.33 per 1000 of the population) is in the mid-range within the ESML and below the NSW average. Figure 51: Stroke 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).

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Coronary heart disease Figure 51 shows that hospitalisations from coronary heart disease in Woollahra (5.9 per 1000 population) are the second lowest rate of the sub regions and are also above the NSW average. Figure 52: Coronary heart disease hospitalisations p

Source: NSW Ministry of Health and Health Statistics NSW (2012)

Diabetes Figure 53 shows that the level of diabetes-related hospitalisations within Woollahra (1.13 per 100 population) is the lowest of the sub regions within ESML and below the NSW average. Figure 53: Diabetes related hospitalisations

Source: NSW Ministry of Health and Health Statistics NSW (2012)

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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 54 shows that Woollahra (9.7 per 1000 population) has the second highest levels of alcohol-related hospitalisations compared to other LGA’s in the ESML catchment and a higher rate than the NSW average. Figure 54: 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 55 shows that the levels of smoking-related hospitalisations within Woollahra are the second highest of the sub regions (6.3 per 1000 population) and are above the NSW average (5.7). Figure 55: Smoking related hospitalisation

Source: NSW Ministry of Health and Health Statistics NSW (2012)

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High body mass Figure 56 illustrates that the levels of hospitalisation related to high body mass in Woollahra (0.439 per 1000 population) are in the mod range within the sub regions and lower than NSW average (0.441). Figure 56: High body mass related hospitalisations

Source: NSW Ministry of Health and Health Statistics NSW (2012)

Falls Woollahra sub region has the lowest level of fall related hospitalisations for those aged 65 years and over in ESML catchment (32.83 per 1000 population). All of the sub regions have higher rates than the NSW average of 31.29. Figure 57: Number of falls

Source: NSW Ministry of Health and Health Statistics NSW (2012)

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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 Woollahra has 15% of the residents in ESML and provides 9% of the ATAPS referrals. Figure 58: Percentage of ATAPS referrals by sub region

Source: Eastern Sydney Medicare Local (2013)

6.8. Home and Community Care (HACC) Figure 59 shows characteristics of HACC consumers in Woollahra, compared to the ESML catchment overall and NSW. The greatest variances between Woollahra, ESML and NSW in terms of HACC consumers are: 

Clients living alone (47.8% compared to 46.1% across ESML and 38.6% in NSW);

Total clients per 100 population (24.14% compared to 33.7% across ESML and 36.7% in NSW); and

Non English speaking clients (8.5% compared to 19.5% across ESML and 10.6% in NSW). Figure 59: Characteristics of HACC clients

Source: PHIDU and Department of Health and Ageing (2013)

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Figure 60 presents the number of instances of care for selected HACC services across Woollahra, which shows that Woollahra residents are less frequent consumers of most HACC services than both the overall ML and NSW. Notably, the greatest variances in HACC service utilisation relate to: 

Transport (7.7 instances per 1000 compared to 8.1 across ESML and 8.9 in NSW);

Allied Health care at home (3.3 instances per 1000 compared to 4.2 across ESML and 2.6 in NSW);

Care coordination (0.9 instances per 1000 compared to 3.1 across ESML and 4.3 in NSW); and

Domestic assistance (2.96 instances per 100 compared to 6.6 across ESML and7.7 in NSW). Figure 60: 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

Woollahra sub regional profile final 20140502  
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