Sub-Regional Profiles - Sydney Local Health District

Inner West Sydney Medicare LocalCANADA BAY LOCALGOVERNMENT AREAHEALTH PROFILECanada Bay Local Government AreaFinal Population Health Sub Regional ProfileHealthConsult Pty LtdACN 118 337 8214409/93 Liverpool Street, Sydney, New South Wales, 2000Phone (02) 9261 3707 Fax (02) 9261 370598 Stonebridge Way, Attwood, Victoria 3049Phone (03) 9333 2209 (02) 9261 370520 January, 2013 / v5.0

Table of ContentsContentsINTRODUCTION ................................................................................................................................ 1POPULATION AND COMMUNITY CHARACTERISTICS ........................................................................32.1 POPULATION CHARACTERISTICS ......................................................................................................................................32.2 BIRTHS AND MATERNAL HEALTH ...................................................................................................................................52.3 CULTURAL CHARACTERISTICS ...........................................................................................................................................72.4 EDUCATION LEVELS ...........................................................................................................................................................82.5 SOCIO-ECONOMIC CHARACTERISTICS .............................................................................................................................82.6 ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITY.......................................................................................92.7 HUMANITARIAN ARRIVALS ...............................................................................................................................................92.8 HOMELESSNESS ...................................................................................................................................................................9HEALTH RISKS OF THE POPULATION ............................................................................................. 123.1 HEALTH RISK FACTORS ................................................................................................................................................... 12LONG TERM CONDITIONS, CHRONIC DISEASE AND DISABILITY .................................................... 144.1 CHRONIC DISEASES .......................................................................................................................................................... 144.2 CANCER ............................................................................................................................................................................. 204.3 MORTALITY ...................................................................................................................................................................... 224.4 INFECTIOUS DISEASES .................................................................................................................................................... 224.5 DISABILITY ........................................................................................................................................................................ 23HEALTH SERVICE UTILISATION ...................................................................................................... 245.1 PRIMARY CARE UTILISATION .......................................................................................................................................... 245.2 EMERGENCY ..................................................................................................................................................................... 255.3 AMBULATORY-CARE SENSITIVE ADMISSIONS ............................................................................................................. 265.4 HOME AND COMMUNITY CARE .................................................................................................................................... 27HEALTH SERVICE AVAILABILITY .................................................................................................... 296.1 ACUTE AND DAY SURGERY............................................................................................................................................. 296.2 MEDICAL ........................................................................................................................................................................... 296.3 ALLIED HEALTH .............................................................................................................................................................. 306.4 COMMUNITY HEALTH SERVICES .................................................................................................................................. 316.5 AGED CARE ....................................................................................................................................................................... 31APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES ..................................................... 33APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS ................................................................... 34

Canada Bay Local Government Area Health Profile1IntroductionThis health profile is one of a series of profiles thatoutlines the health of residents of the Inner West SydneyMedicare Local (IWSML) and Sydney Local HealthDistrict (SLHD) catchment area. The catchmentcomprises Local Government Areas (LGAs) ofAshfield, Burwood, Canada Bay, Canterbury,Leichhardt, Marrickville, Strathfield and StatisticalLocal Areas (SLAs) of Sydney South and SydneyWest and is referred to as the Inner WestSydney catchment. The profile describes thecharacteristics of the Canada Bay LocalGovernment Area (LGA) population and compares it with the populations of the Inner WestSydney catchment and NSW. 1Canada Bay Local Government Area (pop: 75,761) occupies 20 sq. kilometres and encompassesthe statistical local areas of Concord (pop: 39,203) and Drummoyne (pop: 36,558). The CanadaBay LGA includes the suburbs of Burwood North (postcode 2135), Breakfast Point (postcode2137), Cabarita (postcode 2137), Concord (postcode 2137), Mortlake (postcode 2137), NorthStrathfield (postcode 2137), Concord West (postcode 2138), Liberty Grove (postcode 2138),Rhodes (postcode 2138), Abbotsford (postcode 2046), Canada Bay (postcode2046), Chiswick(postcode2046), Five Dock (postcode2046), Rodd Point (postcode2046), Russell Lea(postcode2046), Wareemba (postcode 2046) and Drummoyne (postcode 2047).Population differences exist between the two statistical local areas of Concord and Drummoyne.English is the primary language spoken in both areas, albeit to a much lesser extent in Concord(54.4%) than Drummoyne (71.0%). 16.9% of persons in Drummoyne identify as being SouthernEuropean, most of whom are Greek (10.6%). Concord comprises 12.0% of persons identifyingas Southern European (including 7.5% Italian), but also a significant proportion of Chinese(15.7%) and Korean (5.9%).Concord has a relatively higher proportion of residents aged 29 years or below and a lowerproportion aged 50 years and above, compared to the NSW average. In contrast to this, thepopulation of Drummoyne is older with a lower proportion of residents aged 24 years and belowcompared to the Inner West Sydney catchment (catchment) and NSW averages. Drummoyne1 Users of this information are strongly advised to refer to the source data to ensure accuracy, and to take note of the data explanations whichaccompany the profile to ensure the information provided is interpreted appropriately and that the data limitations are understood. Reference canbe made to the source data through the links and/or references provided.This health profile should be read in conjunction with more detailed information on the health of the local population provided by IWSML andSLHD on their websites: www.iwsml.org.au and www.slhd.nsw.gov.au. Additional information can also be obtained from the NSW Chief HealthOfficer’s Report 2010 and Health Statistics NSW. Available at http://www.healthstats.nsw.gov.au/ and from the NSW Adult Population HealthSurveys: http://www.health.nsw.gov.au/surveys/Pages/default.aspx.Inner-West Sydney Medicare Local and Sydney Local Health District Page 1Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profilehas a higher proportion of residents aged 65 years and over (16.1%) than any other LGA in thecatchment.With lower rates of unemployment than the catchment and higher proportion of residents withprivate health insurance than the catchment and across NSW, Canada Bay ranks within the top20% of most advantaged LGAs across NSW and second across all LGAs/SLAs within the InnerWest Sydney catchment, behind Leichhardt.The population is generally healthy with the health risk profile and prevalence of chronic diseasegenerally lower than that of the catchment as a whole and across NSW. However, the incidenceof most types of cancer is higher in Canada Bay than that within the catchment as a whole,including breast, colon, prostate and stomach cancers, as well as melanoma.The number of General Practitioners per-capita in Canada Bay is one of the lowest in thecatchment, although the GP workforce is also one of the youngest of any LGA in the catchmentarea.IndicatorTable 1: Characteristics of the Canada Bay LGA at a glanceValueLGARank withinInner WestSydneyInner WestSydneyNSWPopulation^ 75,761* 3 rd 548,627* 6,917,656Population growth forecast (2011 to 2025) # 25.0 * 4 th 22.1% 20.3%% Indigenous persons # 0.4% 7 th 0.9% 2.5%Median annual household income^ $94,484 2 nd $78,930 α $64,324Unemployment # 3.5% * 8 th 5.5% 5.7%% English as primary language^ 63.0% * 5 th 54.9% 72.5%Private Health Insurance coverage # 66.7% * 2 nd 50.9% 48.2%Broadband internet penetration # 77.0% 3 rd 73.4% 69.9%Disability – has need for assistance with coreactivities^3.9% 6 th 4.2% 4.9%Actual Births 2011^1,237 4 th 9,041 97,602Source: ^Australian Bureau of Statistics; # Public Health Information Development Unit and Australian Bureau of StatisticsNotes: * Average of both Canada Bay (Concord) and Canada Bay (Drummoyne);α Derived by HealthConsult based on income data published by the Australian Bureau of Statistics (2011)This population number is based on first count data. The values based on estimated resident data (ERP) are 79,905 and 582,100 respectively.Inner-West Sydney Medicare Local and Sydney Local Health District Page 2Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile2Population and community characteristicsHeadlines Affluent, with relatively high incomes (particularly Drummoyne) and low unemployment(around 3.5%); Drummoyne currently has the highest proportion of residents aged over 65 years(16.1%) in the catchment. This is expected to grow to 18.6% of all residents by 2025; Concord is expected to be one of the fastest-growing SLA within the catchment, withtotal anticipated growth 69.1% between 2011 and 2025. Population growth inDrummoyne is expected to be the second-lowest of any LGA in area; High proportion of residents covered by private health insurance (average 66.7%); Home to predominantly English-speaking residents, however a number of residentsidentify as being Southern European (including Italian and Greek); and There are a large proportion of persons that identify as Chinese in Concord (15.7%).2.1 POPULATION CHARACTERISTICSThe population age profile of Canada Bay is varied between its SLAs of Concord andDrummoyne. Concord’s population profile is broadly consistent with that of the Inner WestSydney overall, but with a relatively higher proportion of young residents aged 29 years or belowand a lower proportion of residents aged 50 years and above. On the other hand, the age profileof Drummoyne is older, with a correspondingly lower proportion of persons aged 24 years andbelow, compared to the proportion across both the catchment and NSW. Importantly, theproportion of residents aged 65 years or over in the Drummoyne SLA (16.1%) is higher than anyLGA in the catchment, and is also higher than the proportion of persons aged over 65 yearsacross NSW (14.7%) 2 .Figure 1: Population profile (by age) vs Inner West Sydney and state comparators, 2011Source: Public Health Information Development Unit and Australian Bureau of Statistics (2012)2Population Health Information Development Unit and Australian Bureau of Statistics (2011)Inner-West Sydney Medicare Local and Sydney Local Health District Page 3Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfilePopulation estimates to 2025 are provided in Figure 2, which shows growth in persons aged 40years and above in Concord is expected to easily outstrip the growth expected across both thebroader catchment and NSW. The largest growth is expected to occur in persons aged between75 to 79 years (94.2%), 70 to 74 years (67.0%) and 60 to 64 years (64.1%). Growth in personsaged 19 years and below in Concord is also expected to be well above the rates expected in theoverall catchment and NSW. Major housing developments are anticipated in Rhodes andBreakfast Point, with urban consolidation occurring down the Parramatta Road corridor.Over all age cohorts, Drummoyne is forecast to grow at a much slower rate (18.0%) than boththe overall area (22.1%), and NSW (20.3%), with the exception of those aged between 20 to 29years, where growth is expected to be the second-greatest of any LGA, behind Sydney South. 3These forecasts will have some significant impacts on the mix and number of services required tomeet the health needs of the population, particularly in Concord where the population aged 40years and above will be significantly increased.Figure 2: Forecast population growth (by age) vs Inner West Sydney and state comparators, 2011 to 2025Source: Public Health Information Development Unit and Australian Bureau of Statistics (2012)Table 2 and Figure 3 illustrate the projected changes in population numbers and people indifferent age groups in the Ashfield LGA from 2006 – 2031 based on the estimated residentpopulation (ERP) numbers released by NSW Planning Department in 2009. The totalpopulation projections based on Estimated Resident Population differ from those above.3 Public Health Information Development Unit and Australian Bureau of Statistics (2012)Inner-West Sydney Medicare Local and Sydney Local Health District Page 4Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 2: Projected population, City of Canada Bay LGA and SLHD 2006, 2011, 2016, 2021 and 2031PopulationCity of Canada BayInner West Sydneyprojections 2006 2011 2016 2021 2031 2006 2011 2016 2021 2031Total population 68,725 79,664 87,497 90,149 93,513 531,624 578,162 612,914 642,009 696,211Aged 0 – 4 years 4,330 5,179 5,513 5,452 5,517 31,043 37,279 38,469 39,425 41,571Aged 5 – 14 years 6,752 8,197 9,514 9,833 9,623 49,018 53,637 60,076 64,014 66,763Aged 15 – 24 years 8,031 9,268 9,991 10,320 10,982 73,914 75,761 77,464 79,603 87,569Aged 25 – 44 years 23,663 26,712 28,323 28,232 28,597 198,494 211,686 218,664 223,694 234,486Aged 45 – 64 years 16,493 19,361 21,266 22,175 22,220 117,304 131,328 139,858 147,132 155,676Aged 65 – 84 years 8,291 9,365 10,979 12,128 14,029 54,463 59,580 67,995 76,761 94,544Aged 85 years+ 1,165 1,582 1,911 2,010 2,545 7,388 8,890 10,388 11,381 15,603Source: NSW Health Population Projection Series 1, 2009Figure 3: City of Canada Bay projected population age groups 2006, 2011, 2016, 2021 and 2031Source: NSW Health Population Projection Series 1, 20092.2 BIRTHS AND MATERNAL HEALTHTable 3 and Figure 4 show the number of births to Canada Bay residents in the period 2006 -2011. The annual number of births generally increased between 2006 and 2011. The fertility ratehas increased steadily between 2006 and 2010 and then margionally decreased in 2011. Over thisperiod the fertility rate in Canada Bay was consistently lower than that for NSW.Inner-West Sydney Medicare Local and Sydney Local Health District Page 5Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 3: Births to Canada Bay Residents and Fertility Rate 2006 - 2011Year Canada Bay births Canada Bay totalfertility rateNSW total fertilityrate2006 1,010 1.56 1.792007 1,031 1.62 1.812008 1,171 1.70 1.852009 1,111 1.72 1.872010 1,242 1.79 1.902011 1,237 1.77 1.91Source: ABS 2011 Catalogue No. 330010DO004_2011Figure 4: Births to Canada Bay Residents 2006 - 2011Source: ABS 2011 Catalogue No. 330010DO004_2011The overall immunisation coverage rates for children aged 0 to 84 months calculated from theGeneral Practice Immunisation Incentives Scheme for the August 2012 quarter for the InnerWest Sydney catchment is 89.4%, lower than the state.Maternal indicators are presented in Table 4 and have been extracted from NSW Health ChiefHealth Officer’s Report 2010 and Australian Bureau of Statistics web pages. Althoughsignificantly less women smoke during pregnancy in Canada Bay than in NSW, also significantlyless women attended for antenatal care before 14 weeks gestation.Inner-West Sydney Medicare Local and Sydney Local Health District Page 6Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 4: Maternal indicators, City of Canada Bay LGA and NSWMaternal indicator Canada Bay NSWActual births 2011 4 1,237 99,054Total fertility rate 2011 5 1.77 1.91Smoking at all during pregnancy, 2008 to 2010 combined, number ofmothers who smoked per year, smoothed estimate of standardisedprevalence ratio 6First antenatal visit before 14 weeks of gestation, 2008 to 2010combined, smoothed per cent of pregnancies, smoothed standardisedprevalence ratio53(38.6) -72%(89.4) -Source: ABS 2011 Catalogue No. 330010DO004_2011 and NSW Health Statistics# 2010 only; - below state average at 1% significance11,235 (100)79.3% #(100)2.3 CULTURAL CHARACTERISTICSAlthough a majority of residents within Canada Bay speak English as a first language, there aresome notable differences in the cultural mix of the population between Concord andDrummoyne, as illustrated in Figure 5.The population of Drummoyne is predominantly English-speaking (71.7%), with a further 11.6%of persons identifying their primary language as Italian, 4.2% Chinese and 3.3% Greek. Concordresidents are also predominantly English-speaking (54.4%), albeit to a much lesser extent thanresidents of Drummoyne. The population of Concord also includes 7.5% of persons thatidentify their primary language as Italian, but also a very significant proportion of Chinese(15.7%) and Korean (5.9%). 5.6% of residents in Canada Bay indicated that they speak English‘not well’ or ‘not at all’.Figure 5: Primary language spoken at home vs Inner West Sydney and state comparators, 2011Source: Australian Bureau of Statistics (2011)4 Australian Bureau of Statistics Births Australia 2011. Available athttp://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/3301.02011?OpenDocument. Accessed 11 November 2011.5Total fertility rate represents the number of children a female would bear during her life if she experienced current age-specific fertility rates ateach age of her reproductive life. (ABS 2007)6 The smoothed estimate of standardised prevalence ratio enables comparison with the state average set at 100Inner-West Sydney Medicare Local and Sydney Local Health District Page 7Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile2.4 EDUCATION LEVELSIn Canada Bay 62% of people aged over 15 years have completed Year 12 schooling (orequivalent). 7 This rate of completion is greater than Greater Sydney (55%) and well-above thecompletion rate of NSW (47.6%). Following from this, Canada Bay has one of the highest ratesof participation in secondary school at age 16 of any LGA in the catchment (84.5% 8 ), as well asthe highest proportion of persons continuing to higher education (46.4% 9 ).2.5 SOCIO-ECONOMIC CHARACTERISTICSThe Socio-Economic Indexes For Areas (SEIFA) are used to rank geographic areas acrossAustralia according to their socio-economic characteristics. The Index of Relative SocioeconomicDisadvantage (IRSD) contains indicators of disadvantage such as low income, highunemployment and low levels of education. Relative disadvantage is associated with a lownumber. The average across Australia is 1,000. A number below 1,000 indicates lowersocioeconomic status.The Socio-Economic Indexes For Areas (SEIFA) score for Advantage and Disadvantage in theCanada Bay LGA overall (i.e. combining the Drummoyne and Concord SLAs) is 1,086, whichranks it at the 90 th percentile of Socio-Economic Advantage and Disadvantage 10 for NSW and 2 ndacross all LGAs / SLAs within the Inner West Sydney Medicare Local. 11 Specifically, the SEIFAscore for Canada Bay (Concord) is 1,084 and Canada Bay (Drummoyne) is 1,088, placing them inthe 90 th and 91 st percentile respectively of relative socio-economic advantage and disadvantage.Relative advantage and disadvantage percentiles for all LGAs within the catchment as measuredby SEIFA are shown in Figure 6.Figure 6: Comparison of SEIFA Advantage and Disadvantage percentiles across Inner West Sydney, 2011Source: Australian Bureau of Statistics (2011)The proportion of households in Canada Bay with incomes above $130,000 per annum is higherin both Concord and Drummoyne compared to both the catchment area and NSW.Unemployment in Canada Bay (3.5%) is significantly lower than the catchment (5.5%) 12 , and theproportion of residents with private health insurance coverage (66.7%) is significantly higher thancomparators at the catchment level (50.9%) and across NSW (48.2%).7Profile:id - Canada Bay, accessed from http://profile.id.com.au/canada-bay8This figure represents the average of Canada Bay (Concord) and Canada Bay (Drummoyne)9This figure represents the average of Canada Bay (Concord) and Canada Bay (Drummoyne)10Australian Bureau of Statistics, 201111Public Health Information Development Unit and Australian Bureau of Statistics, 200612ibid.Inner-West Sydney Medicare Local and Sydney Local Health District Page 8Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile2.6 ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITYCanada Bay was originally home to the Wangal people. Indigenous Australians comprise a totalof 0.4% of the total population of the Canada Bay LGA, which is below the average for both thecatchment (0.9%) and NSW (2.5%). Over all LGAs within the catchment, Canada Bay is hometo the equal-second-lowest proportion of Indigenous Australians, behind Strathfield (0.3%). 132.7 HUMANITARIAN ARRIVALSThere were twenty-six humanitarian settlers in the City of Canada Bay LGA in the period 1 July2005 - 30 June 2011. Humanitarian arrivals settling in Canada Bay came from 16 differentcountries, however the small numbers mean data on country of birth is unable to be reported. 142.8 HOMELESSNESSHomelessness data published by the Australian Bureau of Statistics shows that the per-capita rateof homelessness in both Drummoyne (1.7 persons per 1,000) and Concord (2.6 per 1,000persons) is significantly lower than the catchment (6.9 persons per 1,000) and NSW (3.4 personsper 1,000). This is illustrated in Figure 7. Over all LGAs, the rate of homelessness in CanadaBay is the lowest of any LGA in the catchment 15 .Figure 7: Housing and homelessness indicators vs Inner West Sydney and state comparators, 2006Source: Australian Bureau of Statistics (2006)Population Characteristics of the Canada Bay LGA are provided in Table 5. They includeindicators reflecting people and culture, disability, the labour force, education and familycomposition from the Australian Bureau of Statistics (ABS) 2011 Census of Population andHousing.13Australian Bureau of Statistics (2011)14 Department of Immigration and Citizenship Settlement Database. Accessed 21 February 2012. Available at: http://www.immi.gov.au/livingin-australia/delivering-assistance/settlement-reporting-facility/15Australian Bureau of Statistics (2006)Inner-West Sydney Medicare Local and Sydney Local Health District Page 9Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 5: Population characteristics of the City of Canada Bay and NSWPopulation Characteristics Canada Bay NSWPeople and CultureTotal persons 75,763 6,917,658Indigenous persons (comprises Aboriginal and Torres Strait 286 (0.4%) 172,621 (2.5%)Islander)Persons born overseas 26,914 (35.5%) 1,778,548(25.7%)Country of birth – three most common responses other than AustraliaUnited Kingdom 2,523 (3.3%) 274,823 (4.0%)China 4,338 (5.7%) 156,034 (2.3%)New Zealand * 114,233 (1.7%)Italy 3,864 (5.1%) *Language spoken at home – English only spoken at home 44,186 (58.3%) 5,013,343(72.5%)Three most common languages other than English spoken at homeArabic ** 184,242 (2.7%)Mandarin 3,833 (5.1%) 139,825 (2.0%)Cantonese 2,802 (3.7%) 136,374 (2.0%)Italian 6,674 (8.8%) **Disability 16Has need for assistance with core activities 2,921 (3.9%) 338,362 (4.9%)Carers 17Unpaid assistance provided to a person with a disability 6,698 (8.8%) 638,614 (9.2%)Education 18Highest Year of School Completed – Year 12 or equivalent 36,105(64.2%)Highest Year of School Completed – Year 10 or equivalent 8,937(14.7%)Labour force status2,631,287(49.2%)1,278,047(23.9%)Total labour force 40,422 3,334,857Employed full time 26,407(65.3%)2,007,925(60.2%)Unemployed 1,741 (4.3%) 196,526 (5.9%)IncomeMedian individual income ($/weekly) 782 561Median household income ($/weekly) 1,817 1,23716Source: ABS 2006 CDATA Online. This variable has been developed to measure the number of people with a profound or severe disability.(ABS, 2006, 2901.0 – Census Dictionary, 2006, (Reissue)http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2901.0Chapter9908902006+(Reissue)?OpenDocument17Source: ABS 2006 CDATA Online. This variable recorded people who in the two weeks prior to Census Night spent time providing unpaidcare, assistance or help to family members or others because of a long term illness, disability or problems related to old age. It included peoplewho were in receipt of a Carer Payment or Carer Allowance. It did not include work performed via a voluntary group or organisation. (ABS, 2006,2901.0 – Census Dictionary, 2006, (Reissue)http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/2901.0Chapter9943002006+(Reissue)?OpenDocument18Proportion calculated on the total persons 15 years and over who are no longer attending primary or secondary schoolInner-West Sydney Medicare Local and Sydney Local Health District Page 10Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileFamily characteristicsCouple families with children 9,545 (46.4%) 831,850 (45.5%)Couple families without children 8,025 (39.0%) 669,019 (36.6%)One parent families 2,546 (12.4%) 297,904 (16.3%)Household composition – occupied private dwellingsFamily household 20,076(71.7%)1,777,398(71.9%)Lone person household 6,459 (23.1%) 599,148 (24.2%)Dwelling characteristicsTotal private dwellings 30,386 2,736,637Median rent ($/weekly) (occupied private) 480 300Median housing loan repayment ($/monthly) (occupied private) 2,600 1,993Occupied private dwellings - fully owned 9,268 (30.5%) 820,006 (30.0%)Occupied private dwellings - rented including rent-free 9,273 (30.5%) 743,050 (27.2%)Source: ABS 2011 Census of Population and Housing* Not one of the three most common responses** Not one of the three most common languages other than English spoken at homeInner-West Sydney Medicare Local and Sydney Local Health District Page 11Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile3Health risks of the populationHeadlines Highest proportion of overweight persons of the entire catchment in Drummoyne(23.6%), although lower than the NSW average; Lower levels of psychological distress (11.0%) compared to the catchment; Good overall physical activity levels, particularly in Drummoyne within the catchment; Marginally lower levels of obesity compared to the catchment and NSW average, and Marginally lower proportion of smokers and of risky alcohol consumption.3.1 HEALTH RISK FACTORSFigure 8 shows that the health risk profile of Canada Bay residents is generally below that of theoverall catchment area, and is also lower than across NSW in terms of smoking, risky alcoholconsumption, physical inactivity and obesity.However, the proportion of overweight persons in Drummoyne (23.6%) is the highest of anyLGA in the catchment, and overweight persons represent Canada Bay’s most significant healthrisk of any of the factors explored in Figure 8. In spite of the high proportion of overweightpersons in both SLAs, levels of obesity in both Concord and Drummoyne are below theequivalent population proportions across the catchment and NSW as a whole. Psychologicaldistress levels for Concord and Drummoyne (11.0% for both) are also below the average acrossthe catchment (12.9%) and NSW (12.1%).Figure 8: Health risk factors vs Inner West Sydney and state comparators, 2007-08Source: Public Health Information Development Unit and Australian Bureau of Statistics 2007-08 National Health SurveyInner-West Sydney Medicare Local and Sydney Local Health District Page 12Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 6 provides detail reflecting health behaviours of residents covered by the IWSML/SLHDcatchment and NSW and has been extracted from the NSW Population Health Survey 2011 Report onAdult Health. There is a variation in the elements assessed compared to the previous figure andthis table is provided to illustrate trends in Inner West Sydney overall.Table 6 Health behaviours of the residents of Inner West Sydney and NSWIndicatorInner West IWS trend NSW NSW trendSydneyConsumes more than 2 standard drinks 23.9% Since 2002 29.6% Steadyper day when drinking alcohol, personssteady withaged 16 years and over, 2011slightreductionCurrent smoking, persons aged 16 yearsand over, 201114.9% Decreasingsince 199714.7% Decreasing since1997Recommended fruit consumption,51.5% Steady 50.4% Steadypersons aged 16 years and over, 2011Recommended vegetable consumption, 7.1% Steady 8.4% Steadypersons aged 16 years and over, 2011Adequate physical activity, persons aged 56.1% Overall slight 54.6% Overall slight16 years and over, 2011increase sinceincrease since1998. Recent1998. Recentdecline.decline.Vaccinated against influenza in the last 67.3% Increase since 72.4% Increase since12 months, persons aged 65 years andover, 201119971997Vaccinated against pneumococcaldisease, persons aged 65 years and over,201154.0% Increasesince 200259.5% Increase since2002Source: NSW Adult Population Health Survey (SaPHaRI); Centre for Epidemiology and Evidence, NSW Ministry of Health available at HealthStatistics.Vaccination rates for adults within the catchment are lower than that for NSW, with otherindicators reflecting a similar health behaviour pattern to the rest of the state.Inner-West Sydney Medicare Local and Sydney Local Health District Page 13Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile4Long term conditions, chronic disease and disabilityHeadlines Lower rates of mortality from chronic circulatory conditions than state and catchmentaverages, although higher rates of respiratory conditions; Significantly higher prevalence of cancer, compared to prevalence rates observed acrossthe catchment. Melanoma, prostate cancer and breast cancer are of particular concern; Highest prevalence of prostate cancer (0.81 persons per 1,000 population) and breastcancer (0.72 persons per 1,000) of any LGA / SLA in the catchment; In spite of its high cancer incidence, mortality from cancer (all types) is lower than thecatchment and NSW rate per-capita; Lower mortality from chronic circulatory and respiratory diseases compared to thecatchment and NSW; and Higher fall-related hospitalisations compared to the state.4.1 PREVALENCE OF CHRONIC DISEASESData obtained through the 2007-08 National Health Survey (shown in Figure 9) shows that theprevalence of chronic diseases in Canada Bay is approximately equivalent to the rates within thecatchment and NSW more broadly, although Drummoyne tends to have slightly higherprevalence rates for most conditions than Concord. The exception is respiratory conditions,where prevalence is higher for both Concord (25.6%) and Drummoyne (25.0%) than thecatchment average (24.2%).Figure 9: Prevalence of selected chronic conditions vs Inner West Sydney and state comparators, 2007-08Source: Public Health Information Development Unit and Australian Bureau of Statistics 2007-08 National Health SurveyInner-West Sydney Medicare Local and Sydney Local Health District Page 14Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileThe information in Tables 7 and 8 reflecting the health status of NSW residents and residentscovered by the catchment has been extracted from the NSW Population Health Survey 2010 and2011 Report on Adult Health and NSW Health Chief Health Officer’s Report 2010.Table 7: Indicators reflecting health status of residents of the Inner West Sydney and NSWIndicatorIWSNSWCatchmentExcellent, very good, or good self-rated health status by age, 81.3% 80.4%persons aged 16 years and over, 2011Current asthma, persons aged 16 years and over, 2010 8.8% 11.3%Diabetes or high blood glucose, persons aged 16 years and over, 8.5% 7.4%2010Hysterectomy, females aged 20-69, 2010 6.6% 11.3%Overweight and obesity, persons aged 16 years and over, 2011 46.7% 52.2%Visited a dental professional in the last 12 months, people aged 16 59.1% 58.6%and over, 2010Has private health insurance for dental expenses, people aged 16 51.3% 51.2%and over, 2010Source: NSW Population Health Survey 2010 and 2011 (HOIST). Centre for Epidemiology and Research, NSW Ministry of Health.As shown in Table 8, residents of Canada Bay are significantly less likely to be hospitalised ingeneral, including for potentially preventable causes, for coronary heart disease, chronicobstructive pulmonary disease, high body mass index, diabetes, smoking or alcohol attributablereasons than the overall NSW population. However they are significantly more likely to behospitalised for fall related injuries than overall for people in NSW. People living in Canada Bayare also significantly less likely to die prematurely (before 75) from any cause.Inner-West Sydney Medicare Local and Sydney Local Health District Page 15Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 8: Indicators reflecting health status of residents of the City of Canada Bay LGA and NSWIndicator Canada Bay NSW(Ratio only)Hospitalisations 2009-10 to 2010-11, smoothed number ofseparations per year, Smoothed Standardised Separation Ratio(sSSR) 19Potentially preventable hospitalisations 2009-10 to 2010-11,smoothed number of separations (sSSR)Diabetes hospitalisations 2009-10 to 2010-11, smoothed number ofseparations per year (sSSR)Coronary heart disease hospitalisations 2009-10 to 2010-11smoothed number of hospitalisations per year (sSSR)Chronic obstructive pulmonary disease hospitalisations, personsaged 65+, 2008-09 to 2009-10 smoothed number of hospitalisationsper year (sSSR)High body mass index attributable hospitalisations, smoothednumber of separations per year 2008-09 to 2009-10 (sSSR)Alcohol attributable hospitalisations, 2008 – 2009 to 2009 – 2010,smoothed number of hospitalisations per year (sSSR)Smoking attributable hospitalisations, 2009 – 2010 to 2010 – 2011,smoothed number of hospitalisations per year (sSSR)Fall-related injury hospitalisations, persons aged 65 years andover, 2008-2009 to 2009-2010 combined, smoothed number ofhospitalisations per year (sSSR)Potentially avoidable deaths, persons aged under 75 years, 2006 to2007 combined, smoothed number of deaths per year, SmoothedStandardised Mortality Ratio (sSMR) 20Deaths potentially avoidable by primary prevention, persons agedunder 75 years, 2006 to 2007 combined, smoothed number ofdeaths per year (sSMR)Potentially avoidable deaths from causes amenable to health care,persons aged under 75 years, 2006 to 2007 combined, smoothednumber of deaths per year (sSMR)28,386(98.8) -1,413(71.1) -166(80.7) -262(56.2) -102(65.0) -345(76.7) -421(80.8) -316(67.1) -360(110.5) ++83(80.4) -49(80.0) -37(87.5)High body mass attributable deaths 2006 to 2007, Smoothed 28(100)Number of Deaths per Year, sSMR(93.2)Alcohol attributable deaths, 2006 to 2007, smoothed number of 11(100)deaths per year (sSMR)(89.6)Smoking attributable deaths, 2006 to 2007, smoothed number of 46(100)deaths per year (sSMR)(85.7)Source: Health Statistics NSW and NSW Health Chief Health Officer’s Report 2010--below State average at 5% level of significance; - below State average at 1% level of significance++ above State average at 5% level of significance, + above State average at 1% level of significanceTable 9 provides details of the ten most common reasons for hospitalisation in 2010/11 forresidents in Canada Bay:(100)(100)(100)(100)(100)(100)(100)(100)(100)(100)(100)(100)19The smoothed Standardised Separation Ratio (sSSR) can be interpreted as a 'relative risk', and is compared to the NSW average which is set to100.20The smoothed Standardised Mortality Ration (sSMR) can be interpreted as a ‘relative risk’ and is compared to the NSW average with is set to100.Inner-West Sydney Medicare Local and Sydney Local Health District Page 16Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 9: Ten most common reasons for hospitalisation in 2010/11 in the City of Canada Bay LGA and NSWNSW 2010/11s Canada Bay CanadaBay RankNSWSeparationsDigestive system 4126 (20.17%) 1 27803 (16.59%) 1Pregnancy, childbirth and the puerperium 2082 (10.18%) 2 17482 (10.43%) 2Musculoskeletal system and connective 1969 (9.63%) 3 16756 (10.00%) 3tissueCirculatory system 1424 (6.96%) 4 13753 (8.21%) 4Female reproductive system 1266 (6.19%) 5 9897 (5.91) 5Skin, subcutaneous tissue and breast 1115 (5.45%) 6 8296 (4.95%) 9Ear, nose, mouth and throat 1114 (5.45%) 7 8905 (4.95%) 9Eye 1090 (5.33%) 8 7632 (4.55%) 11Respiratory system 1048 (5.12%) 9 9627 (5.75%) 6Nervous system 992 (4.85%) 10 8877 (5.30%) 8Source: Sydney Local Health District Centre for Research, Evidence Management and Surveillance (HOIST)NSWRank4.2 CANCERFigure 10 shows that the incidence of most types of cancer is higher in Canada Bay than in theoverall catchment area. The incidence of breast, prostate and stomach cancer is well above thecatchment on a per-capita basis. The incidence of breast cancer (0.72 persons per 1,000) is alsohigher than the incidence for NSW (0.62 per 1,000) by a significant margin, and is the highest rateof incidence for breast cancer in any LGA of the catchment. Stomach cancer (0.17 persons per1,000) is also higher than the catchment (0.11 persons) and NSW (0.10 persons).The incidence of prostate cancer in Canada Bay is the highest of any LGA (0.81 persons per1,000 compared to a catchment average of 0.62), but is lower than the incidence observed acrossNSW (0.92 cases per 1,000 persons).Figure 10: Incidence of selected cancers per 1,000 persons * vs Inner West Sydney and state comparators,2004 to 2008Source: Cancer Institute NSW (2010)Note: * Data was not available at the SLA level for Canada Bay. Data presented refers to the consolidated LGA (Concord and Drummoyne);Incidences reported are crude rates (not age-standardised)Information on cancer screening rates is not available at an LGA level. For the Inner WestSydney catchment level, cancer screening information is available for both breast and cervicalcancer screening.Inner-West Sydney Medicare Local and Sydney Local Health District Page 17Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileThe NSW Cancer Plan includes a target to increase breast cancer screening participation in theage group 50-69 years so that over 70% of women aged 50-69 years have 2 yearly mammogramsby 2010. In the period 2009-2010, the participation rate in the catchment was 47%, compared to52.7% for NSW. 21Cervical cancer screening rates in NSW for women aged 20 - 69 in 2009 and 2010 combinedwere 56.5% and in the catchment were 54.9%. 22The count and age standardised incidence rates (per 100,000) for cancers (2004-2008) in theCanada Bay LGA and NSW are presented in Table 10. Over this period, 1,747 people from theCanada Bay LGA were diagnosed with cancer, a rate of 464.0 per 100,000 (less than the state rateof 483.2 per 100,000). The most common cancers were prostate, breast, colon, melanoma andlung. Incidence rates for breast, stomach, thyroid, liver and testicular cancer, as well as non-Hodgkins lymphoma, mesothelioma and leukaemia were higher than for the state.21Health Statistics NSW http://www.healthstats.nsw.gov.au/Indicator/can_brstscr_lhn. Accessed 19 November 201222Health Statistics NSW http://www.healthstats.nsw.gov.au/Indicator/can_cervscr_lhn. Accessed 19 November 2012Inner-West Sydney Medicare Local and Sydney Local Health District Page 18Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 10: Count and age standardised incidence rates (per 100,000) for cancers, 2004 – 2008, Canada Bay andNSWCancer Site Canada Bay NSWCountStandardisedIncidenceRate/100,000CountStandardisedIncidenceRate/100,000All Cancers 1,747 464 177,519 483.2Bladder 37 9.7 3,631 9.7Brain 24 6.3 2,356 6.6Breast 248 67.8 21,102 58.2Cervix 8 2.1 1,228 3.5Colon 133 35.1 15,072 40.6Head and Neck 36 9.6 4,686 12.8Kidney 46 12.3 4,857 13.2Leukaemia 51 14.2 4,605 12.6Lip 10 2.7 1,203 3.3Liver 27 7.1 2,088 5.7Lung 133 34.9 15,905 43Melanoma 133 34.8 17,716 48.8Mesothelioma 20 5.3 1,047 2.8Non-Hodgkins Lymphoma 91 24.5 6,828 18.6Oesophagus Cancer 14 3.5 2,024 5.4Ovarian Cancer 24 6.3 2,191 6Pancreatic Cancer 39 10 4,062 10.9Prostate Cancer 279 74.3 31,321 84.4Rectal Cancer 83 21.5 8,338 22.6Stomach Cancer 57 15 3,275 8.8Testicular Cancer 17 4.6 1,084 3.2Thyroid Cancer 42 11.5 3,301 9.4Uterine Cancer 27 7.1 3,043 8.3Cancer at Indef & Unspec Site 56 14.2 6,014 16Other Cancers 112 29.69 10,542 28.77Source: Incidence and Mortality data is from the NSW Central Cancer Registry. Population estimates are from HOIST, Epidemiology andSurveillance Branch, NSW Health Department. 23The count and age standardised mortality rates (per 100,000) for cancers (2004 – 2008) in theCanada Bay LGA and NSW are presented in Table 11. Over this period 655 residents of CanadaBay LGA died from cancer, representing a lower rate than that for NSW. The main cancerscausing death were (in descending order) lung, prostate, colon, breast and pancreas. Standardisedmortality rates for cancer of the pancreas, stomach, liver, ovary, uterus and cervix were higher inCanada Bay than for NSW.23 Cancer Institute NSW, Central Cancer Registry Statistical Reporting Module website. Accessed 10 November 2012. Available at:http://www.cancerinstitute.org.au/data-and-statistics/cancer-statistics/online-statistics-moduleInner-West Sydney Medicare Local and Sydney Local Health District Page 19Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 11: Count and age standardised mortality rates (per 100,000) for cancers, 2004 – 2008, Canada Bay LGAand NSWCancer Site Canada Bay NSWCountMortalityRate/100,000CountMortalityRate/100,000All Cancers 655 168.2 66,228 176.9Bladder 13 3.1 1,644 4.3Brain 12 3.2 1,716 4.7Breast 42 11 4,693 12.6Cervix 5 1.2 415 1.1Colon 43 10.9 5,511 14.6Head and Neck 14 3.8 1,762 4.7Kidney 11 2.9 1,605 4.3Leukaemia 20 5.2 2,248 6Lip NA NA NA NALiver 22 5.8 1,527 4.1Lung 102 26.5 12,781 34.4Melanoma of skin 23 5.9 2,314 6.2Mesothelioma 20 5.3 947 2.5Non-Hodgkins Lymphoma 24 6.1 2,569 6.8Oesophagus 12 3 1,590 4.2Ovaries 19 5 1,394 3.7Pancreas 38 9.7 3,611 9.6Prostate 51 12.7 4,904 12.8Rectal 29 7.5 3,018 8.1Stomach 30 7.6 2,232 6Testicles NA NA NA NAThyroid NA NA 168 0.4Uterus 8 2 614 1.6Cancer at Indef & Unspec 57 14.4 4,473 11.8SiteOther Cancers 60 15.25 4,411 11.75Source: Incidence and Mortality data is from the NSW Central Cancer Registry. Population estimates are from HOIST, Epidemiology andSurveillance Branch, NSW Health Department. 24254.3 MORTALITYThe median age of death and the standardised rate of deaths from all causes for residents of theCanada Bay LGA and NSW is provided in Table 12.24 Cancer Institute NSW, Central Cancer Registry Statistical Reporting Module website. Accessed 10 November 2012. Available at:http://www.cancerinstitute.org.au/data-and-statistics/cancer-statistics/online-statistics-module25 Additional information relating to Cancer can be obtained from the Cancer Institute NSW, Central Cancer Registry Statistical ReportingModule web page. Available at: http://www.statistics.cancerinstitute.org.au/.Inner-West Sydney Medicare Local and Sydney Local Health District Page 20Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileTable 12: Life expectancy and deaths from all causes for residents of the City of Canada Bay and NSWIndicator City of Canada Bay NSWDeaths from all causes 2011, Indirectly4.2 5.7Standardised Death Rate ^Deaths from suicide and self-inflicted 5.8 (Concord)9.3injuries 2003-2007, average annual ASR 26per 100,000 population #10.5 (Drummoyne)Males Females Males FemalesMedian Age of Death 2003 - 2007 27 77 82 77 83Source: ^SSWLHD & SLHD Centre for Research, Evidence Management and Surveillance; # Public Health Information Development UnitIn spite of the high incidence of cancer across Canada Bay, Figure 11 shows that cancer-relatedmortality in Drummoyne is consistent with the level observed across the catchment, and cancermortality in Concord is approximately 10% below the catchment average rate per-capita.Figure 11 also illustrates that mortality from chronic circulatory and respiratory conditions is wellbelow catchment and NSW rates per 1,000 persons. Furthermore, analysis of chronic diseasemortality across the catchment shows that mortality from circulatory and respiratory systemdiseases in Canada Bay is the lowest of any LGA within the catchment 28 .Figure 11: Premature mortality * from chronic disease (ages 0 to 74 years) and external causes per 1,000persons vs Inner West Sydney and state comparators, 2003 to 2007Source: Public Health Information and Development Unit and Australian Bureau of Statistics (2012)Note: * ‘Premature mortality’ is defined by PHIDU as mortality occurring prior to 75 years of age;‘Circulatory system conditions’ include ICD-10-AM codes I00 to I99; ‘Respiratory system diseases’ include ICD-10-AM codes J00 to J99;‘External causes’ include deaths arising from transport accidents, accidental falls, accidental poisoning, assault and suicide;Death rates reported are crude rates (not age-standardised).Figure 12 shows that rates of preventable mortality in Canada Bay are approximately 30% belowthe rate per 1,000 persons in both the catchment and NSW.26 ASR denotes indirectly age standardised rate per 100,000 population27 Public Health Information Development Unit Social Health Atlas of Australia: Statistical Local Area and Local Government Area 2012 http://http://www.publichealth.gov.au/data/social-health-atlas-of-australia%3a-statistical-local-area-and-local-government-area_-published-2012.htmlaccessed 10/11/1228Public Health Information Development Unit (2003 to 2007)Inner-West Sydney Medicare Local and Sydney Local Health District Page 21Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileFigure 12: Preventable mortality * per 1,000 persons vs Inner West Sydney and state comparators, 2003 to2007Source: Public Health Information and Development Unit and Australian Bureau of StatisticsNote: * Data relates to persons aged from 0 to 74 years where mortality is caused by a number of conditions specified by the Public HealthInformation Development Unit. Mortality rates reported are crude rates (not age-standardised).4.4 INFECTIOUS DISEASESWithin New South Wales, Inner West Sydney has the highest rate of Hepatitis B virus reflecting ahigh population from East Asian countries. Inner West Sydney has the second highest rate ofHIV (reflecting a high population of gay and other homosexually active men) and the secondhighest rate of HCV (reflecting high rates of injecting drug use). Sydney LHD has the 3rd highestrate of Chlamydia. 29Figure 13 shows, however, that the prevalence of sexually transmissible infections (STIs) inCanada Bay is significantly lower than across other LGAs in the catchment for all types of STI.Figure 13: Prevalence of sexually transmissible infections per 1,000 persons vs Inner West Sydney and statecomparators, 1998 to 2009Source: Sydney Local Health District and NSW Health Centre for Epidemiology and Research (2010)Note: Rates reported are crude (not age standardised)29 Australian Society for HIV MedicineInner-West Sydney Medicare Local and Sydney Local Health District Page 22Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile4.5 DISABILITYFigure 14 shows that the proportion of persons that require assistance with core activities inCanada Bay is lower than the overall catchment area for persons aged below 80 years. However,the proportion of Concord residents aged over 80 years that require assistance (42.4%) ismarginally higher than across the catchment (41.7%). Given the significant population growthforecast for persons aged over 65 years in Concord, the requirement for aged care places inConcord is likely to be significantly greater than at present.Figure 14: Proportion of persons requiring assistance with core activities * vs Inner West Sydney and statecomparators, 2011Source: Australian Bureau of Statistics (2011);Note: * ‘Core activities’ are defined by the ABS as needing help in one or more of three activity areas of self-care, mobility and communication’Inner-West Sydney Medicare Local and Sydney Local Health District Page 23Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile5Health service utilisationHeadlines MBS services provided in Concord were generally below per-capita benchmark ratesat the catchment level for 45 year old health checks, practice nurse services and mentalhealth care plans, while per-capita services provided for 45 year old health checks andmental health care plans in Drummoyne were higher than for both the catchment andNSW; Although per-capita services provided by Practice Nurses in Drummoyne are lower than theNSW rate (296.2 per 1,000 persons), Drummoyne has the highest provision of PracticeNurse services per capita of any LGA / SLA in the catchment (248.6 per 1,000persons); Canada Bay has the lowest rate of potentially preventable hospitalisations forambulatory-sensitive conditions of any LGA / SLA within the catchment (18.5 per1,000 persons); and The Drummoyne SLA has the highest rate of HACC service provision of any LGA /SLA in the catchment.5.1 PRIMARY CARE UTILISATIONMedicare data shows some variation in the rate of primary care services billed to the MedicareBenefits Schedule (MBS) in 2009/10 between Concord and Drummoyne.As shown in Figure 15, MBS services provided in Concord were generally below per-capitabenchmark rates at the catchment level for 45 year old health checks, practice nurse services andmental health care plans. The exception to this were GP health assessments for persons aged75+ years (259.9 per 1,000 persons), which was significantly higher in Concord than thecatchment and NSW rate.Per-capita services provided for 45 year old health checks and mental health care plans inDrummoyne were higher than for both the catchment and NSW, and are generally consistentwith overall trends across both the catchment and NSW for other primary care services.Although per-capita services provided by Practice Nurses in Drummoyne are lower than theNSW rate (296.2 per 1,000 persons), Drummoyne has the highest provision of Practice Nurseservices per capita of any LGA / SLA in the catchment (248.6 per 1,000 persons).Inner-West Sydney Medicare Local and Sydney Local Health District Page 24Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileFigure 15: Selected primary care services per 1,000 persons, vs Inner West Sydney and state comparators,2010Source: Public Health Information Development Unit and Department of Health and Ageing (2012)5.2 EMERGENCYTable 13 provides analysis of 2011-12 Emergency Department (ED) data across all three publichospitals within Inner West Sydney. Table 13 shows that residents of the Canada Bay LGAmade 13,598 visits to EDs within the catchment area, which represents 9.8% of all ED visits tohospitals in the catchment overall, and 13.5% of visits made by residents living within the InnerWest Sydney catchment area. Of the total number of ED presentations by Canada Bay residents,73.1% visited the ED at Concord Hospital, 25.1% visited the Royal Prince Alfred Hospital andapproximately 2% presented to the Canterbury Hospital.Table 13: Emergency department presentations by hospital, 2011-12Canterbury Concord Royal PrinceHospital Hospital Alfred HospitalTotalPresentations from Canada Bay LGA 247 (1.8%) 9,932 (73.1%) 3,419 (25.1%) 13,598 (100%)ED presentations for all persons (within and outside Inner West Sydney Medicare Local)Total ED presentations for hospital(all persons)35,998 (26.0%) 34,629 (25.1%) 67,586 (48.9%) 138,213 (100%)Canada Bay % of Total 0.7% 28.7% 5.1% 9.8%Source: Statewide Emergency Data provided by Inner West Sydney Medicare LocalData relating to patient triage classification across the catchment per 1,000 persons is provided inTable 14. Table 14 shows that on a per-capita basis, Canada Bay residents present to emergencydepartments to approximately the same extent as all residents across the entire Inner WestSydney. However, the number of residents per-capita that present to EDs for semi-urgentreasons (87.5 persons per 1,000) are the third-highest of any LGA in the catchment and areapproximately 13% higher than the average across the overall catchment area.Further analysis shows that the top ten reasons patients from Canada Bay presentations to EDsfor ‘urgent’ include a number of conditions that can be managed by effective primary care. Asshown in Table 15, these conditions include feeling unwell (5.1%), shortness of breath (combinedtotal of 6.7%), fever (2.6%) and headache (1.7%). Appropriate preventative measures can also beimplemented to mitigate the risk of falls in elderly persons, which appear as the 9 th most commoncause of presentations to EDs by Canada Bay residents.Inner-West Sydney Medicare Local and Sydney Local Health District Page 25Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileLGA / SLATable 14: Emergency department presentations per capita, by triage category, 2011-12Triage classification - number of persons per 1,000Resuscitation Emergency Urgent Semi-urgent Non-urgentAshfield 1.36 13.15 58.57 64.01 13.66Burwood 1.94 17.52 90.55 119.81 14.16Canada Bay 1.17 14.26 62.45 87.51 11.43Canterbury 1.33 14.17 82.05 90.89 10.35Leichhardt 0.84 14.81 59.20 55.92 20.10Marrickville 1.70 20.77 82.51 80.17 28.20Strathfield 0.99 9.49 48.74 72.50 7.25Sydney South 0.69 8.76 35.15 33.17 12.88Sydney West 0.75 15.31 60.39 59.30 23.67Inner WestSydney1.24 14.73 68.56 77.22 15.63Source: Statewide Emergency Data provided by Inner West Sydney Medicare LocalTable 15: Top 10 reasons for ‘urgent’ presentations to emergency departments by Canada Bay residents * ,2011-12Top 10 rank Presenting problem Count % of all ‘urgent’ presentations1 Unwell 251 5.1%2 Pain, abdominal 187 3.8%3 SOB 177 3.6%4 Shortness of breath * 154 3.1%5 Fever 127 2.6%6 Abdominal pain 124 2.5%7 Pain, chest 119 2.4%8 Chest Pain 112 2.3%9 Falls in elderly 91 1.8%10 Headache 82 1.7%Source: Statewide Emergency Data provided by Inner West Sydney Medicare LocalNote: * A number of the presenting problems shown in Table 4 describe the same condition using different names. Examples include ‘shortnessof breath and SOB’, ‘Pain, abdominal and Abdominal pain’ and ‘Pain, chest and Chest Pain’. These represent the descriptors as they appeared inthe dataset provided to HealthConsult.5.3 AMBULATORY-CARE SENSITIVE ADMISSIONSFigure 16 shows that potentially preventable hospitalisations resulting from Ambulatory-CareSensitive Conditions (ACSCs). ACSCs are those conditions for which hospitalisation is thoughtto be avoidable with the application of Public Health interventions and early diseasemanagement, usually delivered in ambulatory setting such as primary care. High rates of hospitaladmissions for ACSCs may provide indirect evidence of problems with patient access to primaryhealthcare, inadequate skills and resources, or disconnection with specialist services. 30 ACSC’sinclude vaccine-preventable conditions, selected acute conditions and selected chronic conditionsthat are modifiable through behaviour modification and lifestyle change.Rates of preventable hospitalisation for ambulatory-sensitive conditions in Canada Bay (18.6 per1,000 persons) are marginally lower than the rate across the total catchment area (18.9 cases per1,000), and also significantly below the rate across NSW (23.8 per 1,000 persons).30 Victorian Department of Health, http://www.health.vic.gov.au/healthstatus/admin/acsc/index.htmInner-West Sydney Medicare Local and Sydney Local Health District Page 26Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileFigure 16: Preventable hospitalisations for ambulatory-care sensitive conditions per 1,000 population vsInner West Sydney and state comparators, 2009-10 to 2011-12 *Source: NSW Health Centre for Epidemiology and Evidence (2011);Note: * Data was not available at the SLA level for Canada Bay. Data presented refers to the consolidated LGA (Concord plus Drummoyne);Rates reported are indirectly standardised by age and gender.5.4 HOME AND COMMUNITY CAREFigure 17 shows the profile of Home and Community Care (HACC) clients in Canada Bay,compared to the total Inner West Sydney Medicare Local catchment and NSW. Figure 17 showsthat there are no Indigenous HACC clients within Canada Bay, and that the proportion of non-English speaking clients are lower than across the total Inner West Sydney catchment area.There are also some important differences between clients living in the two SLAs that comprisethe Canada Bay LGA. Concord has a much lower proportion of clients that live alone (30.7%),and a correspondingly higher proportion of clients with a carer (29.9%), compared toDrummoyne.Figure 17: HACC client profile vs Inner West Sydney and state comparators, 2010-11Source: Public Health Information Development Unit and Department of Health and Ageing (2012)Figure 18 provides a graphical comparison of selected HACC services in Canada Bay, comparedto the catchment and NSW. Figure 18 shows that the utilisation of HACC services by CanadaBay residents is mixed among HACC service types. A shortfall of HACC services per-capita isInner-West Sydney Medicare Local and Sydney Local Health District Page 27Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profileparticularly pronounced in Drummoyne, which lags behind the catchment in each service typeexcept domestic assistance. The Drummoyne SLA has the highest rate of service provision ofany LGA / SLA in the catchment 31 .Concord outperforms the catchment in terms of allied health services delivered at home, carecounselling and case management, but is lower in terms of care coordination, case management,centre-based day care and transport services.Figure 18: HACC service profile vs Inner West Sydney and state comparators, 2010-11Source: Public Health Information Development Unit and Department of Health and Ageing (2012);Note: Rates reported are indirectly standardised by age and gender.31Public Health Information Development Unit and Department of Health and Ageing (2012)Inner-West Sydney Medicare Local and Sydney Local Health District Page 28Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile6Health service availabilityHeadlines The direct Canada Bay catchment area includes Concord Repatriation GeneralHospital, Westside Private Hospital and Concord Centre for Mental Health; Although the number of GPs per capita is low, Canada Bay has the second-lowestproportion of GPs aged over 55 in the catchment (26.3%); The availability of most types of allied health practitioner in Canada Bay isapproximately at or above the rate across the entire catchment; and6.1 HOSPITALS AND DAY SURGERYCanada Bay is well served by acute care, day surgery and mental health facilities, as shown inTable 16. The direct Canada Bay catchment area includes the 655 bed principal referral publichospital (Concord Repatriation General Hospital), a 38 bed private acute surgical facility(Westside Private Hospital) and the 174 bed public psychiatric hospital (Concord Centre forMental Health). An oral health clinic is also available in Concord.In terms of private health care facilities, Canada Bay has day surgery facilities specialising indigestive diseases and eye surgery.Table 16: Public and private health service listings on the NSW HERO databasePublic sector health servicesHealth Service Name Service Type LocationConcord General and Repatriation Hospital Public Hospitals ConcordConcord Oral Health Clinic Oral Health Services ConcordPrivate sector health servicesCentre for Digestive Diseases Day Surgery Five DockDrummoyne Eye Surgery Centre Day Surgery DrummoyneWestside Private Hospital Private Hospitals ConcordSource: NSW Health Establishment Registration Online (HERO) database (2012)6.2 MEDICALSelected characteristics of General Practitioners currently practicing across the catchment areshown in Figure 19. The number of GPs per 1,000 persons in Canada Bay (1.31) is one of thelowest in the catchment, although the number of GPs providing services in an aged care setting(0.37 per 1,000) and under the Access to Allied Psychological Services (ATAPS) scheme (0.61 per1,000) is broadly consistent with the overall catchment. Although the number of GPs per capitaInner-West Sydney Medicare Local and Sydney Local Health District Page 29Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profileis low, Canada Bay has the second-lowest proportion of GPs aged over 55 in the catchment(26.3%) 32 , which is a positive indicator of the sustainability of its GP workforce into the future.Figure 19: GPs and services provided per 1,000 persons, comparison across the catchment *Source: Inner West Sydney Medicare Local (2012)Note: * Data was not available at the SLA level for Canada Bay. Data presented refers to the consolidated LGA (Concord plus Drummoyne);Rates reported are crude (not age standardised).6.3 ALLIED HEALTHFigure 20 shows the availability of various allied health practitioners in Canada Bay on a percapitabasis, compared to Inner West Sydney. As illustrated, the availability of most types ofallied health practitioner in Canada Bay is approximately at or above the rate across the entirecatchment. Compared to the broader area, the most notable examples of practitioners that aremore readily available in Canada Bay include dentistry, dietetics, pharmacy and physiotherapy.Figure 20: Number of selected private allied health practitioners * per 1,000 persons across the catchmentSource: Listings of registered practitioners published by peak professional bodies including Speech Pathology Australia, ChiropractorsAssociation of Australia, Dieticians Association of Australia, Occupational Therapy Australia and the Australian Podiatry Association (NSW andACT).Note: Rates reported are crude (not age standardised).32 Based on data provided by the Inner-West Sydney Medicare Local, 2012Inner-West Sydney Medicare Local and Sydney Local Health District Page 30Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profile6.4 COMMUNITY HEALTH SERVICESCanada Bay residents have access to a range of community health services provided located inmajor facilities in Croydon, Marrickville, Redfern and Canterbury. These services provideservices based on varied catchments, with most being available to all catchment LGAs. Extractsobtained from the NSW Health Establishment Registration Online database show that CanadaBay is serviced by five public mental health services, which are predominantly based in Concord,as shown in Table 17.Public sector health servicesTable 17: Community Health facilities in Canada BayHealth Service Name Service Type LocationConcord Day Centre Mental Health Services ConcordConcord Outpatient Clinic - Concord Hospital Mental Health Services ConcordRivendell Child, Adolescent and Family Unit Mental Health Services Concord WestRivendell Day Program Mental Health Services Concord WestRivendell Outpatient clinic Mental Health Services Concord WestSource: NSW Health Establishment Registration Online (HERO) database (2012)Public listings of community health services available through the Sydney Local Health Districtshow that three early childhood health centres operate in Canada Bay (one in Concord and two inDrummoyne), along with two community health nursing facilities (both in Drummoyne).6.5 AGED CAREMuch of the health-related care delivered to older people, people requiring rehabilitation, andtheir carers is delivered directly by the Aged Care and Rehabilitation (AC&R) service, a core partof the Sydney Local Health District. Other religious, charitable and community organisationsthroughout the inner-west areas of Sydney also provide services. The following informationdetails residential aged care facilities.As shown in Table 18, the NSW Health Establishment Registration Online database lists eightprivate nursing homes and one public aged care facility within the Canada Bay LGA.Table 18: Aged care facilities in Canada BayHealth Service Name Service Type LocationPublic sector health servicesAged Community Services Team, Aged andExtended Care DepartmentPrivate sector health servicesAged CareNot providedConcord Residential Aged Care Facility Public and Private Nursing Homes ConcordKurmala Nursing Home Public and Private Nursing Homes Concord WestOur Lady Help of Christians Nursing Home Public and Private Nursing Homes DrummoyneMinnamurra Public and Private Nursing Home DrummoyneParkview Nursing Home Public and Private Nursing Homes Five DockRedleaf Manor Public and Private Nursing Home ConcordRussell Lea Nursing Home Public and Private Nursing Homes Five DockSt Mary's Nursing Home (Concord) Public and Private Nursing Homes ConcordSource: NSW Health Establishment Registration Online (HERO) database (2012)Inner-West Sydney Medicare Local and Sydney Local Health District Page 31Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileIn spite of the existence of these aged care facilities, Figure 21 shows that the number ofresidential aged care places in Canada Bay lags well behind the average across both the catchmentand NSW.Figure 21: Aged care places per 1,000 persons vs Inner West Sydney, state and national comparators, 2010Source: Public Health Information Development Unit and Department of Health and Ageing (2012)Inner-West Sydney Medicare Local and Sydney Local Health District Page 32Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileAppendix A: Postcode to LGA / SLA correspondencesIn a number of cases, data was only available at the postcode level, rather than a LGA or SLAlevel. Where this occurred, the data at the postcode level has been mapped to the LGA or SLAaccording to the correspondences shown in Table A.1. The correspondences in Table A.1 arebased upon published data sourced from the Australian Bureau of Statistics regarding postcodeto SLA or LGA mappings detemined under the Australian Standard Geographical Classification.In a number of cases, a single postcode spans a number of LGAs or SLAs. Where this occurs,HealthConsult has only considered those postcode where more than 10% are within an LGA orSLA boundary.Table A.1: Postcode to SLA / LGA correspondencesLGA / SLAAshfieldBurwoodCanterburyCanada Bay% WITHINPOSTCODE LGABOUNDARY2045 99.62LGA / SLA% WITHINPOSTCODE LGABOUNDARY2038 98.952130 99.97 2039 100.00Leichhardt2131 100.00 2040 99.992132 40.71 2041 100.002132 59.292042 60.982133 51.54 2044 99.742134 100.00 2048 99.952135 20.33 Marrickville2049 100.002136 52.34 2050 40.172133 40.35 2203 100.002191 78.20 2204 99.962192 100.002129 100.002193 95.86 2135 72.702194 100.00 Strathfield2136 47.662195 100.00 2140 100.002196 74.57 2191 21.802206 100.002008 33.622208 50.22 2015 100.002209 32.92 2016 100.002210 17.78 Sydney South 2017 100.002046 100.00 2018 37.022047 100.00 2042 39.022137 100.00 2043 100.002138 100.00Sydney West2006 100.002139 100.00 2007 92.592008 66.382009 100.002037 100.002050 59.83Inner-West Sydney Medicare Local and Sydney Local Health District Page 33Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfileAppendix B: Data limitations and assumptionsB.1.DATA SOURCESThe background paper to Medicare Locals Health Needs Assessment and Planning released bythe Commonwealth Department of Health and Ageing states that “Medicare Locals will berequired to have an excellent understanding of their catchment area…which will involveMedicare Locals carrying out comprehensive and robust health needs assessment exercises andplanning”. The Department has not prescribed an approach to health needs assessment andplanning at this stage, but has developed an interim approach that aims to ensure that MedicareLocals’ Needs Assessment Reports “reflect on the specific characteristics and health care needsof their populations in determining which priority activities to pursue”.Unfortunately the breadth of detail required to inform the LGA/SLA profiles is not availablewithin a single data source. Accordingly, data has been sourced on a range of relevant indicatorsusing the most appropriate, recently available source for each indicator. In some cases, theabsence of complete data consistency across all indicators may require consumers of theLGA/SLA profiles to interpret some findings with caution, and this document aims to identifythose areas where this is most likely to be the case.The Consultant has attempted to source and attribute external data collections where possiblethroughout the document, either directly below tables or in footnotes at the bottom of each page.These references should be used in conjunction with this document when interpreting theLGA/SLA profiles.B.1.1PHIDU Social Health Atlas of AustraliaWherever possible, data underpinning the development of the LGA/SLA profiles have beendrawn from a single data source. In many cases data has been sourced from the August andOctober 2012 releases of the Social Health Atlas of Australia, which is compiled by the PublicHealth Information Development Unit (PHIDU), which is under the auspices of the Universityof Adelaide.The data obtained from PHIDU is provided at the LGA/SLA, Medicare Local, state and nationallevels and includes a broad number of indicators that are relevant to population health needs.However, in a number of cases the data collections that underpin these indicators have beencompiled by different organisations that use different sampling techniques and assumptions.Furthermore, the range of indicators presented in PHIDU’s Social Health Atlas use data collectedover different years. The breadth of data sources, collection techniques and collectiontimeframes used in PHIDU’s Social Health Atlas should therefore be taken into considerationwhen interpreting the data, and readers should be cautious about drawing direct comparisonsbetween indicators that are based upon data that has been collected at different timeframes, bydifferent organisations, or using different assumptions.Some indicators presented within PHIDU’s Social Health Atlas of Australia are ‘syntheticpredictions’ that have been derived by PHIDU at the LGA or SLA level, based upon variousdifferent data collections. As a result, these predictions do not represent data collected inadministrative or other data sets, should be used with caution, and be treated as indicative of theprevalence of the health condition or risk factor in an area with these demographic andsocioeconomic characteristics. Synthetic predictions within the PHIDU dataset have been madeInner-West Sydney Medicare Local and Sydney Local Health District Page 34Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health Profilefor indicators relating to the prevalence of chronic disease, private health insurance coverage andhealth risk factors.B.1.2 Other data sourcesAlthough PHIDU’s Social Health Atlas of Australia provides an excellent repository of datarelating to population health needs, it does not contain data on some other variables of interestthat HealthConsult has deemed important to inform the LGA/SLA profiles.As a result, these data items have been sourced by the Consultant from a range of publicly andprivately-held data collections; predominantly the Australian Bureau of Statistics and HealthStatistics New South Wales, but also a range of others.As stated above in relation to PHIDU data, the need to obtain data from a range of sourcesintroduces the possibility for misalignment of populations and assumptions when comparing dataacross time periods, or from different data sources. Nonetheless, it has been necessary as part ofthe development of the LGA/SLA profiles to draw conclusions between indicators that arebased upon different data collections. Although the LGA/SLA profiles have been constructed insuch a way that the most relevant, recently available data has been used for each indicator, it isimportant to recognise the limitations inherent in comparing data sourced from differentcollections, and over different timeframes.Considering the diversity of data sources used to construct the LGA/SLA profiles, data was notalways available for all indicators at the state, Medicare Local or LGA/SLA level. As a result,some indicators have been derived in order to provide comparisons between indicators at thesedifferent levels. Where benchmarks have been calculated by the Consultant they have beenidentified in footnotes to Tables and figures included in the LGA/SLA profiles. Consumersshould exercise caution when making comparisons between derived benchmarks and reportedresults.Inner West Sydney Medicare Local provided workforce data on private allied health provider forthis report. Note that this database is still being constructed and is subject to review.B.1.3 Health Risk Factors – definitionsThe data in Figure 8 are self-reported data, reported to interviewers in the 2007–08 NationalHealth Survey.A current smoker is an adult (over 18 years of age) who reported at the time of interview thatthey smoked cigarettes, cigars or pipes at least once a week.Risky alcohol consumption was based on estimated alcohol consumption in the seven days priorto interview using two components – the number of days on which the respondent reportedconsuming alcohol in the previous week; and the quantity consumed in the most recent days onwhich they consumed alcohol. For people who drank on no more than three days in the lastweek, their daily consumption was simply the total consumed divided by seven. Harmful use ofalcohol is defined as average daily consumption of more than 75 ml (three standard drinks) formales and 50 ml (two standard drinks) for females.Physical inactivity is defined as those aged 15 years and over who did not exercise in the twoweeks prior to interview for the 2007–08 NHS, through sport, recreation or fitness (includingwalking).Inner-West Sydney Medicare Local and Sydney Local Health District Page 35Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013

Canada Bay Local Government Area Health ProfilePsychological Distress: This data is derived from the Kessler Psychological Distress Scale (K-10),which is a scale of non-specific psychological distress based on 10 questions asked ofrespondents about negative emotional states in the 4 weeks prior to interview. 'High' and ‘veryhigh’ distress are the two highest levels of distress categories (of a total of four categories).Overweight and Obesity: The BMI was calculated from self-reported height and weightinformation and grouped as follows to allow reporting against both World Health Organizationand National Health & Medical Research Council guidelines – normal range: 18.5 to less than20.0 and 20.0 to less than 25.0; overweight: 25.0 to less than 30.0; obese: 30.0 and greater.A list of ICD codes used as the basis for the calculation of ‘preventable mortality’ (Figure 12) isavailableat:http://www.publichealth.gov.au/pdf/atlases/avoid_mortality_aust_2006/avoid_mortality_appendix_full.pdfInner-West Sydney Medicare Local and Sydney Local Health District Page 36Canada Bay Local Government AreaPopulation Health LGA/SLA Profile v1.0 February 2013