Burwood - Sydney Local Health DistrictConcord Hospital) provides the largest percentage of emergency department presentations (43.4%) and hospital separations for BurwoodLGA residents

Burwood Local Government Area

Health Profile

2015

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

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

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

Director, Planning

SLHD Planning Unit

Telephone: 02 9515 9517

Email: [email protected]

Date of Publication: December 2015

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

mailto:[email protected]

Burwood Local Government Area Health Profile

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

2.1 POPULATION CHARACTERISTICS ...................................................................................... 5 2.2 BIRTHS AND MATERNAL HEALTH ...................................................................................... 7 2.3 ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE ................................................. 8 2.4 PEOPLE FROM CULTURALLY AND LINGUISTICALLY DIVERSE BACKGROUNDS......... 9 2.5 HUMANITARIAN ARRIVALS .................................................................................................. 9 2.6 EDUCATION LEVELS ............................................................................................................ 9 2.7 SOCIO-ECONOMIC CHARACTERISTICS .......................................................................... 10 2.8 HOMELESSNESS ................................................................................................................ 11

3 HEALTH RISKS OF THE POPULATION ................................................................. 13 4 LONG TERM CONDITIONS AND CHRONIC DISEASE ............................................ 15

4.1 PREVALENCE OF CHRONIC DISEASE ................................................................................... 15 4.2 CANCER ..................................................................................................................................... 17 4.3 MORTALITY ............................................................................................................................... 19

5 INFECTIOUS DISEASES ........................................................................................ 20 5.1 HIV .............................................................................................................................................. 20 5.2 CHLAMYDIA ............................................................................................................................... 21 5.3 GONORRHOEA ......................................................................................................................... 22 5.4 INFECTIOUS SYPHILIS ............................................................................................................. 23 5.5 HEPATITIS B .............................................................................................................................. 24 5.6 HEPATITIS C .............................................................................................................................. 25

6 HEALTH SERVICE UTILISATION ........................................................................... 26 6.1 PRIMARY CARE UTILISATION ................................................................................................. 26 6.2 EMERGENCY DEPARTMENT PRESENTATIONS ................................................................... 27 6.3 HOSPITAL SEPARATIONS ....................................................................................................... 28

6.3.1 DAY-ONLY HOSPITAL SEPARATIONS ............................................................................ 28 6.3.2 OVERNIGHT HOSPITAL SEPARATIONS ......................................................................... 29

6.4 AMBULATORY CASE SENSITIVE ADMISSIONS..................................................................... 30 6.5 HOME AND COMMUNITY CARE .............................................................................................. 31

7 HEALTH SERVICE PROVISION ............................................................................. 33 7.1 HOSPITALS AND DAY SURGERY ............................................................................................ 33 7.2 COMMUNITY HEALTH SERVICES ........................................................................................... 34 7.3 GENERAL PRACTICE ............................................................................................................... 35 7.4 ALLIED HEALTH ........................................................................................................................ 36 7.5 AGED CARE ............................................................................................................................... 37

APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES ............................ 38 APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS ......................................... 39

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List of Tables Table 1: Projected population: Burwood and IWS 2006, 2011, 2016, 2021 and 2031 ........... 6 Table 2: Births to Burwood residents and fertility rate 2006 – 2013 ....................................... 7 Table 3: Child immunisation rates by Age; Ashfield-Strathfield-Burwood SA3, 2012-2013 ... 8 Table 4: Preventive maternal indicators, Burwood LGA and NSW, 2011-2013 ..................... 8 Table 5: Humanitarian migration stream, settlers arriving 2009–2014: Burwood and NSW ... 9 Table 6: IRSD by SLA, and rank within IWS, 2011 .............................................................. 10 Table 7: IRSD by suburbs within Burwood LGA, and rank within IWS, 2011 ....................... 10 Table 8: Estimates of homelessness: Ashfield-Strathfield-Burwood (SA3) and NSW, 2011 12 Table 9: Modelled estimates of health risk factors: Burwood, IWS and NSW 2011-13 ........ 13 Table 10: Health behaviours of residents: IWS and NSW, 2013 .......................................... 14 Table 11: Modelled estimates of chronic disease: Burwood, IWS and NSW 2011-2013 ...... 15 Table 12: Indicators of burden of disease - hospital separations: Burwood, 2009-2013 ...... 16 Table 13: High body mass index, alcohol and smoking attributable deaths: Burwood, 2011 16 Table 14: Age standardised cancer incidence rates by cancer site, 2004 to 2008 ............... 18 Table 15: Age standardised mortality rates by cancer site, 2004 - 2008 ............................. 19 Table 16: Deaths (all causes and potentially preventable): Burwood, 2010-2011 ................ 19 Table 17: HIV notification rate, by LGA, IWS, 2005-2014 .................................................... 20 Table 18: Chlamydia notifications, by LGA, 2005 to 2014 ................................................... 21 Table 19: Gonorrhoea notification rate LGA, IWS, 2005-2014 ............................................. 22 Table 20: Infectious syphilis notification rate by LGA, IWS, 2005 – 2014 ............................ 23 Table 21: Hepatitis B age-standardised notification rate by LGA, IWS, 2005 – 2014 ........... 24 Table 22: Hepatitis C age-standardised notification rate by LGA, IWS, 2005 – 2014 .......... 25 Table 23: Primary care services, age standardised rate per 100,000: Burwood, 2010 ........ 26 Table 24: Emergency department presentations by hospital: Burwood, 2013 ..................... 27 Table 25: Emergency department presentations by triage category: Burwood, 2013 ......... 27 Table 26: Day-only hospital separations for Burwood residents 2013-2014 ........................ 28 Table 27: Overnight hospital separations for Burwood residents 2013-2014 ....................... 29 Table 28: Potentially preventable hospitalisations for ACSCs: Burwood, 2011-13 ............... 30 Table 29: HACC Client Profile, 2012-13; % of HACC clients ............................................... 31 Table 30: HACC Service Profile, 2012-13; Instances of care per 1,000 .............................. 32 Table 31: Acute, aged care, mental health and day surgery facilities in Burwood, 2015 ...... 34 Table 32: Community health facilities in Burwood, HERO Database, 2015 ......................... 34 Table 33: Aged care facilities in Burwood, HERO Database, 2015 ...................................... 37 Table 34: Postcode to SLA / LGA correspondences:........................................................... 38

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List of Figures Figure 1: Population Profile: Burwood LGA and NSW by age and gender, 2014 ................... 5 Figure 2: Population Forecasts: Burwood LGA and NSW by age and gender, 2031 ............. 6 Figure 3: Burwood LGA population, by age groups 2011, 2016, 2021, 2026 and 2031 ......... 7 Figure 4: Language spoken at home: Burwood LGA, IWS and NSW, 2011 .......................... 9 Figure 5: Comparison of SEIFA disadvantage percentiles within Burwood LGA, 2011 ........ 11 Figure 6: Type of homelessness: Ashfield, Strathfield And Burwood (Sa3) and NSW, 2011 12 Figure 7: Modelled estimates of health risk factors: Burwood LGA, IWS and NSW 2011-13 13 Figure 8: Modelled estimates of prevalence of selected chronic conditions, 2011-13 .......... 15 Figure 9: Age-standardised incidence of selected cancers: Burwood LGA, IWS and NSW . 17 Figure 10: Number and rate of notifications of newly diagnosed HIV infection, 2005-2014 .. 20 Figure 11: Hiv notification rate, by LGA, IWS 2005-2014 .................................................... 20 Figure 12: Chlamydia notificationrate, by IWS and NSW, 2010 to 2014 .............................. 21 Figure 13: Gonorrhoea notification rate, by IWS and NSW, 2010 to 2014 ........................... 22 Figure 14: Gonorrhoea notification rate, by LGA, 2005-2014 .............................................. 22 Figure 15: Infectious syphilis notification rate, by IWS and NSW, 2010-2014 ..................... 23 Figure 16:Infectious syphilis notification rate, by LGA and IWS, 2005 – 2014 ..................... 23 Figure 17: Hepatitis B notification rate, by IWS and NSW 2005-2014 ................................. 24 Figure 18: Hepatitis B notification rate by LGA and IWS, 2005 – 2014 ................................ 24 Figure 19: Hepatitis C notification rate, by IWS and NSW, 2005-2014 ................................ 25 Figure 20: Hepatitis C notification rate, by LGA and IWS, 2005 – 2014 ............................... 25 Figure 21: Primary Care services: Burwood LGA, IWS and NSW, 2010 ............................. 26 Figure 22: Day-only hospital separations, Burwood LGA residents, 2013-14 ...................... 28 Figure 23: Overnight hospital separations, Burwood LGA residents, 2013-14 ..................... 29 Figure 24: Potentially preventable hospitalisations, by LGA, 2011-13 ................................. 30 Figure 25: HACC client profile: Burwood LGA, IWS and NSW, 2012-13 ............................. 31 Figure 26: HACC service profile: Burwood LGA, IWS and NSW; 2012-13 .......................... 32 Figure 27: General Practitioners and General Practice services, by LGA, IWS, 2015 ......... 35 Figure 28: Private Allied Health practitioners: Burwood LGA and IWS, 2014 ...................... 36

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EXECUTIVE SUMMARY Burwood LGA is culturally and linguistically diverse, with around 53% of its population born overseas and 49% in non-English speaking countries. Notable proportions of the population identify their primary language as being Mandarin (10%) followed by Cantonese (7%) and Italian (4%). Of Burwood LGA residents 0.4% identify as Aboriginal and Torres Strait Islander people. The population of Burwood LGA has high proportions of residents aged 20 to 29 and 80 to 85+ years compared to NSW, while the fertility rate in Burwood LGA remains consistently below the state. The projected population growth in Burwood LGA is expected to be 39% between 2011 and 2031, which is greater than the forecasted population growth for NSW (28%). The index score for socio-economic disadvantage in Burwood LGA is 996, which is below the national average; 1,000 indicating a relatively lower socioeconomic status. Burwood LGA has the second highest rate of unemployment (7.2%) in the Inner West Sydney (IWS) catchment, behind Canterbury LGA (7.3%). The percentage of the homeless population that reside in a boarding house (55%) in the Ashfield, Strathfield and Burwood (SA3) is also notably higher than the state (21%). Health Risks and Chronic Disease in Burwood LGA Compared to NSW, Burwood LGA residents have a comparable prevalence rate of risky alcohol consumption, overweight and psychological distress, while the estimated prevalence of smokers and obesity in Burwood LGA and the IWS catchment are significantly lower compared to NSW. The estimated age-standardised prevalence of type 2 diabetes in Burwood LGA and the IWS catchment are similar; however, there is an increasing trend in comparison with NSW. Respiratory system and musculoskeletal diseases remain the most prevalent chronic conditions in Burwood LGA. When compared to the state, the overall age-standardised rate of cancer in 2004-2008 is lower in Burwood LGA residents, with significantly lower rates observed for melanoma, lung and prostate cancer. Burwood LGA residents have a lower rate of hospitalisations for potentially preventable causes, chronic obstructive disease, high BMI and alcohol attributable admissions, which is reflected in their overall lower hospitalisation rates compared to NSW. Infectious Diseases in Burwood LGA A number of infectious diseases are more prevalent in the IWS catchment when compared to NSW rates. The IWS catchment has higher rates of newly diagnosed HIV infections, hepatitis B, infectious syphilis, chlamydia and gonorrhoea than the state. In 2014, Burwood LGA had the highest notification rates for Hepatitis B (89.3 per 100,000 population). Health Service Utilisation in Burwood LGA The number of General Practitioners (GPs), practice nurses and allied health professionals per-capita is the highest of any LGA/SLA in the catchment. Concord Repatriation General Hospital (Concord Hospital) provides the largest percentage of emergency department presentations (43.4%) and hospital separations for Burwood LGA residents. The proportion of Home and Community Care (HACC) clients with a carer in Burwood LGA (28%) is greater than NSW (21%), and the proportion of clients that live alone in Burwood LGA (36%) is slightly lower than NSW (39%).

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1 INTRODUCTION The Burwood Local Government Area (LGA) Health Profile describes the characteristics of the Burwood LGA population and compares it with the Inner West Sydney (IWS) catchment. The IWS catchment comprises the LGAs of Ashfield, Burwood, Canada Bay, Canterbury, Leichhardt, Marrickville, Strathfield and Statistical Local Areas (SLAs) of Sydney City South and West. Burwood LGA has a population of 36,0531 and occupies 7.26 sq. kilometres, making it the smallest LGA in the IWS catchment. The LGA includes the suburbs of Burwood (postcode 2134), Croydon (postcode 2132), Croydon Park (postcode 2133), Enfield South (postcode 2133), Strathfield (postcode 2135), Burwood Heights (postcode 2136), Enfield (postcode 2136) and Strathfield South (postcode 2136).

2 POPULATION AND COMMUNITY CHARACTERISTICS 2.1 Population Characteristics Figure 1 shows that the 2014 population age profile of the Burwood LGA had a greater proportion of residents aged 20 to 29 and 80 to 85+ years compared to NSW. Persons aged between 20 to 34 years comprise 29% of the total population in Burwood LGA.

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

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

Across all age groups combined, population growth in the Burwood LGA is expected to be 39% between 2011 and 2031, which is greater than the forecasted population growth across both the IWS catchment (32.7%) and NSW (27.8%). Figure 2 further illustrates the

Users of this information are strongly advised to refer to the source data to ensure accuracy, and to take note of the data explanations which accompany the profile. 1 Estimated Resident Population 2014

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

0-45-9

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

85+Burwood Females 2014 NSW Females 2014 Burwood Males 2014 NSW Males 2014

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significant growth above the catchment and NSW average in persons aged between 20 to 35 years.

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

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

Concurrent with population growth are proposed increases in the number of local homes and dwellings. The NSW Household and Implied Dwelling Projections 2011 – 2031 (2014) project an additional 5,150 dwellings from 2011 to 2031 in Burwood LGA. Of these dwellings it is projected that 3,500 will be family households and 1,150 will be lone person households2.

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

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

Burwood LGA IWS Catchment 2011 2016 2021 2026 2031 2011 2016 2021 2026 2031 Total population 34,176 37,838 41,177 44,725 47,517 581,936 628,537 681,493 728,193 772,368

0 4 years 1,720 2,144 2,507 2,690 2,767 36,373 41,391 44,652 46,838 47,689 5 - 14 years 3,174 3,502 4,083 4,709 5,083 51,476 58,228 66,702 72,778 76,748

15 - 24 years 5,646 5,390 5,490 5,826 6,230 77,887 73,294 76,692 82,112 89,093

25 - 44 years 11,009 13,077 14,127 14,930 15,027 218,353 235,564 249,104 256,808 260,590

45 - 64 years 7,730 8,148 8,620 9,213 10,027 129,929 140,960 153,144 164,527 178,495

65 - 84 years 4,084 4,558 5,220 6,075 6,857 59,207 68,272 78,747 90,820 102,430

85 years + 813 1,019 1,130 1,282 1,525 8,711 10,829 12,453 14,309 17,323


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

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

0-45-9

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

85+

BURWOOD Females NSW Females 2031 BURWOOD Males 2031 NSW Males 2031

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


2.2 Births and Maternal Health

Table 2 show the number of births to Burwood LGA residents in the period 2006 - 2013. The fertility rate increased steadily between 2006 and 2010 and decreased between 2010 and 2013. Over this period the fertility rate in Burwood LGA was consistently lower than that for NSW. Burwood LGA ranked lowest within the Inner West Sydney catchment for number of births in 2013 (433).

2014 ABS Births Data has not been referred to in this document secondary to a lag in processing the 2014 Births data due to a new system introduced by the NSW registrar. The ABS has committed to revising the 2014 numbers when the 2015 data is released in October 2016.

Table 2: Births to Burwood LGA residents and fertility rate 2006 – 2013 Year Burwood LGA

estimated resident population

Burwood LGA births

Burwood LGA total fertility rate

NSW total fertility rate

2006 32,199 322 1.31 1.93 2007 32,893 374 1.35 1.99 2008 33,343 423 1.45 2.05 2009 33,708 409 1.54 1.98 2010 33,835 401 1.57 2.02 2011 34,176 382 1.51 1.96 2012 34,668 434 1.5 1.93 2013 35,298 433 1.49 1.94

Source: ABS Births, Australia, 2013 Catalogue No. 3301.0

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

2011 2016 2021 2026 2031

0 4 years

5 - 14 years

15 - 24 years

25 - 44 years

45 - 64 years

65 - 84 years

85 years +

Proj

ecte

d Po

pula

tion

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Table 3 shows the immunisation coverage rates for children aged 0 to 5 years calculated for the Ashfield-Burwood-Strathfield (SA3)3, the rates for 2 to 5 year olds in the SA3 are lower than the IWS catchment and national figures.

Table 3: Child immunisation rates by age; Ashfield-Strathfield-Burwood SA3, IWS and National, 2012-2013

Ashfield-Burwood-Strathfield IWS Catchment National Age Group % Fully Immunised

1 year 91% 90.5% 91.2% 2 years 90.9% 91.4% 92.5% 5 years 88% 89.6% 91.5%

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

Table 4 shows that between 2011 and 2013 the rate of smoking during pregnancy in Burwood LGA was significantly lower than the state average, with a smoothed prevalence ratio between 33 and 35.8 at 95% confidence interval4 (NB. NSW = 100). For the same period, the smoothed prevalence ratio of attendance for antenatal care prior to 14 weeks gestation ranged between 77.1 and 84.4 at 95% confidence interval4, which was significantly below the NSW smoothed prevalence ratio of 100.

Table 4: Preventive maternal indicators, Burwood LGA and NSW, 2011-2013

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

2.3 Aboriginal And Torres Strait Islander People The traditional owners of the land are the Gadigal and Wangal people of the Eora Nation. Aboriginal and Torres Strait Islander people comprise a total of 0.4% of the total population of the Burwood LGA, which is below the average for both the IWS catchment (0.9%) and NSW (2.5%). Across all the LGAs in the IWS catchment Burwood LGA was home to the second lowest proportion of Aboriginal and Torres Strait Islander people, just ahead of Strathfield LGA (0.3%)

3 The NHPA data for 2012-13 combine Ashfield, Strathfield and Burwood in its estimates for Statistical Area Level 3 child immunisation estimates.

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

Maternal Indicator Burwood LGA NSW Smoking in pregnancy

Smoothed estimate of prevalence ratio

95% confidence interval for smoothed ratio

43 (33 – 53.8) (--) 100

First antenatal visit before 14 weeks of

gestation

No. of mothers per year 95% confidence interval for smoothed ratio 268 (77.1 - 84.4) (--) 100

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2.4 People from Culturally and Linguistically Diverse Backgrounds As illustrated in Figure 4, the cultural diversity of the Burwood LGA is broad. Based on the 2011 ABS Census, only 35.8% (11,604) of Burwood LGA residents identified as speaking only English at home. Notable proportions of the population identified their primary language as being Mandarin (10%; 4,128) followed by Cantonese (7%, 2,859) and Italian (4%, 1,831). 8.8% of residents indicated that they speak another language and do not speak English well or do not speak English at all.

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

Source: Australian Bureau of Statistics (2011)

2.5 Humanitarian Arrivals Table 5 provides local and state data relating to humanitarian settlers during the period 1 January 2009 - 1 December 2014. Humanitarian arrivals settling in Burwood LGA came from 10 different countries, with the largest number being from Iran.

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

Humanitarian Stream-number of settlers arriving from 2009 -2014

78 27,450

Top 3 countries of birth for humanitarian migration stream, number of settlers arriving 2009 – 2014 Iran 23 Iraq 10,157

Peoples Republic of China 20 Iran 2913 Egypt 6 Afghanistan 2502

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

2.6 Education Levels Secondary school participation data from the 2011 census showed that within the Burwood LGA 64% of people aged over 15 years had completed Year 12 schooling (or equivalent). Full-time participation in secondary school at age 16 years was higher in Burwood LGA (88.2%) than the IWS catchment overall (82.3%). In 2013 the proportion of school leavers from Burwood LGA that undertook higher education qualifications (53.2%) was the second-highest in the catchment, behind Strathfield LGA.

0%

2%

4%

6%

8%

10%

12%

Mandarin Cantonese Italian Korean Arabic Greek Nepali Hindi Chinese Spanish

BURWOOD

IWS

NSW

% o

f tot

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opul

atio

n

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2.7 Socio-Economic Characteristics

The Socio-Economic Indexes for Areas (SEIFA) are used to rank geographic areas across Australia according to their socio-economic characteristics. The Index of Relative Socioeconomic Disadvantage (IRSD) contains indicators of disadvantage such as low income, high unemployment and low levels of education. Relative disadvantage is associated with a low number. The average across Australia is 1,000. A number below 1,000 indicates lower socioeconomic status. Table 6 shows the index score for socio-economic disadvantage in Burwood LGA was 996, an overall score under 1,000 indicating a lower socioeconomic status within the Burwood LGA.

Table 6: IRSD by SLA, and rank within IWS, 2011 Statistical Local Area Index score

(based on Australian average

of 1000)

Minimum score for SA1s in area

Maximum score for SA1s in area

Rank (SLAs within IWS)

Ashfield (A) 1,015 856 1,112 8 Burwood (A) 996 870 1,073 9 Canada Bay (A) - Concord 1,066 948 1,140 3 Canada Bay (A) - Drummoyne

1,068 819 1,138 2

Canterbury (C) 922 413 1,081 10 Leichhardt (A) 1,079 733 1,150 1 Marrickville (A) 1,022 498 1,135 6 Strathfield (A) 1,022 749 1,134 5 Sydney (C) - South 1,017 435 1,138 7 Sydney (C) - West 1,022 615 1,138 4 Sydney 1,006 413 1,150 Source: Australian Bureau of Statistics (2011)

Table 7 and Figure 5 show the variance of the index score for socio-economic disadvantage across the suburbs that make up Burwood LGA. The suburb of Burwood had the lowest index score for socio-economic disadvantage (972) in Burwood LGA, indicating a greater level of disadvantage in the suburb when compared to Burwood Heights (1050).

Table 7: IRSD by Suburbs within Burwood LGA, and rank within IWS, 2011 State Suburbs within Burwood LGA Score Rank within IWS* Rank within Australia

Most disadvantaged to Least disadvantaged Burwood (NSW) 972 15 2641 Enfield (NSW) 1001 24 3811 Croydon Park (NSW) 1005 25 3938 Croydon (NSW) 1024 34

4828

Strathfield (NSW) 1035 36 5394 Strathfield South 1039 38 5598 Burwood Heights 1050 45 6062

*77 suburbs within the IWS catchment were allocated a score for socio-economic disadvantage. Source: 2033.0.55.001-

SEIFA, 2011.

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Figure 5: Comparison of SEIFA disadvantage percentiles within Burwood LGA, 2011

q Source: 2033.0.55.001-SEIFA, 2011.

The household income distribution in Burwood LGA included a greater proportion of households on lower incomes compared to the average across the IWS catchment. Unemployment in Burwood LGA was at 7.2%, making it the second-highest of all LGAs in the catchment, behind Canterbury LGA (7.3%). Burwood LGA’s workforce was employed in the retail trade (12%), healthcare and social assistance (10.5%), scientific and technical services (9%) and accommodation and food services (8%).

2.8 Homelessness

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

• 25% were in severely overcrowded dwellings5 • 1% were sleeping rough • 57% of homeless people were living in boarding houses • There were less rough sleepers and more people in boarding houses than in

SESLHD.

In addition to Census data, a survey of mental health inpatients in SLHD and South Western Sydney LHD indicated that 20% were affected by unstable housing, and over a quarter of these people reported rough sleeping6.

5 Severely crowded dwellings in the Census are defined as a dwelling which requires 4 or more extra bedrooms to accommodate the people who usually live there. 6 Homelessness in SLHD. Public Health Observatory. Population Health. SLHD. 2014

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The ABS census data for 2011 combined Ashfield, Strathfield and Burwood in its estimates for ‘Statistical Area Level 3 homelessness estimates’ and the results are shown in Table 8.

Table 8: Estimates of homelessness: Ashfield-Strathfield-Burwood (SA3) and NSW, 2011 Type of homelessness Number of people Persons in supported accommodation for the homeless 188 Persons staying in boarding houses 786 Persons in other temporary lodging 9 Persons living in ‘severely’ crowded dwellings 373 Persons living in other crowded dwellings 909 All homeless persons 1430


Figure 6: Type of Homelessness: Ashfield, Strathfield and Burwood (SA3) and NSW, 2011


The statistical area of Ashfield, Strathfield and Burwood (SA3) had the highest number of homeless people (1,430) within the IWS catchment (Table 8), whilst the percentage of the total homeless population that reside in a boarding house (55%) in the Ashfield, Strathfield and Burwood (SA3) was notably higher than the State (21%). The Burwood LGA also had the fourth lowest number of boarding houses (21) in the IWS catchment7.

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

13%

55%

26%

17% 21%

33%

0%

10%

20%

30%

40%

50%

60%

Persons in supportedaccommodation for the

homeless

Persons staying in boardinghouses

Persons living in 'severely'crowded dwellings

Ashfield,StrathfieldandBurwoodNSW

% o

f tot

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omel

ess

popu

latio

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


3 HEALTH RISKS OF THE POPULATION 3.1 Health Risk Factors Figure 7 and Table 9 show that modelled estimates of several risk factors including risky alcohol consumption, psychological distress and overweight were similar in Burwood LGA compared to the IWS catchment and NSW. The estimated prevalence of current smokers and obesity in Burwood LGA was significantly lower compared to NSW, but similar to the IWS catchment.

Figure 7: Modelled estimates of health risk factors: Burwood LGA, IWS and NSW 2011-13

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

Table 9: Modelled estimates of health risk factors: Burwood, IWS and NSW 2011-13 Indicator Burwood LGA IWS NSW Current smokers 12.4% 11.6% 16.2% Risky Alcohol consumption 4.3% 4.5% 4.8% Overweight 32.5% 33.7% 34.6% Obese 20.1% 19.1% 26.4% Psychologically distressed 10.8% 9.8% 10.5% Source: Public Health Information Development Unit (PHIDU) - 2011-2013 National Health Survey. Overall, Burwood LGA residents had significantly fewer health behaviour related hospital separations per capita compared to the state (Table 10).

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

separations / year

Smoothed rate/

100,000

sSSR8 [95% CI]

Smoking attributable 2012-14 135.8 413.4 66 [58.9-73.7] Significantly lower than the state

High body mass index attributable

2012-14 110.5 348.2 66.5 [58.5-74.7]

Significantly lower than the state

High blood pressure attributable

2012-14 187.9 921.8 70 [63.5-76.9] Significantly lower than the state

Alcohol attributable 2012-14 215.1 599.2 83.8 [76.5-91.5]


Fall-related injury 2012-14 265 741.7 88.7 [81-96.2] Significantly lower than the state

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

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

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Data on other health behaviours included in Table 11 are not available at LGA level. However, health behaviours of residents living in the IWS catchment were similar to the entire population of NSW. On average, less than 1 in 10 persons consumed the recommended vegetable intake, and only 50% of persons achieved the recommended fruit consumption. An estimated 51.5% of persons in NSW aged 16 years or more engaged in adequate levels of physical activity, whereas IWS residents performed slightly better with an estimated 58.1% of persons achieving recommended levels.

Table 11: Health behaviours of residents: IWS and NSW (% [95% CI]), 2013 Indicator IWS NSW

Consumes more than 2 standard drinks per day, persons aged 16+ years

29.3 [25.6-33.1] 26.6 [25.5-27.8]

Adequate physical activity, persons aged 16 years and over 58.1 [54.0-62.1] 51.5 [50.2-52.7] Recommended vegetable consumption, persons aged 16 +years 9.9 [7.2-12.5] 9.4 [8.7-10.1] Recommended fruit consumption, persons aged 16+ years 52.1 [48.0-56.2] 51.8 [50.6-53.1] Vaccinated against influenza in the last 12 months, persons aged 65+ years

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

Vaccinated against pneumococcal disease, persons aged 65+ years 44.6 [34.6-54.5] 49.9 [47.5-52.2]

Source: 2013 NSW Adult Population Health Survey (SAPHaRI); Centre for Epidemiology and Evidence, NSW Ministry of Health. CI: Confidence interval

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4 LONG TERM CONDITIONS AND CHRONIC DISEASE 4.1 Prevalence of Chronic Disease Figure 8 and Table 12 displays the estimated prevalence of chronic diseases in Burwood LGA, IWS and NSW. There was a trend for increased estimated age-standardised prevalence of type 2 diabetes in Burwood LGA compared to NSW, with the prevalence in line with IWS levels, which were also raised relative to NSW. The estimated prevalence of mental and behavioural disorders and circulatory system diseases were similar in Burwood LGA compared to the IWS catchment and NSW. There was a trend for decreased estimated prevalence of respiratory system conditions and musculoskeletal diseases in Burwood LGA compared to NSW.

Figure 8: Modelled estimates of prevalence of selected chronic conditions, 2011-13

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

Table 12: Modelled estimates of chronic conditions, 2011-13, age standardised % [95% CI] Indicator Burwood LGA IWS NSW

Type 2 Diabetes 7.9 [5.4-10.4] 7.4 [6.7-8.1] 5.8 [5.6-5.9] Mental and Behavioural Disorders 11.9 [10.0-13.7] 12.4 [11.8-

13.1 [13.0-13.3]

Circulatory System Diseases 17.4 [15.0-19.7] 17.8 [17.1-

17.8 [17.6-17.9] Respiratory System Diseases 22.8 [19.0-26.6] 24.4 [23.3-

27.4 [27.1-27.7]

Musculoskeletal Diseases 24.0 [19.7-28.3] 26.1 [24.8-

28.1 [27.8-28.5] Source: Public Health Information Development Unit (PHIDU) - 2011-2013 National Health Survey

In terms of chronic disease burden, Table 13 shows that Burwood LGA residents had similar estimated prevalence of fair or poor self-assessed health, chronic obstructive pulmonary disease and hypertension (18+ years) compared to the IWS catchment and NSW. On the other hand, Burwood LGA residents were estimated to have lower levels of asthma and arthritis relative to the state.

Table 13: Modelled estimates of chronic disease (ASR per 100): 2011-2013 Indicator Burwood LGA IWS NSW

Fair or poor self-assessed health, > 15 years 15 [12.9-17.2] 14.3 [13.7-14.9] 14.3 [14.2-14.5] Asthma 6.7 [5.4-7.9] 7.2 [6.8-7.6] 9.6 [9.5-9.7] Chronic Obstructive Pulmonary Disease 2.1 [1.3-2.8] 2.3 [2-2.5] 2.6 [2.6-2.7] Hypertension, > 18 years 10.1 [7.9-12.3] 10.7 [10.1-11.4] 10.5 [10.4-10.7] Arthritis 13 [11.2-14.7] 13.9 [13.3-14.4] 15.3 [15.1-15.4] Source: Public Health Information Development Unit (PHIDU) - 2011-13 National Health Survey. ASR: Age standardised rate; 95% CI: Confidence interval

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

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

Indicator Year Smoothed number

separations/ year

Smoothed rate/

100,000

sSSR9[95% CI]

Potentially preventable 2012-14

609 1,770 72.7 [68.7-76.7]


Chronic obstructive pulmonary disease

2012-14

60 1,141 76.3 [63.3-90.7]


Coronary heart disease 2012-14

122 375.8 56.4 [49.7-63.3]


Circulatory disease 2012-14

515 1,517 73.3 [69-78] Significantly lower than the state

Stroke 2012-14

47 132.1 76.5 [63.3-91.7]


Asthma 2012-14

50 160.6 92.3 [75.4-110.4]

Not significantly different to the state

Influenza and pneumonia

2012-14

97 280.4 84.3 [73.5-96.6]


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

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

Table 15: High body mass index, alcohol and smoking attributable deaths: Burwood LGA Indicator Year Smoothed

number of deaths/ year

Smoothed rate/

100,000

sSMR8[95% CI]

High body mass index

2011 14 38.3 98.3 [81.3-115.9] Not significantly different to the state

Alcohol 2011-12 5.1 14.8 85.9 [67.2-107.1] Not significantly different to the state

Smoking 2012 21 60.5 83.4 [65.3-103.3] Not significantly different to the state

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

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

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

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

Source: NSW Central Cancer Registry, Cancer Institute NSW Prostate, breast, colon and lung cancer were the most common cancers in Burwood LGA over this period. When compared to the state, the overall age-standardised rate of cancer was lower in Burwood LGA residents, with significantly lower rates observed for melanoma, lung and prostate cancer (Table 16). The incidence of other prominent cancers in Burwood LGA including colon and stomach were not significantly different to state levels (Figure 9).

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Table 16: Age standardised cancer incidence rates (per 100,000) by cancer site, 2004 to 2008 Cancer Site Burwood LGA IWS Catchment NSW

Count Rate Count Rate Count Rate All types 720 404.7 [375.2-

435.8] 11,397 449.1 [440.8-457.4] 177,519 483.2 [481.0-

485.5] Bladder 14 6.9 [3.8-11.7] 243 9.7 [8.5-11.0] 3,631 9.7 [9.3-10.0] Brain 15 8.7 [4.8-14.3] 166 6.3 [5.4-7.3] 2,356 6.6 [6.3-6.8] Breast 92 55.0 [44.2-67.5] 1447 56.2 [53.3-59.1] 21,102 58.2 [57.5-59.0] Cervix 8 4.9 [2.1-9.7] 92 3.3 [2.7-4.1] 1,228 3.5 [3.3-3.7] Colon 69 37.3 [28.9-47.3] 988 39.5 [37.1-42.0] 15,072 40.6 [39.9-41.2] Head and neck 20 11.0 [6.7-17.1] 370 14.6 [13.1-16.1] 4,686 12.8 [12.5-13.2] Kidney 31 17.8 [12.0-25.4] 321 12.8 [11.4-14.3] 4,857 13.2 [12.9-13.6] Leukaemia 22 12.8 [7.9-19.5] 314 12.5 [11.1-13.9] 4,605 12.6 [12.3-13.0] Lip ** ** 44 1.8 [1.3-2.4] 1,203 3.3 [3.1-3.5] Liver 15 8.6 [4.8-14.3] 224 8.9 [7.8-10.1] 2,088 5.7 [5.4-5.9] Lung 58 31.6 [23.9-41.0] 1157 46.5 [43.9-49.3] 15,905 43.0 [42.3-43.7] Melanoma of skin

31 17.4 [11.7-24.8] 726 27.8 [25.8-29.9] 17,716 48.8 [48.1-49.5]

Mesothelioma ** ** 56 2.2 [1.7-2.9] 1,047 2.8 [2.6-3.0] Myelodysplasia 15 7.6 [4.2-12.7] 195 7.8 [6.7-8.9] 2,817 7.5 [7.2-7.8] Non-Hodgkin’s lymphoma

29 15.6 [10.3-22.5] 485 18.9 [17.2-20.7] 6,828 18.6 [18.2-19.1]

Oesophagus ** ** 108 4.3 [3.5-5.1] 2,024 5.4 [5.2-5.7] Ovary 10 5.8 [2.7-10.7] 195 7.6 [6.6-8.8] 2,191 6.0 [5.8-6.3] Pancreas 16 8.2 [4.6-13.4] 275 11.0 [9.7-12.3] 4,062 10.9 [10.5-11.2] Prostate 99 55.2 [44.7-67.3] 1647 66.3 [63.1-69.6] 31,321 84.4 [83.4-85.3] Rectal 34 18.1 [12.4-25.4] 501 19.9 [18.2-21.8] 8,338 22.6 [22.1-23.1] Stomach 20 11.6 [7.1-18.0] 285 11.4 [10.1-12.8] 3,275 8.8 [8.5-9.1] Testis ** ** 80 2.6 [2.1-3.2] 1,084 3.2 [3.0-3.4] Thyroid 21 13.4 [8.3-20.5] 316 11.7 [10.4-13.1] 3,301 9.4 [9.1-9.8] Unspecified site

31 16.5 [11.1-23.5] 364 14.4 [13.0-16.0] 6,014 16.0 [15.6-16.4]

Uterus(body) 15 9.2 [5.1-15.2] 190 7.5 [6.5-8.6] 3,043 8.3 [8.0-8.6] All Others 42 24.2 [17.3-32.8] 608 23.7 [21.8-25.7] 7,725 21.3 [20.8-21.7] Source: NSW Central Cancer Registry, Cancer Institute NSW. **Cell counts less than 5 are left blank

Cancer-related mortality for Burwood LGA, the IWS catchment and NSW is presented in Table 17. Between 2004 and 2008, cancer was the primary cause of death for 291 persons, with lung, colon, breast and pancreatic cancers the leading types. The overall age-standardised rate of cancer-related deaths in Burwood LGA (155.0 per 100,000) was significantly lower than NSW (176.9 per 100,000). The age-standardised rate of death from prostate cancer was significantly lower in Burwood LGA relative to NSW whereas there was trend of reduced mortality from colon cancer in Burwood LGA relative to NSW (Table 17).

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Table 17: Age standardised mortality rates (per 100,000) by cancer site, 2004 - 2008 Cancer Site Burwood LGA IWS Catchment NSW Count Rate Count Rate Count Rate All types 291 155.0 [137.4-174.2] 4,547 181.0 [175.7-

186.3] 66,228 176.9 [175.5-

178.2] Bladder ** ** 106 4.2 [3.4-5.1] 1,644 4.3 [4.1-4.5] Brain 10 5.4 [2.6-10.1] 126 4.9 [4.1-5.8] 1,716 4.7 [4.5-5.0] Breast 19 10.5 [6.3-16.5] 296 11.7 [10.4-13.1] 4,693 12.6 [12.3-13.0] Cervix ** ** 28 1.1 [0.7-1.5] 415 1.1 [1.0-1.2] Colon 20 10.5 [6.3-16.3] 365 14.5 [13.0-16.0] 5,511 14.6 [14.3-15.0] Head and neck 6 3.2 [1.2-7.1] 154 6.1 [5.2-7.2] 1,762 4.7 [4.5-5.0] Kidney 9 4.9 [2.2-9.3] 87 3.4 [2.8-4.3] 1,605 4.3 [4.1-4.5] Leukaemia 10 5.6 [2.7-10.3] 148 5.9 [5.0-6.9] 2,248 6.0 [5.8-6.3] Liver 10 5.6 [2.6-10.4] 162 6.5 [5.5-7.6] 1,527 4.1 [3.9-4.3] Lung 60 31.6 [24.0-40.9] 937 37.7 [35.3-40.2] 12,781 34.4 [33.8-35.0] Non-Hodgkin’s lymphoma

12 6.2 [3.2-11.0] 176 6.9 [5.9-8.0] 2,569 6.8 [6.6-7.1]

Melanoma of skin

8 4.3 [1.8-8.5] 125 5.0 [4.1-5.9] 2,314 6.2 [6.0-6.5]

Mesothelioma ** ** 56 2.3 [1.7-3.0] 947 2.5 [2.4-2.7] Myelodysplasia 9 4.1 [1.8-7.9] 74 2.9 [2.3-3.7] 1,036 2.7 [2.5-2.9] Oesophagus ** ** 92 3.6 [2.9-4.4] 1,590 4.2 [4.0-4.4] Ovary 6 3.4 [1.2-7.6] 104 4.2 [3.4-5.1] 1,394 3.7 [3.5-3.9] Pancreas 17 8.9 [5.1-14.3] 240 9.6 [8.4-10.9] 3,611 9.6 [9.3-9.9] Prostate 15 7.2 [4.0-11.9] 287 11.4 [10.1-12.8] 4,904 12.8 [12.4-13.1] Rectal 14 7.5 [4.1-12.7] 194 7.7 [6.7-8.9] 3,018 8.1 [7.8-8.4] Stomach 10 5.8 [2.7-10.6] 182 7.3 [6.2-8.4] 2,232 6.0 [5.7-6.2] Thyroid ** ** 12 0.5 [0.3-0.9] 168 0.4 [0.4-0.5] Unspecified site 24 12.4 [7.8-18.5] 287 11.4 [10.1-12.8] 4,473 11.8 [11.5-12.2] Uterus(body) ** ** 43 1.7 [1.2-2.3] 614 1.6 [1.5-1.8] All Others 12 6.8 [3.5-12.0] 263 10.5 [9.2-11.8] 3,375 9.1 [8.8-9.4] Source: NSW Central Cancer Registry, Cancer Institute NSW. **Cell counts less than 5 are left blank

4.3 Mortality In 2007, life expectancy at birth for males and females in Burwood LGA is 80.5 and 85.1 years, respectively, and is comparable to NSW state estimates (80 and 85 years for males and females, respectively). Accordingly, the standardised mortality from all causes in Burwood LGA in 2010-11 was similar to the state (smoothed standardised mortality ratio (sSMR) 98.5; Table 18).

Table 18: Deaths from all causes and potentially preventable deaths: Burwood LGA, 2010-2011 Indicator Deaths per year sSMR [95% CI] Deaths from all causes 250 98.3 [90.6-106.6] Amenable to health care 16 89.1 [70.5-109.5] Preventable causes 24 86.9 [68.1-109.7] Amenable and preventable causes 39 86.0 [70.3-103.4] Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health. sSMR: Smoothed standardised mortality ratio; CI: Confidence interval

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5 INFECTIOUS DISEASES 5.1 HIV The rate of newly diagnosed HIV infections in NSW in 2014 was 5 cases per 100,000 population. In 2014, there were 82 new HIV infections diagnosed in the IWS catchment. The IWS catchment had the highest rates of newly diagnosed HIV infections in the state at 13.4 cases per 100,000 population (Figure 10). Sydney City (South and West) SLA’s and Marrickville LGA had the highest notification rates, at 45 and 19 cases per 100,000 population, respectively (Figure 11 and Table 19). Figure 10: Number and rate of notifications of newly diagnosed HIV infection in IWS, 2005-2014

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

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

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

Table 19: HIV notification rate (per 100,000 of population), by LGA, IWS, 2005-2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 15 5 8 3 7 7 5 5 2 1 Burwood 10 5 6 5 4 5 2 11 0 5 Canada

9 9 3 6 4 5 1 6 2 4

Canterbury 2 5 11 2 4 5 4 3 7 5 Leichhardt 14 6 4 15 7 7 13 11 5 0 Marrickville 32 28 26 24 28 16 27 28 27 19 Strathfield 5 7 10 3 0 3 3 10 0 2 Sydney

54 38 46 42 51 41 43 59 47 45

* Sydney City (South and West SLAs). Source: NSW HIV/AIDS database. (Accessed 18/05/2015)

0.0

5.0

10.0

15.0

20.0

25.0

0

20

40

60

80

100

120

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

Tota

l not

ifica

tions

Rate

/100

,000

pop

ulat

ion

0

10

20

30

40

50

60

70

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney*

Ra

te/1

00,0

00 p

erso

ns

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

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

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

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

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

051015202530354045

0

50

100

150

200

250

300

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

2010 2011 2012 2013 2014

Rate

/100

,000

pop

ulat

ion

Tota

l Not

ifica

tions

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

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

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

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

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


Table 21: Gonorrhoea notification rate (per 100,000 population) LGA, IWS, 2005-2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 24.5 29.1 16.7 16.6 30.4 30.2 36.8 57.1 77.0 96.3 Burwood 18.9 21.7 9.1 30.0 23.7 35.5 58.5 72.0 59.5 119.2 Canada

28.4 24.9 21.4 22.1 23.9 23.2 47.5 59.6 67.1 54.0

Canterbury 24.7 27.4 19.0 12.2 28.2 29.2 44.1 56.5 41.6 59.9 Leichhardt 35.4 37.1 46.1 28.2 35.1 65.5 59.3 87.0 108.3 91.8 Marrickville 143.2 131.8 90.2 66.6 70.7 129.4 150.4 288.8 266.6 315.2 Strathfield 37.3 21.2 32.1 25.5 27.3 35.1 34.9 39.8 73.0 38.6 Sydney* 196.7 225.8 160.0 136.2 164.5 243.3 274.2 374.7 471.9 460.7 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

02468101214161820

0

20

40

60

80

100

120

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

2010 2011 2012 2013 2014IWS total notifications IWS notification rate/100,000 population NSW notification rate/100,000 population

Tota

l not

ifica

tions

Rate

/100

,000

pop

ulat

ion

050

100150200250300350400450500

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydneyRa

te/1

00,0

00 p

opul

atio

n

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

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


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


Table 22: Infectious syphilis notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 0.0 9.7 7.2 2.4 4.7 18.6 4.6 6.9 13.6 13.4 Burwood 0.0 6.2 3.0 12.0 5.9 8.9 11.7 5.8 8.5 27.7 Canada

4.5 1.5 2.8 2.8 1.3 1.3 5.0 3.6 8.2 14.9

Canterbury 3.7 2.2 4.4 6.4 2.1 3.5 1.4 5.4 9.4 8.6 Leichhardt 11.8 9.8 21.1 11.3 18.5 9.1 14.4 10.6 10.5 32.9 Marrickville 14.7 13.3 26.2 32.0 56.8 29.9 29.6 34.3 58.2 69.5 Strathfield 6.2 6.1 0.0 5.7 5.5 2.7 0.0 0.0 7.8 0.0 Sydney* 30.8 44.5 79.5 68.6 83.7 74.3 54.3 65.1 116.4 150.9 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

0

1

2

3

4

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6

0

5

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15

20

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35

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

2010 2011 2012 2013 2014

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

Tota

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ifica

tions

Rate

/100

,000

pop

ulat

ion

020406080

100120140160

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

AshfieldBurwoodCanada BayCanterburyLeichhardtMarrickvilleStrathfieldSydney

Rate

/100

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pop

ulat

ion

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

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


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

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


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

0

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80

100

0

100

200

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600

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

Tota

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s/10

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40

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2005 2006 2007 2008 2009 2010 2011 2012 2013 2014


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Rate

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

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


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


Table 24: Hepatitis C age-standardised notification rate (per 100,000) by LGA, IWS, 2005 – 2014 LGA 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Ashfield 65.4 61.7 62.8 43.8 41.6 35.0 37.6 32.4 27.9 59.9 Burwood 57.8 58.0 36.1 21.5 27.6 34.1 40.3 33.0 15.9 18.5 Canada Bay 29.5 31.8 23.3 18.9 30.9 30.5 25.8 21.3 12.6 16.4 Canterbury 56.8 41.0 41.1 41.4 40.5 38.4 39.5 35.0 44.1 29.7 Leichhardt 46.7 54.1 38.1 31.2 75.2 65.3 50.5 62.2 75.1 47.9 Marrickville 113.1 87.8 83.5 66.2 83.4 66.2 66.6 66.3 63.3 47.9 Strathfield 38.6 40.8 47.7 21.6 25.6 39.9 20.0 20.9 26.6 18.3 Sydney* 120.1 128.0 108.2 85.7 102.8 117.9 87.4 72.6 85.9 117.9 * Sydney City (South and West SLAs). Source: NSW NCIMS database. (Accessed 26/02/2015)

0102030405060708090

0

100

200

300

400

500

600

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

Tota

l num

ber o

f not

ifica

tions

Rate

/100

,000

pop

ulat

ion

0

20

40

60

80

100

120

140

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014


Age-

stan

dard

ised

not

ifica

tion

rate

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

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

Indicator Burwood LGA IWS NSW 45 year old health checks^ 5,193.9 4,796.6 4,627.8 GP health assessment (75+) 13,774.1 17,377.5 20,867.4 GP enhanced primary care 1,950.2 2,147.8 2,618.4 GP practice nurse services 15,488.7 16,320.0 29,844.9 GP Mental Health care plans 6,380.1 7,625.4 8,222.3 Source: Public Health Information Development Unit and Department of Health and Ageing (2014) ^For persons aged between 45-49 years Figure 21: Primary care services (age standardised ratio): Burwood LGA, IWS and NSW, 2010

Source: Public Health Information Development Unit and Department of Health and Ageing (2014)

Dashed line: National reference level; * Significantly different to state at 95% confidence level; ** Significantly different to state at 99% confidence level. ^For persons aged between 45-49 years

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6.2 Emergency Department Presentations The distribution of emergency department presentations, in 2013 by Burwood LGA residents across hospitals in the IWS catchment and all other NSW hospitals is presented in Table 26. Concord Hospital provided the largest percentage of emergency department services for Burwood LGA residents (43.4%), constituting 9.4% of all emergency department visits at Concord Hospital.

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

hospital Concord hospital

RPA hospital

Other NSW hospitals

Total

LGA Presentations 1,557 (19.6) 3,445 (43.4) 1,309 (16.5)

1,628 (20.5) 7,939 (100)

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

2,410,994 (94.3)

2,557,629 (100)

Burwood % of total 4.1 9.4 1.8 0.1 0.3 Source: NSW Admitted Patient Data Collection, Centre for Epidemiology and Evidence, NSW Ministry of Health

The rates of emergency department presentations (per 1,000 persons) by triage category are displayed in Table 27. The age-standardised rates of non-urgent, urgent and emergency-classified emergency department presentations for Burwood LGA residents were lower than the IWS catchment levels. On the other hand, the rate of semi-urgent emergency department presentations was higher in Burwood LGA relative to the IWS catchment.

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

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

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

33.0] 1.7 [1.3-2.0]

Burwood 15.0 [13.7-16.3]

100.2 [97.0-103.5]

80.9 [78.0-83.8] 26.1 [24.4-27.7]

2.2 [1.8-2.7]

Canada Bay

15.1 [14.3-15.9]

105.6 [103.5-107.7]

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

1.7 [1.4-2.0]

Canterbury 22.0 [21.2-22.7]

110.0 [108.4-111.6]

115.2 [113.7-116.8]

41.7 [40.7-42.7]

2.4 [2.2-2.7]

Leichhardt 17.4 [16.3-18.6]

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

1.3 [1.0-1.7]

Marrickville 21.8 [20.8-22.9]

101.9 [99.7-104.1]

114.8 [112.5-117.1]

43.4 [42.0-44.8]

2.0 [1.7-2.3]

Strathfield 16.4 [15.1-17.7]

114.1 [110.9-117.4]

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

2.2 [1.7-2.6]

Sydney City

10.4 [9.7-11.0]

36.2 [34.9-37.5] 40.3 [38.9-41.7] 15.6 [14.7-16.5]

0.7 [0.5-0.8]

IWS 17.4 [17.1-17.7]

90.3 [89.6-91.1] 88.6 [87.9-89.3] 31.3 [30.9-31.8]

1.8 [1.7-1.9]

NSW 52.0 [51.8-52.1]

148.6 [148.3-148.8]

103.8 [103.6-104.0]

33.6 [33.5-33.7]

2.0 [2.0-2.0]

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

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6.3 Hospital Separations 6.3.1 Day-only Hospital Separations

Burwood LGA resident separations from hospital on a day-only10 basis are shown in Table 28. In 2013-14, 44% (3,087) of all day-only separations were provided by SLHD hospitals, followed by private hospitals at 32% (2,181) and private day procedures at 15% (1,025) hospitals.

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

Day-only hospital separations Hospital/LHD No. of separations Percent of total separations

SLHD Hospitals 3,087 44% Private Hospitals 2,181 32% Private Day Procedure Centres 1,025 15% Other LHD Hospitals 595 9% Total 6,888 100% Source Flow-Info v5.0

As shown in Figure 22, 44% (3,087 separations) of Burwood LGA resident day-only separations occurred in SLHD hospitals. Concord Hospital provided for 55% of the total separations within SLHD hospitals (1,697 separations), followed by RPA Hospital at 39% (1,221 separations).

Figure 22: Day-only hospital separations for Burwood LGA residents, 2013-14

Source Flow-Info v5.0

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

Private Hospitals 32% (n=2181)

Private Day Procedure

Centres 15% (n=1025)

Other LHDs 9% (n=595)

Concord 55%

(n=1697)

Royal Prince Alfred 39% (n=1221)

Canterbury 5% (n=169)

Sydney LHD 44% (n=3087)

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6.3.2 Overnight Hospital Separations The breakdown of Burwood LGA resident overnight11 hospitalisations is shown in Table 29. In 2013-2014 SLHD hospitals provided the majority (69%; 3,489) of overnight hospital separations for Burwood LGA residents, followed by private hospitals at 20% (982 separations) and other LHD hospitals at 11% (552).

Table 29: Overnight hospital separations for Burwood LGA residents, 2013-14 Overnight(s) hospital separations

Hospitals No. of separations Percent of total separations SLHD Hospitals 3,489 69% Private Hospitals 982 20% Other LHD Hospitals 552 11% Total 5,023 100% Source Flow-Info v5.0

As shown in Figure 23, SLHD hospitals provided for 69% (3,489 separations) of all Burwood LGA resident overnight separations. Concord Hospital provided 1,787 or 51% of the total overnight separations within SLHD hospitals, followed by RPA Hospital at 33% (1,158 separations) and Canterbury Hospital at 13% (469 separations).

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

Source Flow-Info v5.0

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

Private Hospitals 20% (n=982)

Other LHDs 11% (n=552)

Concord 51%

(n=1787)

Royal Prince Alfred 33% (n=1158)

Canterbury 13%

(n=469)

Other SLHD Hospitals 2% (n=75)

Sydney LHD 69% (n=3489)

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6.4 Ambulatory Case Sensitive Admissions The numbers and rates of potentially preventable hospital separations classified as Ambulatory Care Sensitive Conditions (ACSCs) by IWS LGAs are presented in Table 30 and Figure 24. ACSC admissions are those in which the resulting hospitalisation is thought to be largely preventable via the application of public health interventions that are usually provided in an ambulatory setting such as primary care.

Higher rates of ACSC hospitalisations may reflect indirect evidence of problems with the provision of health care such as difficulties in accessing primary health-care services and a lack of appropriate skills and resources. ACSCs include vaccine-preventable conditions, selected acute conditions and selected chronic conditions that are amenable to behaviour modification and lifestyle change. The rate of ACSC separations was 1847.5 per 100,000 persons in Burwood LGA in 2011-13, and was significantly lower than the state level.

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

levels Ashfield 837 1,882.5 Significantly lower than the state

Burwood 631 1,847.5 Significantly lower than the state

Canada Bay 1,507 1,869.0 Significantly lower than the state

Canterbury 3,255 2,288.4 Significantly lower than the state

Leichhardt 953 1,944.6 Significantly lower than the state

Marrickville 1,488 2,124.9 Significantly lower than the state

Strathfield 593 1,749.5 Significantly lower than the state

Sydney 3,010 2,222.1 Significantly lower than the state Source: Health Statistics NSW, Centre for Epidemiology and Evidence, NSW Ministry of Health Note:* sSSR: The smoothed estimate of standardised prevalence and mortality ratio enables comparison with the state average set at 100.

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

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

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6.5 Home And Community Care (HACC) Figure 25 and Table 31 shows the profile of Home and Community Care (HACC) clients in Burwood LGA compared to the IWS catchment and NSW. During this reporting period, there were nine Indigenous HACC clients in the Burwood LGA. The proportion of clients that did not speak English in Burwood LGA (40%) was higher relative to NSW (11%), but similar to the IWS catchment (39%). The proportion of clients with a carer in Burwood LGA (28%) was greater than both the IWS catchment (23%) and NSW (21%), and the proportion of clients that live alone in Burwood LGA (36%) was slightly lower than both the IWS catchment (39%) and NSW (39%).

Figure 25: HACC client profile: Burwood LGA, IWS and NSW, 2012-13

Source: Public Health Information Development Unit (2014)

Table 31: HACC Client Profile, % of HACC clients (number): Burwood LGA, IWS and NSW, 2012-13

Indicator Burwood LGA Inner West Sydney New South Wales Living alone 36.3 (406) 39.1 (6499) 39.0 (106308) Living with carer 28.2 (316) 23.0 (3825) 20.7 (56385) Indigenous 0.8 (9) 1.4 (230) 3.8 (10268) Non-english speaking 39.8 (446) 39.0 (6484) 11.2 (30469) Source: Public Health Information Development Unit (2014)

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Figure 26 and Table 32 provides a comparison of HACC services in Burwood LGA, IWS and NSW. HACC clients in Burwood LGA received lower numbers of domestic assistance, case management, care counselling, centre-based day care and transport instances of care per 1,000 persons, compared to IWS catchment and state benchmarks. However, the per-capita numbers of care coordination and allied health care services provided to Burwood LGA residents were higher than the IWS catchment and NSW.

Figure 26: HACC Service Profile: Burwood LGA, IWS and NSW; 2012-13

Source: Public Health Information Development Unit (2014)

Table 32: HACC Service Profile: Burwood LGA, IWs and NSW, Instances of care per 1,000 (actual number):2012-13

Indicator Burwood LGA Inner West Sydney New South Wales Allied health care 4.3 (164) 3.5 (1822) 2.3 (17549) Care counselling 2.6 (99) 2.8 (1476) 3.5 (26863) Case management 1.5 (56) 3.0 (1580) 2.0 (15261) Centre-based daycare 2.5 (97) 4.7 (2446) 2.8 (21907) Care coordination 5.4 (208) 4.1 (2096) 4.0 (30940) Domestic assistance 5.5 (212) 5.8 (2979) 7.1 (54720) Transport 6.0 (233) 8.0 (4120) 9.4 (72274) Source: Public Health Information Development Unit (2014)

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

The Royal Prince Alfred Hospital (RPA) is a principle referral hospital, providing tertiary and quaternary acute services to its IWS catchment, rural and other metropolitan residents, interstate and overseas patients. Examples of RPA’s tertiary and quaternary medical, surgical and diagnostic services include Liver and Kidney Transplantation, Open Heart Surgery, Cardiology, Neurology, Respiratory, Immunology, Maternity, Gynaecology, Neo-natal Intensive Care, Colorectal and Upper GI surgery, Orthopaedic surgery, Plastic surgery, Emergency and Critical Care and Trauma services.

The Institute of Orthopaedics and Rheumatology and the Professor Marie Bashir Mental Health Centre are located at RPA. Cancer care, including Haematology and Neurosurgery is provided at the highest level at RPA with other selected cancer services provided in collaboration with the Chris O’Brien Lifehouse, a not-for-profit hospital located on the RPA campus. RPA provides a wide range of non-inpatient services across all medical and surgical specialties, including Hospital-in-the Home. A defining attribute of RPA is its world class research and teaching.

The Sydney Local Health District in collaboration with the University of Sydney, and thirteen affiliated Medical Research Institutes forms Sydney Research. The SLHD is part of Sydney Health Partners which is an advanced Health Research and Translation Centre of the NHMRC.

Concord Repatriation General Hospital (CRGH or Concord Hospital) is a principle referral hospital, providing tertiary and quaternary acute services to its IWS catchment, rural and other metropolitan residents, interstate and overseas patients. Examples of the tertiary and quaternary medical and surgical services at Concord include the state-wide Burns service, Andrology, Bariatric surgery, Neurology and Stroke, Cardiology, Aged Care, Medical Rehabilitation, Ophthalmology, Urology, Immunology, Upper GI, Colorectal, Orthopaedics, Plastic surgery, integrated Cancer care, Emergency Medicine and Critical Care. Inpatient Maternity and Paediatric services are not available at Concord Hospital. The Concord Hospital provides a wide range of non-inpatient services across all medical and surgical specialties, including Hospital-in-the Home. The Concord Centre for Mental Health is located at Concord Hospital. The Concord Hospital provides world class research and teaching in collaboration with the University of Sydney and its affiliated Medical Research Institutes.

The Canterbury Hospital is a major metropolitan hospital that provides district level hospital care to its local community. Canterbury provides emergency services, maternity, paediatrics, aged care, medical and surgical services and a range of non-inpatient services including Hospital-in-the Home.

The Balmain Hospital is a specialist Aged Care and Rehabilitation Hospital. It provides General Practice Casualty service through a consortium of local General Practitioners. The hospital provides a range of outpatient services including Hospital-in-the Home. There are two private hospitals directly located within the Burwood LGA, including the 86-bed St John of God Private Hospital and the 96 bed Strathfield Private Hospital. (Table 33).

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Table 33: Acute, aged care, mental health and day surgery facilities in Burwood LGA, HERO Database, 2015

Health Service Name Service Type Location Croydon Oral Health Clinic Oral Health Services Croydon Alwyn Rehabilitation Private Hospital Private Hospitals Strathfield Burwood Endoscopy Centre Day Surgery Burwood St John of God Private Hospital (Burwood) Private Hospitals Burwood Strathfield Private Hospital Private Hospitals Strathfield

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

7.2 Community Health Services The Sydney Local Health District provides a comprehensive range of community health and community based health services providing prevention, early intervention, assessment, treatment, health maintenance and continuing care services. Community based services include:

• Community Health Services (see below) • Health Promotion • Aboriginal Health Services • Community Mental Health Services • Community Aged Care, Chronic Care and Rehabilitation Services • Community Oral Health Services • Community Drug Health Services

The services provided by Community Health include:

• Sydney District Nursing Service

• Community Development

• Sexual Health /Community HIV services

• Early Childhood Health • Palliative Care Nursing

• Women’s Health

• Multicultural Health • Youth Health • Child and Family Health • Sexual Assault Services • Counseling

• Community Nutrition • Child Protection

Community based health services are located in numerous facilities including community health centres, community clinics, schools and outreach centres. Community health services located within Burwood LGA, that are currently registered on the NSW Health Establishment Registration Online Database (HERO) include early childhood, youth health and mental health services (Table 34).

Table 34: Community health facilities in Burwood LGA, HERO Database, 2015 Service Name Service Type Location Croydon Health Centre Community Health Croydon Croydon Health Centre Drug Health Community Health Croydon Croydon Health Centre Community Health Child and Family Health Nursing Service

Child and Family Health Croydon

Croydon Early Childhood Health Centre Community Health Croydon Source: NSW Health Establishment Registration Online (HERO) database. Accessed Feb 2015.

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7.3 General Practice Figure 27 shows the local availability of selected primary care services in Burwood LGA. The number of GPs per 100,000 persons in Burwood LGA was higher than the average of the IWS catchment. The provision of practice nurses within Burwood LGA was higher than all other LGAs within the IWS catchment.

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

Source: PHN (2015).

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7.4 Allied Health Figure 28 shows the availability of allied health practitioners in Burwood LGA on a per-capita basis, compared to the IWS catchment. The availability of allied health services in Burwood LGA was varied. Most notably, the availability of Dentists and Pharmacists were significantly lower than the availability per-capita across the catchment, while availability of Audiologists, Chiropractors and Optometrists was significantly higher.

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

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

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

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

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

5,580 87,913 126.2 111.2

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

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

Table 36: Aged care facilities in Burwood LGA, HERO Database, 2015 Aged Care Facilities Location Ainsley Residential Aged Care Facility Burwood Bernard Chan Nursing Home Residential Aged Care Facility Burwood Clover Lea Nursing Home Residential Aged Care Facility Burwood Heights Gladstone House Residential Aged Care Facility Burwood Linburn Nursing Home Residential Aged Care Facility Burwood Laureldene Nursing Home Burwood Holy Spirit Croydon Residential Aged Care Facility Croydon St Ezekiel Moreno Residential Aged Care Facility Croydon Winston House and Lorna William Residential Aged Care Facility Croydon Goondee Nursing Home Strathfield Jesmond Nursing Home Strathfield Meredith House Nursing Home Strathfield Restwell Nursing Home Strathfield Strathdale Nursing Home Strathfield Wynleigh Nursing Home Strathfield Source: NSW Health Establishment Registration Online (HERO) database. Accessed Feb 2015.

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APPENDIX A: POSTCODE TO LGA / SLA CORRESPONDENCES In a number of cases, data was only available at the postcode level, rather than an LGA or SLA level. Where this occurred, the data at the postcode level was mapped to the LGA or SLA according to the correspondences shown in Table 37. The correspondences are based upon published data sourced from the Australian Bureau of Statistics regarding postcode to SLA or LGA mappings detemined under the Australian Standard Geographical Classification.

In some cases, a single postcode spans a number of LGAs or SLAs. These postcodes are only included when more than 10% are within an LGA or SLA boundary.

Table 37: Postcode to SLA / LGA correspondences:

LGA / SLA POSTCODE % WITHIN

LGA BOUNDARY

LGA / SLA POSTCODE

% WITHIN LGA

BOUNDARY

Ashfield

2045 99.62

Leichhardt

2038 98.95 2130 99.97 2039 100.00 2131 100.00 2040 99.99 2132 40.71 2041 100.00

Burwood

2132 59.29

Marrickville

2042 60.98 2133 51.54 2044 99.74 2134 100.00 2048 99.95 2135 20.33 2049 100.00 2136 52.34 2050 40.17

Canterbury

2133 40.35 2203 100.00 2191 78.20 2204 99.96 2192 100.00

Strathfield

2129 100.00 2193 95.86 2135 72.70 2194 100.00 2136 47.66 2195 100.00 2140 100.00 2196 74.57 2191 21.80 2206 100.00

Sydney City South

2008 33.62 2208 50.22 2015 100.00 2209 32.92 2016 100.00 2210 17.78 2017 100.00

Canada Bay

2046 100.00 2018 37.02 2047 100.00 2042 39.02 2137 100.00 2043 100.00 2138 100.00

Sydney City West

2006 100.00 2139 100.00 2007 92.59

2008 66.38 2009 100.00 2037 100.00 2050 59.83

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APPENDIX B: DATA LIMITATIONS AND ASSUMPTIONS

B.1 Background to the LGA Health Profiles

The LGA Health Profiles were initially published in 2010 by the Sydney Local Health District. This version of the LGA Health Profiles 2015 was a collaborative project with the Central and Eastern Sydney PHN and the Sydney Local Health District.

Unfortunately the breadth of detail required to inform the LGA/SLA profiles is not available within a single data source. Accordingly, data has been sourced on a range of relevant indicators using the most appropriate, recently available source for each indicator. In some cases, the absence of complete data consistency across all indicators may require consumers of the LGA/SLA profiles to interpret some findings with caution, and this document aims to identify those areas where this is most likely to be the case. Source references are identified and should be used in conjunction with this document when interpreting the LGA/SLA profiles.

B.1.1 PHIDU Social Health Atlas of Australia

In some cases data has been sourced from the October 2014 release of the Social Health Atlas of Australia, compiled by the Public Health Information Development Unit (PHIDU), which is under the auspices of the University of Adelaide.

The data obtained from PHIDU is provided at the LGA/SLA, state and national levels and includes a broad number of indicators that are relevant to population health needs. However, in a number of cases the data collections that underpin these indicators have been compiled by different organisations that use different sampling techniques and assumptions. Furthermore, the range of indicators presented in PHIDU’s Social Health Atlas use data collected over different years. The breadth of data sources, collection techniques and collection timeframes used in PHIDU’s Social Health Atlas should therefore be taken into consideration when interpreting the data and readers should be cautious about drawing direct comparisons between indicators that are based upon data that has been collected at different timeframes, by different organisations, or using different assumptions.

Some indicators presented within PHIDU’s Social Health Atlas of Australia are ‘synthetic predictions’ that have been derived by PHIDU at the LGA or SLA level, based upon various different data collections. As a result, these predictions do not represent data collected in administrative or other data sets, and should be used with caution, and be treated as indicative of the prevalence of the health condition or risk factor in an area with these demographic and socioeconomic characteristics. Synthetic predictions within the PHIDU dataset have been made for indicators relating to the prevalence of chronic disease and health risk factors.

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B.1.2 Other Data Sources

The need to obtain data from a range of sources introduces the possibility of misalignment of populations and assumptions when comparing data across time periods, or from different data sources. Nonetheless, it has been necessary as part of the development of the LGA/SLA profiles to draw conclusions between indicators that are based upon different data collections. Although the LGA/SLA profiles have been constructed in such a way that the most relevant, recently available data has been used for each indicator, it is important to recognise the limitations in comparing data sourced from different collections, and over different timeframes.

Considering the diversity of data sources used to construct the LGA/SLA profiles, data was not always available for all indicators at the state, PHN or LGA/SLA level. As a result, some indicators have been derived in order to provide comparisons between indicators at these different levels. Consumers should exercise caution when making comparisons between derived benchmarks and reported results. The PHN provided workforce data on general practice and private allied health provider for this report. The SLHD Public Health Unit provided data on infectious disease prevalence, incidence and notification rates.

B.1.3 Health Risk Factors – Definitions The data in Figure 7 are self-reported data, reported to interviewers in the 2011–13 National Health Survey. A current smoker is an adult (over 18 years of age) who reported at the time of interview that they smoked cigarettes, cigars or pipes at least once a week.

Risky alcohol consumption was based on estimated alcohol consumption in the seven days prior to interview using two components – the number of days on which the respondent reported consuming alcohol in the previous week; and the quantity consumed in the most recent days on which they consumed alcohol. For people who drank on no more than three days in the last week, their daily consumption was simply the total consumed divided by seven. Harmful use of alcohol is defined as average daily consumption of more than 75 ml (three standard drinks) for males and 50 ml (two standard drinks) for females.

Physical inactivity is defined as those aged 15 years and over who did not exercise in the two weeks prior to interview for the 2011-13 NHS, through sport, recreation or fitness (including walking).

Psychological Distress: This data is derived from the Kessler Psychological Distress Scale (K-10), which is a scale of non-specific psychological distress based on 10 questions asked of respondents about negative emotional states in the 4 weeks prior to interview. 'High' and ‘Very High’ distress are the two highest levels of distress categories (of a total of four categories).

Overweight and Obesity: The BMI was calculated from self-reported height and weight information and grouped as follows to allow reporting against both World Health Organization and National Health & Medical Research Council guidelines – normal range: 18.5 to less than 20.0 and 20.0 to less than 25.0; overweight: 25.0 to less than 30.0; obese: 30.0 and greater.

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Documents

Burwood - Sydney Local Health DistrictConcord Hospital) provides the largest percentage of emergency department presentations (43.4%) and hospital separations for BurwoodLGA residents