Pilbara – population and health snapshot

The covers 507,896 square kilometres (including offshore islands) and is Western ’s second most northern region. The region incorporates two health districts – West and East Pilbara, with the vast majority of the population residing in the west. The main population centres of the Pilbara are Port Hedland, Karratha and Newman.

Population Measure of disadvantage

The estimated resident population in 2013 was 66,298, a Socio-Economic Indexes for Areas (SEIFA) measures a growth of 22,209 people since 2006. This represents an broad range of socio-economic indices from a baseline increase of 6% per year. Most of the population resides in of 1,000. Research shows that a lower SEIFA (<1000) the mining towns of Karratha, Port Hedland and Newman. correlates with a lower health status with increased risk factors to ill health. The Pilbara has a younger age structure compared to other , with a large concentration of Pilbara residents in Based on the 2011 census the lowest SEIFA score for a the 20-54 year old range. This is attributed to an influx of Pilbara Local Government Area was 962 in the East Pilbara, predominantly males aged between 20 and 44 years that and the highest was Roebourne with 1,060. However, work in the and construction industries as residents there is a Statistical Area Level 1 (SA1) within Roebourne or fly-in/fly-out workers. with a score of 1,136 and another SA1 within East Pilbara with a score of 496, which is in the lowest 30% of scores Aboriginal people accounted for 16% of the region’s in the State. The 2011 SEIFA scores for towns in the Pilbara population (State average 3.8%) and has a younger age are1: structure than the non-Aboriginal population. East Pilbara 962 Planning outreach teams Port Hedland 1,033 Ashburton 1,057 [ Consider differing age structure when planning Roebourne 1,060 Aboriginal programs and services. [ Target low SEIFA score areas, in particular very remote 1 ABS, 2033.0.55.001 – Socio-economic Indexes for Areas (SEIFA), Pilbara communities. Data Cube only, 2011.

With thanks to WA Country Health Service for permission to use data from various sources including the Pilbara Regional Health Profile 2015 which can be accessed at www.wacountry.health.wa.gov.au/index.php?id=445.

PAGE 1 Major health service providers Major health services

Community and public health services Mental health and Aboriginal Medical Hospital services aged care services Services

l Nickol Bay l Roebourne Community Health l Pilbara Mental Health l Mawarnkarra Health Hospital l Wickham Health Centre and Drug Service – Service Karratha, Tom Price, l Roebourne l West Pilbara Community Health Service l Puntukurnu Aboriginal Hospital Newman, South Medical Service (PAMS) l Marble Bar Nursing Post Hedland l Newman Hospital l Wirraka Maya Health l Nullagine Community Health Service l Karlarra House – Port l Hedland Health Services Aboriginal l Port Hedland Community Health Hedland Campus Corporation Service l Yaandina Frail Aged l Tom Price Hospital l South Hedland Community Health Care – Roebourne l Onslow Hospital Service l Paraburdoo l Ashburton Community Health Centre Hospital l Onslow Community Health Service Further health service information can be found at www.myhospitals.gov.au and www.ruralhealthaustralia.gov.au.

Maternal health

Overview of rural maternity which was significantly higher (1.3 weight, premature birth, placental services times) than the non-Aboriginal rate complications and stillbirths. (63 per 1,000 women). Community based pregnancy and Figure 1 shows the proportion maternity care services are provided Teenage pregnancy of births to Pilbara women who by WA Country Health Service, private In 2012, 5% of Pilbara women who reported smoking during pregnancy. general practitioners, Aboriginal gave birth were aged less than 20 In 2013, 56% of Aboriginal women, Community Controlled Health years. The proportion of births to and 10% of non-Aboriginal women Services and a range of community Aboriginal teenage women in the who gave birth reported smoking based and non-government Pilbara was 21%. during pregnancy. The reported rate organisations. Specialist obstetric of Aboriginal women smoking during Smoking during pregnancy services are mainly provided at the pregnancy increased significantly regional hospitals. In the Pilbara, Risks associated with smoking during from 2011. planned birthing services are pregnancy include low birth available at Hedland Health Campus, and Nickol Bay Hospital2. Figure 1: 2011-2013 proportion of women smoking during pregnancy, Pilbara residents. Aboriginal maternity issues There is a large body of evidence to demonstrate that Aboriginal women experience poorer maternal health outcomes, higher rates of perinatal and infant mortality and deliver babies with lower average birth weights when compared to non- Aboriginal women. Birth rates In 2012, the overall Pilbara age- specific birth rate was 66 per 1000 women which was similar to the State rate. For 2008-2012, the age-specific birth rate for Aboriginal women in Notes: The error bars represent the 95% confidence interval of the proportion: 2013 is preliminary data. the Pilbara was 80 per 1,000 women Source: Midwives Notification System

2  www.healthywa.wa.gov.au/Articles/F_I/Having-a-baby-in-a-public-country-hospital-in-WA PAGE 2 Alcohol during pregnancy Table 1: 2012-2013 levels of drinking during pregnancy, Australian women aged 18-44 years. Fetal Alcohol Spectrum Disorder Low risk levels of drinking High risk levels of drinking (FASD), miscarriage and stillbirth are Aboriginal 28.4% 11.6% among the consequences of drinking during pregnancy. FASD is a common Non-Aboriginal 42% 9.5% cause of medical, cognitive and Sources: WA Register for Developmental Anomalies and the Midwives Notification System behavioural problems for children Table 2: 2005-2007 women who gave birth in Australia and gestational diabetes mellitus status. including prematurity, brain damage, Gestational diabetes mellitus Births birth defects, growth restriction and Percent Number Total developmental delay. Aboriginal 5.1% 1,562 30,518 The FASD birth prevalence has been Non-Aboriginal 4.7% 37,539 802,175 reported to be 0.26 per 1,000 births within all of the WA population. Of Source: Australian Institute of Health and Welfare, 2010 these, 89% were Aboriginal. The type 2 diabetes later in life. The risk FASD birth prevalence was 4.08 is increased for those with pre- Planning outreach per 1,000 within the WA Aboriginal existing diabetes prior to pregnancy. teams population, significantly higher than Aboriginal mothers and their babies non-Aboriginal children (0.03 per [ Health promotion generally experienced the adverse interventions on smoking and 1,000). Table 1 shows the proportion effects of gestational diabetes drinking during pregnancy of Australian women drinking during mellitus (GDM) at higher rates. targeting Aboriginal women of child pregnancy. bearing age. 7% of Western Australian women who [ Access to dietitians and nutritional Gestational diabetes mellitus gave birth in 2012 were diagnosed professionals for expectant Diabetes in pregnancy increases the with GDM. Table 2 provides an Aboriginal mothers. risk of complications of pregnancy, overview of gestational diabetes [ Strengthen partnerships with labour and delivery for mothers and mellitus status in Australia during primary care providers such as local GPs and Aboriginal Medical their babies. It is also an indicator 2005-2007. Services. of increased risk of developing

Child and adolescent health

Low birth weight the State rate. The low birth rate for In 2012, Australian Bureau of Statistics A baby’s birth weight is a key Pilbara Aboriginal babies was 12%, data classed 22% of Australian indicator of health status. The World which was less than the State rate for children as developmentally Health Organisation defines low birth Aboriginal babies (14%). vulnerable on one or more domains of the AEDC. In addition, 11% were weight as less than 2,500 grams. Australian Early Development developmentally vulnerable on two Babies born with a low birth weight Census are more likely to develop significant or more domains. Within Pilbara The Australian Early Development disabilities and have a greater risk of communities, the proportion of Census (AEDC) is a measure of poor health and mortality outcomes. children rated as developmentally how children are developing upon For 2008-2012, low birth weight rates vulnerable on one or more domains commencing full-time school for the in the Pilbara was 6%, which mirrored ranged from 5.9% to 47%. The towns first time. with the highest proportion of children classed as developmentally Planning outreach teams vulnerable are shown in Table 3. [ Increase allied health professionals to assist early childhood development. Teams could include speech pathologists, To learn more about the AEDC, visit occupational therapists, physiotherapists and child health nurses. www.aedc.gov.au/about-the-aedc.

Table 3: 2012 AEDC, Pilbara children vulnerable on at least one domain. Children vulnerable: 1+ domains Children vulnerable: 2+ domains Community Number % of total surveyed Number % of total surveyed East Pilbara and remote communities 8 47 6 35 Roebourne 6 38 4 25 Nickol/Baynton/Millars Well 45 26 19 11 South Hedland 34 26 16 12 PAGE 3 Ear health

Ear diseases, in particular otitis media, household conditions, passive l Rate of PPH due to ENT infections and associated hearing loss are highly smoking, premature birth and was significantly higher for prevalent among Aboriginal children. malnutrition4. Aboriginal children than for non- In 2012-2013, national prevalence of Aboriginal children. In the Pilbara, the following ear health chronic otitis media causing hearing trends were observed during 2008- problems in Aboriginal children aged 2012 for children aged 0-14 years: 0-14 years was double that of non- Planning outreach Aboriginal chilren (7% as compared l Ear, nose, and throat (ENT) teams to 3.6%)3. infections were one of the leading causes of potentially preventable [ Focus on ENT infections and Otitis media begins within weeks of respiratory disease in children hospitalisations (PPH) in children, birth and can persist into adolescence especially Aboriginal children. accounting for 25% of the region’s with reoccuring episodes. Preventing [ Increase programs aimed at total PPH. ear disease is a high priority as it can prevention and management of risk factors. significantly reduce delays in child l The age group most affected [ Identify links with other primary learning and development. Risk by ENT infections were children health care services. factors include poor environmental- between 0-4.

Adult health

Chronic disease prevalence 15-64 years. Other common cancers l 3.5 times more likely to report Chronic disease refer to long-term in the Pilbara included colorectal; having diabetes. conditions that last for six months lymphoma; lung; bronchus and l 1.2 times more likely to report or more. Prevalence data within the trachea; and thyroid. having cardiovascular diseases. l 2 times more likely to report Pilbara population collected by WA Chronic disease amongst having asthma. population based surveys between Aboriginal people 2009 and 2012 found: l 2 times more likely to report Available national evidence reports l One in four adults (24%) reported kidney disease. a greater burden and prevalence of an injury requiring treatment chronic disease among Aboriginal Diabetes: Majority have type 2 from a medical professional in the people. The demographic factors of diabetes. Risk factors include previous year. remoteness (isolation) and socio- being overweight/obese, leading l One in seven adults (15%) economic disadvantage of the a sedentary lifestyle and poor reported a current mental health Aboriginal population contribute nutritional intake. problem. to the significantly greater burden Cardiovascular disease: The leading l One in ten adults (10%) reported of disease compared to the non- types are ischaemic heart disease and arthritis. This proportion was Aboriginal population. Research stroke. significantly lower than the State. collected from 2011-2013 indicates Respiratory disease: The two major l One in eleven (8.8%) adults that compared to non-Aboriginal types are asthma and chronic reported asthma. people, Aboriginal people were found obstructive pulmonary disease. In 2008-2012, cancers of the breast, to be5,6: Kidney disease: Often develops as skin (melanoma) and prostate each a complication of other medical l Half as likely to report excellent or accounted for 13% of all cancer cases conditions including diabetes, very good health. in the Pilbara for residents aged high blood pressure, urinary tract infections and drug use. Planning outreach teams Strategic focus areas that have been [ Health promotion interventions targeting the prevention and identified for Aboriginal health management of modifiable risk factors for chronic disease. planning in the Pilbara are maternal [ Consider how services can align with the strategic focus areas of the region. and child health, environmental [ Contact major health care providers and discuss how your team could collaboratively work together in service delivery and coordination. health, chronic disease, and mental health7. 3  ABS 2013. Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-2013. 4  Closing the Gap Clearinghouse (AIHW and AIFS) 2014. Ear disease in Aboriginal and Torres Strait Islander children. Resource sheet no.35. 5  AIHW 2015. Cardiovascular disease, diabetes and chronic kidney disease – Australian facts: Aboriginal and Torres Strait Islander people. 6  ABS 2013. Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-2013. 7  Pilbara Regional Aboriginal Health Planning Forum data. PAGE 4 Mental health

Health trends Table 4: 2002-2011 youth suicide rates, Pilbara residents, 15-24 years. Youth suicides (per 100,000 Pilbara For 2009-2012, one in seven (15%) Metro State Pilbara adults aged 16 years and over persons)* Health Region reported having a current diagnosed Males (15-24 years) 20.6 15.6 19.9 mental health problem, with the prevalence nearly twice as high Females (15-24 years) 3.2 5.4 6.0 among females than males. * These rates have been age-standardised to the Australian 2001 population. Source: DoH, Health Tracks Just 6% of Pilbara adults aged 16 years and over reported having used Youth Suicide: For 2007-2011, the Planning outreach a mental health care service in the last youth suicide rate in the Pilbara year. teams region was similar to the State youth [ Increase access to mental 8% of adults reported psychological suicide rate for males and lower for health services targeting the Pilbara distress, while 5% reported a lack of females. Table 4 shows the Pilbara female, male youth and Aboriginal control over their life in general. These youth suicide rates by gender during population. figures are similar to the State. 2002-2011 to preserve confidentiality. [ Health promotion interventions for Aboriginal people need to be targeted and culturally appropriate.

Eye health

Eye health conditions are very In 2011-12, 53.7% of Australians Disease of the eye was the third common in Australia and can reported having a chronic leading cause of hospitalisation for contribute to disadvantage due to eye condition. In 2013-2014, Pilbara residents 65 years and over, childhood learning delays, lower Aboriginal people had a lower from 2008-2012. participation in education and rate of hospitalisations for cataract employment, and social isolation. extraction as compared to non- Aboriginals (7.3 compared with 8.9 per 1,000 population).

Hospitalisations

Regional hospitalisations Table 5: 2008-2012 leading causes of hospitalisation by major category, Pilbara residents. For 2008-2012, the overall % of total State Rank Cause of hospitalisation Number hospitalisation rate of Pilbara (15-64 yrs) rank residents was significantly higher than that of the State. However, 1 Injury and poisoning 88,411 9 4 the hospitalisation rate for males 2 Pregnancy and childbirth 87,889 9 6 in the Pilbara was lower than that of the State rate. Table 5 shows the 3 Digestive diseases 87,522 8 1 top five causes of hospitalisation 4 Respiratory diseases 85,288 6 9 by major category. For 2003-2012, the overall hospitalisation rate of 5 Ill-defined conditions 84,946 6 3 Aboriginal residents of the Pilbara All hospitalisations 88,877 100 was significantly higher than the State Note: leading causes exclude ‘factors influencing health status and contact with health services’ and rate for Aboriginal people, whilst the ‘attending health services for examination and investigation’, reproduction, specific procedures, and hospitalisation rate for non-Aboriginal other circumstances, and potential health hazards related to communicable diseases, socioeconomic and residents of the Pilbara was lower psychosocial circumstances, family and personal history. This also includes renal dialysis. Source: DoH, Health Tracks than that of the State.

8  www.aihw.gov.au/eye-health/cataract-surgery/#t2 PAGE 5 Hospitalisations

There was marked difference During 2008-2012, the following l The leading PPH condition between the leading causes of trends were observed for PPH in for both Aboriginal and non- hospitalisation between Aboriginal Pilbara residents: Aboriginal residents was diabetes and non-Aboriginal residents in the complications (24%) which was l PPH accounted for 4,438 Pilbara. 2.1 times the State rate. Other hospitalisations in the 15-64 age conditions are shown in Figure 2. Dialysis accounted for nearly half the range (6% of all hospitalisations) hospitalisations of Aboriginal people which was significantly higher (47%), while only accounting for 24% than the State rate. for non-Aboriginal residents. Figure 2: 2008-2012 leading conditions for potentially preventable hospitalisations, Pilbara residents . Both of these were above the State rate. Potentially preventable hospitalisations Potential preventable hospitalisations (PPH) are hospitalisations which could have been avoided with disease intervention plans and various methods of preventative care. Three categories are identified: acute, chronic and vaccine preventable.

Source: DoH, Health Tracks

Mortality

Mortality is an important population The current estimated life expectancy Avoidable mortality health indicator. Knowing the for Aboriginal people is ten years During 2007-2011, 56% of Pilbara reasons for and causes of death can lower than for non-Aboriginal people. resident deaths under 75 years could assist in the planning of primary Leading causes of death have been avoided through the and community care services to better use of primary prevention and During the period 2008-2012, the prevent avoidable mortality. There treatment interventions. is still a discrepancy between the leading causes of death in the Pilbara 9 life expectancy of Aboriginal people region were found to be : The rates of treatable and preventable when compared to non-Aboriginal l ischaemic heart diseases, avoidable deaths for Aboriginal people. transport accidents, diabetes people in the Pilbara was 5 and 7 and impaired glucose regulation, times higher respectively than that of unknown causes of morbidity non-Aboriginal residents. Planning outreach and mortality, cerebrovascular The leading cause of avoidable deaths diseases. teams for Pilbara residents was ischemic For Aboriginal residents, the leading heart disease (14%) followed by [ Interventions should 10 diabetes (10%). consider modifiable risk factors causes of death were : for leading causes of avoidable l ischaemic heart diseases; mortality. diabetes and impaired glucose [ Explore partnerships with existing regulation; transport accidents; primary and therapeutic services. cerebrovascular diseases; and unknown causes of morbidity and mortality.

9,10  All mortality and avoidable mortality statistics were sourced from the Department of Health, Health Tracks – Epidemiology Branch (PHI) in collaboration with the Cooperative Research Centre for Spatial Information (CRC-SI). 04.16 PAGE 6