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Health Needs Assessment 2019 - 2021

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Health Needs Assessment 2019 - 2021 Health Needs Assessment 2019 - 2021 Health Needs Assessment 2019 - 2021 1. Overview The revision of the Darling Downs and West Moreton Primary Health Network (PHN) Health Needs Assessment (HNA) has provided the opportunity to expand on the foundational document developed in 2017 providing a comprehensive review of our region. Health is a dynamic environment, ever adjusting to ensure quality and safe provision of care and incorporating new and innovative models of care, research findings related to best practice and evidence-based interventions, and the needs of a growing and evolving population. Understanding the region’s population, and health trends, deficits and risks can be both exciting and daunting but is nonetheless essential for regional, collaborative health planning. The HNA has involved continued consultation with the region’s residents, health care providers, community groups, hospital and health services, councils and universities. Focus of formal consultation has centred on the national priorities of Mental Health (including per- and poly- fluoroalkyl substances (PFAS), psychosocial measures, drought resilience, suicide prevention), Aboriginal and Torres Strait Islander health, alcohol and other drugs, workforce and aged care, as well as the population health segments of vulnerable populations, chronic disease and children and youth. Ongoing collaboration in the roll-out of the MyHealthRecord system has expanded digital health platform across the region. Along with the Board, the West Moreton and Darling Downs Clinical Councils continue to provide expert clinical and community representative input into broadening the understanding of health and services and the gaps within the region. Data from the existing HNA was updated where required and analysed to determine trends, changes and impacts with literature reviews undertaken to increase understanding of cause and potential solutions. Differences in data subset boundaries can prove difficult with many not providing SLA or SA2 level which may be difficult for focused community need identification. The review process discussed had no boundaries with the aim of an authentic search for the needs of the region. Review and analysis of data, consultation and literature enabled a refinement and enhancement to the previous nine PHN priorities with this updated HNA defining 10 clear clinical priorities of the region. 1. MATERNAL AND INFANT HEALTH AND CHILD DEVELOPMENT The most recent data has propelled this priority’s status to very high with the PHN region having the second highest PHN ranked child and infant mortality rate. High levels of poverty throughout the region, with 1 in 4 children living in single parent families, and a rank of the 3rd highest proportion of low income welfare-dependent families, place our children at high risk for poor health outcomes. In particular, a large number of our Aboriginal and Torres Strait Islander children live in communities identified as having a number of markers for socio-economic disadvantage. Mixed with the risks to our children is a the 2nd highest fertility rate for the nation and a teenage birth rate up to four times larger than the Queensland rate in particular communities. Although our children are more physically active than many other regions, a high percentage remain overweight or obese. 2 PHN HNA 2019-2021 122018 Health Needs Assessment 2019 - 2021 Regional child protection units have seen growing activity and the number of children in out-of-home care continues to increase with 49% identifying as Aboriginal and/ or Torres Strait Islander. Literature reviews and consultation have highlighted potential models for reaching families to improve outcomes, however the high rate of child and infant mortality remains unanswered. Regional collaboration is required for further exploration into this concerning statistic. 2. PREVENTION AND MANAGEMENT OF CHRONIC CONDITIONS The PHN region owns some disturbing data associated with risk behaviours and premature death rates related to chronic conditions. With the 4th highest proportion of obesity and highest ranking for physical inactivity, 80.8% of our region rate their health as excellent, very good or good. This is below all other Queensland PHNs. High premature death rates align with areas of socio-economic disadvantage and prevalence of risk factors. Despite the benefits of cancer screening, the PHN ranks second last in National Cancer Screening Program participation. There are difficulties in understanding prevalence rates of disease for Aboriginal and Torres Strait Islander people within our region. While nationally it is known that 79% of the gap in mortality is related to chronic conditions, at a local level inferences may be made for communities with larger Aboriginal and Torres Strait Islander populations although the accuracy of this application across the region is unknown. Further understanding of mechanisms to decrease risk and prevent chronic conditions is required across the lifespan while regional partnership for innovative action guided by the Global Obesity Centre provides a promising option for improvement. 3. HEALTH FOR ABORIGINAL AND TORRES STRAIT ISLANDER PEOPLE Combined with the priorities discussed above is the knowledge of higher impacts of risk factors on our Aboriginal and Torres Strait Islander people and the higher proportion of population within the region. The region has the highest proportion of young people (0-19) and the lowest proportion of people aged 45 and over (out of total Aboriginal and Torres Strait islander population). Limitations in the data examined have prevented further understanding of the trends over decades (to determine migration effect) along with the effect of causes of morbidity and mortality within the region, however will be a future focus to understand reasoning. Chronic conditions, poverty, social determinants and history have significant impacts on morbidity, co-morbidity, mortality and social and emotional wellbeing of the Aboriginal and Torres Strait Islander population. Data available to the PHN do not describe population health categorisation for Aboriginal and Torres Strait Islander people, therefore National data and literature were utilised to assist in analysis. 3 PHN HNA 2019-2021 122018 Health Needs Assessment 2019 - 2021 4. WORKFORCE CAPACITY AND WELLBEING Workforce influences service access and availability. Across the region and within all service types, concerns were expressed regarding service availability and access with and equal concern for shortages in workforce stemming from difficulties in retention and recruitment of staff, especially in rural areas, and an ageing health workforce. New and innovative models for workforce growth and development, and recruitment and retention are the focus of collaborative research proposals across the region. 5. HEALTH FOR OLDER AUSTRALIANS Australia’s older generation continues to grow and 15% of the PHN region are aged 65 years and over while 0.8% of the population is Aboriginal and Torres Strait Islander people aged 50 years and over. Wherever the home, care for older Australians includes healthy ageing and care for the conditions associated with ageing. Approximately half of people living in residential care have a diagnosis of dementia while there are a number of people cared for in their own homes with this diagnosis, resulting in a need for more support. Supports are also required for palliative care, a care type mostly associated with older people while a new focus of anticipatory care (preparing for deterioration in condition) has evolved to assist with end of life planning options. 6. PRIMARY MENTAL HEALTH CARE With high rates of anxiety and depression and deaths from suicide, mental health care is a high priority for the PHN. The implementation of stepped care will allow improved referral options across the region with e-referral and health service navigators enabling closer monitoring of wait times while ensuring appropriate priority for referrals. As a drought affected area, much of the PHN region is under stress and a localised mental health response will be provided to affected communities. The Darling Downs and West Moreton Suicide Prevention Plans, along with the imminent Mental Health Plan will enable a region wide response. National and state levels of data have been used with caution in projection to local communities. 7. DRUG AND ALCOHOL MISUSE While there is ongoing community concern for the influence of alcohol and other drugs, the inability to quantify the depth and breadth of usage causes difficulty in understanding the reach within the community. Because of this, health care providers may not be sure of the need for intervention in every day practice. Travel and transport remain a barrier for some people while an uncertainty about support and service provision may be inhibiting referral uptake and options. Further research to quantify the degree of usage has been suggested to assist in translation into understanding and resource allocation. 4 PHN HNA 2019-2021 122018 Health Needs Assessment 2019 - 2021 8. ACCESS AND INTEGRATED SERVICE DELIVERY Improved access to health care may be achieved through supporting telehealth and may also alleviate the pressure of inadequate transport, particularly in rural areas, for people with disability and for people with complex health needs. Increased uptake of HealthPathways will improve integration while improving referral pathways will increase awareness and access to outreach services. 9. HEALTH FOR
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