Contents Health Needs Assessment 2017 Summary 3 Socioeconomic status 4 Aboriginal and Torres Strait Islander peoples 5 Maternal and infant health 6 Young people 7 Older people 8 Population health 9 Murrumbidgee Primary Health Network acknowledges the Traditional Custodians of the land in the Murrumbidgee region. We pay respect to past and present Elders of this land: the Wiradjuri, Yorta Yorta, Baraba Baraba, Wemba Wemba and Nari Nari peoples. Murrumbidgee Primary Health Network gratefully acknowledges the financial and other support from the Australian Government Department of Health. The Primary Health Networks Programme is an Australian Government Initiative. 2 l MURRUMBIDGEE PHN: HEALTH NEEDS ASSESSMENT 2017 SUMMARY Health Needs Assessment 2017 Summary Murrumbidgee Primary Health Network shares borders MPHN covers a geographic area of 124,413 square with Western NSW, South Eastern NSW, ACT, Gippsland kilometres. MPHN has 22 local government areas and Murray PHNs in Victoria. Its boundaries align with the and has been divided into four sectors for planning Murrumbidgee Local Health District (MLHD). purposes. MURRUMBIDGEE PHN: HEALTH NEEDS ASSESSMENT 2017 SUMMARY l 3 Socioeconomic status What we will be doing The Index of Relative Socio-Economic disadvantage around Griffith and Yoogali; • consider the variation in • commission services in a way that Disadvantage measures how well Lake Cargelligo and Tullibigeal; Barellan, disadvantage across MPHN for ensures the service is targeted to people in an area are faring by Leeton, Yanco, Grong Grong, Boree Creek targeted integration and redesign those who experience disadvantage looking at low-income earners, those and Gillenbal; and Wagga Wagga suburbs of care and commissioning of • use a systematic approach and work with lower educational attainment, including Ashmont, San Isidore and Kapooka. services to ensure access to primary with an interagency focus involving high unemployment and dwellings The most highly disadvantaged areas in the and specialist healthcare services, other providers such as housing and without a motor vehicle. There are Murrumbidgee for Aboriginal and Torres Strait addressing potential barriers such as education to ensure that the social households within the region that Islander peoples are around Young, Deniliquin, affordability, transport and cultural factors that influence health are experience greater disadvantage than Gundagai and Griffith. acceptability addressed NSW, the most disadvantaged areas within MPHN are Narrandera, Hay and Murrumbidgee, with pockets of high Characteristics of residents in MPHN include: • Lower levels of education – year • Incomes – more families report incomes 12 education 30% (42% NSW); less than $600 a week 17% (14% NSW); university education 20% (30% incomes of over $2,000 a week 21% (32% NSW) NSW) • Lower levels of health literacy, • Unemployment in the Aboriginal evidenced by poor understanding population is higher, 17% than whole of of health behaviours contributing region population 4% (5.4% NSW) to chronic disease, low uptake • Aged care pension and concession cards of cancer screening, late stage 35% in Cootamundra, Urana and Murray detection of cancer and chronic areas, compared with 21 % in Carrathool kidney disease (MPHN Clinical and 23% in Wagga Wagga (24% NSW) Council consultations, 2016) Disadvantage can be measured by the following; 4 l MURRUMBIDGEE PHN: HEALTH NEEDS ASSESSMENT 2017 SUMMARY Aboriginal and Torres Strait Islander peoples Maternal and child health – 68% times the rate of non-Aboriginal Aboriginal women had first antenatal people for mental health related What we will be doing visit before 20 weeks (88% NSW); disorders; Aboriginal children 49% of Aboriginal mothers reported markedly over-represented for • participate in the Aboriginal Health • fund a partnership between Aboriginal smoking during pregnancy (7% NSW); childhood mental health disorders Consortium and assist with the community services and employment 12% of low birth weight babies born (36% of separations) implementation of the Aboriginal Health providers to support Aboriginal and to Aboriginal mothers (6.4% NSW) Plan which has a focus on maternal and Torres Strait Islander people whose Alcohol and Other Drugs – child health, chronic disease, cancer drug use is impacting on their ability to Smoking rates – hospitalisation Aboriginal people hospitalised treatment and prevention (screening) gain or maintain employment and/or data shows Aboriginal people are for alcohol related issues at 2.5 and mental health participate in education hospitalised for smoking related issues times the rate of non-Aboriginal at 2.7 times the rate of non-Aboriginal people (1,641 per 100,000 vs • support general practice to implement • work with the Aboriginal Health people non-Aboriginal 662 per 100,000); quality improvement systems for recalls Consortium to develop an Aboriginal feedback from stakeholder and reminders, community awareness of health workforce strategy Respiratory disease – chronic consultations identified screening services, support for delivery • provide immunisation support to obstructive pulmonary disease 4.5% concerning alcohol consumption of culturally appropriate screening general practice (3.9% non-Aboriginal); asthma 20% in vulnerable groups including • ensure that MPHN general practice • build relationships with Aboriginal (13% non-Aboriginal) of general Aboriginal people weight management includes specific medical services and other relevant practice presentations targets for overweight Aboriginal people health service providers of care Aboriginal health workforce – • commission culturally appropriate coordination to Aboriginal people Diabetes – 8.2% of general practice data not available presentations (7.3% non-Aboriginal) mental health and suicide prevention • contribute to closing the gap in life services which meet local community expectancy by improved access to Breastscreen – participation lower for Childhood immunisation – needs culturally appropriate Aboriginal Aboriginal women 34% (40% NSW) 92.8% of Aboriginal children • support young people who are specific and mainstream primary care fully immunised at 1 year of age engaging in risky substance use or services (including but not limited Mental health related disorders – (93.3% NSW); similar rates to NSW experiencing addiction through funding to general practice, allied health and account for 40% of hospitalisations at 2 years of age; at 5 years, 97% of headspace services specialists) for Aboriginal and Torres of Aboriginal people 15-19 years; of Aboriginal children were fully Strait Islander peoples Aboriginal people hospitalised at 2.6 immunised (93% NSW) MURRUMBIDGEE PHN: HEALTH NEEDS ASSESSMENT 2017 SUMMARY l 5 Maternal and What we will be doing • develop a 0-2 year olds strategy for infant health maternal and child health that includes smoking cessation advice Maternal and infant health – 76% of non- • localise and provide access to Aboriginal women first antenatal visit before Murrumbidgee HealthPathways for 20 weeks (88% NSW); 15% of non-Aboriginal healthcare professionals for a number mothers smoked during pregnancy (7% NSW) of relevant conditions Child development – the Australian Early • provide psychological services to Development Census is a nationwide measure children and young people utilising that looks at how well children are developing technology and face to face service by the time they reach school, 21% of children provision are developmentally vulnerable in one or • commission a low intensity more domain, similar to NSW (20%); 30%-42% intervention for new parents, women vulnerable in one or more domains in Urana, at risk of perinatal depression and Hay, Boorowa, Harden and Murrumbidgee parents of children at risk of mental health/behavioural issues Severity of mental health disorders – 4-11 • fund the paediatric consultancy years; mild 10.4%, moderate 3.2%, severe 1.2%, service overall 14.7% (14.2% Australia) • undertake co-design with general Alcohol and other drugs – inadequate access practitioners, the Murrumbidgee Local to alcohol and other drugs counselling or Health District (MLHD), Calvary Health, rehabilitation services specifically for pregnant consumers with lived experience and women and new mothers. Stakeholders Murrumbidgee Family and Community identified concerning use of alcohol and Services to provide low to medium other drugs in pregnancy, and continued use intensity alcohol and other drugs in early childhood. Providers and consumers interventions to pregnant women and identified a need for a service that combines new mothers family and parenting support/education/skill • provide immunisation support to development and alcohol and other drugs general practice support/treatment • participate in the Child Health Consortium Childhood Immunisation – 95.7% of non- Aboriginal children fully immunised at 1 year of age (93.3% NSW); at 2 years, 94% of non-Aboriginal children fully immunised (91.1% NSW); at 5 years, 96% of non-Aboriginal children fully immunised (93.5% NSW) 6 l MURRUMBIDGEE PHN: HEALTH NEEDS ASSESSMENT 2017 SUMMARY Young people What we will be doing Overweight and obesity – 23% Lack of support – consultations with of secondary school aged children stakeholders and the Youth Reference • fund the Wagga Wagga and • rollout the LifeSpan approach overweight or obese (21% NSW) Group indicate children and young people Griffith headspace centres to to suicide prevention in nine experience difficulty coping with parental deliver