HEALTH


INTRODUCTION

Health is defined by the World Health Organisation as 'a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity'. Good health provides social and economic benefits to individuals, families and the wider community.


LIFE EXPECTANCY

Overall, people in NSW are living longer lives. Between 2001 and 2007, life expectancy in NSW improved for both men (by 2.2 years to reach 79.1 years) and women (by 1.4 years to reach 83.8 years). As well as continuing medical advances, recent increases in life expectancy are due to a range of factors including fewer transport and work-related fatalities and fewer deaths from major illnesses such as heart disease.

CAUSES OF DEATH

Causes of death data provide insights into diseases and other factors contributing to overall life expectancy. Underlying causes of death data records the key disease or injury leading directly to death. The death rate for all persons in NSW in 2007 was one of the lowest on record, reflecting a steady decline since 2002, from 6.7 to 5.9 deaths per 1,000 population. This overall decrease in death rates is mainly due to reductions in deaths from heart and cerebrovascular disease. However, deaths from malignant cancer increased from 170 to 174 per 100,000 population between 2001 and 2007.

HEALTH RISKS

There are a range of issues which can influence health outcomes, including socioeconomic status, environmental factors, genetics and specific lifestyle behaviours such as smoking, exercise and dietary habits. From 2007, Australia adopted eight National Health Priority Areas, being cardiovascular disease, cancer, injuries, arthritis, mental health, diabetes, asthma and obesity.

For the total NSW population, comparisons of risk factors between 2001 and 2008 show that more people self-reported as overweight or obese (up from 49.8% to 55.7%), more people are sedentary or only undertake low levels of exercise (up from 69.8% to 71.7%) and more people are drinking alcohol at risky or high risk levels (up from 10.8% to 13.3%). By contrast, 19% of the total NSW adult population in 2008 were current daily smokers, down from 22% in 2001.

BODY MASS INDEX (BMI)

People who have a BMI of 25 or higher are considered to be overweight or obese; this can pose a major risk to their long-term health by increasing the risk of chronic illnesses such as diabetes and cardiovascular disease. For the first time since 1995, the 2007-08 National Health Survey measured the height, weight, hip and waist circumference of respondents. This data was used to calculate Measured BMI (excluding those for whom measurements were not available). Based on this measured data, and comparing it with total persons in NSW aged 18 years and over, 817,700 males (42%) and 593,400 females (32%) were recorded as overweight. A further 522,400 males (27%) and 397,300 females (21%) were recorded as obese.


MENTAL HEALTH

Mental disorders can be divided into three broad categories; anxiety disorders e.g. agoraphobia; affective disorders e.g. depressive episodes; and substance use disorders e.g. alcohol use disorders. The 2007 National Survey of Mental Health and Wellbeing revealed that in the 12 months prior to interview, one in five (20% or 1.1 million) people aged 16–85 years in NSW had a mental disorder. In total,14.4% of people aged 16-85 years (766,100 people) had an anxiety disorder, 6.4% (340,400 people) had an affective disorder and 4.2% (221,200 people) had a substance use disorder, bearing in mind that a person may have had more than one mental disorder in the 12 months prior to interview.

Women experienced higher rates of mental disorders; 22% of all females compared with 18% of all males. Women experienced higher rates than men of anxiety (18% and 11% respectively) and affective disorders (7.5% and 5.2% respectively). However, men had three times the rate of substance use disorders (6.3% compared with 2.0% for women).

The prevalence of mental disorders varies across age groups, with people in younger age groups experiencing higher rates of disorder. More than a quarter (26%) of people aged 16–24 years and a similar proportion (26%) of people aged 25–44 years had a mental disorder compared with 6.7% of those aged 65–85 years old.

AGED CARE

The provision of care for the aged continues to increase. The ratio of total care provided, either as places in residential care or as care provided to the aged at home, has increased from 97.4 per 1,000 persons aged 70 years and over in 2003 to 111.5 in 2008. Residential aged care provision increased in absolute terms from 52,313 places at 30 June 2003 to 60,258 places at 30 June 2008. In the same period the provision of Community Aged Care Packages rose from 9,628 to 13,568. Available packages for Extended Aged Care at Home and Extended Aged Care at Home Dementia increased from 990 at 30 June 2006 to 2,090 at 30 June 2008.


HOSPITALISATION

In 2007-08, there were 2,356,334 hospital separations in NSW, equivalent to an age standardised rate of 33,148.0 separations per 100,000 population.

Variations in hospital separation rates among health areas reflect many factors such as access to primary health care and a tendency to hospitalise people who come from remote areas.

• In 2007-08, the lowest age standardised hospital separation rates in NSW were found in the Sydney South West (31,500 hospital separations per 100,000 population) and Hunter & New England (32,384 per 100,000) Area Health Services.
• The lowest hospital separation rate for males was in the Hunter & New England Area Health Service (30,743 per 100,000).
• The lowest hospital separation rate for females was in the Sydney South West (31,457 per 100,000) Area Health Service.
• The highest hospital separation rates were in the Greater Western and the South Eastern Sydney & Illawarra Area Health Services (37,432 and 34,096 per 100,000 respectively).
• The highest hospital separation rate for males and females was in the Greater Western Area Health Service (36,988 and 38,274 per 100,000 respectively).

Of the 2,356,334 hospital separations in NSW in 2007-08, approximately 56,300 were people who identified as Indigenous. The most common reason of hospital separation for Indigenous people living in NSW was care involving dialysis (25.4%). External causes of harm, such as transport accidents, assaults, self-inflicted harm and falls, accounted for 11.2% of the hospital separation for Indigenous people living in NSW.


DATA SOURCES

ABS Causes of Death Collection (cat. no. 3303.0)

ABS Deaths, Australia (cat. no. 3302.0)

ABS National Aboriginal and Torres Strait Islander Health Survey (cat. no. 4715.0)

ABS National Health Survey (cat. no. 4362.0)

ABS National Survey of Mental Health and Wellbeing (cat. no. 4326.0)

ABS Population Ageing in New South Wales, 2008 (cat. no. 4106.1)

ABS Survey of Disability, Ageing and Carers, Australia 2003 (cat. no. 4430.0)

Australian Institute of Health and Welfare (AIHW), Alcohol and other drug treatment services in Australia 2006-07: report on the National Minimum Data Set

Australian Institute of Health and Welfare (AIHW), Australian Hospital Statistics 2000-01 (AIHW cat. no. HSE 20) to Australian Hospital Statistics 2007-08 (AIHW cat. no. HSE 71)

Australian Institute of Health and Welfare (AIHW), Disability support services: national data on services provided under the Commonwealth State/Territory Disability Agreement (AIHW cat. no. DIS 46) to (AIHW cat. no. DIS 52)

Australian Institute of Health and Welfare (AIHW), Health Expenditure Australia 2006-07 (AIHW cat. no. HWE 42)

Australian Institute of Health and Welfare (AIHW), Mental Health Services in Australia (AIHW cat. no. HSE 40) to (AIHW cat. no. HSE 74)

Australian Institute of Health and Welfare (AIHW), Residential Aged Care in Australia (AIHW cat. no. AGE 38) to (AIHW cat. no. AGE 58)

Department of Ageing, Disability, and Home Care, Home and Community Care Minimum Dataset 2006-07

NSW Department of Health, NSW Health Annual Reports 2007-08

NSW Department of Health, NSW Admitted Patients Data Collection and ABS population estimates (HOIST), Centre for Epidemiology and Research

Private Health Insurance Administration Council <http://www.phiac.gov.au/for-industry/industry-statistics/membership-statistics/>

Steering Committee for the Review of Government Service Provision (SCRGSP) 2009, Report on Government Services, Productivity Commission, Canberra

Tracey E, Alam N, Chen W, Bishop J, Cancer in New South Wales: Incidence and Mortality, Sydney: Cancer Institute NSW, November. <http://www.statistics.cancerinstitute.org.au>

WorkCover Authority of NSW, Workers Compensation Statistical Bulletins 2000-01 to 2007-08


OTHER RELATED INFORMATION

Australian Government Department of Health and Ageing, Home and Community Care Program Minimum Data Set (HACC MDS), HACC MDS Annual Bulletins

Australian Indigenous Health InfoNet

Australian Institute of Health and Welfare (AIHW), National Perinatal Statistics Unit, Australia's Mothers and Babies (AIHW cat. no. PER 25) to (AIHW cat. no. PER 40)

Australian Social Trends, Sep 2009 (cat. no. 4102.0)

Heart Foundation Heart Health Index 2009

National Centre in HIV Epidemiology and Clinical Research (NCHECR), Annual Surveillance Reports