PREVENTION AND EARLY INTERVENTION

2.1 Introduction
2.2 Prevention and Early Intervention
2.3 Health and Wellbeing
2.4 Crime

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2.1 INTRODUCTION

Prevention and early intervention is about preventing problems from happening in the first place, or stopping them from getting worse. It is about seeking to maximise people's wellbeing and health so that they can participate, be productive, and have a good quality of life.

This Chapter provides a range of information to help determine areas where prevention and early intervention strategies could assist as the population ages.

The main focus is on health issues, and so the Chapter outlines data on factors that could promote or hinder ongoing health, such as frequency of visits to a health professional, health risk factors such as smoking, and health literacy. Health literacy is a measure of the knowledge and skills required to understand and use information relating to health issues such as drugs and alcohol, disease prevention and treatment, safety and accident prevention, first aid, emergencies, and staying healthy.

The Chapter also presents a brief overview of information on the current health status of people in NSW, including long-term health conditions, and the average number of years that people can expect to live in "full health" (ie healthy life expectancy).

Finally, the Chapter looks more broadly at non-health factors that can influence ongoing wellbeing where a prevention and early intervention approach could assist. It includes information on people’s experience of crime which can affect their ongoing physical, mental and financial wellbeing. The Chapter also outlines information on causes of death including accidental death.

2.2 PREVENTION AND EARLY INTERVENTION

Health

People take a variety of actions relating to their health, including preventative care and treatment for ongoing illness or injury. In 2004-05, the proportion of people in NSW who consulted a health professional steadily increased with age, from 36% of people 45-54 years, up to 58% of those aged 75 years and over. The most common types of health related consultations taken by people 75 years and over were: visiting a general practitioner (43%), consulting other health professionals (19%) and consulting specialists (11%).

2.1 CONSULTATIONS WITH HEALTH PROFESSIONALS(a), By selected ages and sex, NSW(b) - 2004-05
	45-54	55-64	65-74	75 and over	Total persons aged 45 years and over
	%	%	%	%	'000
MALES
Consulted general practitioner	18.2	24.1	30.7	45.4	311.7
Consulted specialist	8.1	8.7	*3.9	13.6	98.5
Consulted dentist	4.3	5.7	7.4	*3.1	61.5
Consulted other health professional	11.7	11.1	14.0	22.9	161.8
Visited casualty/outpatients/ day clinic	*3.5	5.1	*4.4	*6.5	54.3
Total persons taking action(c)(d)	30.4	39.6	45.9	61.5	482.8
Total males ('000)	452.0	356.7	227.0	162.7	1 198.5
FEMALES
Consulted general practitioner	20.0	27.7	38.0	41.0	372.4
Consulted specialist	7.2	7.0	12.1	8.2	104.9
Consulted dentist	8.7	5.3	*5.8	*5.6	85.0
Consulted other health professional	14.8	21.0	16.9	17.0	220.2
Visited casualty/outpatients/ day clinic	*3.5	5.5	9.3	*6.0	71.2
Total persons taking action(c)(d)	41.2	47.0	54.1	54.7	606.4
Total females ('000)	457.6	352.8	241.2	222.3	1 273.9
PERSONS
Consulted general practitioner	19.1	25.9	34.4	42.9	684.1
Consulted specialist	7.6	7.8	8.1	10.5	203.3
Consulted dentist	6.5	5.5	6.6	4.5	146.5
Consulted other health professional	13.3	16.0	15.5	19.4	381.9
Visited casualty/outpatients/ day clinic	3.5	5.3	6.9	6.2	125.5
Total persons taking action(c)(d)	35.8	43.3	50.1	57.5	1 089.2
Total persons ('000)	909.6	709.5	468.2	385.1	2 472.4
* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) In the two weeks prior to interview.
(b) Percentages calculated using total persons in each sex and age group.
(c) Includes persons who were discharged from a stay in hospital in the two weeks prior to interview.
(d) As people may undertake more than one type of action, components may not add to total.
Source: ABS data available on request, National Health Survey: Summary of Results; State Tables, 2004-05, (cat. no. 4362.0).

Health risks and conditions

A range of factors influence the health outcomes of a given individual or population. These include the interaction of socioeconomic, biomedical and environmental factors which contribute to illness and injury. There are also specific lifestyle behaviours, such as smoking, exercise and dietary habits, which may further affect one's health. In addition to these lifestyle behaviours there are other risk factors, such as high blood pressure and high cholesterol, that are associated with increased risk of diseases such as coronary heart disease and stroke. A growing awareness of health risks and preventative measures, often the result of early warnings of health problems, are contributing to longer life expectancy and a better quality of life in later years.

Health risks associated with smoking include cardiovascular disease, cancer, emphysema, bronchitis and stroke. In 2004-05, 24% of people aged 45-54 years were smokers. A higher proportion of females aged 75 years and over had never smoked (69%) compared with males at the same age (31%).

Excessive alcohol consumption can be harmful and is associated with a number of chronic diseases and conditions. However, low to moderate alcohol consumption is associated with positive health outcomes, including protection from certain types of cardiovascular conditions. In 2004-05, of all people aged 18 years and over, 87% did not drink alcohol or drank at a low risk level, while 13% drank alcohol at risky or high risk levels. The proportion of people with a risky or high risk alcohol status decreased with age, with 15% of those aged 45-54 years having a risky or high risk alcohol status, compared to 5.1% of those aged 75 years and over. More than 16% of males in the 65-74 year age group recorded having a risky or high risk alcohol status compared with 12% of females of the same age group.

Participating in regular physical exercise reduces the risk of cardiovascular disease and other medical conditions such as osteoporosis and diabetes. In 2004-05, in the two weeks prior to interview, 78% of females aged 65-74 years reported they were sedentary or only undertook low level exercise, compared with 63% of males. Similarly, 76% of females and 67% of males aged 18 years and over reported they were sedentary or only undertook low level exercise.

The Body Mass Index (BMI) is a composite measure of a person's body weight against their height, and is used to allocate people into four groups: underweight, normal weight, overweight or obese. In 2004-05, 54% of all people were reported as being overweight or obese according to the BMI. Almost two-thirds (65%) of all persons aged 55-64 years were reported as being overweight or obese. A higher proportion of males aged 45-54 years were overweight or obese (73%) than women in the same age group (50%).

In 2004-05, approximately 354,500 people aged 55-74 years in NSW had high blood pressure, and 230,000 people had high blood cholesterol.

2.3 HEALTH RISK FACTORS, By selected ages and sex, NSW - 2004-05
			45-54	55-64	65-74	75 and over	Total persons aged 18 years and over
MALES
Smoker status
	Smoker	%	24.2	19.6	14.8	*3.1	25.1
	Ex-smoker	%	36.8	48.0	60.8	66.4	34.9
	Never smoked	%	39.0	32.4	24.4	30.5	40.0
	Total	'000	452.0	356.7	227.0	162.7	2 485.9
Alcohol status(a)
	Did not drink/low risk	%	83.7	84.1	83.7	95.5	85.0
	Risky/high risk	%	16.3	15.9	16.3	*4.6	15.0
	Total	'000	452.0	356.7	227.0	162.7	2 485.9
Exercise level
	Sedentary	%	36.4	37.4	27.6	49.0	33.9
	Low	%	33.5	32.2	35.1	22.2	33.2
	Moderate/high	%	30.1	30.4	37.4	28.8	32.9
	Total	'000	452.0	356.7	227.0	162.7	2 485.9
Body Mass(b)
	Underweight/normal	%	27.4	28.5	44.2	44.6	38.0
	Overweight	%	47.4	49.9	38.6	44.3	42.5
	Obese	%	25.2	21.6	17.2	11.2	19.4
	Total(c)	'000	422.0	345.2	219.0	152.3	2 353.8
High blood cholesterol(d)		%	43.3	64.5	59.1	31.6	na
High blood pressure(e)		%	68.6	94.1	66.9	58.0	na
Daily serves of vegetables
	4 serves or less	%	88.1	87.3	84.0	85.9	89.7
	5 serves or more	%	11.9	12.7	16.0	14.1	10.3
	Total(f)	'000	452.0	356.7	227.0	162.7	2 485.9
Daily serves of fruit
	1 serve or less	%	51.4	44.1	41.7	38.5	52.1
	2 serves or more	%	48.6	55.9	58.3	61.5	47.9
	Total(g)	'000	452.0	356.7	227.0	162.7	2 485.9
FEMALES
Smoker status
	Smoker	%	24.2	14.1	10.7	*3.5	19.8
	Ex-smoker	%	32.5	26.1	29.0	27.9	24.6
	Never smoked	%	43.2	59.8	60.3	68.6	55.6
	Total	'000	457.6	352.8	241.2	222.3	2 561.8
Alcohol status(a)
	Did not drink/low risk	%	86.7	86.4	87.8	94.5	88.9
	Risky/high risk	%	13.3	13.7	12.2	*5.5	11.1
	Total	'000	457.6	352.8	241.2	222.3	2 561.8
Exercise level
	Sedentary	%	37.5	33.4	43.8	64.8	37.3
	Low	%	42.3	36.0	34.2	26.5	38.2
	Moderate/high	%	20.2	30.5	21.9	8.7	24.5
	Total	'000	457.6	352.8	241.2	222.3	2 561.8
Body Mass(b)
	Underweight/normal	%	50.2	42.6	41.5	63.8	54.8
	Overweight	%	31.9	31.5	34.4	24.9	28.7
	Obese	%	17.9	25.9	24.1	11.4	16.5
	Total(c)	'000	404.2	324.9	211.5	186.7	2 291.3
High blood cholesterol(d)		%	41.0	57.3	49.1	51.4	na
High blood pressure(e)		%	55.9	96.0	97.5	82.1	na
Daily serves of vegetables
	4 serves or less	%	83.3	79.4	82.6	89.8	86.3
	5 serves or more	%	16.7	20.6	17.4	10.2	13.7
	Total(f)	'000	457.6	352.8	241.2	222.3	2 561.8
Daily serves of fruit
	1 serve or less	%	43.5	29.4	33.5	34.1	40.1
	2 serves or more	%	56.5	70.6	66.5	65.9	59.9
	Total(g)	'000	457.6	352.8	241.2	222.3	2 561.8
PERSONS
Smoker status
	Smoker	%	24.2	16.8	12.7	*3.3	22.4
	Ex-smoker	%	34.7	37.1	44.4	44.2	29.7
	Never smoked	%	41.1	46.0	42.9	52.5	47.9
	Total	'000	909.6	709.5	468.2	385.1	5 047.7
Alcohol status(a)
	Did not drink/low risk	%	85.2	85.2	85.8	94.9	87.0
	Risky/high risk	%	14.8	14.8	14.2	5.1	13.0
	Total	'000	909.6	709.5	468.2	385.1	5 047.7
Exercise level
	Sedentary	%	36.9	35.4	35.9	58.1	35.6
	Low	%	37.9	34.1	34.6	24.7	35.8
	Moderate/high	%	25.1	30.5	29.4	17.2	28.6
	Total	'000	909.6	709.5	468.2	385.1	5 047.7
Body Mass(b)
	Underweight/normal	%	38.6	35.3	42.9	55.2	46.3
	Overweight	%	39.8	41.0	36.6	33.5	35.7
	Obese	%	21.6	23.7	20.6	11.3	18.0
	Total(c)	'000	826.2	670.1	430.5	339.0	4 644.9
High blood cholesterol(d)		%	84.3	121.8	108.2	83.0	na
High blood pressure(e)		%	124.5	190.1	164.4	140.2	na
Daily serves of vegetables
	4 serves or less	%	85.7	83.4	83.3	88.2	88.0
	5 serves or more	%	14.3	16.6	16.7	11.8	12.0
	Total(f)	'000	909.6	709.5	468.2	385.1	5 047.7
Daily serves of fruit
	1 serve or less	%	47.4	36.8	37.5	36.0	46.1
	2 serves or more	%	52.6	63.2	62.5	64.0	53.9
	Total(g)	'000	909.6	709.5	468.2	385.1	5 047.7
* estimate has a relative standard error of 25% to 50% and should be used with caution
na not available
(a) Based on Australian Alcohol Guidelines 2001.
(b) Based on self-reported height and weight.
(c) Excludes 'Body Mass Not Known'.
(d) High blood cholesterol which has lasted or is expected to last 6 months or more.
(e) High blood pressure which has lasted or is expected to last 6 months or more.
(f) Includes 'Does not eat vegetables'.
(g) Includes 'Does not eat fruit'.
Source: National Health Survey: Summary of Results: State Tables, 2004-05 (cat. no. 4362.0); ABS data available on request, National Health Survey, 2004-05.

2.3 HEALTH AND WELLBEING

Healthy life expectancy

The World Health Organization (WHO) defines health-adjusted life expectancy (HALE) as the average number of years a person can expect to live in "full health" by taking into account years lived in less than full health due to disease and/or injury. Australia's healthy life expectancy is among the highest in the world. In 2003, males in NSW could expect to live 70.5 years of life without reduced functioning while females could expect to live 75.3 years.

2.4 HEALTH-ADJUSTED LIFE EXPECTANCY AND LIFE EXPECTANCY AT BIRTH LOST DUE TO DISABILITY(a), By sex, NSW - 2003
		Males	Females	Persons
Health-adjusted life expectancy (years)
	At birth	70.5	75.3	72.9
	At age 60	17.1	20.6	18.9
Life expectancy lost due to disability (%)
	At birth	9.8	9.5	9.6
(a) See Glossary for more detail.
Source: The burden of disease and injury in Australia 2003, AIHW (cat. no. PHE 82).

Self-assessed health

Many older people view their health in a positive way, even though older age may be associated with increasing levels of disability and illness. In 2004-05, people aged 75 years and over assessed their health as either very good or good (57%), excellent (6.4%), or fair or poor (37%). The proportion of people reporting fair or poor health increased with age, with 9.1% of people aged 15-44 years reporting fair or poor health, compared with 37% of those aged 75 years and over. More than 41% of males aged 75 years and over reported fair or poor health status, compared with 34% of females in the same age group. In 2004-05, 46% of Aboriginal and Torres Strait Islander people in NSW aged 55 years and over, reported their health as fair or poor (For more information please refer to the Population Ageing in New South Wales, 2008 electronic datacubes on the ABS website).

2.5 SELF-ASSESSED HEALTH STATUS, By selected ages and sex, NSW - 2004-05
	Age group (years)
	15-44	45-54	55-64	65-74	75 and over
	%	%	%	%	%
MALES
Excellent	24.8	19.0	11.8	15.4	5.9
Very good/good	65.7	65.3	60.4	45.9	53.0
Fair/poor	9.5	15.7	27.8	38.8	41.1
Total males ('000)	1 423.2	452.0	356.7	227.0	162.7
FEMALES
Excellent	26.1	20.5	15.8	11.7	6.7
Very good/good	65.2	64.0	57.4	57.9	59.3
Fair/poor	8.7	15.5	26.8	30.5	34.0
Total females ('000)	1 412.8	457.6	352.8	241.2	222.3
PERSONS
Excellent	25.5	19.7	13.8	13.5	6.4
Very good/good	65.4	64.6	58.9	52.1	56.7
Fair/poor	9.1	15.6	27.3	34.5	37.0
Total persons ('000)	2 835.9	909.6	709.5	468.2	385.1
Source: National Health Survey: Summary of Results; State Tables, 2004-05, (cat. no. 4362.0).

A long-term health condition is a condition expected to last six months or more. In 2004-05, almost all persons aged 75 years and over reported at least one long-term condition. The long-term health conditions most frequently reported by people aged 75 years and over were long sightedness (66%), arthritis (48%), deafness (42%), short sightedness (37%), high blood pressure (36%) and high cholesterol (22%).

2.6 LONG-TERM HEALTH CONDITIONS(a), By age, NSW - 2004-05
	Age group (years)(b)
	0-44	45-54	55-64	65-74	75 and over
	%	%	%	%	%
Arthritis	3.2	19.4	38.9	48.1	48.1
Asthma	9.5	7.4	9.1	12.1	7.9
Back pain problems or disc disorders	9.3	22.4	22.9	22.4	17.9
Bronchitis or emphysema	1.5	2.6	5.3	7.9	8.0
Chronic sinusitis	8.3	11.1	12.4	12.7	9.6
Deafness (total or partial)	3.7	9.4	18.4	27.8	42.1
Diabetes mellitus	0.6	3.9	8.0	17.0	14.8
Diseases of the digestive system	3.4	7.4	13.5	16.1	16.4
Hayfever and allergic rhinitis	14.0	17.6	12.3	10.4	9.3
High cholesterol	1.3	9.3	17.2	23.1	21.6
High blood pressure	1.9	13.7	26.8	35.1	36.4
Ischaemic heart diseases	*0.1	*0.7	3.6	7.2	11.8
Long sightedness	8.8	54.1	65.7	68.3	66.4
Mental and behavioural problems	9.1	12.3	10.1	8.3	9.3
Migraine	5.9	10.0	5.8	5.4	*2.1
Neoplasms	0.5	2.3	3.7	5.3	4.4
Osteoporosis	0.4	*1.7	6.3	13.9	17.4
Short sightedness	14.3	29.7	36.4	34.9	36.7
Other	27.4	46.1	54.1	68.2	74.0
Total with long-term health conditions(c)	61.4	93.3	99.5	99.3	99.8
Total persons ('000)	4 153.1	909.6	709.5	468.2	385.1
* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) Conditions which have lasted or are expected to last for 6 months or more.
(b) Percentages calculated using total persons in each age group.
(c) Persons may have reported more than one type of condition and therefore components may not add to totals.
Source: National Health Survey: Summary of Results; State Tables, 2004-05, (cat. no. 4362.0).

Dementia is a broad term used to describe symptoms such as loss of memory, intellect, social skills and rationality, causing a progressive decline in a person's functioning. In 1998, 3.9% of persons aged 65 years and over were affected by dementia compared to 3.4% in 2003. In 2003, dementia occurred more frequently in people aged 85 years and over (14%) compared with those aged 65-84 years (2.0%), and was more common in females aged 85 years and over than males of the same age (18% and 7.2% respectively). With the projected ageing of the population, the number of older people affected by dementia and demand for dementia-related services is expected to increase (footnote 1).

2.8 DEMENTIA, By selected ages and sex, NSW
		Males	Females	Persons	Males	Females	Persons
		'000	'000	'000	%	%	%
1998
Age group (years)
	65-84	*7.3	*9.0	16.2	*2.2	*2.2	2.2
	85 and over	*3.3	12.0	15.3	*14.2	21.7	19.4
Total persons aged 65 years and over		10.6	21.0	31.5	3.0	4.6	3.9
2003
Age group (years)
	65-84	5.8	9.5	15.3	1.6	2.3	2.0
	85 and over	*2.2	12.0	14.2	*7.2	17.7	14.4
Total persons aged 65 years and over		8.0	21.5	29.5	2.1	4.4	3.4
* estimate has a relative standard error of 25% to 50% and should be used with caution
Source: ABS data available on request, Survey of Disability, Ageing and Carers (cat. no. 4430.0).

Disability is defined as any limitation, restriction or impairment which has lasted, or is likely to last, for at least six months and restricts everyday activities. Types of disability range from hearing loss which requires the use of a hearing aid, to difficulty dressing due to arthritis, to advanced dementia requiring constant help and supervision. Core activity limitation refers to a limitation in the core activities of self care, communication or mobility, and the levels of severity of these limitations are profound, severe, moderate, and mild. In 2003, the prevalence of disability increased with age, with 65% of people aged 75 years and over reporting a disability, and 32% reporting a profound or severe core activity limitation.

2.10 DISABILITY STATUS, By age and sex, NSW - 2003
		Under 25	25-44	45-54	55-64	65-74	75 and over	Total persons
		%	%	%	%	%	%	%
MALES
With a disability
	Profound core activity limitation	1.9	*0.9	*1.3	*0.9	4.7	19.0	2.4
	Severe core activity limitation	1.6	1.4	2.7	4.8	5.5	6.6	2.5
	Moderate core activity limitation	*0.5	1.5	4.0	7.1	10.0	9.1	3.0
	Mild core activity limitation	2.1	2.2	6.5	11.0	15.2	27.3	5.7
	Schooling or employment restriction	1.5	1.6	2.6	*1.8	-	-	1.5
	No specific limitations of restrictions	1.7	2.5	2.7	3.8	6.6	*3.3	2.7
	Total with a disability	9.1	10.1	19.7	29.4	42.0	65.2	17.9
Without a disability		90.9	89.9	80.3	70.6	58.0	34.8	82.1
Total males ('000)		1 138.8	997.4	450.2	338.9	220.2	163.0	3 308.5
FEMALES
With a disability
	Profound core activity limitation	*0.9	*0.7	*1.0	3.3	6.6	25.9	3.3
	Severe core activity limitation	1.1	1.4	2.9	4.8	6.0	9.6	2.8
	Moderate core activity limitation	*0.2	*0.8	4.1	6.0	9.3	8.9	2.8
	Mild core activity limitation	1.7	2.4	5.5	11.1	11.6	17.4	5.2
	Schooling or employment restriction	1.4	1.9	*1.4	*1.9	-	-	1.4
	No specific limitations of restrictions	1.6	2.1	*2.2	*2.9	7.7	*2.9	2.5
	Total with a disability	6.9	9.2	17.2	29.9	41.2	64.8	17.9
Without a disability		93.1	90.8	82.8	70.1	58.8	35.2	82.1
Total females ('000)		1 092.2	990.6	445.1	330.1	236.9	247.7	3 342.7
PERSONS
With a disability
	Profound core activity limitation	1.4	0.8	*1.1	2.1	5.7	23.2	2.9
	Severe core activity limitation	1.3	1.4	2.8	4.8	5.8	8.4	2.6
	Moderate core activity limitation	*0.4	1.1	4.0	6.5	9.6	9.0	2.9
	Mild core activity limitation	1.9	2.3	6.0	11.0	13.3	21.3	5.5
	Schooling or employment restriction	1.4	1.8	2.0	1.8	-	-	1.5
	No specific limitations of restrictions	1.6	2.3	2.5	3.4	7.2	3.0	2.6
	Total with a disability	8.0	9.7	18.4	29.6	41.6	64.9	17.9
Without a disability		92.0	90.3	81.6	70.3	58.4	35.0	82.1
Total persons ('000)		2 231.0	1 988.1	895.3	669.1	457.2	410.7	6 651.2
* estimate has a relative standard error of 25% to 50% and should be used with caution
- nil or rounded to zero (including null cells)
Source: ABS data available on request, Survey of Disability, Ageing and Carers, 2003 (cat. no. 4430.0).

Causes of death

Significant improvements in adult life expectancy are due to a combination of factors, including improved living standards, medical treatments and healthier lifestyles.

A strong indicator for the improving health of the population is the declining death rate, which decreased in NSW from 728 per 100,000 persons in 1996 to 675 per 100,000 in 2006. In 1996, ischaemic heart disease was the leading cause of death for people aged 75-84 years (1,590 per 100,000) - in 2006 this had fallen by almost half to 805 per 100,000 persons. In 2006, the most common causes of death for people aged 75-84 years old were all types of cancer (C00-D48) (1,361 deaths per 100,000), followed by ischaemic heart disease (I20-I25) (805 per 100,000 persons), diseases of the respiratory system (J00-J99) (453 per 100,000 persons) and stroke (I60-I69) (452 per 100,000 persons).

2.11 DEATH RATES (a), Selected causes of death, By age, NSW(b)(c)
	Under 45	45-54	55-64	65-74	75-84	85 and over	Total persons(c)(d)
	rate	rate	rate	rate	rate	rate	rate
1996
Ischaemic heart diseases (I20-I25)	3.1	42.1	168.7	502.8	1 589.7	4 205.2	171.2
Cancer (C00-D48)	12.9	125.5	349.1	793.2	1 446.9	2 096.2	195.6
Stroke (I60-I69)	1.2	9.2	39.9	157.1	715.7	2 588.8	75.3
Diseases of the respiratory system (J00-J99)	1.8	9.5	49.0	212.0	541.4	1 293.7	58.9
Dementia (F00-F03)	np	np	1.5	11.7	118.2	665.4	13.3
Diseases of the digestive system (K00-K93)	1.8	14.0	35.6	63.2	145.6	488.3	22.1
Diseases of the genitourinary system (N00-N99)	0.2	1.4	8.6	26.0	129.3	405.5	12.8
Diabetes (E10-E14)	0.5	4.2	13.3	46.0	111.4	242.7	12.7
Accidents (V01-X59)	16.2	17.8	20.6	30.6	82.7	244.2	23.1
All causes	82.9	283.0	793.4	2 134.4	5 795.4	15 528.4	727.5
2006
Ischaemic heart diseases (I20-I25)	2.4	26.4	74.6	214.5	805.4	3 050.0	117.3
Cancer (C00-D48)	10.7	100.3	278.9	667.3	1 361.3	2 129.8	198.4
Stroke (I60-I69)	1.2	9.9	19.5	87.5	451.7	1 855.7	62.6
Diseases of the respiratory system (J00-J99)	1.4	5.0	27.7	127.3	452.9	1 345.3	57.5
Dementia (F00-F03)	np	np	2.6	15.3	137.1	936.4	23.3
Diseases of the digestive system (K00-K93)	1.5	15.4	23.1	49.2	126.2	434.9	22.2
Diseases of the genitourinary system (N00-N99)	0.1	2.1	4.7	28.3	131.4	510.4	17.6
Diabetes (E10-E14)	0.3	3.4	9.7	41.1	106.4	258.8	14.0
Accidents (V01-X59)	16.6	21.2	16.4	26.0	72.3	282.2	24.9
All causes	61.4	235.6	544.1	1 474.7	4 440.3	13 870.5	675.4
np not available for publication but included in totals where applicable, unless otherwise indicated
(a) Based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision - Australian Modification (ICD-10-AM) from 1997 onwards. For 1996, the International Statistical Classification of Diseases and Related Health Problems, 9th Revision (ICD-9) was used. Refer to the Appendix of Causes of Death, Australia, 2006 (cat. no. 3303.0) for more detail.
(b) State of usual residence.
(c) Death rate per 100,000 of the mid-year 2006 estimated resident population. See Glossary for more detail.
(d) Total includes deaths where age at death was not stated.
Source: Causes of Death, Australia (cat.no. 3303.0).

In 2006, fatalities resulting from road traffic accidents in NSW occurred at a higher rate for vehicle occupants compared to pedestrians. The highest fatality rate for vehicle occupants was among persons aged 17-24 years (17.7 deaths per 100,000) whereas the lowest was for people aged under 17 years (1.8 deaths per 100,000). Of pedestrian fatalities, persons aged 85 years and over had the highest death rate (4.5 deaths per 100,000), and persons aged under 17 years had the lowest death rate (0.3 deaths per 100,000).

2.12 ROAD TRAFFIC INJURIES AND FATALITIES, By age, NSW - 2006
	Fatalities				Injuries
	Vehicle occupants(a)(b)		Pedestrians(b)		Vehicle occupants(a)(b)		Pedestrians(b)
Age group (years)	no.	rate	no.	rate	no.	rate	no.	rate
Under 17	28	1.8	5	0.3	1 274	83.9	316	20.8
17-24	132	17.7	9	1.2	5 907	793.9	430	57.8
25-34	73	7.6	11	1.1	4 590	476.1	293	30.4
35-44	62	6.2	7	0.7	3 728	374.2	227	22.8
45-54	43	4.6	6	0.6	2 870	307.9	198	21.2
55-64	30	4.1	7	0.9	1 799	243.1	173	23.4
65-74	31	6.5	13	2.7	934	195.6	155	32.5
75-84	19	5.7	9	2.7	645	194.3	113	34.0
85 and over	6	5.4	5	4.5	120	107.8	43	38.6
Age unknown	-	. .	-	. .	1 445	. .	178	. .
Total persons	424	6.2	72	1.1	23 312	342.0	2 126	31.2
. . not applicable
- nil or rounded to zero (including null cells)
(a) Includes motor vehicle drivers and passengers, motorcycle riders and passengers and pedal cycle riders and passengers.
(b) Rate is the age-standardised rate per 100,000 estimated resident population at June 2006.
Source: Data available on request, NSW Roads and Traffic Authority; Population by Age and Sex, Australian States and Territories (cat. no. 3201.0).

In 2006, injury rates were higher than fatality rates for both vehicle occupants and pedestrians of all ages. Vehicle occupants aged 17-24 years had the highest injury rate (793.9 per 100,000) whereas occupants aged under 17 years had the lowest injury rate (83.9).
2.4 CRIME

Wellbeing can be strongly affected by the fear of crime as well as the direct experience of crime victimisation. People who witness crimes, or come across evidence of crime in their local area, can suffer anxiety and may feel demoralised or powerless. People may adjust their behaviour or take actions to secure their house and property. All these actions can affect the physical and financial wellbeing of those involved.

2.13 VICTIMS AND NON-VICTIMS OF PERSONAL CRIME(a), By selected ages and sex, NSW - April 2007
		Victims	Non-victims	Total	Victimisation rate(b)
		'000	'000	'000	%
MALES
Age group (years)
	15-24	58.7	407.6	466.3	12.6
	25-34	42.6	432.7	475.3	9.0
	35-44	23.9	468.2	492.1	4.9
	45-54	23.7	442.6	466.2	5.1
	55-64	113.0	369.9	381.2	3.0
	65 and over	*6.1	407.7	413.7	*1.5
Total males aged 15 years and over		166.3	2 528.5	2 694.8	6.2
FEMALES
Age group (years)
	15-24	35.0	413.5	448.4	7.8
	25-34	26.1	449.3	475.5	5.5
	35-44	19.1	477.6	496.6	3.8
	45-54	14.5	457.9	472.4	3.1
	55-64	8.7	373.1	381.8	2.3
	65 and over	*2.9	479.0	481.9	*0.6
Total females aged 15 years and over		106.2	2 650.4	2 756.7	3.9
PERSONS
Age group (years)
	15-24	93.7	821.0	914.7	10.2
	25-34	68.7	882.0	950.7	7.2
	35-44	42.9	945.8	988.7	4.3
	45-54	38.1	900.5	938.6	4.1
	55-64	20.0	743.0	763.0	2.6
	65 and over	*8.9	886.7	895.7	*1.0
Total persons aged 15 years and over		272.5	5 179.0	5 451.5	5.0
* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) Robbery, assault and sexual assault. Survey scope is all persons aged 15 years and over.
(b) Proportion of total persons.
Source: Crime and Safety, NSW, April 2007 (cat. no. 4509.1).

In 2007, persons aged 65 years and over in NSW recorded the lowest victimisation rate for personal crime when compared to other age groups. Both males (1.5%) and females (0.6%) aged 65 years and over recorded low victimisation rates. In comparison, the 15-24 years age group recorded the highest victimisation rate for both males (13%) and females (7.8%).

Personal fraud has been recognised as a crime type that is a growing threat to the community, as a result of the rapid expansion and availability of Internet technology and the increase in electronic storage, transmission and sharing of data. Fraud is a crime where the offender aims to gains advantage over a victim by means of deception, whether financial or otherwise.

2.14 VICTIMS OF PERSONAL FRAUD(a), By selected ages, NSW - 2007
			15-24	25-34	35-44	45-54	55 and over	Total persons aged 15 years and over
Identity fraud(b)
	Persons(c)	'000	*22.7	*41.9	41.5	36.8	24.0	166.8
	Victimisation rates	%	*2.5	*4.5	4.3	4.0	1.5	3.1
Selected scams(d)
	Persons(c)	'000	*14.1	*19.2	*21.1	*16.5	*22.2	93.1
	Victimisation rates	%	*1.6	*2.1	*2.2	*1.8	*1.4	1.7
Total victims		'000	36.8	61.1	61.8	51.5	44.2	255.4
Non-victims		'000	866.7	874.9	912.4	879.0	1 572.2	5 105.1
* estimate has a relative standard error of 25% to 50% and should be used with caution
(a) Survey scope is all persons aged 15 years and over.
(b) Includes credit card fraud and identity fraud.
(c) Persons may be a victim of more than one type of fraud.
(d) Includes lottery scams, pyramid scams, chain letters, advance fee scams, financial advice scams, phishing and other scams.
Source: ABS data available on request, Personal Fraud Survey, 2007 (cat. no. 4528.0).

Identity fraud is the theft of a pre-existing identity without the person's consent, where the person's name, date of birth, address or other personal details are used to engage in fraudulent activities such as conducting business, opening accounts, taking out loans or avoiding criminal liability.

In 2007, 166,800 people were victims of identity fraud in NSW, of whom 24,000 were aged 55 years and over, a victimisation rate of 1.5%. The majority of victims of identity fraud were aged 25-44 years with victimisation rates of 4.5% for those aged 25-34 years and 4.3% for those aged 35-44 years.

A scam is a fraudulent invitation, request, notification or offer, designed to obtain someone's personal information or money or otherwise obtain a financial benefit by deceptive means.

In 2007, 93,100 people were victims of selected scams of whom 22,200 were aged 55 years and over, a victimisation rate of 1.4%. The victimisation rates for scams was lower than the victimisation rates of identity fraud for all ages. The 25-34 year and 35-44 year age groups had high scam rates of 2.1% and 2.2% respectively.

There can be a number of factors contributing to the level of safety people feel when home alone. These factors can include: perceptions of crime levels in their vicinity; previous experience as a victim of assault or household break-in; relationships with people living nearby; sense of their own strength and capacity to be in control; and their level of trust in their local community.

2.15 FEELINGS OF SAFETY WHEN HOME ALONE, By selected ages and sex, NSW - 2005
		Safe or very safe	Neither safe nor unsafe	Unsafe or very unsafe	Never home alone during the period	Total
		%	%	%	%	'000
MALES
During the day
	45-54 years	84.1	7.6	3.1	5.2	453.5
	55-64 years	80.9	10.8	3.7	4.6	361.4
	65-74 years	82.0	8.9	*4.2	*4.8	243.5
	75 years and over	78.4	10.7	*4.9	*6.0	149.4
After dark
	45-54 years	80.6	11.3	4.8	3.4	453.5
	55-64 years	79.8	11.3	5.5	3.5	361.4
	65-74 years	74.4	12.4	6.0	7.2	243.5
	75 years and over	72.0	12.6	*6.8	8.5	149.4
FEMALES
During the day
	45-54 years	81.8	9.2	5.6	3.3	459.3
	55-64 years	81.6	10.2	4.6	3.6	355.6
	65-74 years	75.8	13.2	5.4	5.6	269.2
	75 years and over	77.9	11.0	*6.0	*5.1	197.1
After dark
	45-54 years	70.0	16.0	9.6	4.4	459.3
	55-64 years	69.8	15.1	9.1	6.1	355.6
	65-74 years	63.4	19.2	8.1	9.4	269.2
	75 years and over	65.8	15.8	8.1	10.3	197.1
* estimate has a relative standard error of 25% to 50% and should be used with caution
Source: ABS data available on request, Crime and Safety Survey, 2005 (cat. no. 4509.0).

In 2005, the majority of males and females in NSW felt safe or very safe when home alone, though the proportion of people who felt safe or very safe decreased with age. People feel more safe during the day than after dark when home alone. Males aged 45-54 years felt safe or very safe when home alone during the day (84%) and after dark (81%). Similarly, females aged 45-54 years felt safe or very safe when home alone during the day (82%) and after dark (70%). Females aged 65-74 years reported a difference between feelings of safety during the day and after dark: 76% of females aged 65-74 years felt safe or very safe during the day and only 63% felt safe or very safe after dark.

1 Australian Institute of Health and Welfare, 2004, Australia's Health 2004, Canberra: AIHW, p. 380. <back
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