Wide Bay Health Atlas 2019

™
Pop
the PHCAtlas™
population health profiling

needs assessment + commissioning : an overview
Wide Bay Region
[WBML/WBHHS] | 09/2013
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CENTRAL ADELAIDE AND HILLS
Part1
Introduction to Population Health Commissioning Atlas™ (PHCAtlas™) Concept
Contents Introduction to the PHCAtlas™

This PHCAtlas™ brings together available information from a range of sources to create a population
health profile and utilises the National Health Performance Authority (NHPA) Indicators for Medicare
Part 1 Locals (MLs)1 as a starting point for analysis. A key focus is on highlighting variations in health status and
health service utilisation. The PHCAtlas™ value adds where possible by drawing on additional sources (i.e.
2 Introduction to the local intelligence, stakeholders' views and published reports) to inform the commentary. The intent is to
Population Health provide an information rich and visual document for decision makers who are setting priorities for both the
Commissioning Atlas™ Medicare Local and Hospital & Health Service, as well as recommendations for commissioning and further
Concept in-depth analysis or planning.
A broad range of data sources are used including the Australian Bureau of Statistics (ABS), Medicare
4 Demographics + Social Australia, the Australian Institute of Health and Welfare (AIHW) and various other reports. Many of the
Determinants of Health prevalence maps generated rely on a data set for Medicare Locals provided by the Public Health Information
Development Unit (PHIDU) using synthetic (modelled) data estimates. These estimates should be used
with caution and treated only as indicative of the prevalence of each health indicator in a Statistical Local
Part 2 Area (SLA). In future, data from general practices could provide richer and more up to date aggregated
9 Population Health + data sets for analysis. The Wide Bay Medicare Local is compared to the other 60 MLs for a range of NHPA Key
Profiling [1-5] Performance Indicators, by ranking and assignment within a quintile range – the highest ranked position
having the greatest health need. A colour coding system is used for the quintiles for ease of visualisation.
The darker the colour, the greater the health need, relative to other MLs. The SLAs of highest demand are
Part 3 highlighted within the region.
14 Wide Bay Region
Health Domains + Determinants of Health
Medicare Local Data Social, environmental and economic factors play a significant
Benchmarking role in shaping the health and wellbeing of individuals and
populations and are commonly referred to as the social
16 SLA Analysis determinants of health (SDH) as shown in Figure 1.1. Evidence
documenting the contribution of the SDH to population
17 Potential Needs health outcomes is well established and undisputed, leading
Assessed in each Wide international, national and regional health authorities to
Bay Region Health act to address these factors. The links between SDH and
Domain the development of diseases such as chronic conditions Figure 1.1 Social
are complex, although usually associated with access to Determinants of Health
Potential Needs of opportunities and resources such as quality education, Source: Dahlgren G, Whitehead M 4
18 adequate and meaningful employment, safe and affordable
Specific Populations at
housing, accessible transport, nutritious food, safe local environments and accessible health services.
Risk Within Wide Bay Income also plays a critical role as it provides flexibility and options, enabling people to access the SDH
Region they need. SDH underpin health and influence the movement of individuals and populations across the
Population Health disease continuum.2,3
Part 4
Needs + Commissioning
Figure 1.2 Population Health by Stages of Disease Continuum
19
Approach Controlled
Well Population At Risk Established Disease Chronic Disease
20 Commissioning Primary Secondary Prevention/ Disease Management and Tertiary Prevention
Recommendations for Prevention Early Detection
Wide Bay Region • Promotion of healthy • Screening • Treatment & Acute Care • Continuing Care
behaviours & environments • Case finding • Complications management • Maintenance
across the life course • Periodic health examinations • Rehabilitation
21 References • Universal & targeted • Early intervention • Self management
approaches
• Control risk factors –
lifestyle and medication
• Public health • Primary health care • Specialist services • Primary health care
• Primary health care • Public health • Hospital care • Community care
• Other sectors • Primary health care
Health Health Health Health
Promotion Promotion Promotion Promotion
Ÿ Ÿ Ÿ
Prevent Movement To The “At Prevent Progression To Established Prevent/Delay Progression To
Risk” Group Disease & Hospitalisation Complications & Prevent Readmissions
The Wide Bay Medicare Local and Wide Bay Source: NPHP 5
Hospital & Health Services acknowledge and
respect the Traditional Owners of the Wide Bay The above framework has been used to guide the development of the Population Health Commissioning
Burnett region’s ancestral lands. We acknowledge Atlas. It describes the population health chronic disease continuum from a well population to the
the Wulli Wulli, Wakka Wakka, Taribelang Bunda,
KabiKabi, Gurang, Gooreng Gooreng, Butchulla, development of risk factors, through to the progression of established chronic disease patterns. It recognises
peoples of this land. We acknowledge the Elders the interconnections between the socio-economic and environmental conditions in which people live
past and present and respect the deep feelings of and their access to health and other services has a direct impact on the health status of a population.
attachment and relationship of Aboriginal peoples
to Country.
Action to improve health status needs to occur at each level of the continuum. It recognises a wide range
of collaborative partnerships with multiple stakeholders and sectors will be required to achieve improved
Cover Image: Courtesy of Tourism Queensland, population health and well being outcomes.5 Medicare Locals and Hospital and Health Services are in a prime
Hervey Bay Aerial, image #101926. position to drive these improvements and fulfil their mandate under the National Health Reform agenda. 6
2 Population Health Commissioning Atlas™

Wide Bay Region The Challenge + At a Glance
The Challenge
Wide Bay Medicare Local AND Wide Bay Hospital & Health Services7,8
The Wide Bay Medicare Local (WBML) and Wide Bay Hospital and Health Service (WBHHS) are working
in partnership to deliver a healthier future for Wide Bay residents. By working together, we can better
respond to local health needs, address gaps in local health services and maintain health and wellbeing
through a balanced investment across the entire health continuum. To more effectively plan and deliver
future services, both in the community and in the hospital setting, it is important to have access to accurate
and comprehensive population health data.
That is why we have jointly commissioned the Population Health Atlas to enable us to better understand
health and disease in the Wide Bay region and the associated social determinants of health. Having access Adrian Pennington, CE Shane Dawson, CEO
to this important information will enable us to match services to local health needs and set priorities Wide Bay Hospital & Health Service Wide Bay Medicare Local
for addressing the progression of established chronic disease patterns. Importantly, this information also
provides us with the opportunity to maintain and improve health and wellbeing for the community by
addressing some of the root causes of poor health and illness.
At A Glance
Map 1.1 Wide Bay Regional Councils and Population Boundary The Wide Bay region is located on
the coast of Queensland approx 170-400 kms
north of Brisbane. It is bounded by the Sunshine
Council SLA Group/No.
Coast to the south, Darling Downs to the south-
Monto (1) west and Fitzroy region to the north.
Eidsvold (2)
Mundubbera (3)
Geography The Wide Bay region is on the
1 eastern slope of the Great Dividing Range and
Perry (4) has an agricultural and tourism based economy.
Gayndah (5) It includes Fraser Island, the largest island on
the east coast of Australia. The main towns are
Biggenden (6) Hervey Bay, Bundaberg and Maryborough.
2 Miriam Vale (7)
Kolan (8) General Practitioners - 256
Burnett - Pt B (9) General Practices - 71
3 Isis (10)
Bundaberg (11) Practice Nurses - 146
Burnett - Pt A (12) RACFs - 24
Woocoo (13)
Hervey Bay - Pt B (14) Public Hospitals - 10
4 Hervey Bay - Pt A (15) Private Hospitals - 5
Maryborough (16)
Tiaro (17) Pharmacies - 63
Universities - 3
the PHCAtlas™
Source: PHIDU 9 ML Formation - 1 July 2012
HHS Establishment - 1 July 2012
Figure 1.3 Aboriginal & Torres Strait Islander Population and Percentage of
SLA Population
Population10
Population
Regional Council (ABS, June 2012)
Fraser Coast 98,629

North Burnett 10,301
Bundaberg 93,082
Gladstone 5,818
(Miriam Vale Shire only)
Wide Bay Total 207,830
Indigenous Population10
According to the 2011 Census 3.6% of the
population of the Wide Bay region are Indigenous
(7154 people) with the main centres of Indigenous
populations:
• Bundaberg (1971 people)
• Hervey Bay (1982 people)
• Maryborough (1069 people)
Eidsvold has the highest Indigenous proportion
Source: PHIDU 9 (25%) followed by Gayndah (6.5%).
Population Health Commissioning Atlas™ 3

Demographics and Social Determinants of Health
Demographics & Trends 10 Figure 1.4 Population Pyramid Wide Bay Region Compared to Queensland
The Wide Bay region has an ageing
population relative to the whole of
Queensland and Australia with 20% of the
population (41,006 people) over the age of
65 compared to 12.9% for Queensland and
13.8% for Australia. This significant difference
is projected to continue into the future.
The number of 0-15 year olds tracks with
Queensland and the national average at just
under 20% of the population.
When comparing the Wide Bay region with
other Medicare Local regions it is of note that
there is great variation across the age profile
of the region. For example the proportion
of people aged between 20 and 44 in the
region is the lowest when compared to all
other MLs.
In contrast the percentage of the population
aged between 55 and 79 is higher than the
rest of Australia. Source: ABS 10
Healthy Life Expectancy Figure 1.5 Population Pyramid Wide Bay Region Compared to Australia
The median age in Wide Bay at 30 June 2011
was 44 years (37 for Queensland).
Within the Wide Bay region (30 June 2011)
Biggenden had the highest median age with
49.8 years, and Bundaberg had the lowest
median age with 40.3 years.
“Life expectancy is an indicator of how long
a person can expect to live on average given
prevailing mortality rates. Technically, it is the
average number of years of life remaining to
a person at a specified age, assuming current
age-specific mortality rates continue during
the person's lifetime." 11
In Queensland life expectancy at birth has
increased over the past 10 years from 76.9
for males and 82.3 for females in 2001 to 79.5
for males and 84.1 for females in 2011.12
Population Projection
Figure 1.6 shows projected population
changes in the region over a 15 year period, Source: ABS 10
for each age cohort. This figure predicts a
decline in the percentage of the population Figure 1.6 Wide Bay Population Projection 2010-2025 Age Groups as
in Wide Bay aged 0-64 years and in contrast Percentage of Total Population
an increase for people aged 65 years plus.
Assuming the people in these age cohorts
continue to reside within the Wide Bay
region this will mean significant challenges
for health planning and in particular:
• Supporting healthy ageing
• Provision of aged care services in the
community and in Residential Aged Care
Facilities and
• Health care for people with chronic and
complex conditions including end of life
care (palliative care).
Source: ABS 10

Demographics + Social Determinants of Health
Map 1.2 Index of Relative Social Disadvantage (IRSD) in Queensland by SLA Socio-Economic Index for
Areas (SEIFA)13
SEIFA defines relative socio-economic
advantage and disadvantage of a
region, measuring access to material and
social resources and their influence on a
community's ability to participate in society.
A variety of census indicators are used to
develop four indexes to summarise different
aspects of advantage and disadvantage.
The indicators used are based on education,
occupation, employment, income, families
and housing. The Index of Relative Socio-
economic Disadvantage (IRSD) is created
by rating the proportion of people in an
area by income, educational attainment,
participation in the workforce, housing
status and other variables.
Wide Bay has 3 SLAs - Hervey Bay (Pt B),
Kolan and Eidsvold - all in the lowest
national decile for IRSD. The majority (11)
of the region's SLAs are in the second decile
nationally.
When considering the Index of Relative
Socio-economic Disadvantage (IRSD) as
shown in Map 1.2, the Wide Bay region has a
population that is more disadvantaged than
Australia as a whole with all 17 SLAs being in
the bottom 5 deciles. This is a clear indicator
that disadvantage is widespread across the
Wide Bay Region.
Source: ABS17
Wide Bay SEIFA Analysis

Map 1.3 Index of Relative Social Advantage & Disadvantage in Queensland by LGA A low Index of Relative Social Advantage
and Disadvantage (IRSAD) score indicates a
high proportion of relatively disadvantaged
people in the area – as highlighted by the
red colours in Map 1.3 which compares the
2011 IRSAD scores across Queensland LGAs.
the PHCAtlas™
Wide Bay is only surpassed by those Local
Government Areas (LGAs) with significant
Indigenous populations.
Queensland Health's population profile of
May 2013 shows that the Wide Bay HHS is the
second most disadvantaged HHS region in
Queensland after the Torres Strait - Northern
Peninsula HHS.14
A report from Queensland Treasury and Trade
further documented this disadvantage. The
report compares the Wide Bay population
with the Queensland population using
quintiles. It found that 83.3% of the Wide
Bay population were in the two most
disadvantaged quintiles. 15
‘We are increasingly living in rich countries full of poor

and sick people'. The Wide Bay community symbolises
the sentiment of this statement which was made
by Dr Margaret Chan, Director General of the World
Health Organisation at the Helsinki Health Promotion
Conference in June 2013. 16
Source: ABS17

Ageing Population Map 1.4 Population Aged 65 Years And Over

Addressing the consequences of an
ageing population will require social and
economic investment aimed at supporting
older people to maintain their health
and independence. As people age rates
of chronic disease and disability increase.
AIHW reports disability rates increase with
age from 39% of those 60-64 years to 82%
of those 85 years and older with the rates for
males and females the same. 18
Based on 2009 data, the Wide Bay region
ranks at the top of all 61 Medicare Locals
across Australia for the percentage of people
in the five year age cohorts 60–64, 65-69
and 70-74 with percentages well above the
average for Queensland (Map 1.4). 9
Social Determinants of Health

The SDH (as described on page 2) play
an important role in shaping the health
of populations. The distribution of these Source: PHIDU 9
determinants can vary across populations,
and thereby either increase or decrease Map 1.5 Full-Time Participation In Secondary School At Age 16
communities' opportunities to be healthy.
This section highlights a number of key
determinants for the Wide Bay region,
drawing attention to their unequal
distribution; in particular early life, education,
income, employment and housing.
Participation in Education
Young people who fail to complete
school or further education and training,
run a significant risk of school failure,
unemployment, risky behaviours,
mental health problems and long term
disadvantage. Higher levels of education are
linked to better prospects of employment
and income.2,3 More young people in the
rural areas (Eidsvold, Miriam Vale) and in
the population dense areas (Bundaberg,
Hervey Bay) of Wide Bay are failing to
complete secondary school. There are likely
to be different causes but long term poor Source: PHIDU 9
employment and health outcomes are likely
for both groups. (Map 1.5). For 38.8% of Wide
Bay's population over 15 years their highest Map 1.6 Unemployment Beneficiaries
level of schooling was year 11/12, compared
to 55.3% for all of Queensland. 15
Unemployment
Unemployment puts health at risk, and the
risk is higher in regions where unemployment
is widespread. The health effects of
unemployment are linked to psychological
consequences, financial problems (debt) and
reduced life opportunities.2,3 Figures from
the Queensland Treasury and Trade (March
2013) indicate that the unemployment rate
for Wide Bay (December Quarter 2012) was
8.4% - more than 2% above the Queensland
rate of 5.8%. For Wide Bay the highest levels
of unemployed adults 15 and over are in the
coastal regions of Gladstone, Bundaberg and
Fraser Coast (Map 1.6).15
Source: PHIDU 9

Map 1.7 Concession Card Holders Wealth and Income

Wealth and income are amongst the most
important determinants of health with
an individual's health improving at each
step up the economic and social ladder.19
Thus people with a higher income enjoy
better health and longer lives than those
with lower incomes. Lack of income can be
measured in a variety of ways, concession
card holders and welfare dependent families
are included here.
Total Personal Income (15+ Personal Weekly Income)

< $400 per Week
(Equivalent to the poverty line)20 45.1%
$400 - $999 per Week 31.8%
$1000 - $1999 per Week 12.4%
> $2000 per Week 2%
Source: Queensland Treasury and Trade 15

Source: PHIDU 9
Concession Card Holders
Concession card holders (e.g. people
Map 1.8 Low Income Welfare Dependent Families on health care cards and/or pensioner
concession cards) are a proxy measure
for disadvantage (Map 1.7). All regions in
Wide Bay are significantly above both the
Queensland (21.4%) and Australian (22.5%)
averages for concession card holders. Of
particular note are the regions of Perry,
Kolan, Isis, Biggenden, Maryborough
and Hervey Bay where over a third of the
population are concession card holders.
Welfare Dependent Families

Welfare dependent families are likely to be
living on low income, may have insecure
housing, experience high levels of stress
and may find it difficult to provide optimal
learning and development environments for
the PHCAtlas™
their children. All but four SLAs have a higher
proportion of welfare dependent families
than Queensland (9.7%) and Australia (9.6%)
(Map 1.8).
Source: PHIDU 9
Housing
Map 1.9 Households In Dwellings Receiving Rent Assistance Evidence suggests three elements of
housing that have an impact on health:
suitability; affordability; security of tenure.
These elements have an impact on people’s
identity, stability, safety, social support,
sense of control and mastery over their lives,
physical environments and living practices.21
The heavily populated areas of Wide Bay all
have high levels of households receiving
rent assistance with over a quarter of the
population claiming assistance (Map 1.9).
Wide Bay Financial Stresses

(Rankings against other 60 ML Regions)
Rent Assistance 1st
Rental Stress 2nd
Mortgage Stress 4th
Total Concession Card Holders 2nd
Low Income 11th
Children in Welfare Dependent Families 5th

Source: PHIDU 9
Source: PHIDU 9

Demographics + Social Determinants of Health
Childhood Development Figure 1.7 Percentage Of Children Fully Immunised By Age Group
and Health 2011/2012
Families play a critical role in shaping All Children
Age Group
children’s early life which ultimately Wide Bay Queensland Australia
impacts on their health and wellbeing into
Aged 1 Year 92% 92% 92%
adulthood. The Socio-economic status (SES)
of families has been found to impact on their Aged 2 Years 94% 93% 93%
ability to provide healthy, stimulating and
nurturing environments for their children; Aged 5 Years 92% 92% 90%
due to limited access to resources, supports
and opportunities.22 Figure 1.8 Percentage Of Indigenous Children Fully Immunised By
Child Health Age Group 2011/2012
Infant and child mortality rates, the number Indigenous Children
of low weight babies and child development Age Group
Wide Bay Queensland Australia
are three major indicators of the health and
development of the region's children. Aged 1 Year 87% - 85%
For the Wide Bay region, data on birth weight
and mortality indicates they are doing well Aged 2 Years 91% - 92%
in relation to the rest of Queensland (though Aged 5 Years 86% - 87%
less so for the Indigenous community). 23
There is a high rate of teenage pregnancy Source: NHPA 24
in the Wide Bay region, with 7.9% of non-
Indigenous population (QLD 4.2%) and
Map 1.10 Children Developmentally Vulnerable On 2+ Domains
18.3% of the Indigenous population (QLD
18.2%) giving birth aged between 15-19
years in 2011. 23
Childhood Immunisation
Wide Bay childhood immunisation rates
are consistent or higher than Australian
and Queensland rates for all milestones.
Immunisation rates for Aboriginal and Torres
Strait Islander identified children are slightly
lower in Wide Bay than Australia for the two
and five year old age groups. Childhood
immunisation rates are reported nationally
by three age groups to correspond with
three milestones of immunisation – as
outlined in Figures 1.7 and 1.8.
Child Development and Australian

Early Development Index (AEDI) 25
Childhood development in the Wide Bay
region seems to be an area of concern
and this may reflect the impact of family Source: PHIDU 9
disadvantage in the early years (Map 1.10,
Figure 1.9). The AEDI is a population based
measure of how children have developed Figure 1.9 Australian Early Development Index (AEDI) Vulnerable
by the time they start school. It examines
five areas of early childhood development:
on 2+ Domains
physical health and wellbeing, social
competence, emotional maturity, language
and cognitive skills, and communication
skills and general knowledge. Children
from families with low SES backgrounds
often have poorer AEDI scores and are
more vulnerable compared with their more
advantaged counterparts. This can be
the result of less access to the underlying
social networks that can support families in
bringing up their children. One third of all
children are developmentally vulnerable on
one or more domains, within the Wide Bay
region. This suggests that socio-economic
factors and access to social and early
childhood infrastructure may be having an
impact. Partnerships across key sectors such
as education, child development, health
and primary care will be required if this
downward trend is to be reversed. Source: AEDI 25

Part2
Population Heal
Health + Profiling [1]
The social determinants of health influence

Map 2.1 Physical Inactivity
people's opportunities and exposure to
risk and protective factors. These factors
can appear independently or can cluster
together in socially patterned ways. The
population of the Wide Bay region has
high rates of several risk factors, which
when combined with the region's low
SES status could be argued to be socially
patterned.26
This next section of the PHCAtlas™ maps
a few of these risk factors through to their
common diseases to emphasis the impact
that the SDH and low socio-economic
status of the region have on local health
services.27
Physical Activity
Regular physical activity is important for
improving and maintaining health and
wellbeing for adults and children and is a
protective factor against the development
Source: PHIDU 9 of a range of chronic diseases and other risk
factors. Physical inactivity and unhealthy
Map 2.2 Obese Persons 18+ dietary intake contribute to overweight
and obesity levels within a population.
Given the high level of obesity within the
Wide Bay region it is not surprising to find
that physical inactivity levels are also high
when compared with other MLs. Wide Bay
has a rate of 41.6% people inactive against
the national average of 34.4%, making
it the second worst ML compared to the
rest of Australia. Physical activity levels
tend to decline as people age and as the
region has an older population profile
the higher levels of physical inactivity can
be expected and will be challenging to
reverse. Environmental factors (eg. green
space, active transport options, safe cycle
ways) play an important role in supporting
people to become physically active. This
the PHCAtlas™
requires partnerships across sectors,
including local government, transport and
planning.
Source: PHIDU 9 Obesity

According to the AIHW excess weight,
Map 2.3 Number Of People With Type 2 Diabetes especially obesity, is a major risk factor for
cardio-vascular disease, Type 2 diabetes,
some musculoskeletal conditions and
some cancers.28 Obesity (BMI > 30) is a
major concern for the Wide Bay region.
All SLAs have a higher prevalence of
obese people than the national average
(18 per 100) with particular concern in
the high density areas of Bundaberg and
Maryborough.
Type 2 Diabetes
The rate of Type 2 diabetes in the Wide Bay
region is high when compared to other ML
areas of Australia, ranked fifth out of 61. In
terms of composite indicators, Wide Bay is
ranked seventh for the number of adults
compared with all MLs (who are overweight/
obese and have Type 2 diabetes). Diabetes
complications episodes was the most
common cause of hospitalisation in the
Wide Bay region at a rate significantly
Source: PHIDU 9 higher than the Queensland rate.23

Population Health + Profiling [2]
Chronic Obstructive Map 2.4 Current Smokers 18+

Pulmonary Disease (COPD)
COPD is a serious long term lung disease
with a high level of disability. The principle
risk factor for COPD is smoking, with the
amount and length of time smoking
increasing the risk. COPD is associated with
a high level of disability and associated costs
including unnecessary hospital admissions.
It is under-recognised and under-diagnosed
and could be better managed in primary
care. 29
Smoking & COPD Prevalence

There is a high prevalence of COPD in the
Wide Bay region consistent with high levels
of smokers. The Wide Bay region ranks fifth
highest in Australia for COPD Prevalence
with an age-standardised ratio (ASR) of
3.8 (per 100) compare to an ASR of 2.3 for
Australia and 2.4 for Queensland.
Source: PHIDU 9
For smokers the Wide Bay region is the
eighth worst in Australia with an ASR of 24.8
(per 100) compared to 20.3 for Australia and Map 2.5 COPD Prevalence
21.8 for Queensland. Smoking in pregnancy
rates are also high (see table below). COPD
was the second most frequent hospital
admission behind diabetes complications.
The Wide Bay region has levels of avoidable
separations consistent with Queensland
figures overall but higher for males. 23
Emerging smoking and asthma evidence
suggests that smoking is causally related to
adult Asthma.30
In terms of composite indicators, Wide
Bay ranks third out of all MLs for smokers
with asthma. It has an ASR of 3.00 per 100
compared with Queensland at 2.4 and
Australia at 2.4 per 100.9
COPD Deaths
The death rate from COPD (30.7 per 100,000)
is of concern even though it doesn’t rank as
high as the prevalence. This may be due to
people with COPD moving closer to acute Source: PHIDU 9
care. This rate is still higher than both the
Queensland (25.9) and Australian rates Map 2.6 COPD Deaths 45-74
(23.8).
Comparison Data Wide QLD Aust

Rate per 100 people Bay
COPD Prevalence
PHIDU 2007-08 9 2.6 2.4 2.3
Smoking Rates
PHIDU 2007-08 9 24.8 21.8 20.3
Smoking Rates
Self Reported 19.0 14.4 N/A
WBHHS 2011-12 23
Smoking Rates
Australian Health Survey 2011-1231 N/A 17.8 16.1
Smoking During
Pregnancy (ATSI) 201123
48 50 50
Smoking During
Pregnancy (Non-ATSI) 201123
28 14 15
Source: PHIDU 9

Map 2.7 People Aged 18+ Yrs With Usual Daily Intake of 2 or More Serves of Fruit Cancer
Cancer incidence, deaths and survival rates
differ by Indigenous status, remoteness
and socio-economic status. Incidence rates
and survival were lower for people living
in remote areas compared with those in
major cities, while mortality rates rise with
increasing remoteness. As a person's socio-
economic status decreases incidence and
mortality rates rose and survival rates from
all cancers fell .32
Being overweight or obese, physical
inactivity, poor diet and harmful
consumption of alcohol all contribute to
cancer risk. There are also indications that a
healthy lifestyle can improve quality of life
for cancer patients and reduce the risk of the
disease recurring.
In general, eating a healthy, balanced diet
reduces your risk of developing cancer,
while a poor diet increases your cancer
Source: PHIDU 9 risk. Cancers associated with diet are most
commonly found in the digestive tract,
including the oesophagus, stomach and
Map 2.8 Bowel Cancer Screening Participation Rates
bowel. 33
Fruit intake is one indicator of a healthy
diet and the Wide Bay region ranks 59th
(out of 61) for MLs when comparing fruit
consumption for 18 years and over based
on the 2007/08 National Health Survey. All
SLAs within Wide Bay consume less fruit than
the Queensland (49.0 per 100 people) and
Australian averages (50.2 per 100 people)
(Map 2.12). Findings from the 2011 National
Health Survey shows similar results at both
state and national levels with adequate daily
intake of fruit for Queensland 47.9% and
51.5% for Australia.
Bowel Cancer
the PHCAtlas™
There appears to have been good
participation in the National Bowel Cancer
Screening Program in 2010 in the Wide Bay
region with all SLAs (except Kolan 33.3%)
Source: PHIDU 9 having participation rates above both
Queensland (36.1%) and Australian rates
Map 2.9 Deaths from Colorectal Cancer 2003 to 2007 (36.9%). The heavily populated regions
of Wide Bay (Hervey Bay, Bundaberg and
Maryborough) have screening rates in
excess of 40% - a very strong result.
Bowel cancer is sometimes referred to as
colorectal cancer and there appears to be a
higher incidence of colorectal cancer in Wide
Bay compared with Queensland. 23
There is also a significantly higher rate of
prostate cancer in Wide Bay compared to
Queensland with a rate of 220 per 100,000
males in 2009.
Deaths from bowel cancer (2003-2007) were
at a higher rate than Australia. There were
142 deaths in the region in this four year
period which equates to 12.2 per 100,000
people, quite high compared to 10.9 per
100,000 for Australia.
Source: PHIDU 9

Mental Health Map 2.10 Psychological Distress 18+

Mental illness runs along a continuum,
ranging from minor to severe psychological
distress.
Psychological distress is an indicator of the
mental health of a community. It is the best
population wide measure currently available,
and is indicative of the mental health needs
of a population rather than measuring rates
of mental illness. 34
The Wide Bay region ranks third worst of
all MLs across Australia for psychological
distress. Levels of psychological distress
across the region vary, with particular
concern in Hervey Bay Pt B and Kolan
showing levels a third greater than the
national average. There are 13 Wide Bay SLAs
(with data) above the National rate.
In the 2012/13 Financial Year, the Wide Bay
HHS had a 25% increase in the community
mental health contact rate compared
with 2011/12. In 2012/13 there were
approximately 866 people being actively
Source: PHIDU 9
managed by the HHS Community Mental
Health team for mental health problems.23
Figure 2.1 shows the current hospitalisation Map 2.11 Deaths from Suicide/Self Injury 0-74
rate for mental health patients. Acute mental
health inpatient beds are 20 per 100,000 for
Queensland with Wide Bay only having 13
beds per 100,000.
GP Mental Health Care

Plans
GP Mental Health Plans are a requirement for
patient referrals to short-term psychological
interventions (i.e. CBT) under the Medicare
funded ATAPS Programs. Figure 2.2 indicates
that the preparation of GP Mental Health
Plans in the Wide Bay region is slightly below
the Australian average at 308 per 10,000
people.
Suicide/Self Injury
For deaths from Suicide/Self inflicted harm,
Wide Bay rates as 8th worst in the country
(SDR 129) when compared to other MLs
with a third more deaths than the Australian
average. Self inflicted injury hospitalisation Source: PHIDU 9
rates in females are higher than for males
in Queensland and Wide Bay HHS. There is a Figure 2.2 GP Mental Health Plans
Figure 2.1 Annual Mental Health
significantly higher rate of hospitalisations
Related Hospital Inpatient Separations
for females in the Wide Bay HHS than
Queensland for all years since 2002 and
2011 2012 Occupancy
higher for males since 2005.23
BUNDABERG 91%
Injury
Information from the WBHHS indicates Females 250 237
hospital separations for intentional self harm
are well above Queensland rates for both Males 176 148
males and females.
MARYBOROGH 95%
It is of concern that injury and poisoning
(excluding self harm) is the leading cause of Females 130 143
hospital separations in the Wide Bay region
and rates are significantly higher than the Males 206 202
Queensland rates particularly for males.23
HHS TOTAL 762 730
Source: Queensland Health 23 Source: Medicare Australia 35

Figure 2.3 Selected National Health Priority Areas by Risk Factors National Health Priority
Risk Factor Areas (NHPA)36
Disease or Wide
Tobacco Physical
Poor Excess
High High
Bay Qld Aust By targeting specific areas that impose
Condition Smok- Inactiv-
Diet &
Nutri-
Body
Blood
Pres-
Blood
Choles- high social and financial costs on Australian
ing ity tion
Weight sure terol
society, collaborative action can achieve
MORBIDITY ASR Per 100
significant and cost-effective advances in
Type 2 Diabetes ; ; ; ; 3.8 3.5 3.4 improving the health status of Australians.
The diseases and conditions targeted under
COPD ; 2.8 2.4 2.4
the NHPA initiative were chosen because
Arthritis ; ; ; 17.2 15.2 14.9 through appropriate and focused attention
significant gains in the health of Australia's
Asthma ; 12.4 11.4 9.7
population can be achieved.
Hypertension ; ; ; ; ; 9.1 9.2 8.5 Figure 2.3 highlights the need for controlling
Circulatory Disease ; ; ; ; ; ; 17.3 16.0 16.0 a range of common risk factors associated
with the most prevalent chronic diseases
DEATHS ASR Per 100,000 and their complications. Most of this can be
Coronary Heart Disease ; ; ; ; ; ; 46.7 45.5 44.9 managed in the community effectively and
hence reduce the use of ED and hospital out-
Stroke ; ; ; ; ; ; 10.1 10.5 10.1 patient and in-hospital care. A number of
All Cancers ; ; ; ; 79.8 74.9 74.6 these risk factors have been discussed earlier
in this atlas.
Colorectal Cancer ; ; ; 12.2 11 10.9
Source: AIHW. 37,38 Potentially Preventable
Admissions
Figure 2.4 Potentially Preventable Hospital Admissions
The top two potentially preventable hospital
Chronic & Acute Conditions Per 100,000 Wide Bay Queensland admissions identified in Figure 2.4 for
People Based on 2006/07 - 2010/11 data Males Females Males Females Wide Bay are for diabetes (admissions are
also significantly above Queensland rates)
Total Chronic 1873.6 1506.3 1714.2 1387.3
and COPD. The risk factors for diabetes
Diabetes Complications 818.6 565.7 723.3 491.8 are physical inactivity, poor nutrition and
excess body weight while for COPD the key
Chronic Obstructive Pulmonary Disease 391.1 283.8 342.9 259.8
(but not only) risk factor is smoking status.
Angina 330.1 213.7 254.7 170.5 Interventions that could be considered to
address this are:
Convulsions and Epilepsy 210.8 167.3 169.5 137.2
• Community-wide primary prevention
Asthma 139.1 182.2 142.1 170.0 strategies with at risk populations
• Early detection in primary care and
Hypertension 34.2 60.8 28.1 42.6
promotion of lifestyle modification
Total Acute 1409.6 1568.9 1316.5 1468.6 programs (diet, exercise, and healthy
weight maintenance)
the PHCAtlas™
Dehydration and gastroenteritis 235.5 328.1 224.6 304.7
• Proactive management to limit disease
Cellulitis 266.4 179.6 228.1 152.9 progression
• Better coordination between tertiary
Ear, Nose and Throat infections 212.8 212.8 178.6 178.8 and primary care to support hospital
Source: Queensland Health 23 avoidance strategies for people at risk of
avoidable admissions with action across
Map 2.12 All Avoidable Mortality 0-74 the population health chronic disease
continuum (page 2). 5
Avoidable Mortality
Avoidable mortality comprises those causes
of death that are potentially avoidable,
given available knowledge about social and
economic impacts, health behaviours and
health care and are an important indicator
in monitoring the quality, effectiveness and
productivity of health systems.39
When considering the Wide Bay region 12
SLAs recorded avoidable mortality rates
higher than the national average of 167 per
100,000 which is of concern. Different factors
are relevant for different SLAs however the
overall picture from this Atlas is of high levels
of risk factors across the region as a whole
which can lead to increased chronic disease
and mortality.
Source: PHIDU 9

Part3 Wide Bay Region Health Domains + Medicare Local Data Benchmarking
INDICATOR
ML ML ML WBML WBML
ML Quintile Range
SLA
DOMAIN * 42 ML's only recorded for Selected Cancer Screening information (NSW, NT,Tas not included)
KPI Median Range Result Rank Range
# Positive Screening test result for breast bowel cervical cancer has been used as a proxy indicator Highest Med-Hi Medium Med-Low Lowest
for Cancer incidence to enable comparison across MLs Need Need Need
GP MBS utilisation (consults per year person) 6.3.3.2 5.4 2.4-7.4 6.0 14 No data
GP Services Waiting Times (%) 6.3.3.5 15.0 8.0-28.0 15.0 23 No data

UTILISATION
GP After Hours Service Utilisation 6.3.3.12 0.24 0.05-0.79 0.13 49 No data

ACCESS
Allied Health utilisation (services/person) 6.3.3.3 No data 0.061
Primary Care type ED attendances (type 4 & 5) 6.3.3.13 No data 66403
Community Services Waiting times 6.3.3.6 No data No data
Specialist Service Utilisation 6.3.3.4 No data No data
Selected Potentially Avoidable Hospitalisations 6.3.1.1 No data No data
Smoking Prevalence (18 years and over) (ASR per 100) 6.3.5.4 22.1 12.0-28.5 24.8 54 22.2-27.9
Overweight Prevalence - Males (ASR per 100) 36.0 34.4-38.6 35.4 11 33.7-36.5
PREVENTION
LIFESTYLE 1°
Overweight Prevalence - Females (ASR per 100) 23.2 19.9-23.9 23.7 52 23.1-23.9
6.3.5.5
Obesity Prevalence - Males (ASR per 100) 19.9 14.5-26.5 25.9 59 21.1-29.6
Obesity Prevalence - Females (ASR per 100) 17.3 11.4-19.5 19.5 61 17.3-20.1
Alcohol Use/abuse (ASR per 100) 5.5 3.7-13.4 5.5 30 5.1-7.3
Physical Inactivity (ASR per 100) 34.5 26.4-44.2 41.6 60 36.3-44.8
Prevalence Diabetes (ASR per 100) 6.3.5.3 3.5 2.7-4.3 3.8 57 1.0-15.0
Prevalence COPD (ASR per 100) Nil 2.4 1.8-2.9 2.8 60 2.5-3.2
PREVENTION
Death rate IHD (ASR per 100,000) Nil 33.4 17.4-69.8 33.2 29 0-72.1
CDM 2°
Death rate COPD (ASR per 100,000) Nil 24.1 9.2-77.5 30.7 43 0-55.0
GP MBS Diabetic Annual Care Plan (SIP services) 6.3.1.2 No data 2,719
GP MBS Asthma Care Plan (SIP services) 6.3.1.3 No data 424
Incidence IHD 6.3.5.2 No data 8.5
Incidence End stage Kidney disease (per 100,000 people) 6.3.5.6 No data 16.47
Screening participation – Breast Cancer (%) 6.3.3.7 56.8 35.8-63.2 59.9 8* 49.2-69.1
Breast Screening Outcomes - Screen detected cancer in 50-69yo (ASR per 10,000) # 6.3.5.1 57.9 40.1-91.0 51.5 11* 0-65.1
Screening participation – Bowel Cancer (%) 6.3.3.7 36.9 24-44.1 41.8 6 33.3-52.6
National Bowel Cancer Screening Program (NBCSP) Positive test result (ASR/100) 6.3.5.1 7.9 1.2-9.9 8.8 52 0.0-12.3
Death rate Bowel Cancer (ASR per 100,000) Nil 11.0 6.3-13.9 12.2 50 0-15.1
SCREENING
Screening participation – Cervical Cancer 6.3.3.7 60.4 50.2-78.4 52.9 39* 41.1-76.3
Cervical screening outcomes: high grade abnormality (20-69yo) (ASR per 1,000) # 6.3.5.1 6.3 3.7-21.8 10.2 18* 0-89.2
5 year Survival Breast Cancer (%) 6.3.1.5 No data 88.7
Death rate Breast Cancer (rate/10,000) Nil No data 21.3
5 year Survival Bowel Cancer (%) 6.3.1.5 No data 66.7
5 year Survival Cervical Cancer (%) 6.3.1.5 No data 75
Death rate Cervical Cancer ( rate/100,000) Nil No data 1.6
Infant/young Child Mortality (ASR per 100,000) 6.3.5.8 111.3 73.5-227.0 111.8 32 0-136.3
M=79.5
Life expectancy at Birth 6.3.5.7 No data
HEALTH
F=84.1
CHILD
Proportion babies Low Birth weight 6.3.5.9 No data No data
No. Women with one Antenatel 1st Trimester 6.3.3.11 No data No data
4 yr old Development Check (claims) 6.3.3.10 No data 2597
Completed Suicide Rate (ASR per 100,000) Nil 11.1 6.7-27.4 14.3 54 0-48.0
Prevalence of Depression (ASR per 100)

MENTAL
Nil 11.6 8.9-13.8 13.5 59 10.9-16.1

HEALTH
Population receiving MH Care (rate per 1000) 6.3.3.14 No data 82.2
Rate Child/Young use Primary MH care 6.3.3.15 No data No data

M=5.4
Prevalence of Psychotic disorders (rate/1000) Nil No data F=3.5
Proportion aged 70+ (%) Nil 10.5 1.6-14.2 13.3 59
AGED
RACF
Aged care beds/pop. 70+ years (total care places/1,000) 87.2 68.2-140.3 68.6 60 0-151.2
RACF GP services utilisation 6.3.3.9 13.0 7.0-14.8 10.1 56

M=0.9;
Prevalence of Dementia (%) Nil No data F=1.2

Wide Bay Region Health Domains + Medicare Local Data Benchmarking
COMMENTS
GP Attendances per person 2011-2012, 40
Self reported: percentage of adults who felt they waited longer than acceptable for a GP appointment 2010-2011,40
GP After Hours Attendances per person 2011-2012, 40
EPC utilisation data only, number of services per person. NO SLA data available. 35
ED Presentations by Triage Years Feb 2013 - Triage 4 - 60123 and Triage 5 - 6279 for Bundaberg, Hervey Bay and Maryborough Hospitals 23
No Data
No Data
No Data
Current smokers (synthetic prediction), persons 18 years and over (2007-2008) 9
Overweight (not obese) males (synthetic prediction), 18 years and over (2007-08) 9
Overweight (not obese) women (synthetic prediction), 18 years and over (2007-08) 9
Obese males (synthetic prediction), 18 years and over (2007-2008) 9
Obese females (synthetic prediction), 18 years and over (2007-2008) 9
Alcohol levels considered high risk to health (synthetic prediction), persons aged 18 years and over (2007-2008) 9
Physical inactivity (synthetic prediction), persons aged 15 years and over (2007-2008) 9
Type 2 diabetes (synthetic prediction) (2007-2008) 9
Chronic Obstructive Pulmonary Disease (synthetic prediction)(2007-2008) 9

9
Deaths from IHD, 0 to 74 years (2003-2007) average annual rate/100,000
9
Deaths from COPD, 45 to 74 years(2003-2007) average annual rate/100,000
Completion of annual cycle of care for patients with diabetes mellitus , GP Links Wide Bay data only, July 2011-June 2012. 35
GP Links Wide Bay data 2011. No ML or SLA data available. 35
The percentage of total burden of Cardiovascular disease in Queensland 41 - State data only, no SLA data available.
A Comparison of End Stage Kidney Disease and renal dialysis, Queensland Health 201041 - State data only, no SLA data available
Percentage of women attending over 24 month period (2006 & 2007) 9
Women with an outcome of cancer over 24 month period (2006 & 2007) rate/10,000 9
2010 National Bowel Cancer Screening Program participation percentage 9
National Bowel Cancer Screening Program: positive test result per 100 (2010) 9
the PHCAtlas™
Avoidable Mortality as a result of colorectal cancer, 0-74 years (2003-2007) 9
Women attending over a 24 month period (2008 &2009) 9
Women with high grade abnormality (2006-2007) Women screened over a 24 mth period. Age standardized rate per 1,000 9
Data for men and women for whole of Queensland 2005-2009 42
Data for men and women for whole of Queensland 2005-2009 42
Data for whole of Queensland 2005-2009 42
Data for whole of Queensland 2005-2009 42
Data for whole of Queensland 43
Child mortality(<5yrs) (2003-2007) Rate average annual rate per 100,000 9
No SLA Data 12
No Data
No Data
Item 709 = 2597 claims from Q1 2010 to Q4 2010. QLD data only, no SLA data available. In comparison to all states, QLD has the highest number of 709 claims during the period 35
9
Deaths from suicide and self-inflicted injuries, 0 to 74 years (2003-2007) Average annual rate per 100,000
High/very high psychological distress levels (synthetic prediction), >18 years and over (2007-08). 9
GP Links Wide Bay data 2011. 35 No ML or SLA data available.

No Data
National data: ABS 2007-2008 44 No SLA Data
Persons 70 yrs and over (2010) 9
Residential aged care places Total residential care places per 1,000 9
Average number of GP attendances in residential aged-care facilities per patient who received at least one GP attendance in a facility, by Medicare Local catchments, 2011–12 (NHPA) 40
No SLA data available 23

SLA Analysis
INDICATOR SLAs LEGEND > SLAs IN MOST NEED
DOMAIN 1 North Burnett 2 3 Bundaberg 4 Fraser Coast

# Positive Screening test result for breast bowel cervical cancer has been used as a proxy indicator for Cancer
incidence to enable comparison across MLs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
GP MBS utilisation
GP Services Waiting Times
UTILISATION
GP After Hours Service Utilisation

ACCESS
Allied Health utilisation

Primary Care type ED attendances
Community Services Waiting times
Specialist Service Utilisation
Selected Potentially Avoidable Hospitalisations
Smoking Prevalence
Overweight Prevalence (Males)
PREVENTION
LIFESTYLE 1°
Overweight Prevalence (Females)

Obesity Prevalence (Males)
Obesity Prevalence (Females)
Alcohol Use/abuse
Physical Inactivity
Prevalence Diabetes
Prevalence COPD
PREVENTION
Death rate IHD

CDM 2°
Death rate COPD

GP MBS Diabetic Annual Care Plan
GP MBS Asthma Care Plan
Incidence IHD
Incidence End stage Kidney disease
Screening participation – Breast Cancer
Breast Screening Outcomes - Screen detected cancer in 50-69yo (rate/10,000) #
Screening participation – Bowel Cancer
NBCSP Positive test result (Rate/100) #
Death rate Bowel Cancer
SCREENING
Screening participation – Cervical Cancer

Cervical screening outcomes: high grade abnormality (20-69yo) (Rate/1,000) #
5 year Survival Breast Cancer
Death rate Breast Cancer
5 year Survival Bowel Cancer
5 year Survival cervical Cancer
Death rate Cervical Cancer.
Infant/young Child Mortality
Life expectancy at Birth
HEALTH
CHILD
Proportion babies Low Birth weight

No. Women with one Antenatel 1st Trimester
Proportion 4 yr old Development Check
Completed Suicide Rate
Prevalence of Depression
MENTAL
HEALTH
Percentage population receiving MH Care

Rate Child/Young use Primary MH care
Prevalence of Psychotic disorders
Proportion aged 70+ years
AGED
RACF
Aged care beds/pop. 70+ years

RACF GP services utilisation
Prevalence of Dementia

Potential Needs Assessed in Each Wide Bay Region Health Domain
DOMAIN POTENTIAL NEEDS
There are high levels of health needs in the Wide Bay region as illustrated in the matrix opposite. Importantly access to health services appears to be good, as stated in the
report Healthy Communities (NHPA 2013). Wide Bay residents appear to be able to access a GP of choice in a short time frame. The average number of GP attendances (per
person) are higher when compared to other MLs and this may reflect the health care needs of the local community and the good availability of GP services. (National Health
Performance Authority Healthy Communities Australians’ experience with primary health care in 2010-11).40
UTILISATION
ACCESS
Medicare Local Health Status Use of Primary Health Care Experience with Primary Health Care
Peer Groups
Adults who rated Average number of Average number Adults who
Adults who saw a GP Cost barriers to Their GP listened
health excellent, GP attendances per of GP after-hours reported: Waiting Having a preferred
in previous year(%) seeing a GP (%) carefully (%)
very good or good person (n) attendances per too long for a GP GP (%)
(%) person (n) appointment (%)
Metro 2 87 81 5.1 0.32 13 82 9 89
Regional 2 83 81 5.0 0.12 19 82 8 89
Wide Bay 85 81 5.8 0.10 15 95 5 92
Rural1 82 81 4.9 0.20 16 77 9 87
• For Wide Bay the smoking rate is high (24.8 per 100), based on 07-08 data9 when compared with other Medicare Locals and both Australia (20.3 per 100) and Queensland rates
(21.8 per 100). Nationally smoking rates are trending down compared to 2004 figures, with the self reported health status 2011-12 (Department of Health 2013)45 indicating that
both Queensland and Wide Bay smoking rates are also on the decline. Wide Bay continues to have a high rate of 19.0% people smoking compared to the state average of 14.4%.
PREVENTION
LIFESTYLE 1°
• Obesity is a significant issue for Wide Bay that ranks worst and third worst for females and males respectively in the country when compared to other MLs. With 19.5 per 100
females obese and 25.9 per 100 males obese, compared to Australian rates of 16.4 per 100 females obese and 19.6 per 100 males obese.
These findings are further confirmed from self report data 2011/12 from WBHHS in 2013, with 66.9% of the Wide Bay population reporting as either overweight or obese, and this
is likely to be under-reported. 45 This is significantly higher than the Queensland average of 57.3% of the population. The recent release of the National Health Survey results from
the ABS found that Queenslanders tended to be heavier than Australians overall, which is of concern seeing as Wide Bay residents are heavier than Queenslanders.
• While levels of harmful use of alcohol track with the Australian average (Wide Bay is in the middle quintile for MLs) it is of note that the guidelines regarding long term risks of
alcohol consumption have changed since this data has been collected. The impact of harmful use of alcohol may be higher than figures in the matrix. This is supported by the
Queensland Department of Health self reported health status 2011/12 report where 21.9% of people are at danger of lifetime risk based on the 2009 Australian guidelines.45,46
Two of the major chronic conditions, diabetes and COPD, are prevalent in the Wide Bay community. This is not surprising given the level of behavioural risk factors in the
community, which have been described above and include obesity, smoking, and physical inactivity and alcohol consumption. Chronic conditions poorly managed have a
negative impact on individual wellbeing and health care services. Chronic conditions make up the largest pool of potentially preventable hospital admissions.
PREVENTION
• COPD prevalence is the second highest in the country. Wide Bay COPD prevalence (modelled estimate) 2.8 per 100, Aust 2.3 per 100 people and Queensland 2.4 in 2007-
2008, this is consistent with the high smoking rate in the region (PHIDU 2013).
CDM 2°
• COPD prevalence and deaths may continue to increase despite the reduction in smoking due to the long latency period of COPD and the ageing population. This may be
compounded by the low SES profile of the region and the tendency for higher smoking rates in low SES communities.
• Diabetes hospitalisations are showing an increase in the WBHHS, with males above females, both above Queensland rates. Diabetes complications appear to be on the
increase according to the Wide Bay HHS which stated that hospitalisation rates for both men and women increased in the period between 2006/2007 and 2010/2011.23
Obesity increases the risk of developing diabetes and as the Wide Bay population has a high proportion of obese people it is to be expected that diabetes rates and associated
complications will continue to escalate. The Diabetes Care Project (DCP) currently operating in the region may provide useful insights for improved management of diabetes.
For participation in some screening programs Wide Bay ranks in the best quintile for some recorded programs (Bowel and Breast Cancer screening programs). However for
cervical screening they rank fourth worst in Australia when compared to other MLs.
• The screening outcomes of concern for cervical cancer are for high grade abnormality, Wide Bay is in the mid range when compared to other quintiles. This indicates the
need to promote screening opportunistically across the female population with particular focus with high risk populations to improve the outcomes.
• There are high rates of death from bowel cancer, which points to a likely high incidence rate for bowel cancer in the region. This is further supported from the number
of positive tests resulting from the NBCSP. 9 However as bowel cancer incidence increases with age, these finding can be expected given the age profile of the region. The
the PHCAtlas™
incidence of bowel cancer in Wide Bay is higher than Queensland according to the 2004-2006 document.23,42 Continued promotion and implementation of the NBCSP
SCREENING
will be important for the future health of this region. Screening rates are strong when compared with other MLs indicating current practices are having positive impact.
Participation is already good, but it can be improved or timed better (eg earlier intervention).
• Breast Cancer screening participation is good and the outcomes are tracking well with Queensland averages which are low when compared to Australia as a whole. This is
not an area requiring focus at this point in time, however continued promotion of the breast screening program is still required to ensure ongoing participation.
While the perinatal mortality rates for babies born to Indigenous women in Wide Bay is better compared to their Queensland counterparts, the infant mortality rates for this
population appears to be consistently higher than Queensland Indigenous infant mortality rates. The picture isn’t so consistent for non-Indigenous infant mortality rates
when compared to Queensland, however they are significantly lower than the Indigenous infant mortality rates.23
HEALTH
CHILD
The AEDI is a nationally bench marked population based measure of children’s health and development in their first year of schooling. Wide Bay is in the worst quintile for all
MLs across Australia. It should be noted that the 11 MLs located in Queensland rank in the bottom two quintiles compared with the rest of Australia. There is some variation
across SLAs and this is discussed in the profiling section of the PHCA. 9 Child development needs to be a priority for further work.
• The completed suicide rate of 14.3 (per 100,000) ranks Wide Bay as the eighth worst ML in Australia and prevalence of depression 13.5 (per 100) places Wide Bay in the
highest quintile for MLs. 9 These figures suggest underlying mental health issues within the region and likely unmet needs which require access to timely and appropriate
MENTAL
HEALTH
services.
This suggests a very high need for mental health services in the region.
• High levels of male injuries from accidents and poisoning is associated with risky behaviour and is symptomatic of incidents of depression and/or substance abuse. 47
The total residential care places (per 1000 people 70+) are amongst the lowest in the nation and for Queensland. This is a major concern considering Wide Bay has a high
proportion of people aged 70+, ranking third out of all MLs.
AGED
RACF
To reduce the impact of an ageing population on the Wide Bay community and services, multiple strategies will be required for people to age in place and avoid unnecessary
hospital admissions including keeping seniors healthy, active, independent and socially connected.

Part4
Potential Needs of Specific Populations at Risk Within Wide Bay Region
1 Populations of Interest
Low Socio-economic Communities
Wide Bay is one of Australia’s most disadvantaged populations, with 83% of its population sitting in the two most disadvantaged
SEIFA quintiles (and the entire region located within the bottom five deciles) as documented on page 5 of this Atlas. This is reflected
in the large number of people living below the poverty line, experiencing housing stress and unemployment. These socio–
economic factors (better known as Social Determinants of Health and evidenced by the region's low SEIFA profile), underlie the high
prevalence of lifestyle and behavioural risk factors such as smoking rates, physical inactivity, unhealthy eating and high levels of
obesity. Tackling these challenges will require population wide prevention programs that recognise and account for the impact of
SDH on people’s ability to lead healthy lives. In particular, it will be important to increase protective factors such as physical activity
and healthy eating. The opportunity for the Wide Bay Medicare Local and the Hospital and Health Service is to work in partnership
with state government agencies, regional and local government, community organisations and primary care services to target
action at the whole community to address these issues. In some circumstances it may be appropriate to focus early attention on
vulnerable population groups, including Aboriginal and Torres Strait Islander populations and/or disadvantaged locations.
Children Under 5 Years

2 The development outcomes for children in the Wide Bay region by the age of five years are poor, as measured against the AEDI. There
is overwhelming evidence that the trajectory of children’s lifelong health outcomes are in part determined in the first five years of
their life. The risks to the developing child are significantly greater among those in poor socio-economic circumstances. These risks
can be reduced through investments in systems and programs designed to improve maternal and child health outcomes, provide
increased support for families living in complex circumstances and through building the confidence, skills and resources of parents/
carers to be able to provide positive nurturing environments for their children. The childhood immunisation rate for Wide Bay is
high, a sign that Wide Bay children are protected against a number of infectious diseases throughout their early years.
Older People Living In Wide Bay

3 The region currently has the highest proportion of people aged 65 years and older in Queensland, as identified on pages 4 and 6 of
this Atlas. This proportion is expected to expand during the next decade. Addressing the health needs of this population group will
be essential to curtail the demands across all sectors - health in particular; maximise the health of the whole Wide Bay community
and to promote the independence and dignity of Wide Bay’s older citizens. This will require strategies that span the population
health disease continuum: primary prevention through to management of disease and end of life care. Strategies could include
creating age friendly physical and social environments, supporting independent living and quality social support structures and
increasing the health literacy of Wide Bay's older citizens so that they are better able to self manage conditions, engage in healthy
lifestyles and be able to navigate the health system..
4 Issues of Interest
Obesity and Diabetes
The Wide Bay region has one of the highest rates of obesity in Australia for both males and females, and this may be related to the
elevated levels of disadvantage in the region. Evidence has found, that while high levels of overweight and obesity apply to all
population groups in society, those who are most disadvantaged are more likely to be obese than those in the most advantaged
category. 48 Furthermore, the AIHW state that obesity is more prevalent in people living in outer regional and remote areas, when
compared with those living in major cities.28 There is a direct relationship between excess weight and the risk of developing diabetes
and so it is not surprising, that the rate of Type 2 diabetes in Wide Bay is also amongst the highest in Australia and that diabetes
hospitalisation rates for the Wide Bay HHS district are also above the Queensland rates for both males and females. Excess weight
is not only a risk factor for Type 2 diabetes but also cardiovascular disease, musculoskeletal conditions and some cancers. Investing
in an obesity prevention strategy, in particular increasing physical activity and healthy eating (see recommendations on page 20)
offer the best hope of halting the obesity epidemic and the progression of diabetes at the population level. Additionally, there are
opportunities for the WBML and HHS to build on the outcomes of the Diabetes Care Project currently underway in the region.
Smoking and COPD

5 Smoking and COPD prevalence are among the highest in the country and high when compared to Queensland. Of particular
concern is smoking during pregnancy for both Indigenous and non-Indigenous mothers. Preventing the onset of smoking and
increasing the number of smokers who quit is the single most important strategy to reduce the prevalence of and deaths from COPD.
There is an opportunity to enhance/build on state level tobacco control strategies across the Wide Bay community, and to target
more intensive programs to vulnerable sub-populations such as people from Aboriginal and Torres Strait Islander backgrounds,
adolescent girls and young mothers.
Mental Health
6 The levels of suicide, self harm/injury, and psychological distress within the Wide Bay region are of major concern. The causes for
these high levels are complex and are linked to a number of demographic and socio-economic factors. The situation is likely to have
been further exacerbated by recent economic downturns and the number of natural disasters experienced by the region in recent
years. Given the level of mental health concerns within Wide Bay, it is surprising that the number of GP mental health plans is below
the national average. The reasons around the high level of psychological distress identified in the Atlas for Wide Bay warrants further
investigation. The Region should review its current approaches to prevention including strategies that promote positive mental
health. There may be a need to consider models of care within the community and develop referral and treatment pathways that
lead to lowering levels of psychological distress, creating a community that can more readily identify mental health issues and make
linkages with the most appropriate early intervention services.

Needs + Commissioning Approach
Summary and Key Considerations For Setting Concepts of Need

Need is an important concept in public
Priorities and Commissioning Services health. It is used in the planning and
management of health services including
Within Wide Bay Medicare Local and Wide Bay Hospital & Health Service health improvement, resource allocation,
and equity. However, need is a multi-faceted
The Wide Bay region faces a range of complex challenges that include high levels of social disadvantage concept with no one universal definition. The
which appears to be wide spread across the community. need for healthcare should be distinguished
from the need for health. The need for health
As discussed throughout this Atlas, social disadvantage creates conditions which make it difficult for
is broader and can include problems for
communities to lead healthy lives. This then becomes an additional burden and challenge for the region
which there is no known treatment. Need
and can be clearly seen in the high levels of smoking, physical inactivity and obesity.
for health care exists when an individual
Finally, these social circumstances, unhealthy behaviours and risk factors result in elevated levels of chronic has an illness or disability for which there is
disease, hospitalisation and death. effective and acceptable treatment or care.
Health economists have also distinguished
Health organisations can not resolve these challenges alone. A key strategy in moving forward will be need from supply and demand. Need is
to build and extend partnerships with key regional providers from outside the health sector and with defined as capacity to benefit; demand is
community based primary care providers. defined as what individuals ask for; and
Indications from the National Health Performance Authority Healthy Communities 40 report 2010-11 show supply is defined as what is provided (i.e.
that people have a positive experience with access to services. A challenge will be maintaining this good the services that are available). Demand is
influenced by factors such as the social and
access with the large cohort of the population in the 65+ age group which is likely to place a high burden
educational background of an individual, the
on primary and tertiary services, particularly as they continue to age.
media and the medical profession. Supply is
With all this in mind the following are suggested key focus areas cognizant of the profiling and the influenced by historical patterns and public
potential needs of specific populations. (See Wide Bay Key Focus areas page 20). and political pressure. Finally, health systems
are concerned not only with maximising
health, but also with the fair distribution of
Figure 4.1 Commissioning Cycle health.
Commissioning Framework
The commissioning cycle consists of four
core components - needs assessment;
service development; provider engagement
and evaluation and is directly linked to both
strategic and annual planning cycles. 49
One of the key strategic objectives of MLs is
to identify health needs of local areas and
develop locally focussed and responsive
services.
the PHCAtlas™
This Population Health Commissioning
Atlas provides a tool by which the Wide
Bay Medicare Local (WBML) and Wide Bay
Hospital and Health Service (WBHHS) can
build a specific population health profile to
inform health needs assessment, including
information on the determinants of health,
as a means to establishing priorities for
service development. It also assists in the
identification of key areas in which it can
work in partnership with a wide range of
stakeholders to strengthen the primary
health care system.
Source: AMLA 49
Glossary
ABS Australian Bureau of Statistics ML Medicare Local
AEDI Australia Early Development Index NBCSP National Bowel Cancer Screening Program
AIHW Australian Institute of Health & Welfare NESB Non English Speaking Background
ASR Age Standardised Ratio NHPA National Health Performance Authority
ATAPS Access to Allied Psychological Services PHCA Population Health Commissioning Atlas
BMI Body Mass Index PHIDU Public Health Information Development Unit
CBT Cognitive Behavioural Therapy RACF Residential Aged Care Facility
COPD Chronic obstructive pulmonary disease SDH Social Determinants of Health
DoHA Department of Health & Ageing (Federal) SDR Standardised Death Ratio
FWE Full Time Workload Equivalent SEIFA Socio-Economic Index for Areas
GP General Practitioner / General Practice SES Socio-Economic Status
IHD Ischemic Heart Disease SLA Statistical Local Area
IRSAD Index of Socio-Economic Advantage and Disadvantage SR Standardised Ratio
IRSD Index of Relative Socio-Economic Disadvantage WBHHS Wide Bay Hospital & Health Service
LGA Local Government Area WBML Wide Bay Medicare Local
MBS Medicare Benefits Schedule WHO World Health Organization
MH Mental Health

Part4
Commissioning R
Recommendations for Wide Bay Region
Wide Bay Medicare Local and Hospital and Health Service to consider convening a leadership group with key partners to
General
agree on a priority setting framework and establish priorities for immediate action and to guide future commissioning.
Recommendation For each of the recommendations, consider a collaborative partnership with the primary care sector, in particular general
practice, which has the role of connecting people to appropriate levels of care working across the population health
1 continuum. There are particular opportunities available at this time to utilise the Personally Controlled Electronic Health
Record (PCEHR) as a mechanism to monitor and improve patient outcomes.50
It will be important for the Wide Bay ML and HHS to establish intersectoral partnerships to support comprehensive action
2 designed to address the SDH across the region to minimise the impact of disadvantage and respond to the region's ageing
profile. In addition, there are opportunities to engage with MLs that have similar socioeconomic and geographic profiles
and explore opportunities for shared learning and collaboration, which will result in positive population health outcomes.
Low Socio-economic Communities

Specific
Improving the health and wellbeing of the Wide Bay population will require strong partnerships across multiple sectors
Recommendation through the identification of common goals and co-benefits for all partners. Priorities include -
Physical Activity and Health Eating: The Wide Bay ML and HHS promote a focus on building supportive physical and social
1 environments that encourage increased levels of physical activity and healthy eating across the community.
Obesity prevention strategy: Investigate the potential to develop a population level obesity prevention strategy that
includes a focus on SNAP risk factors and aims to create health promoting environments where the "healthy choice becomes
the easy choice". Strategies are designed to ensure disadvantaged populations access and benefit from the interventions
without creating negative perceptions or a sense of victim blaming.
Health Promoting Settings: Consider using "setting based" strategies, for example in the workplace, school, primary care,
neighbourhood or community setting.
Targeted tobacco control: Work with key stakeholders' to develop and/or promote tailored smoking cessation programs
designed to prevent adolescent girls and young mothers from smoking and in particular during pregnancy.
Child Health
2 Child health and wellbeing is influenced by a range of social, biological and environmental factors. How a child develops
depends on the care and support they experience in their family, neighbourhood and communities. Evidence indicates that
children who do not receive appropriate nutrition, stimulation and care in the earliest months and years of life, including in-
utero have poorer health outcomes. These negative experiences have long lasting effects that can be difficult to overcome
later in life.
Early years strategy: Develop a comprehensive early years strategy to support families and children 0-5 years across the
Wide Bay region. Work in close collaboration with carers/educators and child protection agencies within the region.
Preliminary action: Develop and enhance regional stakeholders' interest and capacity to partner with WBML and HHS on
the development and implementation of an ’Early Years' Strategy
Universal and targeted home visiting: Investigate the scope to implement a universal home visiting program for all
new mothers combined with a targeted sustained home visiting program to support mothers and families experiencing
difficulties.
Age Friendly Environments

3 Creating supportive social and physical environments that promote the health and wellbeing of communities has
been well documented. This is particularly true for older people, and in response the World Health Organization has
developed its ”Age Friendly Cities” program to assist local government and regional health authorities to build positive
built environments that support the needs of older people. 51
The WBML/HHS investigate the potential to implement the WHO Age Friendly Cities program with local governments
in their region, to support increased physical activity, healthy eating, reducing social isolation, maintaining mobility and
independence of the older Wide Bay population.
Increasing Health Literacy of Older People:

4 Poor health literacy has been shown to result in reduced healthy lifestyle choices, increased risk taking behaviours, poorer
self management of chronic conditions, increased hospitalisation and poorer health outcomes. Older people are known
to have poorer health literacy levels when compared with younger populations and this may well impact on their ability
to manage their health and navigate the health system. The WBML and HHS should consider undertaking:
• a survey the health literacy levels of older people across their region, and
• based on the results of the survey develop a comprehensive health literacy strategy in partnership with primary health
care providers and peak ageing organisations drawing on a recently released document by the WHO "Health literacy, The
Solid Facts" 52
Mental Health
5 There appears to be number of challenges in meeting the Wide Bay community’s mental health needs which may include
limited availability of mental health providers and services as well as earlier recognition/diagnosis of mental illness within
primary care. Convene a key stakeholder group to identify priority needs in the community for people experiencing mental
health issues and identify gaps in service provision for those mental health issues that have high prevalence but low
acuity and low prevalence but high acuity. Apply a setting based approach to promote positive mental health strategies
and support early detection and treatment of mental health issues. Examine opportunities to build the capacity of the
primary care sector, including general practice, to identify and refer people in the early stages of mental distress to the most
appropriate service. Work with existing services to strengthen partnerships and extend appropriate care pathways.

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population health profiling

Contents Introduction to the PHCAtlas™

2 Population Health Commissioning Atlas™

Fraser Coast 98,629

Wide Bay Total 207,830

Population Health Commissioning Atlas™ 3

4 Population Health Commissioning Atlas™

Wide Bay SEIFA Analysis

‘We are increasingly living in rich countries full of poor

Population Health Commissioning Atlas™ 5

Ageing Population Map 1.4 Population Aged 65 Years And Over

Social Determinants of Health

6 Population Health Commissioning Atlas™

Map 1.7 Concession Card Holders Wealth and Income

Total Personal Income (15+ Personal Weekly Income)

$400 - $999 per Week 31.8%

$1000 - $1999 per Week 12.4%

> $2000 per Week 2%

Source: Queensland Treasury and Trade 15

Welfare Dependent Families

Wide Bay Financial Stresses

Rental Stress 2nd

Mortgage Stress 4th

Total Concession Card Holders 2nd

Low Income 11th

Children in Welfare Dependent Families 5th

Population Health Commissioning Atlas™ 7

Child Development and Australian

8 Population Health Commissioning Atlas™

The social determinants of health influence

Source: PHIDU 9 Obesity

Population Health Commissioning Atlas™ 9

Chronic Obstructive Map 2.4 Current Smokers 18+

Smoking & COPD Prevalence

Comparison Data Wide QLD Aust

10 Population Health Commissioning Atlas™

Population Health Commissioning Atlas™ 11

Mental Health Map 2.10 Psychological Distress 18+

GP Mental Health Care

12 Population Health Commissioning Atlas™

Population Health Commissioning Atlas™ 13

GP Services Waiting Times (%) 6.3.3.5 15.0 8.0-28.0 15.0 23 No data

GP After Hours Service Utilisation 6.3.3.12 0.24 0.05-0.79 0.13 49 No data

Allied Health utilisation (services/person) 6.3.3.3 No data 0.061

Primary Care type ED attendances (type 4 & 5) 6.3.3.13 No data 66403

Community Services Waiting times 6.3.3.6 No data No data

Specialist Service Utilisation 6.3.3.4 No data No data

Selected Potentially Avoidable Hospitalisations 6.3.1.1 No data No data

Alcohol Use/abuse (ASR per 100) 5.5 3.7-13.4 5.5 30 5.1-7.3

Physical Inactivity (ASR per 100) 34.5 26.4-44.2 41.6 60 36.3-44.8

GP MBS Asthma Care Plan (SIP services) 6.3.1.3 No data 424

Incidence IHD 6.3.5.2 No data 8.5

5 year Survival Breast Cancer (%) 6.3.1.5 No data 88.7

Death rate Breast Cancer (rate/10,000) Nil No data 21.3

5 year Survival Bowel Cancer (%) 6.3.1.5 No data 66.7

5 year Survival Cervical Cancer (%) 6.3.1.5 No data 75

Death rate Cervical Cancer ( rate/100,000) Nil No data 1.6

Proportion babies Low Birth weight 6.3.5.9 No data No data

4 yr old Development Check (claims) 6.3.3.10 No data 2597

Prevalence of Depression (ASR per 100)

Nil 11.6 8.9-13.8 13.5 59 10.9-16.1

Population receiving MH Care (rate per 1000) 6.3.3.14 No data 82.2

Rate Child/Young use Primary MH care 6.3.3.15 No data No data