Eastern metropolitan region health status Summary profile

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Published by the Modelling, GIS and Planning Products Unit

Victorian Government Department of Health, Melbourne Victoria. December 2010

© Copyright State of Victoria, 2010

This publication is copyright. No part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968.

Authorised by the State Government of Victoria, 50 Lonsdale Street, Melbourne.

Contents

Key demographic trends 1

Population projections 1 Table 1: Current and projected resident population, 2009 and 2022 1 Table 2: Current and projected resident population aged 65 years and over, 2009 and 2022 1 Figure 1: Percentage change in resident population from 2009 to 2022, Eastern metropolitan region, by LGA 2

How healthy are Easterners? 3

Health outcomes 3 Table 3: Life expectancy at birth in Victoria, 2007 3 Table 4: Life expectancy at birth in Eastern metropolitan LGAs, 2007 4 Table 5: Disability Adjusted Life Years (DALY) rate per 1,000 population 4 Table 6: Years Life Lost (YLL) rate per 1,000 population, 2001 Burden of Disease Study 5

Behavioural determinants 6

Body Weight Status 6 Table 7: Body weight status, by sex and LGA, Eastern metropolitan region, 2008 6

Fruit and vegetable intake 7 Table 8: Daily vegetable consumption, Eastern metropolitan region by LGA, 2008 7 Table 9: Daily fruit consumption, Eastern metropolitan region by LGA, 2008 8 Table 10: Not meeting guidelines for consumption of fruit and/or vegetables, Eastern metropolitan region by LGA, 2008 9

Smoking 10 Table 11: Smoking status, Eastern metropolitan region by LGA, 2008 10

Physical activity 11 Table 12: Physical activity levels, Eastern metropolitan region by LGA, 2008 11 Table 13: No days of incidental physical activity, Eastern metropolitan region by LGA, 2008 12

Alcohol consumption 13 Table 14: Frequency of drinking alcohol at above short-term risk levels, Eastern metropolitan region by LGA, 2008# 13 Table 15: Did not consume alcohol at above long-term risk, Eastern metropolitan region by LGA, 2008# 14

Cancer screening 15 Table 16: Had a test to detect bowel cancer in the past two years, Eastern metropolitan region by LGA, 2008 15 Table 17: Had a Pap smear in the past two years, females aged 20-69 years, Eastern metropolitan region by LGA, 2008 15 Table 18: Had a mammogram in the past two years, females aged 50-69, Eastern metropolitan region by LGA, 2008 16

Major causes of disease and illness 17

Table 19: DALYs by Major Disease Category for Eastern metropolitan region, 2001 17

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Figure 2: Burden of disease (DALYs) attributable to risk factors in Eastern metropolitan region compared to Victoria, 2001 18

Health sector performance 19

Ambulatory care sensitive conditions 19 Table 20: Total ACSC, acute ACSC and chronic ACSC admission numbers, rates and average bed days, Victoria 2008-09 19 Table 21: Top ten ambulatory care sensitive conditions (ACSCs), Eastern metropolitan region by LGA, 2008-09 20

Immunisation rates 21

Table 22: Proportion of children fully immunised, by age and region in Victoria, September 2010 21 Table 23: Proportion of children fully immunised, Eastern metropolitan region by LGA, September 2010 21 Figure 3: Year 10 secondary school Boostrix percentage coverage rate by LGAs, 2009 22

How strong are Eastern metropolitan communities? 23

Social, economic and environmental determinants of health 23 Table 24: Proportion of unemployed persons, Victoria by region, 2009-10 23 Table 25: Proportion of unemployed persons, Eastern metropolitan region by LGA, 2009-10 23 Table 26: Indicators of income and socio-economic status, Eastern Metro by LGA 23 Table 27: Recorded family incident reports, Eastern metropolitan region by LGA, 2009-10 24 Table 28: Social wellbeing and connectedness indicators by percent of population, Eastern metropolitan region by LGA, 2006 25 Table 28 continued: Social wellbeing and connectedness indicators by percent of population, Eastern metropolitan region by LGA, 2006 25

Reference 26

1

Key demographic trends

Population projections

Table 1: Current and projected resident population, 2009 and 2022 LGA 2009 2022 % changeBoroondara (C) 168,090 179,869 7.0Knox (C) 155,969 163,923 5.1Manningham (C) 118,544 126,197 6.5Maroondah (C) 106,224 116,381 9.6Monash (C) 176,069 188,838 7.3Whitehorse (C) 155,725 164,642 5.7Yarra Ranges (S) 148,912 151,796 1.9Eastern metro 1,029,533 1,091,646 6.0Victoria 5,443,228 6,409,575 17.8Source: Australian Bureau of Statistics [1] and Department of Planning and Community Development [2]

Table 2: Current and projected resident population aged 65 years and over, 2009 and 2022 LGA 2009 2022 % changeBoroondara (C) 23,269 29,341 26.1Knox (C) 17,654 30,983 75.5Manningham (C) 20,787 27,822 33.8Maroondah (C) 15,200 22,859 50.4Monash (C) 29,150 31,998 9.8Whitehorse (C) 26,338 29,461 11.9Yarra Ranges (S) 16,739 27,959 67.0Eastern metro 149,137 200,424 34.4Victoria 738,131 1,072,540 45.3Source: Australian Bureau of Statistics [1] and Department of Planning and Community Development [2]

Figure 1: Percentage change in resident population from 2009 to 2022, Eastern metropolitan region, by LGA

7.0 5.1 6.59.6 7.3 5.7

1.9

26.1

75.5

33.8

50.4

9.8 11.9

67.0

0

10

20

30

40

50

60

70

80

Boroon

dara

(C)

Knox (

C)

Manningh

am (C

)

Maroon

dah (

C)

Monash

(C)

Whitehors

e (C)

Yarra R

anges

(S)

Perc

enta

ge

All ages 65+

In percentage terms, the largest increase in population in Eastern metropolitan region is expected to be in the City of Maroondah. The population of Maroondah is projected to increase by 9.6 per cent from 2009 to 2022. The population aged 65 years and over, is projected to increase by 75.5 per cent in the City of Knox, from 2009 to 2022. The second highest increase in aged population is 67.0 per cent in the Shire of Yarra Ranges.

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How healthy are Easterners?

On a range of indicators people who live in Eastern metropolitan region have better health than people who live in other regions of Victoria. Presented below are available data on health outcomes, behavioural determinants of health and indicators of performance of the health system.

Health outcomes On a range of indicators of health status, residents of the Eastern metropolitan region have better health than Victorian averages, and on some indicators are comparable to the state average.

Reported here are data on life expectancy and burden of disease.

People living in the Eastern metropolitan region have the highest life expectancy when compared with any other region in Victoria and also Victorian average. Males are expected to live 1.7 years more than the Victorian life expectancy of 80.3 years. Females are expected to live 1.0 year more than Victorian women who have a life expectancy of 84.4 years.

Table 3: Life expectancy at birth in Victoria, 2007 Males Females

Region LE Lower 95% CI

Upper95% CI Sig∗

LE Lower

95% CI Upper

95% CI Sig∗

Barwon-S/W 79.4 78.7 80.0 L 84.0 83.4 84.5 Eastern 82.0 81.6 82.4 H 85.4 85.1 85.7 H Gippsland 78.1 77.3 78.9 L 84.0 83.3 84.7 Grampians 79.1 78.2 79.9 L 83.6 82.9 84.4 Hume 79.3 78.5 80.1 L 84.1 83.4 84.8 Loddon Mallee 78.6 77.9 79.4 L 83.4 82.8 84.1 L North and West 80.0 79.7 80.3 84.2 83.9 84.5 Southern 80.8 80.4 81.1 84.5 84.2 84.8 Victoria 80.3 80.1 80.5 84.4 84.2 84.6 LE = life expectancy, CI = confidence interval, Sig = significance (see footnotes) Source: Department of health, 2010 [3]

∗ H= indicates a life expectancy at birth significantly higher than the Victorian average L= indicates a life expectancy at birth significantly lower than the Victorian average

Average life expectancy varies within the Eastern metropolitan region with the lowest life expectancy experienced by residents of City of Knox followed by the Shire of Yarra Ranges.

Table 4: Life expectancy at birth in Eastern metropolitan LGAs, 2007 Males Females

LGA LE Lower 95% CI

Upper95% CI Sig∗

LE Lower Upper ∗Sig95% CI 95% CI

Boroondara (C) 81.8 82.6 H 85.4 86.1 H 82.2 85.8Knox (C) 79.3 80.2 82.5 83.4 L 79.7 83.0Manningham (C) 81.4 82.3 H 85.2 86.0 H 81.9 85.6Maroondah (C) 80.0 81.1 H 84.3 85.3 H 80.5 84.8Monash (C) 81.1 81.9 H 85.4 86.2 H 81.5 85.8Whitehorse (C) 80.9 81.7 H 84.9 85.7 H 81.3 85.3Yarra Ranges (S) 79.6 80.5 83.9 84.8 80.1 84.3Eastern metro 82.0 81.6 82.4 H 85.4 85.1 85.7 H Victoria 80.3 80.1 80.5 84.4 84.2 84.6 LGA = local government area, LE = life expectancy, CI = confidence interval, Sig = significance (see footnotes) Source: Department of health, 2010 [3]

Residents of the Eastern metropolitan region have the lowest rates of Disability Adjusted Life Years (DALY) lost due to all causes and therefore have better health than other regions.

Table 5: Disability Adjusted Life Years (DALY) rate per 1,000 population Region Males Females

158.8 140.5 Gippsland (highest) 155.2 137.1 Grampians 154.8 136.3 Loddon-Mallee 153.4 135.0 Hume 144.8 128.5 Barwon-South Western 142.8 128.3 Western metropolitan 142.7 128.2 Northern metropolitan 138.0 126.3 Southern metropolitan 135.3 124.9 Eastern metropolitan (lowest) 143.0 129.1 Victoria

Source: Department of Human Services, 2006, Burden of Disease [4]

∗ H= indicates a life expectancy at birth significantly higher than the Victorian average L= indicates a life expectancy at birth significantly lower than the Victorian average

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Residents of the Eastern metropolitan region have the second lowest rates of Years of Life Lost (YLL) due to all causes. The rates for Eastern metropolitan males and females are significantly lower than for Victoria.

Table 6: Years Life Lost (YLL) rate per 1,000 population, 2001 Burden of Disease Study Males Females

Region Rate Status indicator∗

Rate Status indicator∗

Gippsland (highest) 84.1 H 64.6 H Grampians 82.1 H 63.1 H Loddon-Mallee 81.6 H 63.3 H Hume 80.9 H 61.5 H Barwon-South Western 73.1 H 57.8 H Northern metropolitan 70.2 L 55.4 L Western metropolitan 69.1 L 55.8 L Eastern metropolitan 65.9 L 56.5 L Southern metropolitan (lowest) 67.6 L 56.5 L Victoria 71.3 57.7 Source: Department of Human Services, 2006, Burden of disease [5]

∗ H= indicates rate higher than the Victorian average, reflecting poor health status L= indicates rate lower than the Victorian average, reflecting better health status

Behavioural determinants

Data on determinants of health can be categorised as behavioural or related to social, economic and environmental conditions. Behavioural determinants are presented here. Those related to social, economic and environmental conditions that are known to impact on health are presented in the section How strong are Eastern metropolitan communities?

Body Weight Status 1Table 7: Body weight status , by sex and LGA, Eastern metropolitan region, 2008

Males Females Overweight (25.0-29.9) Obese (≥30.0) Overweight (25.0-29.9) Obese (≥30.0) LGA

% Lower 95% CI

Upper95% CI % Lower

95% CIUpper

95% CI % Lower 95% CI

Upper95% CI % Lower Upper

95% CI 95% CI 6.0(b)Boroondara (C) 24.4 38.7 5.0 17.3 14.6 24.6 3.7 9.7 31.1 9.5* 19.1

Knox (C) 32.7 49.5 13.6 26.3 18.1 30.0 11.6 20.2 40.9 19.1 23.6 15.4 Manningham (C) 32.5 49.1 8.7 18.8 17.2 28.3 11.0 20.6 40.5 12.9 22.3 15.2 Maroondah (C) 34.6 52.3 14.2 28.3 19.7 31.2 8.2 16.1 43.2 20.4 25.1 11.6 Monash (C) 27.9 44.4 8.6 20.2 15.8 25.2 14.7 23.8 35.7 13.4 20.1 18.8

10.1(b)Whitehorse (C) 32.7 49.2 10.2 20.3 19.9 30.8 7.3 13.7 40.7 14.6 25.0Yarra Ranges (S) 36.7 50.5 9.4 20.4 18.5 30.1 15.5 25.9 43.5 14.0 23.8 20.2

36.8 43.4 12.1 16.6 20.4 24.8 12.4 15.8 40.0 14.2 22.5 14.0 Eastern metro Victoria 39.9 17.3 24.2 16.1 38.7 41.2 16.4 18.2 23.4 25.1 15.4 16.8 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

1 Determined by calculation of body mass index (BMI).

(b) Estimates are (statistically) significantly below Victorian estimates. * Estimate has a relative standard error of between 25 and 50 per cent and should be interpreted with caution.

Data are age-standardised to the 2006 Victorian population.

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Fruit and vegetable intake

Table 8: Daily vegetable consumption, Eastern metropolitan region by LGA, 2008 per day Serves#

None 1-2 serves 3-4 serves 5 or more serves LGA % Lower

95% CIUpper

95% CI % Lower 95% CI

Upper 95% CI % Lower

95% CIUpper

95% CI % Lower Upper 95% CI 95% CI

Boroondara (C) 3.0 8.6 50.8 62.0 24.0 34.1 5.8 11.9 5.1 56.5 28.8 8.3Knox (C) 2.2 6.7 55.2 65.5 22.5 31.4 5.6 10.9 3.9* 60.4 26.7 7.8Manningham (C) 2.0 7.0 47.9 59.4 27.9 38.6 5.7 11.1 3.7 53.7 33.0 8.0Maroondah (C) 3.3 9.2 51.3 62.6 22.9 33.0 6.3 12.1 5.5* 57.0 27.7 8.8Monash (C) 5.0 12.2 53.4 64.6 20.4 29.0 4.8 10.7 7.9 59.1 24.5 7.2Whitehorse (C) 2.2 7.1 52.9 64.2 23.4 33.9 5.6 10.3 4.0* 58.7 28.4 7.6Yarra Ranges (S) 2.8 6.9 47.9 58.4 28.3 38.2 5.8 11.3 4.4 53.2 33.1 8.2

4.1 6.4 55.4 59.7 26.4 30.2 6.9 9.0 5.1 57.5 28.2 7.9Eastern metro Victoria 5.8 56.9 28.2 7.75.3 6.2 56.0 57.7 27.4 28.9 7.4 8.2 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

# A serve is half a cup of cooked vegetables or a cup of salad vegetables.

* Estimate has a relative standard error of between 25 and 50 per cent and should be interpreted with caution. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses. Data are age-standardised to the 2006 Victorian population.

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Table 9: Daily fruit consumption, Eastern metropolitan region by LGA, 2008 per day ∧Serves

None One serve Two or more serves LGA % Lower

95% CIUpper

95% CI % Lower 95% CI

Upper95% CI % Lower Upper

95% CI 95% CI Boroondara (C) 9.3 17.7 27.9 38.8 46.3 57.3 12.9 33.2 51.8Knox (C) 10.3 18.5 33.5 44.4 41.4 52.6 13.9 38.8 47.0Manningham (C) 7.0 14.3 29.8 41.0 48.4 60.2 10.1 35.2 54.4Maroondah (C) 9.1 16.4 30.9 42.6 44.7 56.5 12.3 36.6 50.6Monash (C) 11.3 20.5 32.9 44.3 40.3 51.2 15.3 38.4 45.7Whitehorse (C) 7.5 15.0 29.9 41.0 47.5 59.3 10.7 35.3 53.4Yarra Ranges (S) 8.8 15.5 30.3 40.7 46.1 56.7 11.7 35.3 51.5

11.2 14.5 34.1 38.5 47.9 52.3 12.7 36.3 50.1Eastern metro Victoria 14.3 36.1 48.613.7 14.9 35.3 37.0 47.8 49.5 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

∧ A serve is one medium piece or two small pieces of fruit, or one cup of diced pieces. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses. Data are age-standardised to the 2006 Victorian population.

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#Table 10: Not meeting guidelines for consumption of fruit and/or vegetables, Eastern metropolitan region by LGA, 2008 Did not meet guidelines

Fruit guidelines Vegetable guidelines Either fruit or vegetable guidelines LGA % Lower

95% CIUpper

95% CI % Lower 95% CI

Upper95% CI % Lower Upper

95% CI 95% CI Boroondara (C) 40.7 51.9 85.3 92.0 37.0 48.0 46.2 89.1 42.4Knox (C) 46.8 58.0 87.7 93.3 45.4 56.6 52.4 90.9 51.0Manningham (C) 38.6 50.4 86.9 92.6 36.9 48.6 44.4 90.1 42.6Maroondah (C) 42.7 54.4 85.6 92.0 39.5 51.2 48.5 89.2 45.3Monash (C) 48.4 59.2 87.8 93.9 47.0 57.8 53.8 91.3 52.4Whitehorse (C) 40.3 52.0 86.7 92.5 38.6 50.3 46.1 89.9 44.4Yarra Ranges (S) 42.3 52.9 84.5 91.1 38.4 48.9 47.6 88.2 43.6

46.7 51.2 88.8 91.1 44.4 48.9 49.0 90.0 46.6Eastern metro Victoria 50.5 90.0 48.249.6 51.3 89.5 90.4 47.3 49.1 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

# Based on national guidelines (National Health and Medical Research Council, 2003). Data are age-standardised to the 2006 Victorian population.

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Smoking

‡, Eastern metropolitan region by LGA, 2008 Table 11: Smoking statusCurrent smoker Ex-smoker Non-smoker

LGA % Lower 95% CI

Upper95% CI % Lower

95% CIUpper

95% CI % Lower Upper 95% CI 95% CI

63.7(a)Boroondara (C) 9.9 18.5 17.9 26.6 58.0 69.1 13.6 21.9 26.7(a) 22.0 32.0 18.6 27.2 45.2 56.1 Knox (C) 22.6 50.7

15.2(b) 70.1(a)Manningham (C) 10.4 20.0 11.8 19.4 64.3 75.4 14.6 Maroondah (C) 13.0 22.1 19.3 27.5 54.3 64.8 17.1 23.1 59.6 Monash (C) 13.4 23.4 16.9 24.9 55.5 66.8 17.9 20.6 61.3 Whitehorse (C) 9.6 18.8 19.1 27.3 57.7 68.8 13.6 23.0 63.4 Yarra Ranges (S) 16.8 25.8 19.6 27.9 50.2 60.8 21.0 23.5 55.5 Eastern metro 17.8 16.0 19.7 21.5 19.9 60.5(a)23.1 58.3 62.7

18.4 19.9 23.1 24.4 56.0 57.7 19.1 23.8 56.8 Victoria CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

‡ A person who smokes daily or occasionally was categorised as a current smoker. (a) Estimates are (statistically) significantly above Victorian estimates. (b) Estimates are (statistically) significantly below Victorian estimates. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses. Data are age-standardised to the 2006 Victorian population.

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Physical activity

†, Eastern metropolitan region by LGA, 2008 Table 12: Physical activity levelsSedentary Insufficient time and/or sessions Sufficient time and sessions

LGA % Lower 95% CI

Upper95% CI % Lower

95% CIUpper

95% CI % Lower Upper 95% CI 95% CI

2.1*(b) 67.3(a)1.2 3.5 22.9 33.0Boroondara (C) 61.9 72.3 27.7Knox (C) 3.6 7.5 21.1 30.5 59.3 69.2 5.3 25.5 64.4 Manningham (C) 3.1 7.1 23.5 34.0 56.4 67.5 4.7 28.5 62.1 Maroondah (C) 2.8 7.4 22.0 32.1 56.1 67.0 4.6 26.7 61.7 Monash (C) 2.5 5.9 23.8 33.7 53.8 64.5 3.8 28.5 59.3 Whitehorse (C) 4.4 9.6 20.9 31.6 56.8 68.3 6.5 25.9 62.8 Yarra Ranges (S) 4.0 8.9 21.8 31.4 55.5 66.0 5.9 26.3 60.9

4.0 5.5 24.9 28.9 60.8 65.0 4.7 26.9 62.9 Eastern metro 4.9 5.6 26.6 28.1 59.5 61.1 5.3 27.4 60.3 Victoria

CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

† Based on national guidelines (Department of Health and Ageing, 1999) and excludes adults aged less than 19 years. * Estimate has a relative standard error between 25 and 50 per cent and should be interpreted with caution. (a) Estimates are (statistically) significantly above Victorian estimates. (b) Estimates are (statistically) significantly below Victorian estimates. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses. Data are age-standardised to the 2006 Victorian population.

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‡Table 13: No days of incidental physical activity , Eastern metropolitan region by LGA, 2008 LGA % Lower 95% CI Upper 95% CI

52.5(b)Boroondara (C) 46.8 58.0 Knox (C) 62.2 72.8 67.7 Manningham (C) 61.6 72.5 67.2

70.8(a)Maroondah (C) 65.3 75.8 Monash (C) 56.5 67.8 62.3 Whitehorse (C) 49.8 61.8 55.9

72.5(a)Yarra Ranges (S) 67.3 77.1 61.4 65.7 63.6 Eastern metro

Victoria 61.7 60.9 62.6 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

‡ Incidental physical activity involves physical activity in everyday activities to get from place to place (for example, to school, work, the shops or the train stop). The VPHS 2008 asked respondents about the number of days on which they walked or cycled for transport for trips talking longer than 10 minutes. (a) Estimates are (statistically) significantly above Victorian estimates. (b) Estimates are (statistically) significantly below Victorian estimates. Data are age-standardised to the 2006 Victorian population.

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Alcohol consumption

§ levels, Eastern metropolitan region by LGA, 2008# Table 14: Frequency of drinking alcohol at above short-term risk Risky or high risk

**Low risk At least yearly At least monthly At least weekly ††Short-term risk

LGA %

Lower 95%

CI

Upper95%

CI%

Lower 95%

CI

Upper95%

CI%

Lower 95%

CI

Upper95%

CI%

Lower 95%

CI

Upper95%

CI%

Lower Upper 95% 95%

CI CI 6.2(b) 4.0 9.6 42.6 53.7 Boroondara (C) 34.0 43.9 20.0 30.4 13.1 21.8 48.1 38.8 24.8 17.0

Knox (C) 30.0 40.2 18.4 27.3 7.9 15.0 9.7 18.2 41.7 52.1 34.9 22.6 10.9 13.4 46.9 5.2*(b) 36.1(b)Manningham (C) 36.0 46.5 17.1 27.2 6.4 13.1 2.9 9.1 30.6 41.9 41.1 21.7 9.2

Maroondah (C) 34.1 44.6 17.6 27.3 10.1 18.9 6.8 15.6 41.1 51.8 39.2 22.0 13.9 10.4 46.4 Monash (C) 38.2 49.2 14.5 23.6 8.7 17.1 5.8 13.3 34.3 45.5 43.6 18.7 12.3 8.9 39.8 Whitehorse (C) 32.5 42.9 21.2 32.6 6.6 14.9 5.7 13.6 39.9 51.1 37.5 26.5 10.0 8.9 45.4 Yarra Ranges (S) 30.1 39.3 15.9 24.9 9.3 17.5 9.3 17.3 41.0 50.5 34.6 20.1 12.8 12.8 45.7 Victoria 36.2 22.0 13.0 10.2 45.2 35.5 37.0 21.3 22.7 12.4 13.7 9.7 10.8 44.4 46.1 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

§ Based on national guidelines (National Health and Medical Research Council, 2001). ** Drinkers who consumed alcohol at levels that did not expose them to risk of short-term harm were classified as low risk. †† Includes those who consumed alcohol at risky or high risk levels weekly, monthly or yearly. (b) Estimates are (statistically) significantly below Victorian estimates. * Estimate has a relative standard error between 25 and 50 per cent and should be interpreted with caution. # Eastern metropolitan regional level data is not available. Data are age-standardised to the 2006 Victorian population.

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‡‡, Eastern metropolitan region by LGA, 2008# Table 15: Did not consume alcohol at above long-term riskNot at long-term risk of harm LGA % Lower 95% CI Upper 95% CI

Boroondara (C) 94.0 98.2 96.7Knox (C) 89.2 95.4 92.9Manningham (C) 90.2 96.9 94.4Maroondah (C) 92.9 97.3 95.6Monash (C) 92.2 97.5 95.5Whitehorse (C) 94.1 98.0 96.5Yarra Ranges (S) 93.3 97.6 96.0Victoria 95.5 95.1 95.9 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

‡‡ Based on national guidelines (National Health and Medical Research Council, 2001). Includes those who were abstainers (non-drinkers) and those at low risk of long-term harm. # Eastern metropolitan regional level data is not available. Data are age-standardised to the 2006 Victorian population.

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Cancer screening §§Table 16: Had a test to detect bowel cancer in the past two years , Eastern metropolitan region by LGA, 2008

LGA % Lower 95% CI Upper 95% CI 37.9(a)Boroondara (C) 31.0 45.3

Knox (C) 22.8 35.6 28.7 Manningham (C) 20.4 32.5 26.0 Maroondah (C) 23.9 36.7 29.9 Monash (C) 24.8 37.5 30.8 Whitehorse (C) 23.0 35.2 28.7 Yarra Ranges (S) 19.5 30.9 24.7 Eastern metro 29.9 27.5 32.4 Victoria 29.4 28.4 30.3 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

***Table 17: Had a Pap smear in the past two years , females aged 20-69 years, Eastern metropolitan region by LGA, 2008 Yes No LGA % Lower 95% CI Upper 95% CI % Lower 95% CI Upper 95% CI

Boroondara (C) 68.1 82.4 17.6 31.9 76.0 24.1Knox (C) 67.1 79.8 20.3 32.9 73.9 26.1Manningham (C) 63.8 79.0 21.0 36.2 72.0 28.0Maroondah (C) 63.5 78.9 19.8 35.1 71.8 26.7Monash (C) 66.0 79.2 20.6 33.7 73.1 26.6Whitehorse (C) 64.3 81.3 17.0 33.8 73.6 24.4Yarra Ranges (S) 65.0 79.1 20.9 35.0 72.6 27.4Eastern metro 73.1 70.1 75.8 26.4 23.7 29.4 Victoria 71.1 70.0 72.2 28.4 27.3 29.5 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6] §§ Only respondents aged 50 years and over were asked whether they had a test for bowel cancer in the past two years. Based on persons for whom a bowel examination to detect bowel cancer was applicable at the time of the survey. (a) Estimates are (statistically) significantly above Victorian estimates. *** Female survey participants were able to select ‘not applicable’ as a response to this question. They have been excluded from the denominator when calculating estimates. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses.

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Table 18: Had a mammogram in the past two years†††, females aged 50-69, Eastern metropolitan region by LGA, 2008 Yes No LGA % Lower 95% CI Upper 95% CI % Lower 95% CI Upper 95% CI

Boroondara (C) 81.5 70.7 88.9 17.9* 10.6 28.7 Knox (C) 89.1(a) 80.8 94.1 10.9*(b) 5.9 19.2 Manningham (C) 82.6 73.8 88.9 17.4 11.1 26.2 Maroondah (C) 69.7 57.5 79.6 29.4 19.6 41.5 Monash (C) 77.0 66.5 85.0 23.0 15.0 33.5 Whitehorse (C) 76.0 65.9 83.9 24.0 16.1 34.1 Yarra Ranges (S) 74.5 64.1 82.6 24.8 16.8 35.1 Eastern metro 79.2 75.5 82.4 20.6 17.4 24.2 Victoria 75.9 74.5 77.2 23.6 22.2 24.9 CI = confidence interval Source: Department of Health, 2010, Victorian Population Health Survey 2008 [6]

††† Female survey participants were able to select ‘not applicable’ as a response to this question. They have been excluded from the denominator when calculating estimates. Note that figures may not add to 100 per cent due to a proportion of ‘don’t know’ or ‘refused’ responses. (a) Estimates are (statistically) significantly above Victorian estimates. (b) Estimates are (statistically) significantly below Victorian estimates. * Estimate has a relative standard error between 25 and 50 per cent and should be interpreted with caution. Data are age-standardised to the 2006 Victorian population.

17

Major causes of disease and illness

Table 19 presents the ranking in absolute DALYs for the broad disease categories contributing most to the burden of disease in the Eastern metropolitan region. Cancer, cardiovascular disease, mental disorders and neurological and sensory disorders are the leading causes of burden in the Eastern metropolitan region. Cancer burden is primarily years of life lost through premature death, while mental disorders rarely cause mortality but are a major cause of ill health.

Table 19: DALYs by Major Disease Category for Eastern metropolitan region, 2001 Mortality YLLs Disability YLDs Total DALYs

Cardiovascular diseases 17,577.7 5,197.1 22,774.8Chronic respiratory diseases 3,171.5 5,752.2 8,923.7Congenital abnormalities 663.3 1,441.8 2,105.1Diabetes mellitus 1,489.9 3,208.7 4,698.6Digestive disorders 1,679.9 1,135.6 2,815.5Genito-urinary disorders 1,186.4 2,630.2 3,816.6Infectious diseases 849.8 723.6 1,573.4Injuries 5,420.7 2,087.5 7,508.2Malignant cancers 21,179.0 6,400.9 27,579.9Maternal conditions 2.4 66.5 68.8Mental disorders 880.2 17,243.3 18,123.5Musculo-skeletal diseases 412.3 3,862.4 4,274.7Neonatal conditions 849.2 481.6 1,330.8Neurological and sensory disorders 2,899.5 12,915.9 15,815.4Oral health 5.5 1,923.1 1,928.5Other 2,175.5 2,712.4 4,888.1TOTAL 60,442.8 67,782.8 128,225.6YLL = years of life lost to premature death YLD = years lived with disability DALY = disability adjusted life years (DALY = YLL + YLD) Source: Department of Human Services, 2006, Burden of disease [7]

Figure 2: Burden of disease (DALYs) attributable to risk factors in Eastern metropolitan region compared to Victoria, 2001

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Source: Department of Human Services, 2006, Burden of disease [7]

Health sector performance

Ambulatory care sensitive conditions Better access to primary health care increases the use of ambulatory care, prevents unnecessary hospitalisations and improves the health status of the population. Analysis from the Victorian Ambulatory Care Sensitive Conditions study identified significant differentials and inequalities in access to the primary health care system in Victoria. The analysis of ACSCs included a broad range of health conditions that are classified as ACSC’s. Data is firstly presented for total, and acute and chronic ACSC’s for each region. Table 21 gives details of the top ten ACSC’s by LGA for Eastern metropolitan region.

Table 20: Total ACSC, acute ACSC and chronic ACSC admission numbers, rates and average bed days, Victoria 2008-09

Barwon-

South Western

Eastern metro Gippsland Grampians Hume

North and Loddon Southern Victoria West Mallee metrometroTotal ACSC 181,126 13,836 29,805 10,411 8,514 10,136 12,692 52,883 42,849

Number of admissions Acute ACSC 5,733 13,126 3,677 3,381 3,612 4,779 20,669 16,780 71,757

Chronic ACSC 8,002 16,432 6,691 5,101 6,515 7,904 31,720 25,670 108,035 Total ACSC 33.6 34.4 28.1 36.0 35.9 34.8 36.9 36.7 33.1

Rate per 1,000 persons Acute ACSC 15.1 12.6 13.9 15.0 12.6 14.8 13.5 13.0 13.4

Chronic ACSC 18.9 15.3 21.9 20.7 21.2 22.1 22.9 19.8 20.0 Total ACSC 5.2 4.9 5.3 5.2 5.1 5.2 5.0 5.4 5.0

Average bed days Acute ACSC 2.5 2.9 2.9 2.9 2.9 2.9 2.6 2.7 2.7

Chronic ACSC 6.9 6.7 7.3 6.4 6.7 6.5 6.3 7.3 6.6Rates are age-standardised to the 2006 Victorian population. Source: Victorian Admitted Episodes Dataset 2008-09

19

20

Table 21: Top ten ambulatory care sensitive conditions (ACSCs), Eastern metropolitan region by LGA, 2008-09

Diabetes complications

Dental conditions Pyelonephritis

Congestive Cardiac

failure

Chronic Obstructive Pulmonary

Disease

Iron deficiency

anaemia Cellulitis Asthma

Dehydration and

gastroenteritis

Ear, nose and throat infections

LGA Number of admissions Boroondara (C) 1,164 772 356 340 224 251 195 179 231 190 Knox (C) 1,591 357 386 306 375 232 343 226 125 242 Manningham (C) 1,153 316 221 221 194 225 140 98 133 126 Maroondah (C) 964 276 270 270 316 156 174 153 128 134 Monash (C) 1,761 363 445 378 356 342 219 250 205 181 Whitehorse (C) 1,769 488 408 441 349 307 253 241 174 208 Yarra Ranges (S) 1,139 508 308 262 321 233 319 244 288 196 Eastern metro 9,541 3,080 2,394 2,218 2,135 1,746 1,643 1,391 1,284 1,277 Victoria 64,903 16,159 15,055 13,444 12,628 8,370 8,361 7,783 9,219 7,552 LGA Rate per 1,000 persons Boroondara (C) 6.5 4.6 1.9 1.6 1.2 1.4 1.1 1.1 1.3 1.2 Knox (C) 11.6 2.3 2.7 2.4 2.9 1.7 2.4 1.5 0.9 1.6 Manningham (C) 8.3 2.7 1.7 1.7 1.4 1.7 1.1 0.9 1.1 1.1 Maroondah (C) 8.7 2.6 2.4 2.3 2.8 1.4 1.6 1.5 1.2 1.3 Monash (C) 8.8 2.1 2.4 1.8 1.8 1.8 1.2 1.6 1.1 1.1 Whitehorse (C) 9.6 3.2 2.2 2.2 1.8 1.7 1.4 1.5 1.0 1.3 Yarra Ranges (S) 9.0 3.5 2.3 2.3 2.6 1.8 2.3 1.6 2.1 1.3 Eastern metro 8.9 3.0 2.2 2.0 2.1 1.6 1.6 1.4 1.2 1.3 Victoria 12.0 3.1 2.8 2.5 2.3 1.6 1.6 1.5 1.7 1.4 Source: Department of Health, 2010, Victorian ambulatory care sensitive conditions study [8]

21

Immunisation rates

The immunisation rates in Eastern metropolitan region are generally comparable with the Victorian rates. Within the region, there is variation by local government area (see Table 23). City of Knox has consistently higher rates than Victoria, while City of Monash and Shire of Yarra Ranges have lower rates across all age bands.

Table 22: Proportion of children fully immunised, by age and region in Victoria, September 2010 Region 12-<15 months 24-<27 months 60-<63 monthsBarwon-South Western 93.2% 93.8% 91.0%Gippsland 93.0% 95.9% 92.7%Grampians 93.8% 96.7% 92.7%Hume 91.5% 92.9% 88.4%Loddon Mallee 91.6% 93.6% 90.3%North and West metro 92.3% 93.0% 89.7%Southern metro 92.0% 93.0% 91.1%Eastern metro 91.8% 93.0% 90.0%Victoria 92.2% 93.4% 90.4%Source: Medicare Australia, 2010 [9]

Table 23: Proportion of children fully immunised, Eastern metropolitan region by LGA, September 2010 LGA 12-<15 months 24-<27 months 60-<63 monthsBoroondara (C) 94.1% 93.9% 88.2%Knox (C) 93.9% 95.9% 93.5%Manningham (C) 92.6% 90.6% 91.8%Maroondah (C) 90.9% 94.2% 88.0%Monash (C) 91.4% 92.8% 89.1%Whitehorse (C) 90.8% 92.8% 92.2%Yarra Ranges (S) 89.4% 90.2% 87.4%Eastern metro 91.8% 93.0% 90.0%Victoria 92.2% 93.4% 90.4%Source: Medicare Australia, 2010 [9]

Figure 3: Year 10 secondary school Boostrix percentage coverage rate by LGAs, 2009

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23

How strong are Eastern metropolitan communities?

Social, economic and environmental determinants of health

Table 24: Proportion of unemployed persons, Victoria by region, 2009-10

Region March Qtr 2009

June Qtr 2009

Sept Qtr 2009

Dec Qtr 2009

March Qtr 2010

Barwon-South Western 4.4% 5.1% 5.6% 5.9% 5.5%Gippsland 4.2% 4.5% 4.7% 4.6% 4.9%Grampians 6.3% 6.6% 6.1% 6.0% 6.3%Hume 4.8% 4.3% 4.8% 5.3% 5.6%Loddon Mallee 5.7% 5.8% 5.8% 5.8% 5.7%North and West metro 5.0% 5.5% 5.8% 6.2% 6.2%Southern metro 4.8% 5.0% 5.5% 5.6% 5.4%Eastern metro 3.9% 4.4% 4.8% 4.9% 5.0%Victoria 4.7% 5.1% 5.5% 5.6% 5.6%Source: Department of Employment and Workplace Relations (DEWR), 2010 [10]

Table 25: Proportion of unemployed persons, Eastern metropolitan region by LGA, 2009-10

LGA March Qtr 2009

June Qtr 2009

Sept Qtr 2009

Dec Qtr 2009

March Qtr 2010

Boroondara (C) 2.8% 3.0% 3.3% 3.4% 3.6%Knox (C) 3.4% 4.0% 4.3% 4.3% 4.4%Manningham (C) 3.8% 4.2% 4.6% 4.8% 5.1%Maroondah (C) 4.3% 5.1% 5.4% 5.3% 5.3%Monash (C) 4.7% 5.2% 5.7% 5.9% 6.1%Whitehorse (C) 4.8% 5.2% 5.7% 5.8% 6.2%Yarra Ranges (S) 4.0% 4.7% 4.9% 4.8% 4.8%Eastern Metro 3.9% 4.4% 4.8% 4.9% 5.0%Victoria 4.7% 5.1% 5.5% 5.6% 5.6%Source: DHS Intranet Service Planning Website, Datasets, Socio-Economic10

Table 26: Indicators of income and socio-economic status, Eastern Metro by LGA

LGA

% population with income

<$400 per week 2006 [11]

Gaming machine losses per head 2008-

09 [12]

Children in households with

income <$650 per week 2006

[13]

% households with housing

costs greater than 40% of income

[14]Boroondara (C) 37.3% $150.98 7.3% 7.9%Knox (C) 42.4% $759.76 13.2% 7.8%Manningham (C) 44.0% $724.00 12.5% 7.5%Maroondah (C) 42.2% $849.22 13.1% 7.7%Monash (C) 47.1% $883.42 13.7% 8.9%Whitehorse (C) 44.6% $482.36 12.7% 7.8%Yarra Ranges (S) 44.0% $316.81 14.8% 8.1%Eastern metro 43.1% $583.03 12.4% 8.0%Victoria 45.8% $674.27 17.9% 9.0%

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Table 27: Recorded family incident reports, Eastern metropolitan region by LGA, 2009-10 Family incidents Where charges were laid Where IVO applied for

LGA Number

Rate per 100,000

population Number

Rate per 100,000

population Number

Rate per 100,000

population Boroondara (C) 443 263.5 62 36.9 27 16.1 Knox (C) 909 582.8 169 108.4 56 35.9 Manningham (C) 379 319.7 76 64.1 39 32.9 Maroondah (C) 536 504.6 87 81.9 33 31.1 Monash (C) 592 336.2 91 51.7 37 21.0 Whitehorse (C) 507 325.6 66 42.4 29 18.6 Yarra Ranges (S) 677 454.6 131 88.0 53 35.6 Victoria 33,720 649.9 9,082 165.2 5,489 106.4IVO = family violence intervention order Rate is calculated against total estimated resident population at 30 June 2009. Source: Victoria Police, 2010 [15]

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Table 28: Social wellbeing and connectedness indicators by percent of population, Eastern metropolitan region by LGA, 2006

LGA

Can get help from

friends family or

neighbours when

needed

Could raise$2000 in

twodays in an

emergency

VolunteersMember of organised

groups

Member of group that has taken

local action

Parentalparticipation

in schools

Decision making

board orcommittee

Attendance at

community events

Feels valued by

society

Boroondara (C) 92.9 81.3 42.8 39.9 39.9 81.6 19.6 33.5 73.8 Knox (C) 93.9 78.4 38.7 30.2 47.8 70.4 15.1 41.5 65.3 Manningham (C) 91.4 77.0 45.1 42.3 43.7 71.6 19.1 32.5 67.1 Maroondah (C) 93.1 71.8 37.9 36.5 43.7 64.9 9.7 39.0 62.0 Monash (C) 90.0 70.8 40.2 38.8 35.7 72.0 15.8 29.4 70.8 Whitehorse (C) 92.6 80.1 42.2 48.3 41.5 66.6 18.3 37.3 67.6 Yarra Ranges (S) 92.9 76.6 38.0 39.5 43.5 66.5 16.8 50.7 64.1 Eastern metro 92.5 77.7 41.4 41.3 40.1 70.4 17.3 38.7 66.4 Victoria 93.1 77.1 48.7 47.3 47.5 67.6 20.6 48.9 68.8 Source: Department of Planning and Community Development, 2006 [16]

Table 28 continued: Social wellbeing and connectedness indicators by percent of population, Eastern metropolitan region by LGA, 2006

LGA

Opportunities to have a real say on issues

that are important

Multiculturalismmakes life in the

area better

Feels safe on the street

alone afterdark

The area has easy

access to recreational and leisure

facilities

The area has good facilities

andservices like

shops, childcare,

schools, libraries

The area has opportunities

to volunteer

The area has a wide range

ofcommunity

and support groups

It’s an active community

Boroondara (C) 58.0 82.0 72.1 90.5 90.3 80.8 81.2 72.1 Knox (C) 47.3 73.7 57.9 86.6 91.7 75.7 75.4 68.5 Manningham (C) 60.2 80.6 65.0 89.7 85.8 73.9 75.1 69.5 Maroondah (C) 49.4 65.8 48.4 88.8 83.7 78.4 71.5 63.6 Monash (C) 59.7 80.4 68.0 86.1 87.1 79.0 80.8 65.0 Whitehorse (C) 56.2 79.1 63.2 93.2 91.0 82.0 83.3 78.8 Yarra Ranges (S) 57.1 60.6 63.0 82.9 73.8 75.4 66.7 61.8 Eastern Metro 55.1 74.7 63.9 88.8 87.2 78.3 77.8 69.6 Victoria 58.7 67.5 67.8 81.0 77.8 79.6 74.2 71.8 Source: Department of Planning and Community Development, 2006 [16]

Reference

1 Australian Bureau of Statistics, 2010, Population by age and sex, Victoria, estimated resident population at 30 June 2009. Released August 2010. <www.abs.gov.au> 2 Department of Planning and Community Development, 2009, Victoria in Future Population Projections. Released September 2009. <http://www.dpcd.vic.gov.au/victoriainfuture> 3 Department of Health, 2010, Life expectancy at birth: Victoria 2003-2007. Health Intelligence Unit. <http://www.health.vic.gov.au/healthstatus/le.htm> 4 Department of Human Services, 2006, Burden of disease for local government areas of Victoria, 2001. Measure: Disability Adjusted Life Year (DALY) rates. <http://www.health.vic.gov.au/healthstatus/bod/bod_reg.htm> 5 Department of Human Services, 2006, Burden of disease for local government areas of Victoria, 2001. Measure: Years of Life Lost (YLL) rates. <http://www.health.vic.gov.au/healthstatus/bod/bod_reg.htm> 6 Department of Health, 2010, Victorian Population Health Survey Report 2008. <http://www.health.vic.gov.au/healthstatus/vphs_current.htm> 7 Department of Human Services, 2006, Burden of disease for local government areas of Victoria, 2001. Measure: Mortality and morbidity 2001 searchable LGA estimates. <http://www.health.vic.gov.au/healthstatus/bod/bod_reg.htm> 8 Department of Health, 2010, Victorian ambulatory care sensitive conditions study. Victorian Health Information Surveillance System (VHISS). <http://www.health.vic.gov.au/healthstatus/acsc/index.htm> 9 Medicare Australia, 2010, Australian Childhood Immunisation Register (ACIR) – coverage report. Measure: Proportion of children fully immunised by age, by region. 10 Department of Employment and Workplace Relations (DEWR), 2010, Small area labour markets – Australia. Measure: Proportion of persons unemployed. <http://www.workplace.gov.au/salm> 11 Australian Bureau of Statistics, 2006, Cat no. 2068.0 – 2006 Census tables. Measure: Gross Individual Income (Weekly) by age by sex. <www.abs.gov.au> 12 Victorian Commission for Gambling Regulations, 2010. Measure: Gaming machine losses per head, people 18 years of age or older. 13 Australian Bureau of Statistics, 2006, Basic community profiles. Table B28 - gross household income (weekly) by household composition. <www.abs.gov.au> 14 Australian Bureau of Statistics, customised data from the 2006 Census of Population and Housing.

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15 Victoria Police, 2010, Crime Statistics - Family incidents 2009-10. <http://www.police.vic.gov.au/content.asp?Document_ID=782> 16 Department of Planning and Community Development, 2006, Indicators of Community Strength at the Local Government Area Level. <http://www.dvc.vic.gov.au/web14/dvc/dvcmain.nsf/headingpagesdisplay/research+and+publicationsindicators+of+community+strength>