Summary risk factors

Table4: Summary of evidence for priority areas health determinants

Outcomes of the health needs analysis

Identified Need Key Issue Need to increase life expectancy due to lower life expectancy experienced Life expectancy for persons, males and females all lower compared with Australia (males; rank 25/31, variance to Aust -2%)

Increased need for ante-natal support due to higher teenage mother birth rate Higher proportion teenage mother birth rates (rank 25/31, variance to Aust -89%) Description of Evidence AIHW 2016; Table 53 Life expectancy

PHIDU 2018; Table 52 teenage mothers

Increased need for ante-natal support due to less fully breastfeed babies at six months

Need for support related to domestic violence related assault

Need for support for victims of sexual or indecent assault Lower proportion of fully breastfed babies at six months of age (rank 28/31, variance to Aust -15%) PHIDU 2014; Table 56 Breastfeeding and early nutrition

Higher rate of domestic violence related assault Boscar 2020; Table 82 Violence related assault

Higher proportion of alcohol related non-domestic violence related assault Higher rates of sexual assault Boscar 2020; Table 83 Alcohol related violence related assault Boscar 2020; Table 84 Sexual and indecent assault

Higher rates of indecent assault Boscar 2020; Table 84 Sexual and indecent assault

MPHN has higher rates of people, both males and females that consume alcohol at harmful levels compared with both NSW and Australia. These rates are across all sectors with the exception of Wagga Wagga. Both short and long term risk associated with alcohol drinking is higher in the Murrumbidgee compared with NSW. Drinking daily is higher in the Murrumbidgee region compared with NSW. There is a lower proportion of drinking within the recommended levels in the Murrumbidgee compared with NSW. MPHN has higher rates of possession and or use of amphetamines, cannabis compared with NSW but lower rates of cocaine and ecstasy use compared with NSW.

MPHN has higher rates of people with low or very low or no exercise are higher compared with both NSW and Australia. People with adequate fruit intake are similar in the MPHN to both NSW and Australia. Conversely MPHN has higher proportions of vegetable intake compared with NSW. MPHN has higher rates of people with high blood pressure and higher proportions of people with a long term condition of high blood pressure or hypertension compared with Australia.

Proportions of people who are overweight and obese are higher in MPHN compared with Australia. Obesity is higher in three sectors, Riverina, Border and Western. MPHN has the highest rates of overweight males and females for young people compared with NSW and Australia. This rate of overweight young people is reflected in all four sectors. Obesity is the same for MPHN young people, although this is not reported in the Wagga Wagga sector however is evident in the other three sectors.

MPHN residents do not have higher rates of people with high or very high psychological distress compared with NSW and Australia.

Higher rates of male smokers are reported in MPHN compared with NSW and Australia, in all sectors except Wagga Wagga. In MPHN proportions of women that smoke during pregnancy are higher for both nonAboriginal and Aboriginal and Torres Strait Islander mothers and smoking throughout the pregnancy. For Aboriginal and Torres Strait Islander mothers the proportion is more than double that of non-Aboriginal mothers. In the first 20 weeks of pregnancy the MPHN proportion is approximately double NSW and Australia.

Exposure to the sun in the Murrumbidgee is similar to NSW.

In summary for risk factors there are six key areas which require consideration when planning and delivering primary care healthcare services. Table 5 describes the priority areas and the population groups affected by identification of issues in MPHN’s population. Table 6 provides a description of evidence where MPHN ranks 25th or more indicating that MPHN is in the lowest third of the nation.

Table 5: Priority areas for action for population groups from risk factors

Reduction of alcohol at harmful levels

Reduction of use of amphetamines and cannabis Increased exercise due to current low rates

Reduction in risk related to high blood pressure Reduction in overweight and obesity

Increase smoking cessation during pregnancy Aboriginal and Torres Strait Islander people Maternal, Child and Youth Older persons Population

Table 6: Summary of evidence for priority areas risk factors

Outcomes of the health needs analysis

Identified Need Key Issue Reduction of alcohol at harmful levels Higher rate of people who consume alcohol at harmful levels (people, rank 26/31, variance to Aust -27%; males, rank 26/31, variance to Aust -25%; females, rank 26/31, variance to Aust -27%) Description of Evidence PHIDU 2017; Table 88 consume alcohol at harmful levels

Reduction of use of amphetamines and cannabis Higher proportion of levels of risky alcohol consumption (rank 31/31, variance to Aust -191%)

AIHW 2017; Table 89 levels of risky alcohol consumption Higher rate of possession and or use of amphetamines BOSCAR 2020; Table 90 Possession and or use of amphetamines

Higher rate of possession and or use of cannabis BOSCAR 2020; Table 91 Possession and or use of cannabis

Increased exercise due to current low rates Higher rates of people with low or very low or no exercise (rank 26/31, variance to Aust -6%) PHIDU 2017; Table 94 Diet and exercise

Reduction in risk related to high blood pressure Higher rate of people with high blood pressure (rank 25/31, variance to Aust -3%) and high blood pressure or hypertension as a long term health condition (rank 25/31, variance to Aust -9%) PHIDU 2017; table 95 high blood pressure