South Metropolitan Health Service
Shire of Murray
Health and Wellbeing Profile
South Metropolitan
Population Health Unit
southmetropolitan.health.wa.gov.au
May 2016
© Department of Health, State of Western Australia (2016)
Copyright to this material produced by the Western Australian Department of Health
belongs to the State of Western Australia, under the provisions of the Copyright
Act 1968 (Commonwealth of Australia). Apart from any fair dealing for personal,
academic, research or non-commercial use, no part may be reproduced without written
permission of the South Metropolitan Population Health Unit, Western Australian
Department of Health. The Department of Health is under no obligation to grant this
permission. Please acknowledge the WA Department of Health when reproducing or
quoting material from this source.
Important disclaimer
All information and content in this material is provided in good faith by the WA
Department of Health, and is based on sources believed to be reliable and accurate at
the time of development. The State of Western Australia, the WA Department of Health
and their respective officers, employees and agents, do not accept legal liability or
responsibility for the material, or any consequences arising from its use.
Acknowledgment
The South Metropolitan Population Health Unit respectfully acknowledges the
Aboriginal Noongar people both past and present, the traditional owners of the land
on which we work.
Notes
In this report:
The terms ‘Shire of Murray’ and ‘Murray LGA’ are used interchangeably.
The use of the term ‘Aboriginal’ within this document refers to Australians of both
Aboriginal and Torres Strait Islander people.
Shire of Murray – Health and Wellbeing Profile
Contents
Abbreviationsii
About this report
iii
Infographic: Shire of Murray Lifestyle Risk Factors iv
WA Health and Wellbeing Surveillance System v
Limitations of the data
v
Introduction1
What determines health and wellbeing?
2
Why is health and wellbeing important? 2
What population groups are vulnerable to poor health and wellbeing?
3
What is local government’s role in health and wellbeing?
3
Population overview
4
Socio-economic disadvantage
5
Health and wellbeing data 6
Health conditions
6
Physiological risk factors
12
Psychosocial risk factors
13
Psychological distress
14
Conclusion16
References18
i
ii  South Metropolitan Population Health Unit
Abbreviations
ABS
Australian Bureau of Statistics
AIHW
Australian Institute of Health and Welfare
BMI
Body mass index
CI
Confidence interval
Department of Health
Department of Health Western Australia
ERP
Estimated resident population
HWSS
Health and Wellbeing Surveillance System
LGA
Local government area
NHPA
National Health Priority Areas
RSE
Relative standard error
SMHS
South Metropolitan Health Service
SMPHU
South Metropolitan Population Health Unit
WA
Western Australia
Shire of Murray – Health and Wellbeing Profile
About this report
The purpose of this profile is to support local government to prepare local public health plans.
It provides an update on the self-reported measures of health and wellbeing in each LGA.
This document has been prepared by the SMPHU with data from the Western Australian
Health and Wellbeing Surveillance System (HWSS).
 iii
iv  South Metropolitan Population Health Unit
Infographic: Shire of Murray lifestyle risk factors
Source: Western Australian Health and Wellbeing Surveillance System: Shire of Murray
self-reported measures of health and wellbeing for adults 2004–2014.
Shire of Murray – Health and Wellbeing Profile
WA Health and Wellbeing Surveillance System
The HWSS is managed by the Health Survey Unit in the Epidemiology Branch at the
Department of Health Western Australia (Department of Health). Householders are selected
at random to participate in a computer-assisted telephone interview. Questions are asked on
a range of indicators related to health and wellbeing. Topics include chronic health conditions,
lifestyle, physiological and psychosocial risk factors.
Since 2002, the WA HWSS has captured health and wellbeing data from over 6,000 Western
Australians each year. Information from the survey is used to:
„„ monitor
„„ inform
„„
the health status of all Western Australians
and evaluate health promotion programs
support health policy development
„„ identify
emerging trends.
Limitations of the data
It is important to be cautious when comparing the HWSS data in this profile to that in the
previous profile because:
„„ Changes
could be due to a change in the demographic mix of the population,
particularly as there have been some minor revisions to LGA boundaries over time.
„„ As
small numbers of people were surveyed in each LGA, the 95 per cent confidence
intervals around the results are wide. This means that it is difficult to show any
statistically significant changes from the last results.
„„ There
are only two time points to compare so it is difficult to determine whether any
increase or decrease is due to a trend or to random variability.
For these reasons, it is important not to overstate any perceived differences between the
results in the last profile compared to this one.
Results are also not comparable between LGAs because, for each LGA, the minimum number
of years necessary to make up a sufficient sample has been used. This means that the time
period for other LGAs may differ.
v
vi  South Metropolitan Population Health Unit
Shire of Murray – Health and Wellbeing Profile
Introduction
The World Health Organisation defines health as:
‘… a state of complete physical,
mental and social wellbeing
and not merely the absence of
disease or infirmity.’1
Health is impacted by a number of factors often outside the control of the individual; these
factors fall into the social, economic, built and natural environments in which people live, work
and play.
1
2  South Metropolitan Population Health Unit
What determines health and wellbeing?
Health is impacted by a number of factors often outside the control of the individual. These
factors are referred to as the social determinants of health and include socio-economic
status, employment, income, education, housing, social support, access to health care, drug
addiction, transport, food security and community safety.
The relationship between the determinants of health and the health and wellbeing of
individuals and communities can also be understood by considering factors that:
„„ contribute
to good health and wellbeing – ‘protective factors’
„„ jeopardise
good health and wellbeing – ‘risk factors’.
Why is health and wellbeing important?
Under the National Healthcare Agreement,2 nine of the 21 conditions reported to be
potentially avoidable hospitalisations are due to preventable chronic conditions. They include
asthma, diabetes complications, lung disease, angina and high blood pressure.
Many of the risk factors associated with these chronic conditions such as high blood
pressure, high blood cholesterol, lack of physical activity, smoking, overweight/ obesity and
poor nutrition can be prevented through modification of environments and lifestyle behaviour
change.
From a community perspective, the health and wellbeing of the population contributes to
social interaction and the vitality of the community. For example, it enables participation in
sports, volunteering, arts, culture and other activities that bring the community together. By
contrast, poor health and wellbeing reduces this participation and brings with it the high costs
of medical care and other community services.
Shire of Murray – Health and Wellbeing Profile
What population groups are vulnerable
to poor health and wellbeing?
Some members of the community are more vulnerable to poor health and wellbeing. This
might be the result of culture, ethnicity, gender, age, illness, injury, lack of mobility or even
where they live. It might also result from lack of income or skills. Groups of particular interest
include:
„„ children
„„ young
„„ older
(birth to 12 years)
people (13 to 25 years)
people (65 years and over)
„„ Aboriginal
people
„„ people
with a disability
„„ people
from culturally and linguistically diverse backgrounds
„„ people
with a mental illness
„„ economically
disadvantaged people.
The resource, Pathway to a healthy community: A guide for councillors,3 provides a series of
questions for local governments to consider when planning for the health and wellbeing of
vulnerable population groups within their community.
What is local government’s role
in health and wellbeing?
Local government traditionally played a central role in public health through the Health Act
1911. This role was primarily regulatory and related to housing standards, drains, sewerage,
water supply, refuse disposal and food handling and safety practices. The aim was to
maintain basic sanitation requirements in order to prevent and control disease.
However, local governments have become increasingly focused on building resilient
communities through the Local Government Act 1995 to ensure that policies, services and
resources meet community needs and expectations. LGAs have actively built the capacity
of communities, by increasing the knowledge, skills and capabilities of individuals and local
organisations so they can support themselves and each other.
3
4  South Metropolitan Population Health Unit
Population overview
The Murray LGA covers an area of 1,709 square kilometres. In 2011, its total population was
14,149 (Table 1) which represented 0.6 per cent of the state’s population. Aboriginal people
accounted for 2.1 per cent of the area’s population, which is lower than the state average of
3.1 per cent.
Table 1: Population of the Shire of Murray by age group and sex, 2011
Age group
Sex
0–4
5–14
15–24
25–44
45–64
65+
Total
Male
427
978
801
1,494
2,050
1,424
7,174
Female
449
945
729
1,579
2,010
1,263
6,975
Total
876
1,923
1,530
3,073
4,060
2,687
14,149
Source: 2011 Census, ABS – Usual resident population.
Socio-economic disadvantage
Although the overall level of health and wellbeing of Australians is relatively high compared
with other countries, there are significant disparities in the health outcomes of different
populations within Australia. In particular, people who live in areas with poorer socioeconomic conditions tend to have worse health than people from other areas. Previous
analysis has shown that disadvantaged Australians have higher levels of disease risk factors
and lower use of preventative health services than those who experience socio-economic
advantage.4
The socio-economic indexes for areas (SEIFA) scores are made up of four indices which
summarise a variety of social and economic variables such as income, educational
attainment, employment and number of unskilled workers. SEIFA scores are based on a
national average of 1000 and areas with the lowest scores are the most disadvantaged.
Based on 2011 Census data, the Shire of Murray had a SEIFA Index of Relative SocioEconomic Disadvantage score of 982. The range of scores for this SEIFA index for LGAs
within the SMHS was 948 to 1088.5 Table 2 shows the SEIFA scores for each suburb in the
Shire of Murray.
Shire of Murray – Health and Wellbeing Profile
Table 2: SEIFA Index of Disadvantage scores by
suburb, Shire of Murray, 2011
Suburb
SEIFA
score
Barragup
1023
812
Coolup
983
357
Dwellingup
975
709
Furnissdale
920
1,024
Meelon
1030
225
Nambeelup
1034
511
North Dandalup
1028
569
North Yunderup
992
846
Pinjarra
922
4,248
Ravenswood
1005
1,658
South Yunderup
1036
2,239
Stake Hill
1077
495
West Pinjarra
1011
396
Source: ABS (2011). Socio-economic Indexes for Areas (SEIFA).
Usual resident
population
5
6  South Metropolitan Population Health Unit
Health and wellbeing data
The health and wellbeing data for the Murray LGA are shown in Tables 3 to 6. This
information is based on responses from 274 adults (aged 16 years and older) in the Murray
LGA, 11,681 adults in the SMHS, and 69,112 adults state-wide, who were surveyed over the
period January 2004 to December 2014.
The data is weighted to compensate for oversampling in the rural and remote areas of WA
and then adjusted to the age and sex distribution of the WA population in 2013.
The ‘estimated population’ in the tables refers to the estimated number of people in the
Murray LGA with the particular risk factor, based on the Australian Bureau of Statistics’ (ABS)
2013 estimated resident population (ERP).
Health conditions
Many of the health conditions included in the HWSS are National Health Priority Areas
(NHPAs). These are diseases and conditions that the Australian government has chosen
to focus on because they contribute significantly to the burden of illness and injury in the
community and there is potential to reduce their burden.
There are nine NHPAs, most of which are chronic health conditions, i.e. long-term health
conditions lasting more than six months. Chronic health conditions are a major concern
because they can have a significant impact on a person’s life, particularly because of the
ageing population. These conditions develop over a long period of time and can often be
modified by changes in lifestyle.
Population surveys can provide an indication of the prevalence of long term health conditions.
The HWSS asked respondents questions about the following eight NHPAs (dementia, the
ninth NHPA, was added to the list of NHPAs in 2012, and is not currently included in the
HWSS).
Diabetes mellitus
Diabetes is a condition where the body is unable to maintain normal blood glucose levels and
contributes significantly to ill health, disability and premature death in Australia.6
Cardiovascular disease
Cardiovascular disease, such as heart disease and stroke, is the largest cause of premature
death in Australia and accounts for the highest proportion of health service costs, much of
which is preventable.7
Shire of Murray – Health and Wellbeing Profile
Cancer (excluding skin cancer)
Cancer is a diverse group of diseases in which some of the body’s cells become defective
and multiply out of control. These abnormal cells form tumours and invade and damage
the tissues around them. They can also spread to other parts of the body and cause further
damage. If the spread of tumours is not controlled they can result in death.8
Asthma
Asthma is a reversible narrowing of the airways in the lungs. Symptoms include wheezing,
coughing, tightness of the chest, breathing difficulties and shortness of breath.9
Arthritis and musculoskeletal conditions
Arthritis and osteoporosis are musculoskeletal conditions that can greatly reduce a person’s
quality of life. Arthritis causes inflammation of the joints, while osteoporosis is a disease
where bone density and structural quality deteriorate, leading to an increased risk of
fracture.10
Injury
Injury is a leading cause of hospitalisation and death in Australia. A major contributor to the
injury burden is fall injuries in older people.11
Mental health
Mental health conditions include short-term conditions, such as depression and anxiety, and
long-term conditions, such as chronic depression and schizophrenia. Mental health problems
are associated with higher rates of death, poorer physical health and increased exposure to
health risk factors.12
Obesity
Obesity was added to the NHPAs in 2008. This is covered in the section on physiological risk
factors in this report.
7
8  South Metropolitan Population Health Unit
Results
Respondents to the survey were asked whether their doctor had ever diagnosed them with
certain health conditions. For the conditions examined arthritis, injuries and mental health
conditions were the most common ones reported by residents of Murray LGA.
Table 3: Prevalence of self-reported doctor-diagnosed conditions for persons aged
16 years and over, Murray LGA, SMHS and WA, 2004–2014
Murray LGA
Condition
SMHS
WA
Persons
(%)
Estimated
population
Persons
(%)
Persons
(%)
9.2
1,179
6.3
5.9
11.2
1,270
7.6
7.0
8.5
1,092
5.7
5.5
Current asthma
11.5
1,480
9.1
9.2
Stroke
*2.7
307
2.1
2.1
Arthritis
24.6
2,789
24.0
23.4
7.1
909
5.2
4.9
Injury (a)
20.9
2,692
22.0
22.9
Current mental health
problem (b)
12.0
1,537
13.5
13.2
Current respiratory
problem (c)
*2.3
301
2.4
2.2
Diabetes
Heart disease
Cancer
(excluding skin cancer)
Osteoporosis
Source: WA Health and Wellbeing Surveillance System, Epidemiology Branch, Department of Health WA.
Notes:
* Prevalence estimate has a relative standard error between 25 per cent and 50 per cent and should be used
with caution.
(a) Injury in the last 12 months requiring treatment from a health professional.
(b) Diagnosed with depression, anxiety, stress-related or other mental health condition in the past 12 months
by a doctor.
(c) Respiratory problem other than asthma that has lasted 6 months or more, e.g. bronchitis, emphysema, or
chronic lung disease.
Shire of Murray – Health and Wellbeing Profile
Lifestyle risk factors
There are many factors that can influence a person’s health, including genetics, lifestyle,
environmental and social factors. These factors may have a positive effect on health, such
as a high consumption of fruit and vegetables, or a negative effect, such as smoking and
physical inactivity.13 Modifiable lifestyle behaviours are also associated with the onset of
physiological risk factors, such as high cholesterol, high blood pressure and obesity (these
are covered in the next section).
Smoking
Smoking increases the risk of developing a number of health conditions, including respiratory
disease, coronary heart disease, stroke and several cancers, such as lung and mouth
cancers.14 Respondents were asked about their smoking status (including cigarettes, cigars
and pipes). Current smoking status was re-categorised into those who smoke (daily or
occasionally), ex-smokers and those who have never smoked regularly. Respondents who
had tried cigarettes and had smoked 100 or more cigarettes in their lifetime were classified as
ex-smokers, while those who had smoked less than 100 cigarettes were classified as having
never smoked.
Nutrition
Diet has an important effect on health and can influence the risk of various diseases,
including coronary heart disease, type 2 diabetes, stroke and digestive system cancers.15
Eating fruit and vegetables is important for health and protects against disease. It is
recommended that Australian adults aged 19 years and over eat two serves of fruit and
five serves of vegetables, while three serves of fruit and four serves of vegetables are
recommended for those aged 16 to 18 years.16,17
Alcohol
Excessive alcohol consumption increases the risk of some health conditions, including
coronary heart disease, stroke, blood pressure, liver and pancreatic disease. It also increases
the risk of accidents and mental illness.14 Respondents were asked about their alcohol
drinking habits, including how many days a week they usually drink and how many drinks they
usually have. The information was categorised into risk levels based on the 2009 National
Health and Medical Research Council guidelines (which categorise any drinking by people
aged 16 and 17 years as risky). Long term harm is the potential for alcohol-related harm
over a lifetime of drinking and short term harm is the risk of harm due to a single occasion of
drinking.
9
10  South Metropolitan Population Health Unit
Physical activity
Physical inactivity is associated with several chronic health conditions, including coronary
heart disease, stroke and diabetes. Being physically active reduces the risk of developing
such conditions, and also improves general wellbeing.18 Respondents were asked to rate their
physical activity level. The Australian Physical Activity and Sedentary Guidelines19 for adults
aged 18 to 64 years recommends: accumulating 150 to 300 minutes of moderate intensity
physical activity or 75 to 150 minutes of vigorous intensity physical activity, or an equivalent
combination of both moderate and vigorous activities, each week. For older Australians
(65 years and older), 30 minutes of physical activity is recommended in their daily lives.
Results
Respondents to the survey were asked about certain lifestyle risk factors. For the risk factors
examined, insufficient fruit and vegetable consumption and insufficient physical activity were
the most common ones reported by residents of the Murray LGA.
Shire of Murray – Health and Wellbeing Profile
 11
Table 4: Prevalence of lifestyle risk factors for adults (aged 16 years and over),
Murray LGA, SMHS and WA, 2004–2014
Murray LGA
Risk factors
Persons
(%)
Estimated
population
SMHS
WA
Persons
(%)
Persons
(%)
Currently smokes
17.2
2,211
15.6
15.8
Never smoked (or smoked
<100 cigarettes)
54.7
7,036
56.9
56.3
Eats less than <2 serves of
fruit daily
47.7
6,134
48.7
48.2
Eats less than <5 serves
of vegetables daily
78.8
10,131
87.2
87.0
Risky/high risk drinking for
long term harm (a)
33.9
4,357
32.6
34.6
Risky/high risk drinking for
short term harm (b)
11.4
1,467
13.8
15.3
Insufficient physical activity (c)
37.5
3,478
37.8
37.0
Source: WA Health and Wellbeing Surveillance System, Epidemiology Branch, DoH WA.
Notes:
(a) As a proportion of all adult respondents 16 years and over. Drinks more than 2 standard drinks on any day.
Any alcohol consumption by persons 16 or 17 years classified as high risk.
(b) As a proportion of all adult respondents 16 years and over. Drinks more than 4 standard drinks on any day.
Any alcohol consumption by persons 16 or 17 years classified as high risk.
(c) Completes less than 150 minutes of physical activity per week (adults 18+ years).
12  South Metropolitan Population Health Unit
Physiological risk factors
Physiological risk factors such as high cholesterol, high blood pressure, and overweight
or obesity can be major contributors to ill health and chronic disease. These risk factors
are expressed through physical changes in the body and are highly interrelated.9 They
are managed through a combination of medications, population-based interventions and
modification of lifestyle behaviours.20
Blood pressure
High blood pressure is a major risk factor for the development of coronary artery disease,
stroke and renal failure.21
Cholesterol level
Cholesterol is a fatty substance produced by the liver and carried by the blood to the rest of
the body. Its natural function is to supply material for cell walls and hormones, but high blood
cholesterol can form plaque that clogs the blood vessels supplying the heart and certain
other parts of the body. High blood cholesterol can be a major risk factor for coronary heart
disease, ischaemic stroke and peripheral vascular disease.18
Body weight
Being overweight or obese can contribute to the development of chronic conditions, such as
cardiovascular disease, type 2 diabetes, osteoarthritis, some cancers and sleep apnoea.22
As excess body weight increases, so does the risk of chronic disease and mortality.18
Respondents were asked how tall they are and how much they weigh. A body mass index
(BMI) was derived from these figures by dividing weight in kilograms by height in metres
squared, after adjustment for errors in the self-reported height and weight.23 The BMIs were
then categorised. Adults with a BMI greater than 25kg/m2 are considered to be overweight,
and those with a BMI greater than 30kg/m2 obese. BMI may not be a suitable measure for
athletes who have a muscular build, older people and some ethnic groups.
Results
Respondents to the survey were asked about certain physiological risk factors. For the risk
factors examined, being overweight or obese were the most common ones reported by
residents of Murray LGA.
Shire of Murray – Health and Wellbeing Profile
 13
Table 5: Prevalence of physiological risk factors for adults (aged 16 years and over),
Murray LGA, SMHS and WA, 2004–2014
Murray LGA
Risk factors
Persons
(%)
Estimated
population
SMHS
WA
Persons
(%)
Persons
(%)
Current high blood pressure
25.3
3,250
17.1
16.3
Current high cholesterol
22.8
2,931
18.4
17.7
Overweight (a)
41.5
5,338
39.2
39.7
Obese (a)
33.6
4,324
26.4
26.0
Source: WA Health and Wellbeing Surveillance System, Epidemiology Branch, Department of Health WA.
(a) BMI of 25 to <30 = overweight; BMI of 30+ = obese. Self-reported height and weight have been adjusted for
under-reporting (i.e. over-estimating of height and under-estimating of weight).
Psychosocial risk factors
Mental health involves the capacity to interact with people and the environment and refers
to the ability to negotiate the social interactions and challenges of life without experiencing
undue emotional or behavioural incapacity.11 Mental health is also referred to as psychosocial
health as it involves aspects of both social and psychological behaviour.
14  South Metropolitan Population Health Unit
Psychological distress
Psychological distress may be determined in ways other than having been diagnosed or
treated for a mental health condition. The Kessler 10 (K10) is a standardised instrument
that measures psychological distress by asking ten questions about levels of anxiety and
depressive symptoms experienced in the past four weeks. Each item on the K10 is scored
and then summed, resulting in a range of possible scores from 10 to 50. These are then
categorised into low, moderate, high and very high levels of psychological distress.24,25
Low level psychological distress is regarded as not requiring any intervention, moderate and
high levels require self-help, and very high levels require professional help.24
Feeling lack of control
Perceptions of control relate to an individual’s belief as to whether outcomes are determined
by external events outside their control or by their own actions.26 Feelings of lack of control
have been found to have adverse effects on health and to increase the risk of mortality.27,28
Results
Respondents to the survey were asked about certain psychosocial risk factors.
Table 6: Prevalence of psychosocial risk factors for adults (aged 16 years and over),
Murray LGA, SMHS and WA, 2004–2014
Murray LGA
Risk factors
Persons
(%)
Estimated
population
SMHS
WA
Persons
(%)
Persons
(%)
High/very high psychological
distress
*5.8
745
8.9
8.2
Lack of control over life in
general (a)
*2.8
365
4.4
4.1
Source: WA Health and Wellbeing Surveillance System, Epidemiology Branch, Department of Health WA.
Notes:
* Prevalence estimate has a relative standard error between 25 per cent and 50 per cent and should be used
with caution.
(a) Often or always feels a lack of control over life in general.
Shire of Murray – Health and Wellbeing Profile
 15
16  South Metropolitan Population Health Unit
Conclusion
Health and wellbeing profiles support local government to develop local public health plans to
ensure the health and wellbeing of the community can be effectively promoted and protected.
The increasing prevalence of preventable chronic health conditions due to lifestyle,
physiological and psychosocial risk factors outlined in this profile present challenges for all
tiers of government. The focus on the prevention of health conditions is expected to continue
to target risk factors such as physical inactivity, unhealthy eating, harmful alcohol use, and
smoking as well as the promotion of psychological wellbeing.
Although individuals ultimately make the decisions that affect their own health, local
government can assist people in making healthy choices and leading healthier lives. Local
government plays an important role in creating environments that support healthy living,
wellbeing and quality of life at a local level. Many aspects of community life are influenced,
for example urban planning, parks and facilities, transport, social support and community
participation.
Shire of Murray – Health and Wellbeing Profile
 17
18  South Metropolitan Population Health Unit
References
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Murray: South Metropolitan Population Health
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Department of Health WA.
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au/_files_nhmrc/publications/attachments/n33.
pdf.
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17
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(2003). Dietary guidelines for children and
adolescents in Australia. Canberra: NHMRC.
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