Medical Positions
Overview of Sydney West Area Health Service catchment
Sydney West Area Health Service (SWAHS) consists of both urban and semi-rural areas, covering almost 9000 square kilometres. The AHS is responsible for providing primary and secondary health care for people living in the Auburn, Baulkham Hills, Blacktown, Blue Mountains, Hawkesbury, Holroyd, Lithgow, Parramatta and Penrith local government areas (LGAs) and tertiary care to residents of the Greater Western Region.
The estimated resident population of SWAHS in 2008 is 1,143,871 (Table 1), which includes a substantial Aboriginal community. The Darug, Gundungarra and Wiradjuri people are acknowledged as the traditional owners of the land covered by the AHS. The number of people identifying as indigenous in the Census has been increasing in recent years. The official figure reached 16,629 in 2006, although this is widely regarded as an underestimate. The larger indigenous communities reside in Blacktown and Penrith and are younger than the wider NSW community, with 57 per cent under 25 years of age.
These two LGAs, along with Hawkesbury, have almost a quarter of their residents aged less than 15 years. At the other end of the spectrum, the population aged 65 years and over is predicted to increase by 37 per cent between 2008 and 2018 in the LGAs of Parramatta, Holroyd and Baulkham Hills.
Overall, the population is increasing by about 1.3 per cent each year. Births to existing residents contribute about 16,000 persons per annum, with the highest total fertility rate occurring in Auburn (2.5 per woman). Continued major land releases, greater density of dwellings in older areas and new arrivals of refugees and other migrants all contribute to population growth. During the year ending December 2007, SWAHS was the recipient of 42 per cent (13,571) of new settlers under the Humanitarian Program in NSW and a further 63,639 settlers under the Non-Humanitarian Program.
Perhaps unsurprisingly, SWAHS is extremely culturally diverse. On Census night in 2006, one third of the population reported being born overseas. The most frequently reported countries of birth were UK, Philippines, India, China, New Zealand, Lebanon, Fiji, Sri Lanka, South Korea and Malta.
The increasing sectors of older residents, culturally diverse communities and new arrivals and refugees are distinct populations within the AHS. These populations pose new and unique challenges in health care planning, service delivery and access to specialised care.
Based on the Socio-economic Indexes for Area (SEIFA) 2006, Index of Socio-economic Disadvantage, SWAHS comprises LGAs at both ends of the spectrum. Among the most disadvantaged areas in NSW, scoring well below the 1,000 average, were Lithgow (937) and Auburn (922), characterised by low income and educational attainment and a high level of unemployment. At the opposite end, LGAs receiving a score over 1,000, suggesting least disadvantaged areas, were Baulkham Hills (1116), Blue Mountains (1051), Hawkesbury (1033) and Penrith (1006).
The age standardised death rates for SWAHS residents for the five year period 2000 to 2004 were slightly higher than the State average for males (825 and 810 per 100,000 respectively) and significantly higher for females (553 and 532 per 100,000 respectively). The major causes of death were circulatory diseases, cancers, respiratory diseases injury and poisoning. A similar pattern existed for premature deaths among residents aged less than 75 years, with rates somewhat higher among males in SWAHS compared to NSW (348 and 342 per 100,000 respectively) but significantly higher among females than the State average (210 and 198 per 100,000 respectively).
