Healthy Wellington. Municipal Public Health and Wellbeing Plan

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1 Healthy Wellington Municipal Public Health and Wellbeing Plan

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3 contents Acknowledgements Welcome Message 1. Introduction 2. Whose Role is Health and Wellbeing Planning? 3. Establishing Health Priorities 4. Priority One: Mental Wellbeing - Increasing Social Connectedness and Inclusion 5. Priority Two: Mental Wellbeing - Preventing violence against women and children 6. Priority Three: Healthier Living - Healthy Eating 7. Priority Four: Healthier Living - Increasing Physical Activity 8. Other Health and Wellbeing Issues 9. Links to Actions 10. Healthy Wellington and Climate Change 11. Primary Prevention Approach to Health Promotion 12. The National State and Local Policy Context 13. Appendix

4 acknowledgements We acknowledge the traditional custodians of this land the Gunai Kurnai people, and pay respects to their elders past and present. Wellington Shire Council worked with many organisations in the development of Healthy Wellington, the Municipal Public Health and Wellbeing Plan Council would like to thank people from the following organisations and groups for their contributions: Healthy Wellington Action Group Health and Wellbeing Plan Working Group Wellington Primary Care Partnership Central Gippsland Health Service Yarram and District Health Service Gippsland Women s Health Service Ramahyuck District Aboriginal Corporation Uniting Care Gippsland Department of Health Department of Human Services Community Representative Groups Gippsland Medicare Local Department of Environment and Primary Industry Neighbourhood Houses in Wellington Shire Men s Sheds in Wellington Shire University of the 3rd Age Probus Wellington Access and Inclusion Advisory Group GippSport Aqua Energy Wellington Shire Youth Council Parent groups Service clubs Faith groups Sporting groups Community contributors to the Municipal Public Health and Wellbeing survey Schools Wellington Liquor Accord Committee Wellington Early Years Network Quantum Support Services Latrobe Community Health Service Latrobe Regional Hospital Healthy Wellington was developed through a process of engagement with representatives from the organisations listed above and the general public. Their contribution to the development of this plan has been greatly appreciated and provides assurance that the process has been inclusive and reflective of our community. We will continue to work in partnership to ensure that Healthy Wellington provides a framework for better health and wellbeing outcomes for residents of Wellington Shire. 4 Municipal Public Health and Wellbeing Plan

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6 welcome message We are pleased to introduce the Wellington Municipal Public Health and Wellbeing Plan , Healthy Wellington. Healthy Wellington sets out how Council will meet its statutory role in public health, working with the Wellington Primary Care Partnership and other partners. This is an important plan for improving the health, safety and well being of our community. We have developed Healthy Wellington through a comprehensive process of data analysis, reference to policy and frameworks, and consultation. Wellington Shire Council and Wellington Primary Care Partnership have led the process, engaging with our local community and professional organisations. We appreciate the contribution made by so many people in the development of this plan. With our community and partners, we identified that the top health priorities in Wellington Shire are: To improve Mental Wellbeing through 1. Increasing social connectedness and inclusion 2. Preventing violence against women and children To encourage Healthier Living through 3. Healthy eating 4. Increasing physical activity We will focus on these priorities over the next 4 years. We will continue to work with our community on a number of other health issues, but our research indicates that we will achieve the greatest impact by directing efforts to the four top priority areas. The strategies will be developed into yearly action plans, aligned with resource allocations, and include any new emerging issues identified with partner organisations. 6 Municipal Public Health and Wellbeing Plan

7 Through our community vision for the future, Wellington 2030, Council is working towards a community where everyone feels valued, supported and has the opportunity to participate. Healthy Wellington is the Plan which will help us achieve this vision. Council will work in partnership and initiate preventative strategies through changes to the physical, natural, economic and social environments that will assist all members of the community to lead healthy lives. Wellington Primary Care Partnership will focus on implementing the health and wellbeing priorities with its partner organisations to improve the population s health and wellbeing. We look forward to working with our community, local groups and agencies to achieve improved health, safety and wellbeing for Wellington. Cr. Scott Rossetti Mayor Wellington Shire Council Leonie Coleman Executive Officer Wellington Primary Care Partnership Municipal Public Health and Wellbeing Plan

8 1introduction

9 Healthy Wellington is the Wellington Municipal Public Health and Wellbeing Plan , hereafter referred to as Healthy Wellington. 1.1 Our Plan Healthy Wellington provides the framework for an integrated approach to public health planning for the Wellington Shire. It is a major policy document that aims to improve the health, safety and wellbeing for the people who live, work and play in Wellington Shire. Improvements in population health and wellbeing can take a long time and involve a complex range of factors. The plan has a focus on physical, social and mental wellbeing, and not merely the absence of disease or infirmity. 1.2 Why Health and Wellbeing Planning is Important Health is the top priority. Without health it s difficult to live lives we value. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition (WHO 2006). Many people in the health system - including those who are running hospitals and the health services - recognise that better treatment alone is not going to deliver better health. Much of the heart disease, cancer, diabetes, asthma and mental illness now being experienced by Australians could have been avoided through better diets, more physical activity, less smoking and drinking alcohol, less stress, and less social and economic marginalisation (VicHealth 2009). Through a process of engagement and consultation the top health priorities in Wellington Shire for the next four years were identified as: Improve Mental Wellbeing through 1. Increasing social connectedness and inclusion 2. Preventing violence against women and children Healthier Living through 3. Healthy eating 4. Increasing physical activity Municipal Public Health and Wellbeing Plan

10 introduction Other health issues are also important to the lives of Wellington Shire residents and work will continue in these areas, but the evidence and research indicates that the most impact can be achieved by directing efforts to these four priority areas. The strategies will be developed into annual action plans, aligned with resource allocations and funding opportunities, and including any new and emerging issues that are identified with partner organisations. Wellington Shire Council and Wellington Primary Care Partnership will work in partnership to ensure that actions linked to each of the health and wellbeing priorities are followed through to improve the health and wellbeing of residents of Wellington Shire. We commit to measure these improvements, evaluate the results and provide open and transparent information to the people of Wellington Shire on our progress. 10 Municipal Public Health and Wellbeing Plan

11 2WHOSE ROLE IS HEALTH AND WELLBEING PLANNING?

12 WHOSE ROLE IS HEALTH AND WELLBEING PLANNING? The Wellington Primary Care Partnership and Wellington Shire Council have historically both been responsible for developing Health and Wellbeing Plans. In addition to this, public health planning is a component of health and community organisations. In December 2011, in response to the Victorian Public Health and Wellbeing Plan , the Gippsland Health Services Partnership agreed that: By October 2013, Gippsland seek to integrate all prevention activity on shared priorities into a single local government area plan which would meet the legislated requirements for Primary Care Partnership and Community Health Integrated Health Promotion funded agencies. Wellington Shire is leading the way in developing this, our first integrated health and wellbeing plan which combines the health promotion planning activity of Wellington Shire Council and the Wellington Primary Care Partnership. 2.1 Council s Role in Health and Wellbeing Planning Wellington Shire Council s vision for community wellbeing is that Wellington Shire is a safe and healthy community where everyone feels they are valued, supported and have the opportunity to participate. Social issues have been addressed through the joint efforts of community and supporting agencies (Wellington Shire Council 2008). To do this we will: Encourage the provision of high quality, integrated services including age care, health care, disability and community services Support community initiatives that promote participation and working together Address physical, cultural and socio-economic barriers that prevent people from fully participating in community Support community and agency partnerships to address identified social issues such as reducing family violence and improving mental health Work in partnership to promote and facilitate healthy lifestyles 12 Municipal Public Health and Wellbeing Plan

13 Acknowledging the important role of local government in improving the health of their communities, the Victorian Parliament has legislated through the Public Health and Wellbeing Act (2008) requiring all Councils to produce a Municipal Public Health and Wellbeing Plan. Within a year of a full Council election, each local government must: Examine the health status and determinants of their municipality Identify goals and strategies to achieve maximum health Involve the community in health planning The previous Wellington Municipal Public Health and Wellbeing Plan was the Community Wellbeing Strategy and Action Plan A few highlights from this plan include: The Deadly in Gippsland Conference in November This highly successful gathering showcased Aboriginal community achievements and partnerships across Gippsland. In 2012 Wellington Shire Council received a National Local Government Award for the efforts of the Deadly in Gippsland Conference in Promoting Reconciliation. The Talking Transport resource, Aqua Energy Inclusive Leisure Initiative, and Wellington Hospitality Kit have greatly enhanced the participation of people with disabilities in community life. The Wellington Municipal Early Years Plan , Wellington Access and Inclusion Plan and Wellington Walking and Cycling Strategic Plan 2012 were all launched in Implementation of action plans for each of these is well underway and working groups are overseeing progress. Gippsland Women s Health Service secured funding to develop and implement the Gippsland Prevention of Violence Against Women Strategy from The Municipal Public Health and Wellbeing Plan links closely to Council s guiding strategic document, Wellington 2030, and to the Council Plan Council s integrated planning for population health is illustrated in the following Environments for Health Framework which identifies four areas of planning - the social, built, natural and economic environments - all of which interrelate to influence health and wellbeing outcomes. Listed under each of these planning areas are Council s current plans that impact on health and wellbeing outcomes. Municipal Public Health and Wellbeing Plan

14 WHOSE ROLE IS HEALTH AND WELLBEING PLANNING? Wellington Shire Council s Plans and Strategies - Links to the Environments for Health Framework Healthy Wellington links closely to Council s guiding strategic document, Wellington 2030, and to the Council Plan Council s integrated planning for population health is illustrated in the following Environments for Health Framework which identifies four areas of planning - the social, built, natural and economic environments - all of which interrelate to influence health and wellbeing outcomes. Listed under each of these planning areas are Council s current plans that impact on health and wellbeing outcomes. natural environment Environmental Sustainability Strategy Coastal Boating Plan Open Space Plan Municipal Emergency Management Plan built environment Pools Strategic Plan Municipal Strategic Statement Built Environment Strategy Walking and Cycling Strategic Plan Municipal Services Strategy Municipal Services Plan Road Management Plan Healthy Wellington Access and Inclusion Plan Arts and Culture Strategy Community Engagement Strategy Healthy Lifestyles Strategy Municipal Early Years Plan Municipal Emergency Management Plan social environment economic environment Municipal Strategic Statement Economic Development and Tourism Strategy 14 Municipal Public Health and Wellbeing Plan

15 Wellington Shire Council provides services that are fundamental to maintaining an environment that promotes a healthy community and high quality of life. These include: land use planning and enforcement, enforcing building standards and conditions, sewerage systems, storm water, roads, waste management, animal control, inspecting food premises, immunisation and emergency management. Council s role in improving health and wellbeing is also linked to the provision of services and facilities such as maternal and child health services, child care services, activities and spaces for young people, services for older residents, ensuring access for people of all abilities, and the provision of parks, libraries, leisure centres and arts and recreational activities. Council works in partnership and enters into joint funding arrangements with other levels of government and local services and agencies to deliver many of these services. Examples of Wellington Shire working within the environments for health framework Natural Environment: Encouraging outdoor activity Protecting and improving the natural environment Preparing for current and future climate change Economic Environment: Stimulating employment through business and industry growth Supporting and advocating for skills improvement, particularly access to higher education qualifications Encouraging infrastructure planning and delivery to support economic growth Built Environment: Enhancing the built environment for all people Improving connectivity and active transport Enhancing parks and open spaces Improving safety through urban design Enhancing social inclusion through facility and open space design Enhancing supporting infrastructure for regular and safe physical activity Using aesthetic and universal access design principles Social Environment: Promoting community connectedness Encouraging healthy lifestyles Enabling safer communities Supporting health and wellbeing promotion Protecting the health and wellbeing of communities. Supporting lifestyle opportunities and tourism sector Municipal Public Health and Wellbeing Plan

16 WHOSE ROLE IS HEALTH AND WELLBEING PLANNING? Together we will enhance health opportunities and outcomes for the communities of Wellington. WPCP Vision 2.2 Wellington Primary Care Partnership s Role The Wellington Primary Care Partnership (WPCP) is a voluntary partnership of health and community based agencies in the Wellington Shire. Members have agreed to work in partnership, and with consumers and carers, to plan, coordinate and develop their services and activities. Communication has been identified as a key element to achieve this. Wellington PCP s overall vision focuses on collaboration and partnership with a vision to bring together all people, health professionals, agency staff and community members in Wellington, to share the goal of improving health opportunities and outcomes for all. The WPCP aims to: Improve the experience and outcomes for people who use primary care services. Reduce the preventable use of acute and residential services via a greater emphasis on health promotion programs, early intervention and chronic disease management. Develop service coordination links between primary care providers to enable early needs identification and service planning, and effective and efficient referral and care coordination between GP s and other healthcare agencies. Plan and deliver more effective health promotion programs and services underpinned by a social model of health. Increase community participation in needs identification, service development and implementation. 2.3 Integrated Health Promotion Agencies Role The Integrated Health Promotion agencies are partners in the development and implementation of Healthy Wellington and will commit state funded Integrated Health Promotion funding towards the development and implementation of this plan. This contribution may be through staff time and or financial support for initiatives. 16 Municipal Public Health and Wellbeing Plan

17 3establishing health priorities for

18 establishing health priorities for The Process A number of groups have been established to develop and implement Healthy Wellington. A steering committee was formed with membership of the partner agencies who are funded to provide health promotion in Wellington Shire. The role of this group is to guide the development of the plan. The Healthy Wellington Action Group has been established as a joint working group and includes representatives of all relevant health and community sector agencies. Its role is to implement the recommendations of the plan. Working groups will be formed or co-opted to lead particular initiatives and individuals will be co-opted to provide particular expertise. Wellington Primary Care Partnership is currently funding a part-time position at Wellington Shire Council to support this process. Structure for the development and implementation of the Wellington Municipal Public Health and Wellbeing Plan Wellington Shire Council Authoriser through the Public Health and Wellbeing Act Wellington Health and Wellbeing Partnership Partnership between Wellington Shire Council, Wellington Primary Care Partnership (WPCP) and the Integrated Health Promotion Funded agencies in Wellington: Central Gippsland Health Service, Yarram and District Health Service and Gippsland Women s Health Service Health and Wellbeing Plan Working Group Time limited group to support the development of the plan. Healthy Wellington Action Group Implement plan. Partnership between the Shire, WPCP, Integrated Health Promotion funded agencies across Wellington and other interested stakeholders and community. Various working groups will be formed to deliver agreed actions for the group. 18 Municipal Public Health and Wellbeing Plan

19 In Australia, we have a good healthcare system and high living standards, but we are facing some very serious health problems. The greatest burden of disease is related to illness that can be reduced or prevented through lifestyle changes and improved living conditions. To understand where future priorities lie, it is important to understand the existing health status of people in Wellington. The most up to date health and wellbeing profile for Wellington Shire has been completed by the Wellington Primary Care Partnership (WPCP). A lot of the data referenced in the following sections is available in this profile. The Wellington Primary Care Partnership Catchment Health and Wellbeing Profile is available on the WPCP website (Wellington Primary Care Partnership 2012). Municipal Public Health and Wellbeing Plan

20 establishing health priorities for Mental Health, social inclusion, freedom from violence, healthy eating and physical activity all rated highly during the consultation phase. 3.2 The Consultation Process A planning workshop was held with over 40 people representing health, welfare, community support, police, leisure, local and state government, WPCP, Aboriginal, women and youth organisations. The group reviewed the data on Wellington s health status and developed a list of priorities based on the information. Community consultation occurred through June and July to establish priorities for the broader community. Surveys were made available online and at all libraries, neighbourhood houses and community learning centres. The survey was also circulated to Community Representative Groups, Men s Sheds, University of the 3rd Age, Probus, Wellington Access and Inclusion Advisory Group, GippsSport, Aqua Energy, Wellington Shire Youth Council, parent groups, service clubs, faith groups, sporting groups, schools, and the Wellington Early Years Network. The results of the two consultation processes were combined and there was a high degree of consistency between the results of the community consultation and the priority setting workshop for agencies and other stakeholders. Further information on the consultation feedback is in the Appendix. Mental Health including social inclusion and freedom from violence, particularly family violence and child protection rated highly. Healthy eating, physical activity and the related infrastructure such as walking tracks and support for health promotion programs including Neighbourhood Houses and Men s Sheds also rated highly. Alcohol, illegal drugs and gambling, were also of significant concern. 18% of responses to the question Are there any other areas of importance and would they involve specific groups?, expressed concern about the potential health and wellbeing impacts of unconventional on-shore gas exploration including coal seam gas and tight gas, and possible impacts of fracking upon underground water if this goes ahead in parts of Wellington Shire. Following input from Council the Plan was further developed and had additional community consultation. Through a process of data analysis, engagement and consultation the top health priorities in Wellington for the next four years were determined and presented to Council. Council is the body that is authorised to approve the final plan. The Healthy Wellington Action Group s role is to establish working groups to develop actions to address the priority areas and to monitor and report on outcomes. 20 Municipal Public Health and Wellbeing Plan

21 3.3 Wellington Population Wellington Shire had a total population of 44,441 in Compared to Victoria as a whole, we have a higher percentage in the age groups 10 to 19 years, and 50 to 84 years, and a lower percentage in the age groups 20 to 44 years. Some towns show distinct differences in the age profile of residents, with Dargo, Loch Sport and Port Albert having a significantly higher proportion of older residents and Heyfield, Wurruk and Maffra having a higher proportion of the 0-4 age group (ABS 2011). The projected population of Wellington is expected to have an average annual increase of 0.6% between 2011 and The estimated residential population is anticipated to have a net increase of 5,356 persons in the period 2011 to 2031 (DPCD 2012). The projected age structure sees a steady decline in persons 0-59 years, and an increase in persons 60 years plus. The largest increase is anticipated in the year age group, which is expected to double during this period. An ageing population will increase demand for support services, health, aged care, and housing services and facilities. The Aboriginal population of Wellington is 1.4%, which is double Victoria s at 0.7%. The local Aboriginal community is much younger than the overall Wellington population. 24.0% of the Aboriginal population in Wellington were aged 0 to 8 years in 2011, compared to 12.0% in the total population. The percentage of Wellington residents born in Australia is 84.15%, significantly higher than 73.8% born in Australia for Victoria as a whole (ABS 2011). Municipal Public Health and Wellbeing Plan

22 4priority one: mental wellbeing - increasing social connectedness and inclusion

23 Social isolation or lack of connection to family, friends, services, recreation, interest groups, employment and training opportunities has been shown to significantly impact on people s physical and mental health. Researchers at the University of Adelaide have stated that social isolation is equivalent to the health effects of smoking 15 cigarettes a day or consuming more than six alcoholic drinks daily, Professor Beer said. It is more harmful than not exercising and twice as harmful as obesity. (University of Adelaide 2011) Within Wellington the following factors need to be considered when addressing social inclusion and connection: Psychological Distress 15.8% of Wellington Shire residents rated high to very high levels of psychological distress compared with 11.1% across Victoria (Department of Health 2012) Proportion of people experiencing Psychological distress level based on Kessler score in % of population (Department of Health 2008) Low Moderate High/Very High Wellington Shire Council Victoria Municipal Public Health and Wellbeing Plan

24 priority one: mental wellbeing - increasing social connectedness and inclusion Adolescent Mental Health In 2009/2010 the psychiatric hospitalisation rate for adolescents in Wellington was 10.5 adolescents per 1,000 compared with Victoria 6.7 adolescents per 1,000 (Department of Health 2013). In 2012 the percentage of young people in Wellington aged receiving unemployment benefits was 6%, which was higher than Victoria at 4.4% (DEECD 2013). In 2009, 11.4 % of adolescents in Gippsland Region felt that lack of access to transport impacted on their ability to work, study, see a doctor or socialise. This was higher than, but not significantly different to that reported across rural Victoria 10.5 % (DEECD 2011). Depression and Anxiety Almost 35 per cent of Aboriginal Victorians, compared with 20 per cent of non-aboriginal Victorians, have been diagnosed by a doctor with depression or anxiety (Department of Health 2008a). Homophobic violence One in seven gay men, lesbians, bisexuals and transgender Victorians live in fear of homophobic violence and 85% report having experienced some form of homophobic violence or harassment in their lifetimes (Better Health Channel 2012). Suicide Standardised Mortality Rates for Suicide in Gippsland in were 17.7 for males and 5.0 for females compared with 11.9 for males and 3.6 for females in the Victorian population as a whole (Department of Health 2013). 24 Municipal Public Health and Wellbeing Plan

25 Nearly 25% of people with severe or profound disabilities have a high level of psychological distress compared with 5% in the general population (VicHealth 2012). Alcohol Use In 2011, 5.8% of those from Wellington who participated in the Victorian Population Health Survey were at high risk of long term alcohol related harm compared with 3.3% of Victorians (Department of Health 2012). There s clearly a connection between substance abuse and mental health disorders. The National Bureau of Economic Research (NBE) reports that there is a definite connection between mental illness and the use of addictive substances and that mental health disorder patients are responsible for the consumption of 38% of alcohol, 44% of cocaine and 40% of cigarettes (Dual Diagnosis 2013). Alcohol consumption is a central feature of Australian culture and identity, particularly for young people. Many young people aged drink alcohol on a regular basis. Drinking to intoxication is a common feature of socialising for young people aged and is viewed as an important and largely pleasurable social experience. In a context where there is a strong imperative to drink the idea that young people should be responsible low risk drinkers at all times is problematic. Indeed it was very difficult for young people to abstain from alcohol consumption in the current context (DrinkWise Australia 2009) Proportion of rates of intentional self harm in Victoria (Department of Health 2013) Wellington Gippsland Victoria Males (Per 100,000 population) Females (Per 100,000 population) Municipal Public Health and Wellbeing Plan

26 priority one: mental wellbeing - increasing social connectedness and inclusion Attendance at Arts Activities Compared with the Victorian average (63.6%), Wellington residents were significantly less likely to have attended arts activities or events in the previous three months (52.8%) (VicHealth 2011). Internet Access 83.9% of people in Wellington had internet access at home, compared with Victoria 88.8% in 2011 (VicHealth 2011). Living Alone In 2011, 3.8% of people in Wellington are aged over 75 and living alone compared to 2.2% in Victoria (ABS 2011). Acceptance of Diverse Cultures In 2011, 37.6% of Wellington residents reported acceptance of diverse cultures, compared with 78% for Victoria (VicHealth 2011). Transport Limitations There is strong evidence showing that lack of transport impacts significantly on social exclusion and wellbeing. People in Gippsland also own more cars than average, and own their vehicles for longer, due to limited access to public transport across the region and the need therefore to keep more cars in the family to service the needs of everyone in the household (Climateworks Australia 2011). The source of this data was the 2008 Motor Vehicle Census completed by Australian Bureau of Statistics. The Motor Vehicle Census was completed again in 2011 and there were similar findings. As a rural area, Wellington Shire residents have significantly less access to public and taxi transport compared with those living in Melbourne or other regional areas in Victoria. The following locations in Wellington do not have access to taxi or any public transport: Dargo, Licola, Briagolong, Boisdale and coastal communities between Port Albert and Woodside. At present there are no public transport services that bring people into Sale between am weekdays or return between pm % of the working population leave Wellington Shire each day to work in other Gippsland municipalities. The average number of motor vehicles in Wellington Shire is 1.9 vehicles per household. However at least 943 households in Wellington Shire do not have any motor vehicles and are totally reliant on public transport (6% of the total). One third of households (33.3%) have only one vehicle and in many cases this is required for commuter use - leaving other members of the family with no access to a vehicle for eight to ten hours per day (ABS 2011). In 2007, 28.8% of women and 17.3% of men in Wellington experienced transport limitations (Community Indicators Victoria 2013). 26 Municipal Public Health and Wellbeing Plan

27 4.1 Factors that strengthen social connection and inclusion in Wellington Shire The Indicators for Community Strength survey results for Wellington in 2008 show that Wellington rates higher than Victoria and regional Victoria in the following areas (DPCD 2008): Rates of volunteering for local groups (45.7% of adults compared to 40.8% for Victoria as a whole) Membership of organized groups such as sports, church, community groups or professional associations Parental participation in schools The 2011 results from the VicHealth Indicators Survey reveal that Wellington residents rated more highly than Victoria overall (VicHealth 2011); Residents reported higher levels of personal wellbeing and feeling part of the community than the Victorian average Sharing a meal with family 5 or more times per week. (significantly higher than Victoria). Getting more sleep, having more time for family, better work life balance and less time stress (not significantly higher than Victoria). In 2011 there were 32,667 hours of volunteer work completed across Neighbourhood Houses in Wellington which equates to $786,940 (Source: Gippsland Regional Neighbourhood Houses Group estimate of value of volunteer time, drawn from ABS data). Wellington has an active arts and culture community which support a rich array of community events for example; the Shakespeare Festival, Maffra Mardi Gras, Tarra Festival and Home is Where the Hall Is project. Municipal Public Health and Wellbeing Plan

28 priority one: mental wellbeing - increasing social connectedness and inclusion Across the shire there are strong and active networks of: Neighbourhood Houses and Community Learning Centres (10 in total) Community Representative Groups supporting community planning People committed to advocacy for accessibility and inclusion eg. through the Wellington Access and Inclusion Advisory Group (WAIAG) Service clubs Sport clubs and recreational groups (e.g. bike riders) Arts and culture and heritage groups Environment groups such as Landcare Men s Sheds Young people involved in groups such as Wellington Shire Youth Council and FReeZA events Faith groups from a wide variety of denominations Best Start partner agencies supporting social connections for vulnerable parents. Wellington Shire Council is proactively partnering with agencies in projects that contribute towards social inclusion. Two examples are; the Gippy Rideshare car pooling project and the Transport toolkit Transport is Everyone s Business (Wellington Primary Care Partnership 2013). 28 Municipal Public Health and Wellbeing Plan

29 Wellington communities have a strong record of supporting each other and showing resilience through many natural disasters such as floods and fires and the recovery process that follows. Components of Resilience Material Resources (Economic Capital) Income, jobs, secure housing, services available, infrastructure, transport Relationships (Social Capital) Connectedness, Social participation, Positive socialisation: inclusive, tolerant, safe involvement in decision making Resilient Families and Resilient Communities Skills and Knowledge (Human Capital) Education, Training, Workforce participation, Good health, Local leadership Municipal Public Health and Wellbeing Plan

30 5priority two: mental wellbeing - preventing violence against women and children

31 At least one woman in Australia is killed each week by a current or former partner (White Ribbon 2013). Family violence and sexual assault are the most prevalent forms of violence against women in Australia. Intimate partner violence is responsible for more ill-health and premature death in Victorian women under the age of 45 than any other risk factor (Royal Women s Hospital Victoria 2010). More than half of Australian women (57%) experience a form of physical or sexual violence at or after the age of 16 years. Intimate partner violence has wide-ranging and persistent effects on women s physical and mental health. The greatest of these is mental illness anxiety and depression which make up 58% of the disease burden resulting from violence. (VicHealth 2013b) Many women experience multiple inequalities based on culture, ethnicity, and disability. Aboriginal women experience rates of family violence and sexual assault many times higher than non-aboriginal women (Lievore 2003). This has been linked to the level of lateral violence in Aboriginal communities. Lateral violence is often described as internalised colonialism and according to Richard Frankland includes: The organised, harmful behaviours that we do to each other collectively as part of an oppressed group: within our families; within our organisations and; within our communities. When we are consistently oppressed we live with great fear and great anger and we often turn on those who are closest to us (Gooda 2011). People with disabilities are more likely to experience violent crime. Females with intellectual disabilities are particularly vulnerable (VicHealth 2012). Women with physical and cognitive disabilities experience higher rates of intimate partner violence than those without disabilities (Brownridge 2006). Women from immigrant and refugee backgrounds are more likely to be murdered as a result of domestic and family violence and are less likely to receive appropriate assistance when they try to leave a violent relationship (Dimopoulos & Assafiri 2004). At an individual, organisational and community level, the main determinants include rigid gender roles and/or weak support for gender equality, a sense of male entitlement, and male dominance and control of wealth in relationships. Family violence and sexual assault are the most prevalent forms of violence against women in Australia. Municipal Public Health and Wellbeing Plan

32 priority two: mental wellbeing - preventing violence against women and children Within Wellington, the following factors are to be considered when looking at how to prevent family violence: 1600 Wellington PSA - Family Incident Reports (Per 100,000 population) (Department of Health 2013) / /13 Family violence incidents Family violence charges laid There has been a significant increase in the number of family violence incidents in Wellington Shire involving police in the last 4 years (up 120%), and in the number of charges being laid (up by 255%) (Victoria Police 2013). Children were present at 42.8% of reported family violence incidents in Wellington 2011/12 (Victoria Police 2013). 32 Municipal Public Health and Wellbeing Plan

33 Municipal Public Health and Wellbeing Plan

34 priority two: mental wellbeing - preventing violence against women and children From there was a 257% increase in police callouts for family violence incidents in Wellington Shire compared with a 158% increase overall for Victoria (City of Greater Dandenong 2013) Police call out rates for family violence incidents (Per 100,000 population) Wellington Victoria 5.1 Factors that strengthen a reduction in the incidence of violence against women and children in Wellington Shire There is a strong focus in Wellington Shire on addressing family violence through Victoria s Action Plan to Address Violence Against Women and Children and Gippsland Regional Prevention of Violence Against Women Strategy White Ribbon Day is promoted across the Shire on an annual basis and many different organisations within Wellington have promoted this day Gippsland Women s Health Service provides access to training for community members and workers about the causes of violence against women and children and strategies for prevention. Since , there has been a 200% increase in reports to Inner and Outer Gippsland Child Protection from Victoria Police. In Victoria Police made over 2400 reports to Inner and Outer Gippsland Child Protection, most of which were family violence related. Inner and Outer Gippsland have the highest Child Protection re-report rate of any region at approximately 73%. In , 58% of substantiated child protection cases in Inner and Outer Gippsland identified family violence as a risk factor. Department of Human Services Child Protection data shows Gippsland has the highest rates of family violence reports to police in the state. (DHS data received 23 October 2013) 34 Municipal Public Health and Wellbeing Plan

35 6priority three: healthier living - healthy eating

36 priority three: healthier living - healthy eating Poor nutrition accounts for around one-sixth of the total burden of disease and costs Victoria between $1.25 and $4.15 billion every year. While the well-educated and those on higher incomes have relatively better diets, those from disadvantaged backgrounds bear the greatest part of the burden of poor nutrition (VicHealth 2013) The major causes of death, illness and disability in which diet and nutrition play an important role include coronary heart disease, stroke, hypertension, atherosclerosis, some forms of cancer, Type 2 diabetes, osteoporosis, dental caries, gall bladder disease and nutritional anaemias (Australian Institute of Health and Welfare 2013) Within Wellington the following factors are to be considered when addressing healthy eating; Proportion of the population consuming the recommended fruit and vegetable intake (Department of Health 2008 / Department of Health 2012) 10 0 Fruit Intake Wellington Fruit Intake Victoria Vegetable Intake Wellington Vegetable Intake Victoria The Victorian Healthy Food Basket survey conducted in Wellington in 2010 and 2012 found that the healthy food basket was cheaper in towns with a chain supermarket or more than one store. These towns were also more likely to have all of the contents available. The purchase of healthy food in Wellington can cost up to 44% of an unemployed family s income. This is considerably higher than the Victorian household average of 17% and may be unaffordable for many (Wellington Primary Care Partnership 2012a). 36 Municipal Public Health and Wellbeing Plan

37 Inadequate access to transport in Wellington affects people s ability to have the quality and variety of foods that they want. The percentage of females experiencing food insecurity is consistently higher than males (Community Indicators Victoria 2013). Food security refers to the availability of healthy food and one s access to it. A household is considered foodsecure when its occupants do not live in hunger or fear of starvation. The percentage of infants exclusively breastfed at 3 months has decreased in Wellington from to In 2012, 45.3% of infants in Wellington were exclusively breastfed which is lower that the Victorian average of 51.7% (DEECD 2011a) Proportion of the population who are overweight or obese (Department of Health 2008 / Department of Health 2012) Overweight Wellington Overweight Victoria Obese Wellington Obese Victoria Obesity in Wellington Shire affects 17.2% of females and 14.4% of males while 30.1% of females are overweight and 44.9% of males are overweight. Obesity is more common in those experiencing greater social disadvantage, including those living in more remote areas (Department of Health 2008). Municipal Public Health and Wellbeing Plan

38 priority three: healthier living - healthy eating Oral Health - Healthy eating has a direct connection to healthy gums and teeth and a reduction in cavities. Wellington has higher rates of hospital admissions due to dental conditions than Gippsland or Victoria (Wellington Primary Care Partnership 2012). ACSC Standardised Admission Rate Trend for Dental Conditions Year Standardised Admission Rate per 1,000 Persons Wellington Standardised Admission Rate per 1,000 Persons Gippsland Standardised Admission Rate per 1,000 Persons Victoria Factors that strengthen healthy eating in Wellington 74.4% of people in Wellington share a meal with family five or more times a week compared with 54.7% of Victorians (VicHealth 2011) Community kitchens and gardens operating from Neighbourhood Houses, Community Centres and schools across the Shire are providing people in Wellington Shire with access to healthy and nutritious food Healthy breakfast programs are offered through many schools across Wellington Shire SecondBite Community Connect has commenced the delivery of fresh fruit and vegetables to Sale to be freely distributed to those in need The Wellington Best Start project has a dedicated working group implementing strategies to improve breast feeding rates in Wellington 38 Municipal Public Health and Wellbeing Plan

39 7priority four: healthier living - increasing physical activity

40 priority four: healthier living - increasing physical activity Physical inactivity ranks first as the leading contributor to preventable illness and morbidity among women, given their lower tobacco usage rates than men. Physical inactivity contributes to more than an estimated 8,000 deaths per year in Australia, of which 1,531 would occur in people under the age of 70 years and would represent an estimated 77,000 premature potential years of life lost because of inactivity. The annual, direct healthcare costs attributable to physical inactivity are about $400m each year, and it is indicated that gross savings of up to $8 million in healthcare costs might be achieved for every one per cent gain in the proportion of the population that is sufficiently active (Bauman et.al. 2002). We can significantly improve our health by moving more and sitting less. This means we need to promote participation in sports, active travel and active recreation. It also means we have to tackle the barriers that make it hard to live an active lifestyle, for example by helping build more inclusive and accessible sports. Increasing participation in physical activity has health, social and economic benefits. As well as the health gains to be made by preventing chronic disease, the benefits include promoting mental wellbeing and social connections, increasing productivity, and positive changes to the environments we live and play in, such as reduced traffic congestion and safer neighbourhoods (VicHealth 2013a). Regular and adequate levels of physical activity in adults: Reduce the risk of hypertension, coronary heart disease, stroke, diabetes, breast and colon cancer, depression and the risk of falls; Improve bone and functional health; and Are a key determinant of energy expenditure, and thus fundamental to energy balance and weight control. (World Health Organisation 2013) 40 Municipal Public Health and Wellbeing Plan

41 Within Wellington the following factors are to be considered when addressing physical inactivity: Insufficient Physical Activity % of Wellington Shire adult residents did not complete sufficient time and sessions of physical activity in 2011 (Department of Health 2012). Access to leisure and recreational facilities - 77% of Wellington adult respondents to the Indicators of Community Strength survey completed in 2008 had easy access to leisure and recreational facilities. This was lower than the Victorian total of 82% and similar to the regional Victorian total of 79% (DPCD 2008). Gender and Physical Activity - Percentage of the population completing sufficient times and sessions of Physical Activity (Department of Health 2008) Population Female Male Total Wellington Gippsland Victoria Cultural considerations - There were no significant differences between Aboriginal men and women or between Aboriginal and non-aboriginal Victorians in the proportion who did or did not engage in sufficient physical activity to meet the Australian guidelines (Department of Health 2008a). Barriers to activity for people with disabilities - In Victoria people with an intellectual disability are far less likely than the general population to participate in an adequate amount of physical activity (22% compared to 60%) (VicHealth 2012). Green Space % of Wellington residents visit green space more than once per week compared with 50.7% of Victorians (VicHealth 2011). Municipal Public Health and Wellbeing Plan

42 priority four: healthier living - increasing physical activity 7.1 Factors that strengthen involvement in physical activity in Wellington 70.8% of Wellington Shire residents completed sufficient time and sessions of physical activity in 2011 compared with 55.9% in This is a significant improvement over four years. The Victorian figures are 63.9% in 2011 compared with 60.3% in 2008 (Department of Health 2008 and 2012). 44% of Wellington adult respondents to the Indicators of Community Strength survey completed in 2008 participated in organised sport. This was higher than the Victorian total of 41% and similar to the regional Victorian total of 43% (DPCD 2008). Wellington residents spend less time sitting down. Only 20.5% are likely to spend seven hours or more sitting on an average weekday compared with Victoria wide 32.6% (VicHealth 2011). Exercise and physical activity were the most important areas of health and wellbeing identified by the Wellington residents who completed the Healthy Wellington Survey in July % of respondents to the Healthy Wellington survey highlighted that the following areas in physical activity and exercise are working well; walking tracks (Lake Guthridge), Aqua Energy and other Council recreation facilities and walking and exercise groups available throughout the Shire. Strong partnerships have been established between Wellington Shire Council, local agencies and community members to develop and implement the Wellington Physical Activity Strategy 2010 and Wellington Walking and Cycling Strategic Plan As at August 2013, a working group is continuing to implement strategic actions from the Wellington Walking and Cycling Strategic Plan Community consultation for the Wellington Physical Activity Strategy in 2009, revealed that walking and cycling were the most common types of physical activity completed by residents across Wellington Shire. Wellington Shire s expenditure on bicycle infrastructure (BiXe) for 2012 was $10.07 per resident. This figure was above the Regional Zone council average for 2012, which is $6.47. Wellington Shire Council s BiXe expenditure has significantly improved since 2010 when it was $1.62 per resident (Bicycle Network Victoria 2013). 42 Municipal Public Health and Wellbeing Plan