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Social Determinants of Health

  • Population

  • Economy

  • Family

  • Diversity

The social determinants of health are complex and many. They drive the health and wellbeing of women and we need to understand these to undertake health promotion and primary prevention in the Southern Region.

Population

Southern Melbourne is dynamic and diverse. Growth and economic projections from local councils indicates an increase from approximately 1.573M residents in 2018 across all 10 LGAs to 2.103M in 2036.

Economy

Australian Bureau of Statistics data (2019) tells us that 30 June 2018 there were 157,918 businesses across all sectors in the 10 LGAs in the Southern Melbourne region.  Of those, the LGA’s of Casey had 14% and Port Phillip had 13% of those businesses.

The region’s biggest businesses are a) construction followed by b) professional, scientific and technical services, followed by c) rental, hiring and real estate, d) financial and insurance and e) transport, postal and warehousing.

These businesses employed some 678,043 people (Australian Bureau of Statistics, 2018). Of this the greatest employer in the region is Health Care and Social Assistance followed by the Retail Industry, then Professional and Technical Services, Construction and Manufacturing.

Future Employment

As primary prevention activity occurs across a range of settings, and is long term behavioural and cultural work responding to the social determinants of health, it is useful to consider what forecasts there are for employment (and workplaces) in the next 5 to 10 years.

Evidence and government forecasting shows a decline in manufacturing industry (currently a significant employer) and growth in administrative support, accommodation & Food services and education & training. The most significant growth will be in the education and training sector.

Socio-economic advantage/disadvantage

The SMR consists of contrasting socio-economic statuses. At one end of the spectrum for example, Greater Dandenong, with a medium income for persons over the age of 15 at $476 per week, is one of the most disadvantaged areas in Victoria. In contrast, Port Phillip’s median income for the same grouping is $1,088, signifying one of the least disadvantaged areas in the country.

According to the Socio Economic Index for Areas (SEIFA ABS 2018), Greater Dandenong is ranked as the second most disadvantaged municipality within Victoria.  Within Australia, Greater Dandenong is ranked in the lowest 10% of municipalities in terms of disadvantage.  On the other end of the socio-economic spectrum four of the 10 municipalities within the SMR are ranked in the top 10% of least disadvantage within Victoria and Australia (ABS 2016).

Poverty

Those with ‘high poverty indicators’, experience greater poverty, while those with a lower poverty indicator experience less poverty in terms of disposable income.

Across all LGA’s in the SMR, men have lower poverty indicators than females.  Greater Dandenong and Casey have the highest poverty indicators for females across the region, indicating greater poverty amongst women in these areas.  Greater Dandenong also has the highest poverty indicator for males across the region.

Homelessness

Homelessness is a significant issue within the SMR.  The LGA’s of Greater Dandenong, Casey and Port Phillip are shown to have the highest numbers of homeless persons enumerated as part of the 2016 Census.

Between 2011 and 2016, there was an increase in the number of homeless persons within the SMR was seen with the exception of Stonnington, Port Phillip and Bayside which saw a decrease of approximately 20% between 2011 and 2016. Cardinia saw the biggest increase in the number of homeless persons, with a 52% increase, followed by Casey (37%), Glen Eira (30%) and Greater Dandenong (28%).

Homeless women

According to recent data, “the number of women aged 55 and over who experienced homelessness in Australia grew by 31% between 2011 and 2016” (Women’s Agenda 2019). ABS figures support this analysis with data showing that between 2011 and 2016 the number of females aged 55 and over facing or experiencing homelessness grew by 40% in Victoria.  ABS data (ABS 2018) also shows that the number for all females facing or experiencing homelessness also grew in Victoria.

Family violence and Housing Insecurity and homelessness

In its ‘Domestic and family violence, housing insecurity and homelessness’ (ANROWS 2019) research synthesis, ANROWS reveals the impact that domestic and family violence have on women’s ability to secure safe and affordable housing.

“Many women who leave their homes following DFV struggle to find suitable accommodation. Over 90 per cent of first requests by DFV clients to Specialist Homelessness Services for long-term accommodation were unable to be met” (ANROWS 2019)

Almost “60 per cent of women who had separated from their partners reported experiencing housing stress post-separation” (ANROWS 2019).

Family

Single Parent Families

There are significant number of single parent households in our region. They are predominantly female headed with most LGAs having around 81% as female headed households. According to ABS figures, Frankston and Greater Dandenong have the highest number of single parent households.

Single parent families can experience a number of forms of disadvantage including poverty. This is visible in rates of poverty amongst single parent households, rates of poverty amongst children and reliance on welfare.

Diversity

Aboriginal and Torres Strait Islander population

In 2016, the total Indigenous population was approximately 7,200 within the SMR (Greater Dandenong, 2018).

While this number is not as substantial as found in other parts of Victoria, this still represents a large proportion of those living in the SMR. The municipalities of Casey, Frankston and Mornington Peninsula had the highest numbers of Indigenous individuals. Casey had 1,616 individuals, Frankston had 1,338 and Mornington Peninsula had 1,304 Indigenous individuals.

Within the SMR, there exists significant ethnic diversity. Within Greater Dandenong, 61.7% of the population is born overseas, while Port Phillip’s overseas born population is 35.1%.  Furthermore, within Greater Dandenong the top countries of birth (outside those born in Australia) include India (8.2%); Vietnam (8.7%); Cambodia (4.5%) and Afghanistan (3.2%).  In contrast, within Port Phillip the top overseas countries of birth are the U.K (7.1%); New Zealand (3%); India (2%) and China (1.8%) (Australian Bureau of Statistics, 2018).

These differences in ethnic makeup of both Greater Dandenong and Port Phillip may reflect the relative affluence (or lack of) of particular overseas born communities.  In addition, this could also reflect the variety of reasons for why people migrate.  Within Greater Dandenong, there exist a greater number of refugees fleeing war and persecution.  In Port Phillip, those re-settling there from other countries are based on other reasons, including accessing higher education and lifestyle choices.

Within the SMR, several LGAs have higher numbers of refugees and asylum seekers.  For example, Greater Dandenong represents 23.6% of all asylum seekers residing in Victoria, which is the most of any LGA. This is followed by Casey with 8.1% (ABS 2018).

Disability

Within the SMR, the percentage of individuals living with a severe or profound disability varies across its municipalities. In 2016, 5% of the population living in the SMR had a severe or profound disability (Greater Dandenong, 2018). While this is slightly below the state average of 5.5%, a number of LGAs exceeded the state average.

Greater Dandenong had a rate of 6.8 % of individuals with a disability, closely followed by Frankston and Mornington Peninsula with 5.8%. In contrast, Port Phillip and Stonnington only had 3.6% respectively of individuals affected by disability. Across most LGAs, females with a disability exceed the number of males with a disability. In Greater Dandenong, 7.8% are females with a disability, while 5.9% are males.

In terms of actual numbers, 304,940 individuals were living with a severe or profound disability across Victoria in 2016.  The number for Greater Dandenong was almost 10,000 individuals, while Casey had 14,000 individuals with a disability.  These numbers contrast markedly with other LGAs in the SMR.  Port Phillip had a total of 3,219 individuals with a disability and Stonnington had 3,459 individuals.

% of individuals with a disability Females as a proportion of those with a disability Males as a proportion of those with a disability
Bayside 4.6 5.4 3.8
Cardinia 4.5 4.5 4.4
Casey 5 5.3 4.7
Frankston 5.8 6.1 5.5
Glen Eira 4.6 5.4 3.8
Greater Dandenong 6.8 7.8 5.9
Kingston 5.3 5.9 4.8
Mornington Peninsula 5.8 6.3 5.4
Port Phillip 3.6 3.9 3.2
Stonnington 3.6 4.3 2.9
Victoria 5.5 5.9 5.1
SMR average 4.96 5.5 4.5

Despite a lack of wide ranging research into the drivers and experiences of violence against people with a disability, available research supports the ABS statistics.  In a paper authored by ‘Women with Disabilities Victoria’ (2017), it is reported that violence against women with a disability, in particular, is not well understood and often ignored or under-reported (Women with Disabilities Victoria, 2017).  Moreover, the paper calls for “more robust data collection and consideration of risks for women with disabilities and different sectors of service provision. In Australia and Victoria there are limited sources of correlated data that provide accurate information about the prevalence of violence against girls and women with disability” (Women with Disabilities Victoria, 2017).

Carers

Across the SMR, significant numbers of individuals are carers (Greater Dandenong, 2018). In Port Phillip, 9.8% of the population are defined as carers. In Frankston, the percentage is 12.5%, while in Greater Dandenong the rate is 11.5%. In actual numbers, the SMR has a total population of

129,243 carers (see figure 8 and 9). Interestingly, and perhaps not surprisingly, carers are predominantly female across all LGAs.

Young People

Young people within the SMR represent a large proportion of the population.  Both Cardinia and Casey, in particular, have substantial populations in the 0-14 year bracket (Australian Bureau of Statistics, 2018). These two LGAs also encompass large numbers within the 15-24 year bracket.  Although not as substantial as that of the 0-14 year bracket, these statistics highlight the significant presence of young people.  As two of the fastest growing regions in Victoria, the growth corridors of Cardinia and Casey have attracted large numbers of young families as evidenced in the data.

LGBTQIA+ communities

It is difficult to ascertain exact numbers and statistics about the numbers of individuals who identify as belonging to the LGBTQIA+ community across Australia.  Despite this lack of data, the Australian Human Rights Commission has estimated that “up to 11 in 100 Australians may have a diverse sexual orientation, sex or gender identity” (Australian Human Rights Commission 2014). The Commission also reveals that in 2011, 6,300 children were living in same-sex couple families.

The ABS outlines that in the 2016 census, there were 8,418 same sex couples with children under 15 across Australia. Out of these 7,291 were female same sex couples.   The rate of same sex couples in Victoria was 12,658 with 6,589 male same sex couples and 6,066 female same sex couples (ABS 2016).

Additionally, it is estimated that 34% of LGBTQIA+ people hide their identity when accessing services; 42% hide their identity when participating in social and community events and up to 39% of LGBTQIA+ people will hide their identity at a workplace.