Cardinia Shire Council
Strategic directions paper
– for development of the Cardinia Shire Municipal Public Health
and Wellbeing Plan 2013–17
Cardinia Shire Council
8 March 2013
CONTENTS
INTRODUCTION .............................................................................................................. 3
DEVELOPMENT METHOD ............................................................................................ 3
Internal consultation and document review ............................................................................................ 4
Community and stakeholder engagement ................................................................................................ 5
Population health data................................................................................................................................. 6
Analysis of data ............................................................................................................................................ 6
CARDINIA SHIRE TODAY – A SNAPSHOT................................................................... 9
Into the future .............................................................................................................................................. 9
COMMUNITY CAPACITY................................................................................................ 10
Geography................................................................................................................................................... 10
Demographics ............................................................................................................................................ 11
Socio-economic factors ............................................................................................................................. 14
SUPPORT SYSTEMS AND HEALTH SERVICES .......................................................... 17
Community facilities and access to services ........................................................................................... 17
HEALTH AND WELLBEING .......................................................................................... 19
Age and disability characteristics ............................................................................................................. 20
Health behaviours ...................................................................................................................................... 25
KEY FINDINGS ................................................................................................................ 28
CONCLUSION .................................................................................................................. 30
APPENDIX 1: MPHWP CONSULTATION SURVEY FINDINGS ............................... 31
Our people and our community .............................................................................................................. 31
Our environment ....................................................................................................................................... 36
Our economy .............................................................................................................................................. 39
REFERENCES .................................................................................................................. 42
LIST OF FIGURES
Figure 1. Map of Cardinia Shire............................................................................................................ 10
Figure 2. Cardinia Shire Population Forecast 2011-2031 ................................................................. 11
Figure 3. Population age structure in Cardinia Shire compared to Greater Melbourne
in 2011 (ID)............................................................................................................................. 12
Figure 4. Change in age structure from 2006 to 2011 (ID) .............................................................. 12
Figure 5. South-East Melbourne migration patterns from 1850-2010 ........................................... 13
Figure 6. Industry output in Cardinia Shire (Jan 2011) ..................................................................... 16
Figure 7. Ambulatory Care Sensitive Condition admissions in Cardinia and Victoria 2001-12 . 22
LIST OF TABLES
Table 1.
Table 2.
Table 3.
Table 4.
Table 4: Rates are Avoidable Mortality Rate, per 100,000 persons, 2001-05 .............. 21
Table 5: ACSC admissions in Cardinia Shire for all age groups 2011-2012 ................ 22
Table 6: Top five non-communicable diseases in Cardinia Shire (2001) ..................... 24
Needs for improving health and wellbeing ...................................................................... 34
INTRODUCTION
The purpose of this document is to present and summarise information about our community
and the health needs of our people which has been used to inform the priority areas for focus in
the 2013–17 Municipal Public Health and Wellbeing Plan (MPHWP). In the development of this
plan, evidence was gathered from a range of sources to construct a health and wellbeing profile
of our community, and heighten our understanding of the community and the health needs we
are currently experiencing.
From the Community Indicators Victoria (2007) survey, we have learnt that Cardinia Shire
residents consider themselves to be in good health (see ‘health and wellbeing’). While this is a
positive finding, it is also problematic as such self-perceptions are at times in conflict with what
we are learning through other sources of information such as hospitalisation rates, burden of
disease statistics, obesity prevalence, and the levels of physical activity or fruit and vegetable
consumption of residents in Cardinia Shire.
Throughout the community consultation process, participants raised concerns about the
prevalence of disease, in particular obesity, in our local communities. They also reported a lack of
awareness of the seriousness around major health issues such as heart disease, diabetes and
stoke. In addition to consultation information, we know that many of our residents are unaware
of physical activity recommendations or the amount of fruit and vegetables they should be eating
(Department of Health 2012). Despite self-reports that we are in good health, the burden of
illness and disease in our community, prevalence of problematic health behaviours, and lack of
knowledge of health issues indicate there are opportunities to improve the health and wellbeing
of Cardinia Shire residents. We feel we are supported by our residents to achieve this. In
consultations, participants acknowledged the importance of prevention for reducing the burden
of chronic disease in our communities, minimising the financial cost of ill health and instilling
health promoting lifestyle behaviours in younger generations (see Appendix 1).
Existing population surveys and statistical information, community consultations, stakeholder
engagement and document review processes provided information from which we have
identified the following priority ideas which aim to improve the health and wellbeing of Cardinia
Shire residents:
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physical activity
healthy eating
mental health
alcohol and tobacco use
cancer prevention
oral health
social connection
community safety
climate change awareness
education and employment.
DEVELOPMENT METHOD
The health and wellbeing priorities outlined in this document were constructed through the
careful consideration of a vast amount of information garnered from within and outside of
Cardinia Shire Council. This process involved four distinctive aspects: (i) internal consultation
with council staff; (ii) review of current documentation and actions of business units concerning
health and wellbeing; (iii) the analysis of population health data through existing sources such
Census and Victorian Population Health surveying and; (iv) community and stakeholder
consultations.
The consultation data applied additional perspectives to existing demographic and health data to
create a fuller picture of the challenges confronting the community. It also allowed for the
identification of community assets and opportunities that might be used to respond to these
challenges. Furthermore, the consultation process helped build the relationships that assisted
Council in refining our health and wellbeing actions, which in turn will support implementation.
While we conducted consultations specifically for the Municipal Public Health and Wellbeing
Plan, we were also able to draw on consultation data from a range of other consultations Council
has hosted. For instance:
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Council Plan consultation
Youth Forum consultation
Healthy by Design consultation
Food Security consultation
Internal consultation and document review
Internal consultations were conducted with business units delivering actions in the current
Municipal Public Health and Wellbeing Plan. These business units were identified by reviewing
the existing MPHWP, and contacted to organise an appropriate discussion time. Discussions
identified initiatives which support health and wellbeing not being captured in current plans and
sought feedback on the strategic direction for health and wellbeing we are currently pursuing.
This enabled us to identify ‘gaps’ in the prevention and health promotion efforts of Council.
Subsequently, we arrived at priority areas for the MPHWP which take into account pertinent
issues in our community, but also where we currently lack action, focus or resource, so that the
health and wellbeing of Cardinia Shire residents can be improved.
Internal staff had a lot of knowledge to offer about the way in which their work impacts the
health and wellbeing of Cardinia Shire residents. Although the roles of business units outside of
Health Promotion may not traditionally be directly associated with health and wellbeing, many
units are working in this space as they contribute to creating an improved and thriving Cardinia
Shire. For example, Environment and Engineering are responsible for waste management across
the Shire. The effective management of waste helps us to sustain a better environment, which in
turn may support health and wellbeing by contributing to a less polluted place in which we can
live. The relationship between the actions and work of other areas of council and health and
wellbeing was raised repetitively in our internal consultations.
In our internal consultations we identified an array of policies and strategies across council that
address health and wellbeing in some capacity. In themselves, these documents were a rich
source of information, providing a rationale and understanding of needs and resources required
for people in our community. In particular, the following three documents have a strong health
and wellbeing focus and are targeted towards population groups across the life span from birth
to maturity:
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Municipal Early Years Plan
Youth Strategy
Positive Ageing strategy
A Municipal Public Health and Wellbeing Plan will be developed to accompany this strategic
background document and will make further reference to the other strategies of Council and
draw links between them and the priorities. Because health and wellbeing is increasingly being
recognised in the plans and strategies of other business units across Cardinia Shire Council, many
areas of health and wellbeing are being addressed. This presents an opportunity to offer a
broader strategic direction for health and wellbeing, reduce duplication of prevention and health
promotion efforts of Council, and address any gaps which have been identified in the internal
consultation process.
Community and stakeholder engagement
Development of the MPHWP has Legislative considerations under the Public Health and
Wellbeing Act for engagement as described in Section 26.
(2)(C) Provide for the involvement of people in the local community in the
development, implementation and evaluation of the public health and wellbeing
plan;
(2)(d) Specify how the Council will work in partnership with the Department and
other agencies undertaking public health initiatives, projects and programs to
accomplish the goals and strategies identified in the public health and wellbeing
plan.
In the development of the Municipal Public Health and Wellbeing plan, community engagement
was undertaken with internal and external stakeholders including residents in several community
settings. Community and stakeholder interest and ability to influence the development of the
plan are different and therefore, engagement techniques used varied accordingly.
Opportunities to be involved in the consultation process were promoted through a variety of
mediums and networks. Stakeholder groups that Council currently works with were informed of
consultation opportunities through an email alert. An article in Connect promoted the chance for
residents to participate in a survey which was offered in both hard copy (upon request) and
online formats. Residents were also invited to write to Council about their health and wellbeing
issues.
Surveys were distributed to various community organisations across Cardinia Shire who were
able to facilitate participation from residents they work with in our local communities. Cardinia
Shire Council encouraged the staff of these community organisations to promote the survey and
assist community members, where possible and practical, to complete it should they require
support to do so. Surveys were provided to Neighbourhood houses, Libraries, Services Central
and Council Customer Service, Koo Wee Rup and Cockatoo After School Care, Freeza, Young
Mum’s Group and My Bus @Bunyip Bike Track Youth Services programs.
Special interest groups representing key groups in the community were engaged through
workshops to identify what health and wellbeing needs they are observing and experiencing.
Community health services participated in this process, facilitating focus groups targeting
isolated or lower socio-economic clients. Five of these discussions or focus groups were held to
encourage participation from a diverse range of residents. These were hosted at The Men’s Shed
and Women’s Group at Casey–Cardinia Community Health in Cockatoo, and the women’s
group in Pakenham. Two focus groups were held with Koo Wee Rup Regional Health Service
with volunteers and participants from the Community Kitchen, Garden Group, Walking group,
and Men’s Shed.
Peak advocacy bodies were given the opportunity to participate in the survey or have a focus
group. The following peak bodies responded to the invitation and participated in the
consultation process:
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Positive Ageing Steering committee
Best Start Partnership
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Culturally and Linguistically Diverse Network
Disability Action Group
Community workers in Cardinia Shire
General Practitioners Network
Additionally, a workshop was conducted with Monash Health, key partners of the Healthy
Together Cardinia Shire preventative health initiative. The objective of the workshop was to
develop an action plan to align the work each organisation delivers and identify opportunities to
work in partnership. The workshop aimed to achieve an understanding of each organisation’s
roles and responsibilities, the programs and initiatives delivered, and the population groups
targeted. Discussions with peak bodies and health services provided an opportunity for Cardinia
Shire Council to become more aware of the issues being experienced at the ‘coal face’ of health
promotion or other workforces who are regularly engaging with the community.
Finally, a public consultation was also offered at Council’s Sustainability Expo. This presented
the opportunity for any member of the public to approach council representatives and tell us, in
written or verbal form, about the health and wellbeing needs they are observing in the
community. Following the analysis of all consultation and other data, and the subsequent
development of our priority areas, a series of workshops were held in Pakenham, Emerald,
Gembrook, Koo Wee Rup, Lang Lang and Garfield. In these workshops, Council presented the
findings of this report and sought feedback, validation and the identification of any gaps about
our proposed priorities from the community.
Population health data
Population health data was also an important source of information which informed the
MPHWP. There are various sources of information which communicate health trends at a
national, state and local level, although the availability of localised information is more limited in
some instances.
The following are examples of information sources which are both publically accessible and
useful for application in the context of local government:
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Census
Victorian Population Health Survey
Community Indictors Victoria
Department of Education and Early Childhood Development
Victoria Police
Australian Bureau of Statistics
The information from sources such as these provided some direction about health and wellbeing
needs in our community. This was particularly the case for indicators or trends which differed
significantly from the state of Victoria. Such cases are highlighted herein.
Analysis of data
The MPHWP community consultation survey presented a series of questions to identify the top
health and wellbeing needs or issues in the community. The questions were aligned with the four
environments for health: social, natural, built and economic. Questions for the focus group
consultations were oriented towards facilitating discussion about health and wellbeing needs in
the community, why these needs are important, and what solutions are suggested in response to
these needs.
Demographic information was collected from participants who completed the survey and
attended focus groups. This indicated that a diverse range of residents participated in the
consultation, including people from a range of different cultural groups (Australian, British,
Dutch, Indian, Italian, Greek, New Zealand, Germany, Hungarian, and Croatian), across a wide
age span (from 17 years of age or less to persons aged 60 years or more). Participants included
employed persons, as well as unemployed and retired. Most professionals were employed as
managers, accountants, teachers, community service and health professionals, and business
owners or in real estate.
Reflecting the high population density in the central ward, most participants lived in Pakenham
at the time of consultation. There was also some level of participation from people residing in
Emerald, Clematis, Avonsleigh, Hughesdale1, Monbulk, St Kilda, Gembrook, Beaconsfield,
Beaconsfield Upper, Officer, Maryknoll, Garfield/Cora Lynn, Cape Woolamai/San Remo,
Bunyip, Cranbourne, Athlone/Drouin, Koo Wee Rup, and Caldermeade. Participation from a
range of localities across the Shire was aided by the use of online surveying which could be
completed in the homes of residents, and also by hosting consultations in Central, Ranges and
Port wards. As a result, participation was distributed over many geographical locations
enveloping both rural and urban townships across the Shire.
While we are confident that we have captured a range of different perspectives and health needs,
participation was over represented with females, despite efforts being made to gather the
perspectives of males with the inclusion of consultations at Men’s Shed’s. Furthermore, we need
to become better at engaging and including our Culturally Linguistic and Diverse (CALD)
communities. In efforts to capture CALD perspectives and health needs, the CALD network
was consulted in the development of this MPHWP. However, the need for contribution from
CALD communities is likely to increase as these population groups continue to grow in our local
communities. Because of this growth, exploration and advice around best practice to achieve
increased participation from CALD communities should be a major consideration in the
development of the next MPHWP.
Consultation data was analysed thematically to assist in identifying key themes and messages
emerging in participants’ responses. A more extensive summary of the key themes from
consultation data is available in Appendix 1. Demographic information and health data was also
collected from various sources such as Census and Victorian Population Health surveys. Health
statistics and related information is presented in this report where it is a relevant or pertinent
need/issue in Cardinia Shire, or where it conflicts with the perspectives or experiences of
residents captured during the consultation process. As a result, this report presents findings from
multiple sources which form a dialogue about health needs in Cardinia Shire.
People in the community considered the following to be the most important health and
wellbeing needs:
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physical activity
healthy eating
mental health
alcohol, tobacco and other drug use
skin cancer prevention.
To develop healthy urban and rural townships, our community suggested that the following are
important.
1
Participation from people who reside outside of the Shire was accepted for those who work in Cardinia Shire.
Built
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Bike paths
Parks and reserves
Walkability
Getting around your town access
Access to transport
Natural
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Bushfire prevention
Vegetation removal/loss of biodiversity
Recycling and waste management
Water management
Emergency management
Finally, opportunities for local employment and tertiary and postsecondary education were
identified as integral to support the growth of our economy for better health and wellbeing.
CARDINIA SHIRE TODAY – A SNAPSHOT
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Estimated population in 2013 is 84,979 residents (Informed Decision, 2013).
In the year-to-date, four new families have moved into Cardinia Shire per calendar
day (CSC, 2013).
Official birth notifications are 2 per cent higher than the same time last year with 112 births
recorded in June 2013 (CSC, 2013).
Median weekly household income is $1,303 (ABS, 2011).
The number of 20 to 24 year olds in the Shire who completed Year 10 or less is 22.3 per cent
– in metropolitan Melbourne the figure is 9.8 per cent.
Total stock of social housing is 1.3 per cent.
In Cardinia Shire 39.7 per cent of residents live near public transport as opposed to 72.6 per
cent in Victoria.
There are no obstetrics services, TAFEs or universities in the municipality.
Outreach support services which operate from the City of Greater Dandenong and the City
of Casey have annual targets for service delivery which are often exceeded before they reach
Cardinia Shire.
The number of family violence incident reports from November 2011 to July 2012 increased
by 71 per cent from the previous reporting period (VicPol, 2011–12).
Into the future
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Children 15 years and under will make up 24 per cent of the population (Informed
Decisions, 2012).
The number of residents aged 70 to 85+ years will more than double from 5,625 to 13,808
older people.
Over the next 20 years, lone person households will make up 19 per cent of dwellings in
Cardinia Shire.
COMMUNITY CAPACITY
Our health and wellbeing is impacted by the environments in which we work, live and play.
Features of our environment such as access to public transport, housing, land, recreational space
and food, and having a safe urban environment with adequate roads, footpaths and street lights,
all influence our health outcomes. Natural environmental factors including climate change and
air and water quality can have an impact on farming and food production, and in turn our health.
Providing a safe and liveable environment through addressing these key areas can enable the
people to be physically and emotionally healthier.
Geography
Cardinia Shire Council was established on 15 December 1994 as the result of state-wide local
government reform by merging the Shire of Pakenham with rural sections of the Shire of
Sherbrooke and City of Cranbourne. Located south-east of Melbourne, Cardinia Shire is one of
nine ‘interface councils’ around the perimeter of metropolitan Melbourne. An interface council is
defined as 30 per cent urban and 70 per cent rural, forming the interface between regional and
metropolitan Victoria. The primary urban centre is Pakenham, which is located 55 kilometres
from Melbourne’s central business district.
The Princes Highway and Gippsland railway corridor runs east-west through the centre of
Cardinia Shire providing a key road and rail link between Melbourne and West Gippsland. The
western end of this corridor includes the Cardinia Shire urban growth area comprising the
townships Beaconsfield, Officer and Pakenham (about 10% of the Shire’s land area).
Figure 1. Map of Cardinia Shire
Cardinia Shire has a large rural population with 27 rural townships outside the urban growth
area. The northern part of the Shire is set in the foothills of the Dandenong Ranges, and includes
Bunyip State Park and Cardinia Reservoir. The Koo Wee Rup swamp and Westernport Bay are
significant features of the southern part of Cardinia Shire.
With an area of approximately 1,280 square kilometres, the Shire faces unique challenges due to
the diverse nature of communities who have varying needs and aspirations. Urban sprawl,
existing rural communities, and new suburbs pose both challenges and opportunities for
managing health and wellbeing.
Demographics
Population growth
Cardinia Shire is one of Victoria’s fastest growing municipalities (.id, 2013). The Shire is growing
by an average of four families every day with a current population estimated at 84,979 residents
and 31,913 households. Pakenham is the largest town with approximate 40,000 residents.
Figure 2. Cardinia Shire Population Forecast 2011–31
By 2023, it is estimated the Shire will be home to over 129,597 residents. The State Government
nominated Casey–Cardinia as one of five regions around the metropolitan fringe where
residential development and population growth is to be concentrated. As a result, rapid
population growth will occur for the next 15–20 years within the Shire’s urban growth area.
The population within the urban growth area is expected to grow from 50,404 in 2013 to 80,686
people by 2021 and to an estimated 104,568 residents in 2031. By 2031, about 67 per cent of the
Shire’s population is forecast to reside in the urban growth area with the remaining 33 per cent
to reside in the rest of the Shire. Combined with the neighbouring City of Casey, the State
Government designated south-east urban growth region is forecast to be home to more than
half a million people by 2026.
Population growth outside the urban growth area is not evenly spread. Rural townships within
the southern and eastern parts of the Shire will experience incremental population growth while
the population of northern hills townships will remain relatively stable. Koo Wee Rup is the rural
township expected to experience the greatest growth, expanding from 3,098 residents at present
to an estimated 4,571 by 2031. Population growth will be restricted outside designated urban
growth boundaries to preserve valuable agricultural land and environmentally sensitive ‘green
wedge’ areas.
Age structure
Population trends in Cardinia Shire show that there is a higher proportion of people in the
younger age groups (under 15), and a lower proportion of people in the older age groups (65+)
in comparison to Greater Melbourne (ABS, 2011). 23.4 % of the population in Cardinia Shire
was aged between 0 and 15, and 10. 7 % were aged 65 years and over. Population structure
provides an insight into where the demand for services and facilities are into the future.
Figure 3. Population age structure in Cardinia Shire compared to Greater Melbourne in
2011 (ID)
Couples with child(ren) are the most dominant family structure in Cardinia Shire, accounting for
38.9 per cent of family types. At 11.1 per cent, the number of one-parent families is also
increasing (.id, 2012). The remaining population is made up of 17.9 per cent lone person
households, and 25.5 per cent couples without children. The main population groups in the Shire
comprise couple families with child(ren) and lone households. With 10.7 per cent of the
population aged 65 years and over, it can be assumed lone households comprise of older people.
Figure 4. Change in age structure from 2006 to 2011 (ID)
Cultural diversity
From 2002 to May 2013, almost 3,350 (3,347) primary migrants have settled in Cardinia Shire.
The most common countries of origin for these migrants include: United Kingdom, India,
Philippines, Sri Lanka, South Africa, China, Sudan, Mauritius and Fiji.
Historical migration patterns suggest that there has been a gradual south-east movement of
migrant communities for many years in Melbourne. In past decades, there have been
concentrations of migrants who have settled in Richmond, Oakleigh, Clayton, Springvale, Noble
Park and Dandenong. Over the past 10 years, there has been considerable growth in the City of
Casey – in particular within suburbs of Hallam, Narre Warren and Cranbourne. This migration
pattern is thought to be largely attributable to:
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accessibility along the rail corridor
affordability of dwellings in newly developing areas
the establishment of a ‘critical mass’ for emerging communities that encourage new settlers
to choose these suburbs to live amongst their families, friends or those from the same or
similar CALD background.
Figure 5. South-east Melbourne migration patterns from 1850–2010
Social participation
Healthy communities are ones in which people feel socially connected and included. Initiatives
that promote health and wellbeing through social inclusion include participation in community
organisations, arts and cultural activities, and volunteering. When asked 'In the last twelve
months [did you] spend any time doing voluntary work through an organisation or group?' (2011
Census), 18 per cent of people reported doing some sort of voluntary work (.id, 2012). 36 per
cent of people reported they had volunteered more than once in the past month in the
VicHealth Indicators Survey 2011, and 54 per cent reported participation in citizen engagement,
which was higher than the Victoria which was 34 per cent and 51 per cent respectively. 22 per
cent of residents stated they are members of a local community organisation and/or decisionmaking bodies (DPCD, 2008).
People in Cardinia Shire report a higher level of community willingness to support one another
than the Victorian average, indicating a level of cohesiveness in the community. Making sure our
residents are not socially isolated is particularly important given the geography of Cardinia Shire;
rural residents have fewer support services and facilities readily available to them in comparison
to those residing in our urban centres. Furthermore, being socially connected is integral to the
support and resilience required to effectively manage and recover from natural disasters such as
fires and flooding, which are known to have major impacts on the health and wellbeing of
residents.
Community safety
Family violence emerged as a key community safety concern in consultations. Victoria Police
crime statistics 2011/12 (measured at rates per 100,000 people) have reported a 71 per cent
increase in the number of family violence incident reports in Cardinia Shire over the reporting
period from April 2011 to July 2012. On one particular afternoon in July there were seven family
violence incidents in the Pakenham area and police were bought in from Casey to assist with the
high volume of callouts. Over the 2011–12 the number of sexual assault offences recorded for
Cardinia Shire increased by 264.3 per cent; from 28 in the period 2010–11 to 102 in the period
2011–12 (VicPolice, 2011–12). Reports are per incident and can include multiple visits to the
same address. Increased reporting can also be attributed to increased confidence in the police
manage the incident.
While some men are the victims of family violence and sexual assault, women and children of all
ages are predominately the victims of these forms of violence. Family violence and sexual assault
impact negatively on the physical and mental health of women and children. Women living with
violence can become isolated and often unable to receive the support that they need. Children
are also being deeply affected. If they witness or experience violence it can impact on their ability
to participate fully in education, sports or social events.
The connection between family violence and its impact on mental health problems has been
firmly established in numerous studies (for example Krug et al. 2002). It is now well evidenced
that abuse and neglect (both in childhood and in adult life) is often a key impact from the on-set
of depression; anxiety; and other mental disorders; and is linked to self-harming behaviour,
substance abuse and suicide.
Socio-economic factors
Our economy and health are linked through factors such as employment, industrial development
and resources. Access to resources and employment, equity and equal income distribution are all
important aspects of the economies impact on health. Socio-Economic Indexes for Areas
(commonly known by its acronym, SEIFA) is a product that enables the assessment of the
welfare of communities. The indexes have been created by the Australian Bureau of Statistics
and cover a number of domains including household income, education, employment,
occupation, housing and other indicators of advantage and disadvantage
Socio-economic status
Within Cardinia Shire, there are areas of relative socio-economic advantage and disadvantage.
Areas of the greatest socioeconomic advantage identified by the 2011 Census include rural areas
north of the growth corridor, towns such as Upper Beaconsfield and Upper Pakenham, and the
suburbs of Beaconsfield and Officer. There are also pockets of distinct disadvantage within the
Shire. These include areas of Pakenham, Koo Wee Rup, and Lang Lang. An area of central
Pakenham has a SEIFA index of disadvantage score in the lowest 10 per cent in the state.
Income
Median weekly household income in Cardinia Shire is $1,303 (ABS, 2011). Compared to Greater
Melbourne the Shire had a lower proportion of persons earning a high income (those earning
$1,500 per week or more) as well as a lower proportion of low income persons (those earning
less than $400 per week) (.id, 2012). 9.2 per cent of the population were deemed to have earned a
high income, and 35.0 per cent earned a low income.
Housing
The Real Estate Institute of Victoria’s latest quarterly data states the median price for a house in
Pakenham is currently around $315,000(REIV, 2013) compared with $248,000 in 2005. This
accounts to an increase of 21 per cent in house value over the past eight years. The number of
affordable rentals available in Cardinia Shire has decreased considerably over the past five years
from 70 per cent in early 2007 to fewer than 37 per cent by the end of 2012.
Almost three quarters (74%) of housing is either fully owned or mortgaged. Cardinia Shire’s fully
owned housing tenure is 25.6 per cent which is lower compared to Greater Melbourne (31.5%).
Almost half (48.4%) of housing is mortgaged and 20.1 per cent of housing is rented; 18.6 per
cent is in private rental and 1.3 per cent in social housing. Cardinia Shire has lower mortgage and
rental housing than Greater Melbourne which were 35.3 per cent and 26.5 per cent respectively
(.id, 2012).
The traditional measure of housing affordability is where housing costs (mortgage or rental) do
not exceed 30 per cent of the gross household income. Housing affordability is particularly an
issue for those whose household income is in the lower 40 per cent of National Income Scale.
One quarter (24%) of households in Cardinia were spending 30 per cent or more of their gross
household income on rent or mortgage payments, compared to 22.7 per cent in the Southern
Metro Region and the Victorian State average of 20.4 per cent (ABS, 2011).
Cardinia Combined Churches Caring (4Cs) is one of the largest emergency relief services
currently operating in Pakenham. Over the past 18 months, 4Cs has identified the new
residential developments as one of its growing clientele bases. Currently more than 20 families
from this area are seeking some form of assistance on a weekly basis. It is anticipated that this
group will reach 30 per cent of the 4Cs client base over the next year. With a higher population
of couples with child(ren) and a higher percentage earning a lower income demand for
emergency relief and support services will continue to increase.
Education
Thirty-six schools are located in Cardinia Shire, comprising 20 government schools and 16 nongovernment schools. These schools cater for more than 14,000 primary and secondary school
students. Almost 10 per cent (9.8%) of the population were attending primary school, and
7.4 per cent of the population were attending secondary school (.id, 2013). No large tertiary
education provider is currently operating within Cardinia Shire which limits the availability of
and access to post-secondary education opportunities for residents. 4.8 per cent were attending
tertiary education, compared with 7.6 per cent for Greater Melbourne (.id, 2013).
Cardinia Shire residents have achieved lower rates of tertiary education than elsewhere in
metropolitan Melbourne. At the time of the 2011 Census, approximately 13 per cent of Cardinia
Shire residents had a Bachelor or higher degree, compared to the metropolitan Melbourne
average of 57 per cent. Approximately 9 per cent of residents aged 20 to 24 years old have a
TAFE qualification. In our consultations, residents commonly suggested the need for local
tertiary education facilities in Cardinia Shire to assist school leavers in obtaining further
qualifications. It was important for residents to have a skilled community which facilitates
employment opportunities and the subsequent development of our economy (see Appendix 1).
Employment
There is a limited level of industry diversity within the Shire. Majority of employment
opportunities are found in the retail trades, manufacturing, construction, education and training,
and agricultural sectors with an estimated 13,680 jobs located within the Shire. In 2011, Cardinia
Shire had a workforce of 34,763 residents. Sixty three per cent of employed residents leave the
municipality to access employment, with 95 per cent of these residents driving to work. In
comparison to the rest of metropolitan Melbourne, more Cardinia Shire residents are employed
as managers, technicians and trades workers, machinery operators and drivers, and labourers.
Less Cardinia Shire residents are employed as professionals, clerical and administrative workers
and sales workers.
Consultation participants stated they would like to see increased employment opportunities in
Cardinia Shire. Increasing employment opportunities has impacts above and beyond the growth
of our local economy. Enabling our residents to both live and work locally reduces the cost and
time needed to commit for traveling to work, subsequently allowing more time to dedicate to
their relationships and family. Reduced stress and increased community identify are potential
outcomes of living and working locally (see Appendix 1).
Figure 6. Industry output in Cardinia Shire (Jan 2011)
Unemployment
Unemployment in Cardinia Shire for the December quarter 2012 was sitting at 5.3 per cent. This
is slightly lower than the Victorian average of 5.5 per cent. There are higher levels of
unemployment in urban growth area – Pakenham, Officer and Beaconsfield (7.6%) and the
southern rural parts of the Shire (5.2%). Unemployment levels are lower in the northern hills of
the Shire (3.2%) (DEEWR 2012)
Financial stress
With a high population of couples with child(ren), higher housing tenure with a mortgage and
lower income levels, families are experiencing varying levels of financial stress. There has been a
significant increase in families in financial stress attributed to the increased cost of food, petrol
and utilities.
Financial stress impacts on the wellbeing of the community and like many social problems – has
a ‘domino’ effect. A sudden illness, job loss or relationship breakdown can tip an individual or
family into debt and other problems can rapidly follow. Once a family or individual is in trouble
then other ‘dominoes’ like physical and mental health, relationships and access to
accommodation start to tumble and can lead to homelessness, physical and mental illness and
risky coping behaviours. The social and economic cost to families and the community can be
enormous (Wesley Mission 2010).
While there is assistance available for those suffering from financial stress, many do not
understand the implications of debt recovery and/or do not seek help until it’s too late because
of a sense of guilt or embarrassment. It is crucial for people to understand where they can go
and who they can contact to assist them with their debt before it escalates. As identified by
consultation participants, there is a need to better communicate and promote the support
services available in our local communities.
SUPPORT SYSTEMS AND HEALTH SERVICES
Cardinia residents experience significant travel distances to access everyday activities that are
frequently within walking distance, cycling distance or short tram ride from home for many other
metropolitan Melbourne residents. Many ‘local’ health and community services for Cardinia
Shire residents are delivered in Dandenong and Cranbourne which is more than 20 kilometres by
road. Most employment, post-secondary training and entertainment opportunities are also often
located beyond Dandenong leading to substantial travel times. For many families with only one
vehicle these services and activities are inaccessible.
There are also limited public transport options within Cardinia Shire. There are many townships
where there is no public transport available. In other parts of the Shire there are bus services but
frequency levels are insufficient to meet the needs of local residents. Without access to public
transport, some residents are unable to access the necessary employment, services, education and
recreational facilities.
Car ownership levels in Cardinia Shire are understandably high with the majority of households
required to own and maintain multiple vehicles. The 2011 ABS census notes the average motor
vehicle per household is 2.1 vehicles. This not only has implications for the natural environment,
but also adversely affects the economic and social cost of living in Cardinia Shire.
Anecdotal reports from the Shire townships outside the urban growth areas indicate that there
are disadvantaged groups, such as older people or social housing tenants, who do not have the
financial capacity to own a car or who do not drive (CSCHS 2008–09). Given transport
limitations in the Shire, housing development needs to be well supported by timely delivery of
community infrastructure and local support service delivery to reduce the dependence on private
car ownership and use.
It is envisaged that ‘regional self-containment strategies’ including the development of
employment precincts within the growth area will result in improved access to services and
employment. To accommodate the forecast population growth, the need for an expanded range
of local health services and flexible models of service delivery that combine community
development and service integration will need to grow with the emerging communities in the
urban growth corridor. While in the rural townships, the distance and lack of transport options
will also continue to be problematic for couples and single parent families with child(ren).
Community facilities and access to services
It is believed that when community members have access to the services they need, when they
need them, they are more likely to have feelings of civic engagement and wellbeing (Bastian
2000). Council has 112 facilities in 24 townships across the Shire for children’s services, seniors
clubs and groups, youth services and recreational activities. Community facilities provide access
to a range of support groups, services and local learning opportunities. Council has community
gardens located at three of the community centres supporting the community to learn how to
grow fruit and vegetables.
Provision of access to services is important for social connectedness in the community,
particularly for vulnerable groups. Consultation data found access to local services is important
for the community to reduce the cost of travel and impacts on time with the family. Participants
indicated that they want greater access to information and programs which support health and
wellbeing at facilities in their local area.
Community facilities
Community Centre
Children’s services
15 Child Care Centre
2
Cultural Centre
1 Kindergarten
Library
2 Kindergarten/MCHC
4
Performing Arts Centre
1 MCHC
2
Public Hall
12
Recreational facilities
Clubrooms
Seniors facilities
24 Senior Citizens Centre
Kiosk/Canteen
2 U3A
Multi-use Recreation Building
3
Pavilion
Sports Complex
12
24 Youth Facilities
1 Youth Services Centre, My Place
4
2
1
HEALTH AND WELLBEING
Understandings of health and wellbeing have evolved significantly over time. While health was
once defined simply as the absence of disease, the conceptualisations of health we employ today
are comparatively holistic, taking into account spiritual, emotional, physical and
mental/psychological wellbeing. Recently, more attention is being paid to how our changing
natural environment will impact our current and future populations, particularly as we begin to
observe the impacts of climate change and understand what this means for our health and
wellbeing. The expected health impacts of climate change include changing patterns of disease,
water and food insecurity, extreme climatic events, and need for adequate shelter from extreme
temperatures (Costello 2009). Those particularly vulnerable are older people, the chronically ill
and the socio-economically disadvantaged.
As how we understand health and wellbeing has changed and continues to change as new issues
and evidence emerge, so to have our responses to health issues. For the first time in Municipal
Health and Wellbeing Plans, we are acknowledging and planning for the health impacts of
climate change. Particular concerns include household energy and water use, food security,
mental health, heat stress, Indigenous health and the sustainability of transport. Sustained action
is required to address the threat of climate change (Smith 2011). Efforts to reduce the impact of
climate change focus both on mitigation and adaptation. Mitigation seeks to reduce the level of
greenhouse gas being emitted, while adaptation seeks to increase our ability to moderate, cope
with and take advantage of the consequences. Adaptation recognises that some level of impact is
inevitable and hence a response strategy will be required to minimise the impacts. Interventions
to protect health and wellbeing will be focused on household energy; household water use;
affordable food supply; heat preparedness and community strength and resilience.
Beyond the impacts of climate change, our changing understandings of health have placed
emphasis on the structure and function of our wider social, economic, built and natural
environments. It is widely known that lifestyle choices such as poor nutrition, physical inactivity,
smoking and consumption of alcohol can have detrimental effects to one’s health. We are getting
better at understanding how the wider environments in which we live can have positive or
negative impacts on the health and wellbeing of communities and the choices ‘individuals’ make.
For instance, access to fresh food, health services, education and employment are integral to the
development and maintenance of healthy and happy communities.
This section explores the current burden of illness in disease in Cardinia Shire and presents
information about key modifiable behaviours which are impacting our health and wellbeing. This
includes a discussion about how the wider environment may be reinforcing, supporting or
minimising behaviours which detract from or promote better health and wellbeing. In the 2007
Community Indictors Victoria Survey, residents were asked to rate their health as ‘excellent’,
‘very good’, ‘good’, ‘fair’ or ‘poor’. 58.3 per cent of our residents reported that their health was
either ‘excellent’ or ‘very good’ (Community Indicators Victoria 2007). This is a higher level of
self-reported health in comparison to Southern Metro Region (55.0%) and the state of Victoria
(54.3%).
More recently, subjective wellbeing was measured by asking residents to rate their level of
satisfaction with their lives on a scale of 0 (completely dissatisfied) to 100 (completely satisfied)
in seven domains including: standard of living; health; achievements in life; community
connection; personal relationships; safety; and future security. The resulting Personal Wellbeing
Index is an average of all seven domain scores. The Personal Wellbeing Index for Cardinia Shire
residents was 78.1 in 2011; higher than the Southern Metro Region average of 76.8 per cent and
the state of Victoria average of 77.5 per cent. As earlier highlighted, although most Cardinia
Shire residents consider themselves to be in good health, the following dialogue indicates that
there is significant room for health improvements which require change, effort and resources
from Council, stakeholders and residents alike.
Age and disability characteristics
Community Indicators Victoria rationalises life expectancy at birth is an indicator of mortality
conditions, and by proxy, of health conditions. With increasing life expectancy, this has
implications for planning to support the physical, social and mental wellbeing of the community
for health services and beyond. In Cardinia Shire, female life expectancy is 83.8 years and for
males is 80.3 years (Department of Health, 2007). The Victorian average for males is
comparative, while for females life expectancy is slighter lower in Cardinia Shire (84.4 years for
Victoria). The percentage of Cardinia Shire’s population in need of assistance is lower (3.3%)
than the Victorian average (4.5%) (Australian Bureau of Statistics 2011). A lower percentage
(2.6%) of people with severe and profound disability live in the community than the Victorian
average (3.5%).
Avoidable mortality (AM)
Published in 2011, Avoidable mortality trends in Victoria between 1997 and 2003, the first
comprehensive report on avoidable mortality (AM) in Victoria, identified predictors of avoidable
mortality with a focus on the underlying social determinants of health. The term ‘avoidable
mortality’ refers to deaths classed as ‘avoidable’, which have the ‘potential’ to be avoided.
Between 1997 and 2003, more than 60 per cent (63%) of deaths in Victoria were potentially
avoidable. Overall, the rates of AM are declining and are predicted to further decline. Males were
found to have significantly higher AM rates due to all causes than females.
Males with the highest rates of total AM lived in rural Local Government Areas, were in the
lowest most disadvantaged socioeconomic group, or had the least access to services including
health care. The highest rates of total AM among females were for those in the most
disadvantaged socioeconomic groups. AM associated predominately with persons aged 30 years
or younger included suicide, road traffic accidents and poisonings, while Ischaemic Heart
Disease (IHD), lung cancer, colorectal cancer, breast cancer, chronic obstructive pulmonary
disease (COPD), stroke and diabetes were predominantly associated with older people, over 30
years of age.
The top ten causes of avoidable deaths in descending order were IHD, lung cancer, colorectal
cancer, suicide, breast cancer, COPD, stroke, diabetes, road traffic accidents, and poisoning.
Fifty per cent of all avoidable deaths were from cardiovascular disease (ischaemic heart disease
and stroke) and cancer (lung, colorectal and breast).
There were 286 avoidable deaths in Cardinia Shire 2002–06. Conditions in ascending order are in
the following table.
Table 1.
Rates are Avoidable Mortality Rate, per 100,000 persons, 2001–05
Any given cause of avoidable death could be potentially prevented before it develops by
addressing its risk or protective factors, or responding to early detection and intervention. The
value of avoidable mortality as an indicator is to assist in monitoring trends in local population
health over time to inform the development of health promotion and chronic disease
prevention strategies.
Potentially preventable hospital admissions
Rates of ambulatory care sensitive conditions (ACSC) admissions to hospital can be used as an
indirect measure of patient access to primary healthcare and specialist health services or facilities
(Department of Health 2011). ACSCs admissions include those cases where hospitalisations are
potentially avoidable where effective preventative care and disease management is employed.
This is important to monitor in Cardinia Shire as the disconnection between residents and
primary health care services was a recurring theme raised throughout the community
consultation process. Furthermore, our rapid population growth and ageing is placing increased
pressure on primary healthcare services and facilities. Access to primary health care services may
be impaired by geographic, financial, cultural or organisational barriers (Department of Human
Services 2001). The concerns raised during our consultations relate largely to the geographic
access to health care services.
Total admissions for ACSCs across Victoria are monitored annually by the Chronic Disease
Surveillance and Epidemiology Section of the Department of Human Services and summarised
in the graph below.
Figure 7. Ambulatory care sensitive condition admissions in Cardinia and Victoria
from 2001–12
In the Southern Metropolitan Region, the admission rate for ACSCs increased from 19.58 per
1000 persons in 1995–96 to 41.29 per 1000 persons in 2004–05. Some of this increase can be
attributed to a change in the way diabetes complications are recorded. From 2008 a decrease in
ACSCs is notable at both state and local levels. In Cardinia Shire, there were 45.89 incidences per
1000 persons in 2007–08, which decreased to 34.30 per 1000 in 2008–09, and further to 33.87
per 1000 in 2009–12. This decreasing trend was similar across the state of Victoria. At 36.96 per
1000 persons, there was a slight increase in ACSC incidences in Cardinia Shire from in 2010–11.
In the following year this rate decreased to 33.30 per 1000.
ACSC admissions for all age groups during the period 2011–12 in Cardinia Shire are presented in
the table below.
Table 2.
ACSC admissions in Cardinia Shire for all age groups 2011–12
Condition
Number of
admissions
Rate per
Average bed
1000 persons
days
Total bed
days
Diabetes complications
525
8.42
8.57
4498
Pyelonephritis
249
3.84
2.85
709
Chronic Obstructive Pulmonary
Disease
168
2.93
5.54
930
Dental conditions
206
2.60
1.16
239
Cellulitis
141
2.12
4.63
653
Asthma
152
1.85
2.12
322
Angina
112
1.80
1.43
160
Ear, nose and throat infections
145
1.80
1.39
201
Iron deficiency anaemia
102
1.62
1.38
141
Dehydration and gastroenteritis
89
1.34
2.02
180
Convulsions and epilepsy
97
1.26
2.25
218
Influenza and pneumonia
48
0.74
7.83
376
Gangrene
31
0.48
19.74
612
Perforated/bleeding ulcer
22
0.35
4.91
108
This shows that complications from diabetes were the most common cause ACSCs and account
for a large proportion of hospital resources such as bed space. This suggests that there is room
for improvement in the knowledge and management of Diabetes for those affected.
Immunisation
Immunisation assists in protecting communities and individuals from communicable diseases
such as polio, tetanus, measles and whooping cough. Where high levels of immunisation are
maintained, such diseases have less opportunity to spread. Ensuring high rates of immunisation
are maintained across our population is therefore an important function of public health and
Council services.
Environment Health at Cardinia Shire Council coordinates the delivery of immunisation
programs in local schools to maintain and increase immunisation coverage rates. In 2012, they
increased the number of session times delivered to accommodate for our rapid population
growth and the needs of parents and students. For students who are not present at school on the
day of visit, additional measures are taken to promote and encourage the immunisation of
children so as to not miss this population group. In their home visits to parents with young
children, Cardinia Shire Council’s Maternal Child and Health nurses are actively involved in
reminding and encouraging parents to follow Australian Government direction and expert advice
to immunise their children.
Research shows that in Cardinia Shire, approximately 93.2 per cent of children are fully
immunised at 24–27 months of age (National Health Performance Authority, 2013). This rate is
similar to the state of Victoria at 93.1 per cent. A national assessment of immunisation rates at 1,
2 and 5 years of age indicates that the percentage of children who are fully immunised is highest
at 2 years of age, and lowest at 5 years of age (Commonwealth of Australia, 2013). This research
also showed that immunisation rates are lower for Aboriginal and Torres Strait Islander children,
meaning uptake could be improved in this population group.
As part of the National Partnership Agreement on Essential Vaccines (Council of Australian
Governments 2009), states and territories are required to maintain or improve their existing
immunisation rates. From July 1, 2012, Medicare locals will play a primary role in ensuring this is
achieved across their catchment areas.
Health conditions
The top five most prevalent non-communicable diseases in Cardinia Shire in 2001 are presented
in the following table.
Table 3.
Top five non-communicable diseases in Cardinia Shire (2001)
Non-communicable disease
Examples
Total
Oral Health
Dental caries
23282
Mental Disorders
Alcohol abuse/dependence, depression,
generalised anxiety disorder
7744
Neurological and sense
disorders
Hearing loss
5354
Chronic respiratory diseases
Asthma
3686
Diabetes mellitus
Diabetes mellitus – NIDDM
1975
Further to the above information about disease prevalence, 53.2 per cent of adults in Cardinia
Shire are overweight or obese (Department of Health 2008). The prevalence of obesity in
Cardinia is higher, for both males and females, than the state of Victoria. For females in the
Southern Metropolitan area, obesity is the most significant risk factor contributing to disease
(Department of Health 2001). Considering the causes of obesity necessitates a ‘systems thinking’
approach which is increasingly being applied in the context of public health and responding to
health issues. While there is a direct relationship between obesity and behaviours such as physical
activity and food consumption, our wider environment and resources available to residents
impacts these behaviours in complex ways.
Mental health and wellbeing
Statistics from the National Survey of Mental Health and Wellbeing indicate that nationally,
45.5 per cent of our population will experience a mental health disorder at some point in their
lifetime. Across Australia, depression and anxiety are the most prevalent mental disorders people
experience (Australian Bureau of Statistics 2007). On average, one in five people will experience
depression (National Survey of Mental Health and Wellbeing 2007). Generally, people believe
that directly addressing the issues and being inclusive are useful behaviours for those
experiencing depression (beyondblue 2013). This finding points to the importance of having
communities that are socially connected and inclusive.
Mental health and wellbeing is about more than just the prevalence of diagnosable mental health
conditions in any given community. Poor mental health and wellbeing is something we are all
likely to experience in our life time as we grapple with the challenges and stresses of everyday
life. Our emotional wellbeing, reactions to stress and levels of anxiety change all the time for a
myriad of social, economic and physiological reasons. The Victorian Population Health survey
indicates that 68.1 per cent of males and 61.3 per cent of females in Cardinia Shire experienced
low levels of psychological distress.
From our community consultations, we have learnt that financial pressure, emergencies (such as
bushfire or flooding), and travel distances to education, employment, entertainment and other
services are sources of stress for Cardinia Shire residents. Furthermore, bullying is known to
negatively impact on young people’s mental health status (DEECD 2009) and has been shown to
cause high levels of distress for young people, with significant risk of psychological problems
including depression, poor self-esteem and disengagement (YACVIC 2010). Bullying was ranked
as the highest issue of concern for youth in Cardinia Shire aged 10–12 in the 2011 Youth Forum
Survey. Young people in the 13–17 and 18–25 year age groups ranked bullying as their third
highest issue of concern.
Prevalence of mental health disorders decline with age (Medical Health Council of Australia), so
youth and young people are an important population group requiring mental health support
services. However, two-thirds of people who have experienced a mental health disorder report
that they did not use any services for their disorder (Australian Bureau of Statistics 2007), which
suggests we should consider and reduce barriers to access.
Mental health and wellbeing is impacted by health behaviours such as what we eat and how
much we exercise. In our consultations, participants reported the benefits of improved mental
health and wellbeing when they are being physically active and eating well. The links between
mental health and wellbeing and these health behaviours, as well as socio-economic factors such
as employment, point to the need for complex and systematic responses to mental health and
wellbeing needs. Poor mental health and wellbeing may be experienced by individuals, but is
influenced by the wider social, economic, built and natural environments in which we live.
Health behaviours
Food and nutrition
Good nutrition is integral to health and wellbeing, but it seems that our lifestyles are
continuously getting busier, which sometimes makes it difficult to purchase and cook healthy,
nutritious food for ourselves and/or family. In our community consultation, healthy eating
emerged as the second most important health need. While Cardinia Shire residents know that
they should be eating healthier food and recognise its importance, this is often considered too
difficult. They lack the time or feel too stressed, believe that vegetables are too expensive to buy
regularly, or simply want to eat foods we know are not good for us as a ‘treat’ (Department of
Health 2012). Such beliefs and behaviours are having consequences on our health and wellbeing.
Only 37.3 per cent of children in Cardinia Shire aged 0–16 years of age eat at least the minimum
recommendation for vegetable servings per day (DEECD 2008). At 86.5 per cent, the
proportion of children (4–12 years of age) eating at least the minimum recommendation for fruit
servings per day is higher, but still lower than the state of Victoria at 87.5 per cent. Research
conducted by the Department of Health (2012) suggests that as little as 8.7 per cent of adults in
Cardinia Shire residents meet the recommended 5 serves of vegetables per day. As well as not
eating enough fruit and vegetables, Cardinia Shire residents have high levels of fast food
consumption. The consumption of fast food or ‘junk’ food is the single most important factor
contributing to Cardinia Shire residents being overweight or obese (Department of Health 2012).
In addition, 17.5 per cent of Cardinia Shire residents consume soft drink on a daily basis, in
comparison to 12.4 per cent of people in Victoria (Community Indicators Victoria 2011). These
food choices also have implications for our oral health and wellbeing, with dental carries
commonly caused by poor diet.
In Cardinia Shire, a family (comprising two adults and two dependent children) on government
assistance could expect to pay on average $451.50 for a ‘healthy food basket’ which provides
over 80 per cent of nutritional needs (based on Nutrient Reference Values (NRVs) 2006) and at
least 95 per cent of energy needs over a two week period. This amounts to 33.27 per cent of
their total income, which according to Australian budgets standards, is considered unaffordable
(Saunders et al. 1998). The Community Indicators Survey Victoria indicates that 7.4 per cent of
persons living in Cardinia Shire ran out of food and could not afford to purchase more on at
least one occasion in the previous 12 months. This is a higher level of food insecurity in
comparison to the state of Victoria (7.0%).
Across Victoria, demand is increasing for assistance from emergency food relief services
(Foodbank Victoria 2012). Foodbank Victoria (2012) advises that the unemployed are vulnerable
to food insecurity, but that they are also assisting a high percentage of low income households
and single parents. At a local level, Cardinia Combined Churches Caring (4Cs) can attest to
supporting a growing proportion of households with working parents. Despite being employed
and having a regular income, many are experiencing financial hardship. These are important
considerations as the (perceived or actual) cost of healthy food is a major determinant of what
we purchase and consequently consume as part of our daily diet (Burns & Friel 2007).
Consultation participants identified the need for affordable food.
Physical accessibility to food is also important to enable changes in the types of food we are
consuming (see Appendix 1). Majority of food retailers in Cardinia Shire are located inside Urban
Growth Boundaries. Environment health data (Cardinia Shire Council 2012) indicates there are
approximately 269 food retailers2 in Cardinia Shire and 220 (88%) of these fall inside Urban
Growth Boundaries (UGB). Of the 49 food retailers that fall outside of Urban Growth
Boundaries, only three are supermarkets. This presents challenges for our population living
rurally to easily access healthy and nutritious foods. Our local food system was a popular point
of discussion in consultations. Residents would like to have easier access to affordable fresh
food. Overall, there is a ratio of one supermarket or green grocer to every six takeaway food
outlet, restaurant or café in Cardinia Shire.
The density and proximity of food retailers in any given community is known to have population
health impacts. For instance, the presence of supermarkets which offer a variety of foods and
fresh produce are correlated with a lower prevalence of obesity in nearby populations (Morland
& Evenson 2009; Morland, Diez Roux & Wing 2006). In Cardinia Shire, there are a total of 20
supermarkets, 15 of which stock 98–100 per cent 3 of items or similar alternatives that comprise
a ‘healthy food basket’. There are 5 stores, however, that stock 82 per cent or less of the ‘healthy
food basket’. The unavailability of items was more pronounced in some stores, the worst case
being 66 per cent of items unavailable, followed by 59 per cent, 55 per cent, 50 per cent and
18 per cent.
The inaccessibility of healthy and nutritious foods in some areas of Cardinia Shire is problematic
and compounded by the comparative ease of access to ‘unhealthy’ foods. Coca Cola, potato
chips and chocolate bars are consistently available at all supermarket and general stores across
Cardinia Shire. Furthermore, observations showed such foods are also available in kiosks, service
stations, milk bars, pharmacies, convenience stores, sporting venues, mobile food providers and
other retail environments not typically associated with food; usually in highly prominent and
visible places. These aspects of our built environment influence the food choices we make as
individuals and contribute to the rising prevalence of obesity locally, nationally and globally.
How food is produced, distributed and accessed is predicted to change as we experience the
effects of climate change. Globally, climate change will have short and long term impacts on the
availability, accessibility, utilisation and stability of food. An increase in severe weather
conditions such as flooding poses challenges for food growers who may face significant crop
loss and damage. Weather conditions aside, climate change presents challenges around the
growth, manufacturing and distribution of food goods; processes which are largely dependent on
the use of unrenewable fossil fuels. A pertinent example of the effect of climate change incidents
on the wider community was apparent throughout the course food security research conducted
by Cardinia Shire Council, when tomatoes were observed as being more expensive than usual.
2
Food retailers include supermarkets, green grocers, butchers, seafood retailers, bakeries, restaurants, cafes,
takeaway outlets, convenience stores, delicatessens, health food stores, hotels, kiosks, milks bars and service
stations. Numbers are likely to change quickly due to our fast growth of rate.
3 Percentages have been rounded to zero decimal places unless otherwise stated.
Local supermarkets informed us that this was due to ‘severe weather conditions in growing
regions’, resulting in crop loss and damage. As the above example demonstrates, the community
may experience increased cost of food items, or complete unavailability. This is the type of
instability in our food system which planning for climate change should seek to address and
minimise.
Physical activity
The National Physical Activity Guidelines for Australians recommend that adults (19 years of
age or more) engage in at least 30 minutes of moderate intensity physical activity on most (if not
all) days. It is advised that that children and young people participate in at least 60 minutes (and
up to several hours) of moderate to vigorous intensity physical activity every day. Research
recently conducted by Department of Health (2012) showed that just over half (56.7%) of
Cardinia Shire residents achieve sufficient exercise. Only 11 per cent of young people do the
recommended amount of physical activity per day (DEECD 2009). The perception that physical
activity is ‘unenjoyable’ and/or ‘boring’ is the most significant predictor of residents not
engaging in adequate levels of physical activity (Department of Health 2012). Further, people are
also time poor, and may know what to do to be healthier, but simply find it too difficult.
Despite the low level of people who engage in sufficient physical activity, ‘physical activity’
emerged as the number one health need in our community consultations. Increasing the number
of local activities available was raised as a solution to increase levels of physical activity amongst
residents. Additionally, participants also suggested residents need more areas for physical activity
that are safe, well maintained and easily accessible (see Appendix 1). Having a built environment
which supports the community being physically active is fundamental to changing our
behaviours. Cardinia Shire Council has recently developed Healthy By Design Guidelines, which
aim to provide planners and developers direction for building communities which support
increased physical activity amongst residents. Key features of such built environments might
include adequate lighting, footpath connectivity, increased surveillance of open spaces,
accessibility to open space, and provision of bicycle amenities.
The amount of time we spend sedentary in our daily lives is problematic for our health and
wellbeing. Research shows that sedentary time is associated with being overweight or obese,
increased risk of heart disease and unhealthy blood-glucose and blood-lipid profiles (VicHealth
2012). Spending too much time sitting is a strong predictor of being overweight or obese for
Cardinia Shire residents, regardless of the amount of physical activity they do (Department of
Health 2012). 33.5 per cent of Cardinia Shire residents spend 7 hours or more per day sitting
(Community Indicators Victoria 2011) and 76.3 per cent are not getting enough daily incidental
activity (Department of Health 2012). We spend time sitting while we travel to and from work or
other destinations, while at work or school, and in our homes. On average, Australians spend 76
per cent of our time at work each day sitting. We are also likely to spend too much time utilising
electronic media such as television or computers. For instance, children and young people
should spend no more than 2 hours per day using electronic media, but only 33 per cent of
Australian children aged 9–16 do not exceed this recommendation (Commonwealth Scientific
and Industrial Research Organisation 2008).
Tobacco smoking
As the single most preventable cause of ill health and death in Australia (Australian Institute of
Health and Welfare 2012), tobacco smoking is the focus of various health promotion initiatives
at national, state and local levels. The Victorian Population Health Survey (Department of
Health 2008) indicates that 19.0 per cent of Cardinia Shire residents over 18 years of age smoke
tobacco daily or occasionally. More males (19%) smoke tobacco in comparison to females
(17.7%), while more females in Cardinia Shire smoke in comparison to females in the State of
Victoria (16.9%). In Cardinia Shire Council’s Youth Forum Survey (2011), youth identified
smoking as a health issue every year since the survey inception in 2007. Overall, smoking was
ranked as the 5th top issue of concern for youth in the most recent survey conducted in 2011.
18.8 per cent of youth aged 15–17 in Cardinia Shire reported having tried smoking tobacco on at
least one occasion (DEECD 2009). It is important to reduce youth exposure to tobacco, as
tobacco smoking is most commonly taken up in these early stages of life (Tyas &
Pederson 1998).
While tobacco smoking is linked with major health risks such as heart disease, stroke, cancers,
vascular disease and other diseases and conditions (Australian Institute of Health and Welfare,
2012), it also known to negatively impact the health and wellbeing non-smokers exposed to
second-hand smoke. Second-hand smoke inhalation most commonly occurs in the home
environment, but people can also be exposed to second-hand smoke in public spaces. Creating
smoke free environments in public spaces continues to gain momentum. Most recently, newly
elected councillor for the City of Melbourne, Richard Foster, proposed Melbourne city become a
smoke free zone with designated smoking areas. Furthermore, tobacco smoking between the
flags on popular Victorian beaches was recently outlawed. The declining rate of smoking across
Australia is supported by such societal changes. However, in 2003 smoking still remained the
largest single risk factor contributing to disease and death (Australian Institute of Health and
Welfare 2012). Currently in Cardinia Shire there is no policy on tobacco smoking outdoors.
Tobacco smoking remains uncontrolled for sports fields, swimming pools, playgrounds, alfresco
dining areas, within entrances to Council owned building and facilities, pedestrian malls, council
events, beaches, bushland, parks and reserves and within council car parks.
Alcohol consumption
Alcohol has a range of short and long term health and social impacts. While it is possible to
enjoy alcohol responsibly and in moderation, 10.4 per cent of our adult population are at risk of
short-term harm from alcohol consumption (Department of Health 2008). Some of the shortterm harms from alcohol include headaches, nausea and vomiting, loss of inhibition, intense
mood such as aggression, elation or depression, blackouts, and various injuries associated with
falls, accidents violence and intentional self-harm. Alcohol consumption can also cause
blackouts, drowning, fires, motor vehicle accidents and alcohol poisoning. Long-term health
risks include, but are not limited to, depression, poor work performance, stomach problems,
cirrhosis of the liver, cancer, family and relationship problems, and alcohol related brain injury.
Through consultations, support around alcohol and other drug use emerged as the fourth most
important need in our community.
Alcohol consumption isn’t just impacting our adult population. In 2011, youth aged 13–17
ranked alcohol as the most important issue facing young people in Cardinia Shire. Research
conducted by DEECD (2010) found that 81.2 per cent of youth in Cardinia Shire aged 15–17
had consumed alcohol at some point, while 56.5 per cent of this same group reported consuming
alcohol in the past 30 days. VicHealth estimates at 90 per cent of Australian teenagers over 14
years of age have tried alcohol at least once. Alcohol is tolerated as a socially acceptable drug, yet
it is responsible for most drug-related deaths in the teenage population and is also associated
with a variety of serious health risks (VicHealth 2011).
KEY FINDINGS
A summary of the statistical evidence are presented as follows:
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Female life expectancy is 83.8 years
Male life expectancy is 80.3 years
Percentage of population in need of assistance 3.3 per cent
Percentage of population with server and profound disability is 2.6 per cent
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Most potentially preventable hospital admission conditions are diabetes complications,
chronic obstructive pulmonary disease and dental conditions
93.2 per cent of children are fully immunised at 24–27 months of age
The top cause of avoidable death is ischaemic heart disease (IHD)
68.1 per cent of males and 61.3 per cent of females experienced low levels of
psychological distress
37.3 per cent of children aged 0–16 years of age eat at least the minimum recommendation
for vegetable servings per day
86.5 per cent of children 4–12 years of age eat at least the minimum recommendation for
fruit servings per day
8.7 per cent of adults meet the recommended 5 serves of vegetables per day
7.4 per cent of persons living in Cardinia Shire ran out of food and could not afford to
purchase more on at least one occasion in the previous 12 months
56.7 per cent of Cardinia Shire residents achieve sufficient exercise
11 per cent of young people do the recommended amount of physical activity per day
19.0 per cent of Cardinia Shire residents over 18 years of age smoke tobacco daily
or occasionally.
Males (19%) males smoke tobacco in comparison to females (17.7%)
81.2 per cent of youth aged 15–17 had consumed alcohol
10.4 per cent of our adult population are at risk of short-term harm from
alcohol consumption
71 per cent increase in the number of family violence incidence
A summary of the consultation data identifying the top health needs for the community are
presented as follows.
To improve the health and wellbeing of the community the top five needs identified are:
Health and community
1. Being active/physical activity
2. Healthy eating
3. Mental health
4. Alcohol and other drug use
5. Skin cancer prevention
To develop healthy urban and rural townships and environments the top five needs
identified are:
Built
1. Bike paths (i.e. linkages)
2. Parks and reserves (i.e. location, maintenance)
3. Walkability (i.e. footpaths, seating)
4. Getting around your town access (i.e. ramps, footpaths, shop and building access)
5. Access to transport
Natural
1. Bushfire Prevention
2. Vegetation removal/loss of biodiversity
3. Recycling and waste management
4. Water management (i.e. septic tanks, grey water, run off)
5. Emergency management
To support the growth of our economy for better health and wellbeing the top three needs
identified are:
1. Local employment (i.e. diverse selection of local jobs)
2. Tertiary and postsecondary education (i.e. TAFE, university)
3. Fuel costs (i.e. impact)
CONCLUSION
Through the collation and analysis of information from internal consultations with Council staff,
review of current documentation and actions of Council business units concerning health and
wellbeing, population health data, and community and stakeholder consultations, the following
priorities were developed to focus on in the Municipal Public Health and Wellbeing Plan:
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physical activity
healthy eating
mental health
alcohol and tobacco use
cancer prevention
oral health
social connection
community safety
climate change awareness
education and employment.
These priority areas are heavily linked with the health and wellbeing of Cardinia Shire
communities, reflect our local needs and health issues, and have high costs of inaction. Perhaps
most importantly, these priorities resonate with areas that Council may have some capacity to
make a difference.
Three objectives are recommended to address these priorities:
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improve the health and wellbeing of the community
develop healthy urban and rural townships and environments
support the growth of our economy for better health and wellbeing.
In these objectives, consideration is paid to the built, natural, economic and social environments
in which we live, work and play.
APPENDIX 1:
MPHWP CONSULTATION SURVEY FINDINGS
The Municipal Public Health and Wellbeing Plan Consultation Survey was designed to gather
data aligned with the Council Plan priority areas: ‘Our people’, ‘Our community’, ‘Our
environment’ and ‘Our economy’. Survey questions were structured to assist us in identifying
what our health needs are and why they are important, and gather information around
community suggestions for solutions. This was disseminated in the form of an online survey,
hardcopy survey and focus group discussions. The survey questions formed the basis of subjects
for discussion in the focus groups held.
In ‘Our people’ and ‘Our Community’ further questions were asked to identify barriers to
participation in activities and assets in the community. Local assets in a community include, but
are not limited to, the skills of local residents, power of local associations, and supportive
functions of local institutions; these are viewed as the primary building blocks of sustainable
community development. These existing strengths in our local communities form a base from
which we can build stronger, more sustainable communities into the future (Northwestern
University, 2009).
Our people and our community
Ten questions were asked in the themes ‘Our people’ and ‘Our community’, as follows:
1. Tell us your top five health and wellbeing needs in our community.
2. Tell us why these needs are important to you.
3. Are there other health and wellbeing needs you are noticing for yourself or among friends
and family?
4. Tell us what you need to improve your health and wellbeing.
5. What activities or groups in your community do you currently take part in?
6. If you do not participate in activities in our community, why not?
7. Is there an activity or group you would be keen to take part in?
8. If yes, please provide details of what type of activity would interest you.
9. List at least three things which support your health and wellbeing in our community.
10. What solutions would you suggest to respond to these issues?
Top five needs
To assist us in identifying health and wellbeing needs specific to Cardinia Shire, participants
ranked their top five needs from a list of the state health priorities and pre-existing issues of
concern in the community. In all cases, they were also able to select ‘other’ and describe an issue
if their experience or issue was not captured in the options available. Participants identified the
following as top health and wellbeing needs in our community:
1. Being active/physical activity
2. Healthy eating
3. Mental health
4. Alcohol and other drug use
5. Skin cancer prevention
Following these top five issues, participants also identified personal safety, injury prevention,
family violence, oral health and tobacco control as health and wellbeing needs. Other health and
wellbeing needs participants are noticing for themselves or amongst their friends and family
include obesity and a lack of awareness of the seriousness around major health issues such as
heart disease, diabetes and stroke.
Why these needs are important
There were some general themes which emerged in participants explanations around why the
above needs are important. Firstly, participants cited the importance of prevention for both
reducing the burden of disease in our community, and saving financially. For instance, one
participant commented that ‘prevention saves a lot more money’. Participants recognised both
the health and financial benefits to individuals, families and communities for prevention
interventions. Secondly, participants spoke about how health and wellbeing builds community
resilience. Another participant reported, ‘I'm finding that a healthy body greatly influences
positive mental health outcomes which in turn reflects on other important aspects of human
health whether it be safety issues, injury prevention and the confidence and ability to tackle
violence and addiction in the community’. Another comment was, ‘With increasing impacts of
obesity, mental health issues and extreme weather events we need to build stronger communities
that support those who are more vulnerable i.e. our elderly. Physical activity and healthy eating
are preventative healthcare; they can help prevent chronic disease later on’. Finally, participants
also recognised the importance of promoting a healthy lifestyle to children and demonstrated
understanding the value of health and wellbeing and the impact it has on individuals, families and
communities. Consideration of the ‘next generation’ was a recurrent theme in participants’
explanations around the importance of physical activity and healthy eating.
Physical activity and healthy eating were important to participants because they perceived them
as integral to quality of life, reducing the burden of disease in our community, role modelling
lifestyle behaviours to younger generations and families, and mental health and wellbeing. Lack
of physical activity and poor diet were seen as the cornerstone of many problems we are facing
in our community, ‘as well as disconnection to nature, food growing, food preparation and eating
in a good, positive social environment either with family or friends’.
Commentary around quality of life included references to how being physically active and eating
healthily can contribute to longevity, ‘living a full life’, increased energy levels and stress
reduction. Participants identified a number of trends in our community that point to the
importance of these lifestyle behaviours, including an increasing population of overweight and
obese persons, population ageing, reduced participation in physical activity, and residents being
time poor.
In explaining the importance of being physically active and eating well, participants drew on their
personal experiences of the benefits of a healthy lifestyle. For instance, they described how being
active and eating well has positively influenced their mental health and wellbeing. In addition,
they reported having a better quality of life, increased energy levels and ‘balance’. Amongst
participants, there is an understanding that levels of physical activity and the foods we are eating
are issues which ‘effect everyone’, and are closely linked with several other important health
issues, such as chronic disease prevention and management, mental health and wellbeing, and
alcohol consumption.
Although not prioritised as a top five need, personal safety was recognised as important to
participants as they want to ensure their families are confident to feel safe in the community. A
participant commented, ‘I value good health and it's important to me to have opportunities to
participate in physical activity, have access to healthy food and to feel safe’. Concern was
expressed about family violence and the impact it has on families and the community.
Participants reported a lack of or limited services available around this issue.
Suggested solutions to the needs
The community proposed a range of suggestions for solutions to their health and wellbeing
needs. Though we welcome suggestions from the community, this does not guarantee the
delivery of any particular solutions, which must also be aligned with Council’s legislative role and
responsibilities for health and wellbeing.
Themes which emerged as areas for action were to: increase services and facilities to meet the
demands of a growing community; deliver information and programs promoting a healthy
lifestyle; build environments which support a healthy lifestyle; and build a healthier and more
secure local food system. Community consultation disclosed partnerships as integral to achieving
these solutions. Consultation with the community workers network found they would like to
work more collaboratively with Council to facilitate and strengthen program delivery and
networks linking people into services. Support is sought from Council to assist in the facilitation
to set up local networks and support groups.
Increasing the number of local activities available was raised as a solution to health needs. For
instance, in Emerald, participants suggested having more school holiday care programs for
school aged children of working parents and a bigger community centre. One participant
proposed an early intervention involving offering affordable sport to all families, children and
youth, aimed at encouraging a love of sport in young children 5–12 years. They suggested that
this should be followed by another program targeted at re-engaging 13–16 year old secondary
school students into sport. Programs offered should link people with other health and
wellbeing initiatives.
More effective communication methods were proposed as a solution for raising awareness
amongst the public about health and wellbeing, events, programs and services being delivered in
the community. ‘Greater advertising is needed for community events and activities, as simple as
putting notice boards up in local supermarkets’. Alternatively, Community Centres and Libraries
could be better utilised as a place for people to go to for health and wellbeing information and
for these centres to be accessible during holiday periods. We acknowledge that as well as
effectively communicating and delivering programs and services, changes in the wider
environment are also needed to achieve better (and more sustainable) health outcomes in
our community.
In relation to the environment, transport is a key issue in the Shire and adequate public transport
was raised as a solution. Participants also suggested that more accessible areas to exercise are
needed. To facilitate access to spaces for physical activity, they suggested ‘walking paths are well
lit and have high visibility’ and are well maintained, that there are lots of trees planted for shade
cover around the shops, and adequate pedestrian crossings are installed to get across busy roads.
The need for a local hospital, specialist rooms and 24 hour clinics was also raised. A consistent
theme in the information from Emerald was to have a local swimming pool. The community are
required to travel to Pakenham or to Narre Warren in the City of Casey to access a suitable
facility.
Finally, participants made a number of comments about the local food system. ‘Better fresh local
food distribution’ is described as a solution for supporting healthy eating, as well as ‘working
with local farmers/abattoirs to advise residents where to source their products and possible
loyalty programs’. Better access to farmers markets, affordable fresh produce and community
gardens were also suggested.
What is needed to improve health and wellbeing
Participants understand Cardinia Shire as a growth area is attracting families who require support
and services. Community service organisations are experiencing an increased demand for their
services. When asked ‘What do you need to improve your health and wellbeing?’ participants
responded as per Table 4.
Table 4.
Needs for improving health and wellbeing
Need to improve your health and wellbeing
Access to affordable physical activity
Access to affordable healthy food
Access to local health services
Health and community information
Social networks
Immunisation and disease management
Access to local relationship support services
Food safety (hygiene)
Home budget advice
Other (please specify)
%
74
69
61
54
47
22
18
16
15
10
Participants not only wanted access to affordable physical activity programs but to have options
local to the community which met the needs of different age groups. Participants reported a lack
of knowledge and education available in the community about what is healthy food and correct
serving sizes to eat for age and lifestyle. There is also a lack of knowledge and education about
physical activity recommendations.
Access to services was a strong focus of consultation discussions and written responses. Due to
a growing population, participants suggested a hospital is needed in Pakenham, and reported lack
of access to 24 hour and emergency medical services. Access to health services is identified as
the third most important need to improve health and wellbeing. Specialist services such as
Urology, Oncology and Psychiatry are not available in the Shire, requiring travel outside of the
Shire. There is also a lack of psychology and counselling services and support groups for mental
health.
Discussion was also oriented around there being lack of awareness of services and how to access
them. During the consultation at Koo Wee Rup, participants reported MIND a leading provider
of community mental health services, was in the town but is now no longer available. This was
attributed to the service not being utilised. The realisation here is without the awareness of
services and how to access them much needed services can be lost to the community. Access to
bulk billing General Practitioners is unavailable or limited in the townships of Emerald,
Cockatoo and Koo Wee Rup. In these locations there is a proportion of the population on lower
incomes who would benefit from this service.
Activities or groups the community take part in
Participants reported they currently take part in the following activities and groups:
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Volunteering
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Church
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Events such as the Pakenham show and
the Yakkerboo festival
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Courses at Community centres
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Environmental groups
Gardening
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State Emergency Service volunteer
Walking alone, with a group or with the
dog
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Mother’s group
Heart foundation walking group
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Arts Society
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Swimming
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Volunteer with Football Club and Auskick
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Yoga
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Netball
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Scouts
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University of the third Age
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Volunteer at the local Primary School
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Genealogy
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Emerald Karate Club
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Gembrook craft group
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Riding lessons at an Equestrian Centre.
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Em2Gem Transition Towns
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Gym
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Cockatoo community garden.
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Bike riding
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Computer tutor
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Basketball
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Local dance group
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Historical society
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Social outings with friends and family to
outdoor public areas to play and be active
Country Fire Authority volunteer
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Township Hall committee
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Agricultural show committee
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Tai Chi
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Art class
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Political parties
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Singing
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Surfing
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Running
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Township/Village Committee member
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Tennis
These activities provide us with an indication of which activities are being utilised by residents
and therefore may be of demand in the future.
Why people do not participate
Participants reported financial limitations, lack of time, access to activities outside of business
hours, feelings of safety in the community, lack of awareness of activities and limited
opportunities in their town as reasons why they did not participate in activities.
Gym programs are considered to be too expensive for some people. Also the requirement to
commit to a long term membership does not suit everyone. Where time was cited as a key barrier
to participation in activities, work commitments and family responsibilities were identified as the
main demands on respondents’ time. Health was not always seen as a priority by parents for
themselves. They are busy working and raising children and their focus has been to organise
activities to support the health of their children.
The availability of childcare in various settings for physical activity would assist parents of
younger children being able to participate in physical activity. Participants suggested flexibility in
the delivery of activities was required to make them available outside of business hours to engage
full time workers into physical activity, particularly those who travel long distances to work.
New activities of interest
Participants requested some activities in their community which are currently (i) not available at
all across Cardinia Shire, (ii) not available in their local area, or (iii) not available at suitable times
(either during school hours or in the evening after work). Additionally, sometimes participants
requested activities that are currently being delivered in their community, which suggests there is
a lack of knowledge, or effective communication and promotion, of what activities are available.
Activities that were requested which are currently not available in Cardinia Shire include Italian
language classes, Scottish Country dancing and a bicycle club. Rather than suggesting further
activities they may be interested in, participants took the opportunity to again communicate
barriers to engaging in activities. Cost and/or activities not being available in the local area or at a
suitable time were more the issue.
What currently supports health and wellbeing
Access to social activities, information, services, transport and a strong feeling of community
connection were cited as supporting health and wellbeing. Particular services such as afterschool
care and the Community Health Service were identified as important to support health and
wellbeing, as well as access to local shopping. For those with access to the railway line at
Pakenham, this was viewed as a good support in the community. The following anecdotes from
participants help to establish, in part, a picture of what a health promoting community might
look like.
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A community consultation participant described her neighbourhood environment at
Lakeside in Pakenham as one which supported the family’s health and wellbeing as they have
access to exercise (YMCA and running paths), services and feel safe. Shopping and medical
services are also easily accessible. The children can safely walk to school with their friends.
The lake is a great place to walk and young people ride there on their bikes to go fishing.
In Koo Wee Rup, participants reported that seniors clubs, Men’s Sheds, Scouts, St John’s
Youth group and playgroups support their health and wellbeing. Participants stated the
YMCA is a good facility and affordable. While access to transport is often identified as an
issue in the community, a participant reported a very positive experience in Koo Wee Rup,
saying ‘Great Vline and Grendas bus service. I use it every day, the drivers are very friendly’.
In Cockatoo there is a willingness to help each other. Participants reported a real sense of
community connection as they can rely on the help of friends, family and community
members when it is needed. Community members are also connected through the local
church. Access to information is important to support health and wellbeing, and media was
described as the best way to promote what is happening in Cockatoo. ‘The local’, an
established local community paper, is helpful for disseminating information to the local
community.
Our environment
The following four questions were asked in the theme ‘Our environment’:
1. Tell us your top five needs for improving were you live
2. Tell us your top five needs for improving our environment
3. Tell us why these needs are important to you
4. What solutions would you suggest to respond to these issues?
Top five needs
Participants ranked their top five health and wellbeing needs for improving where they live as
follows:
1. Bike paths (i.e. linkages)
2. Parks and reserves (i.e. location, maintenance)
3. Walkability (i.e. footpaths, seating)
4. Getting around your town access (i.e. ramps, footpaths, shop and building access)
5. Access to transport
Participants selected from a list of options which support a healthy natural environment to
identify what the top five needs are in the community:
1. Bushfire prevention
2. Recycling and waste management
3. Vegetation removal/loss of biodiversity
4. Water management (i.e. septic tanks, grey water, run off)
5. Emergency management
Although climate change was not identified in the final list of top five needs, climate change was
recognised by participants as ‘affecting us all’. Participants expressed concern for the ‘long term
health of the planet and its safety’. Participants reported, ‘A lot of people are unaware of the
impact of climate change and are ill prepared for meeting extreme weather events. Food security
and the cost of utilities are very concerning for the future’. Participants reported an
understanding of climate change was needed to be able to ‘mitigate the effects’.
Why these needs are important
Participants report a well-planned built environment was integral to facilitating participation in
physical activity and feeling safe in the community. The provision of well-maintained bike paths,
parks and reserves and footpaths was considered fundamental. Participants report that building
tracks for walking and cycling which provide links to parks, shops and transport, as well as
maintenance of current footpaths is needed. Seating and shade on pathways was also discussed
as an important need. Participants were critical of new estates where people had to drive to
access essential items such as food. Participants need access to parks and outdoor space with
facilities such as drinking water and waste bins in off leash dog areas. They also considered it
very important for toilet facilities to be clean and maintained.
Access to transport is identified as a need particularly in the Upper Beaconsfield, Emerald and
Cockatoo areas. The focus group in Cockatoo stated people need to leave the area when they no
longer drive as they cannot depend on public transport because it is not available or not easily
accessible. The V-Line bus services the Lang Lang and Koo Wee Rup area, however participants
reported links to other transport services is an issue.
The importance of having a sustainable environment was central to participants’ explanations of
natural environment needs to support our health and wellbeing. For instance, a participant
stated, ‘If everyone did their bit to recycle and manage resources better it would have a huge
impact on the environment that we are leaving behind for future generations’. Another
participant commented, ‘I want to be part of a better environment and keep it safe for my
children’. With our population growth, waste management is likely to become a more pertinent
issue. ‘We all produce waste, and more people equals more waste, so we need to think carefully
how we manage our waste’. Participants want the cost of recycling and waste disposal affordable
to all of the community to ensure it is done correctly instead of being dumped.
Water management also has links with sustainability and was identified as a need by participants
to prepare for droughts. Maintenance of water management systems was identified as an
important need in flood prevention. Grey water was also mentioned with a participant reporting
it ‘can save us money if grey water could be recycled back into houses’.
A proactive approach in planning strategies to protect the environment against natural disaster
was very important to participants. It was reported, ‘To live in a well maintained and protected
environment in high risk areas increases a sense of safety and wellbeing, building a more
connected and resilient community’. In the Ranges Ward mitigation of environmental threats
such as bushfire was discussed and flooding in the Port Ward. Devastation caused from flood
was viewed equally as that from fire, so the need for emergency management and prevention
strategies are essential. Protecting the environment and emergency management strategies were
identified as a need to prevent the loss of life, homes and personal belongings. Emergency
management was described as, ‘fundamental for me to not feel so isolated’.
Due to the amount of development in the Shire, participants reported concern for the loss of
vegetation and want to ensure this is well managed. They felt more was needed to preserve
vegetation on private property as ‘they are high risk areas of great concern’. Participants wanted
to ensure protection of wet lands and biodiversity including protection of our native animals,
particularly the bandicoots.
The above comments summarise a need expressed by many participants that everyone has a
responsibility to protect the environment for future generations. Participants reported that by
responding to environmental concerns we can build a safe and healthy environment resulting in
increased community resilience.
Suggested solutions to the needs
Solutions suggested in response to the needs include accountability, information, education and
partnerships for collaborative action. Most of the suggestions made is work that Cardinia Shire
Council is already doing. This may indicate a lack of knowledge about what Council is doing to
address climate change, waste and water management, bushfire/flood prevention and emergency
management.
Suggestions to increase the work Council is already doing include:
 education programs particularly for climate change
 support for community groups
 increase green space maintenance and gardening services.
Suggestions to enhance communication to the community include:
 promote awareness in the community about ‘Apps’ that help people link to information
quickly
 utilise Council’s Facebook site more for warnings and information about local emergencies,
e.g. bushfires.
Other suggestions to expand the reach of initiatives to the community include:
 a focus on early years services and primary schools to encourage change through the next
generation
 programs to be delivered on a weeknight and/or weekend for working people to attend
 education about designing an energy efficient home.
Suggestions to improve the built environment include the following.
 One participant suggested the path along Toomuc Valley Creek needs to be longer so there
is a 5–8 kilometre track for cycling and running.
 Koo Wee Rup consultations identified a path is needed along Rossiter Road to the new
estate with a pedestrian crossing to cross safely.
 When the Koo Wee Rup bypass is built to include a cycling path connecting to Pakenham.
 Walking paths and access to the shore line or ‘green walks’ along Western Port Bay.
 A child-proof fence is required at Cochrane’s Park, Koo Wee Rup.
 Provision of shade in play spaces.
 Line of sight pruning to prevent ‘black spots’ on roadways.
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
Off-road bike tracks between Gembrook, Emerald, Belgrave and Pakenham.
More open spaces.
Suggestions to protect the environment include the following.
 A suggestion to keep the local environment clean was to implement an ‘adopt a street/road
scheme’ as well as ‘Tidy Street’ campaigns.
 More targeted fuel reduction burning for bushfire risk prevention.
 More information on fire resistant vegetation for use around private property.
 Stronger local laws to ensure vacant blocks and building sites are maintained.
Suggestions for waste and water management include the following.
 Participants in Emerald would like sewerage installed in all parts of the town.
 Roadside recycling programs to include materials such as polystyrene and plastic bags.
 Roadside hard rubbish collections should include a separate electronics recycling program
(instead of having to drive to Pakenham).
 Green rubbish disposal during hard rubbish collections should be in large paper bags.
 Facility to collect large amount of weeds.
 Larger capacity green waste bins for large properties.
 Support ‘The Go List’ and other community initiatives aimed at preparing and managing in
times of bushfires and other emergencies.
 More education on recycling.
Our economy
Three questions were asked in the theme ‘Our economy’, as follows:
1. Tell us what your top three needs are for improving employment, training and business
opportunities
2. Tell us why these needs are important to you
3. What solutions would you suggest to respond to these issues?
Top three needs
As with other sections of the survey, participants selected from a list of options which support a
healthy local economy to identify what the top three needs are in the community. Responses
emerged as:
1. local employment opportunities (i.e. diverse selection of local jobs)
2. tertiary and postsecondary education (i.e. TAFE, university)
3. fuel costs (i.e. impact).
Agricultural land was not listed as a top need, but participants did express concern for a loss of
fertile farm land and the impact it will have on our local food system. A participant stated,
‘Seasonally grown foods as a cycle are better for all’. Participants want access to locally grown
food which keeps the money in the community.
Why these needs are important
Having local employment opportunities was important to participants because this allows them
to contribute to our local economy. A participant reported, ‘By being employed locally it
increases the ability of the Council to grow, enhances wellbeing and creates a better sense of
community’. Similarly, another participant commented that local employment ‘creates a more
sustainable community and supports the economic development of the municipality’. Access to
tertiary and post-secondary education was seen as integral to employment opportunities.
Discussion about tertiary and post-secondary education was largely oriented around the need for
access to a local facility. Participants who identified tertiary education as a need reported that it
was important for the Shire to have a local tertiary facility to increase accessibility to tertiary
education for young people. Participants reported, ‘A local tertiary facility would assist school
leavers in obtaining qualifications and subsequently employment’. Participants acknowledged
that education is very important to breaking the poverty cycle. To have a skilled community was
important to participants.
A participant who is local to the Hills area said, ‘Younger people need to believe that they can
study and/or make a living and/or home in this area. They shouldn't feel shut out and at a
disadvantage because they live in the hills’. A participant also reported, ‘We need vibrant local
communities with local employment opportunities and education facilities to provide for people
in all age groups’.
Above and beyond the benefits to our local economy, participants recognised further benefits of
local employment and education opportunities. Living and working locally benefits families
because they have more time together and reduced fuel costs. Having local jobs for local people
resulted in less stress due to the travel time. Local employment was viewed as vital for a healthy
community because travelling takes people away from their personal, relationship and family
time. It also had financial impacts due to the cost of travel placing stress on families. A
participant reported, ‘Families are being forced to live apart due to the lack of employment in the
Shire’. Another participant reported, ‘I would love to have a local job and not have to travel to
the city each day. I have finished studying, but I really would have liked tertiary education closer
to home and a lot of young people feel the same’. Participants reported an improved ‘quality of
life’ where they are able to live and work locally.
Fuel was identified as a need because of the cost impacts on individuals and families. Participants
described Cardinia Shire as socially isolated and the cost of fuel is impacting on families and
individuals because a lot of them need to leave the Shire to access employment and higher
education opportunities. As one participant succinctly described, ‘Fuel costs are rising but my
wage is not’.
Suggested solutions to the needs
Creating more jobs by attracting business investment in Cardinia Shire was perceived by
participants as a key solution to our economic needs. Participants want to see the creation of
more opportunities and incentives for a wider variety of businesses to operate within the Shire.
They also suggested that attracting a local provider for tertiary and post-secondary education
would result in more local employment.
Related suggestions include the following.

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Create opportunities for commercial businesses to develop by providing incentives, such as
subsidies in land purchase.
Use community centres to expand educational opportunities.
Establish a jobs board for local employers to advertise for local workers.
Offer a more generous rebate for farmers, especially those preserving some biodiversity.
Encourage more farms to be open to the community.
Support for communities who wish to establish community markets.
Encourage residents to think local and buy local.
In response to rising fuel costs, participants suggested the need to advocate for better public
transport. A theme in response to these needs was the importance of long term planning. A
participant suggested, ‘Planning of infrastructure, not just for the next 5–10 years but long term
is required, but doesn't appear to be happening’.
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