#2328_WSLHD_CPH_YIR 2023_4A_WEB

Western Sydney Local Health District

Centre for Population Health YEAR IN REVIEW 2023

Acknowledgment of Country In Western Sydney Local Health District, we acknowledge the Darug people, the traditional custodians of the land we are living and working on. We pay our respect to Elders past and present. WSLHD continues to be committed in Closing the Gap for Aboriginal and Torres Strait Islander people. Artwork by Leanne Tobin. Leanne’s artwork reflects the vibrancy and traditional motions of the dragonflies as they move through their journey of life.

Contents

‘I’m tremendously proud of the Centre for Population Health and the strong leadership the team have demonstrated for the District on population health issues. Two initiatives have stood out to me over the past 12 months. First, CPH led a comprehensive mapping and synthesising of all District work related to e-cigarettes and vaping, a serious emerging public health risk. As the Executive Sponsor of the resulting WSLHD E-Cigarette Action Plan I’m looking forward to seeing the collective efforts of staff across the District over the next two years to prevent the uptake of e-cigarettes and assist e-cigarette users to quit. Second, I’m also pleased to see prevention being strongly embedded in our clinical services. This has included CPH’s alignment with maternity service leaders to strengthen prevention in our offerings to pregnant women so that all babies can have the best start to life. I look forward to another great year in 2024.’

Foreword

3

About...

4 4 5

Our community in context

Our team

Strategic Achievements

6

Healthy People

8

Healthy Places

18

Awards, Conferences & Key Presentations, Publications, Professional Qualifications & Grants 30

Jasmin Ellis General Manager, Directorate of Integrated

and Community Health, WSLHD.

Future Directions

34

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WSLHD Centre for Population Health Year in Review 2023

Foreword

We draw on our strong connections and networks to protect the population from infectious disease and environmental health risks through our surveillance and response teams. We use a settings-based approach to help shape and support places in offering healthy choices as easy choices. An example is our partnership with Blacktown City Council, introducing a Healthy Food and Drink Policy to enhance the availability of healthy food and drinks in aquatic and leisure centres. We also apply an equity lens to support those most in need; for example, by engaging parents and local practitioners to improve timely childhood immunisation in low coverage areas. I want to express my sincere appreciation for the dedication and hard work of our staff who are the driving force of our Centre. It is during times of challenge that the true spirit of a team is revealed, and I am grateful to be part of such a kind, compassionate and resilient group. As we farewell the year that was, I want to remember our colleagues Avelyn Kumar, Christian Jones and Joanne Cheatham, who left us too soon but forever remain in our hearts. I look forward to continuing to build on the Centre’s momentum and achieving success against our strategic plans. See you all in 2024.

As we welcome the arrival of a brand-new year, it is with both gratitude and reflection that we look back on the year that was. The Centre for Population Health (CPH) has had quite a journey in 2023 marked by resilience, innovation and collaboration, and our commitment to excellence and collective growth. A milestone for the year was the finalisation of our new leadership team. The infusion of fresh perspectives, diverse skills and increased leadership capacity has strengthened our operational and strategic governance. We have set a strategic direction that aligns with our core values and propels us toward our collective vision: that people who live, work, play, learn and age in western Sydney are healthy and well. As part of charting our roadmap for the next few years, in 2023 we: • Published key strategic directions: ° Centre for Population Health (CPH) Strategic Framework (2022-24) ° Health Promotion Framework and Strategy (2023-25) ° WSLHD E-Cigarette Action Plan (2023-25) More on page 6 about these. • Initiated review and consolidation of Public Health Unit teams and functions with consideration of what will be required in the future public health context as we transition out of the COVID-19 emergency response. • Incorporated learnings from COVID-19 into a renewed Emergency Management and Preparedness program. • Launched our updated and refreshed CPH website; and • Continued focus and commitment to our priority life stages through our Maternity Clinical Engagement strategy. Our focus on strong partnerships with WSLHD services, local councils, educational institutions, community organisations (and others) continues, resulting in innovative approaches and projects that further amplify our population health impact within the community.

Dr Shopna Bag MBBS BSc(MED), MIPH, FAFPHM Director, Centre for Population Health Western Sydney Local Health District February 2024

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WSLHD Centre for Population Health Year in Review 2023

About... Our community in context

Our population

Our environment

Our health

Our settings

Our District has 100 health service sites and 4 hospitals that are supported by approximately 13,491 healthcare staff We have 534 early childhood education and care services, 468 of which are engaged in Munch & Move reaching approximately 32,000 children We have 221 primary schools engaged in Live Life Well at School, reaching up to 124,000 students We have 64 aged care settings reaching 6,270 residents in the community We work with TAFE and Western Sydney University to reach tertiary students and staff We work with the 4 councils in our District (Blacktown, Cumberland, Parramatta and The Hills Shire) We have 114 high schools reaching approximately 24,000 students for school vaccinations

14,635 babies were born in WSLHD in 2020, the largest number of births across all of NSW Before the COVID-19 pandemic, WSLHD had the highest burden of travel related communicable disease in NSW For Cumberland LGA residents, there are 21% more preventable hospitalisations* than the rest of NSW In NSW, 32.7% of all 16–24-year-olds are reported to have ever used e-cigarettes from 2020-2021

We have one of the fastest growing populations in NSW which is estimated to reach 1,198,907 by 2030 50% of our residents were born overseas, compared to 31% in NSW 54% of our residents speak a language other than English at home, compared to 28% in NSW We have one of the largest urban populations of Aboriginal people in Australia Between 2010 and 2020 11,864 refugee and humanitarian entrants settled in WSLHD and 85% had poor English proficiency We are a young population with the largest number of children under 10 years of age in NSW

The number of days exceeding 35ºC in Western Sydney is increasing at twice the rate of the Sydney CBD We have 10 splash parks, 47 public swimming pools, 12 hospital pools, and 64 commercial pools to support recreational use, active living and heat management Sydney, and is accessible to 2.3 million people by car or public transport within 45 minutes Western Sydney residents have lower rates of cycling, walking and public transport use, and higher use of private vehicles to travel to work compared to Greater Sydney residents In Parramatta, 62% of dwellings were medium to high density, compared to 20.1% in The Hills Shire, and 46% across Greater Sydney Parramatta is the geographic centre of

Western Sydney is a diabetes hotspot with 13% of adults with diabetes compared to 11% across NSW

*Potentially Preventable Hospitalisations (PPH) are those conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management For references: WSLHD Centre for Population Health Strategic Framework 2022-2024 (page 5) https://www.wslhd.health.nsw.gov.au/Population-Health/news-resources

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WSLHD Centre for Population Health Year in Review 2023

What is population health? At the Centre for Population Health, we aim to support the health of everyone living within WSLHD throughout their lives. We do this by: • working with our partners to protect people from infectious disease and environmental risks in the community, helping and empowering people to stay healthy; preventing health problems, and responding when there are health issues • ensuring the places where people live, learn, work and play are healthy, to improve health outcomes and reduce unnecessary hospital visits. We look at the health of a whole group of people, not just one person. This way, we can ensure everyone in our community gets a fair chance at being healthy. Health and wellbeing can be very different for different people in society. Our job is to make these differences smaller. Learn more about what we do and population health plans.

Our team

We have a range of qualified health professionals supporting work across health promotion, health protection and health prevention to help people be healthy and to shape healthy places.

Centre for Population Health

Operations and Administration

Strategy, Planning and Engagement

Public Health

Health Promotion

Communicable Disease

Healthy Early Years

Environmental Health

Healthy School Years

Executive team L-R and below: Dr Catherine Bateman (Director, Public Health Unit), Dr Shopna Bag (Director, CPH), Janelle McNicholas (Operations Manager, Health Promotion), Michelle Nolan (Director, Health Promotion).

Healthy Adults

Immunisation

Public Health Response Epidemiology

Healthy Ageing

Healthy Places

Smoking and Vaping Prevention

See pages 36 - 39 for our full team.

Dr Conrad Moreira (Clinical Staff Specialist)

Joann Mannion (A/Operations Manager, CPH)

Bronnie Anderson Smith (Manager, Strategy, Planning & Engagement, CPH)

Communications

New Public Health Director Dr Catherine Bateman (appointed 20 November 2023)

Dr Catherine Bateman is a public health physician, originally from the UK but has made Australia home for the over 20 years. Catherine has a background in medical anthropology and spent over a decade as a global health academic before becoming a public health physician. She has a passion for work in social equity and inclusion, environmental health, and health management. Catherine worked in Sydney LHD, South Eastern Sydney LHD, and the NSW Ministry of Health before coming to WSLHD as a Visiting Medical Officer in December 2022 and as Acting Director - Public Health Unit from 19 June 2023. She is undertaking an MBA at University of Sydney and is working towards Associate Fellowship from the Royal Australasian College of Medical Administrators.

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WSLHD Centre for Population Health Year in Review 2023

Strategic achievements Strategic Framework 2022 - 2024

We released several new strategic documents this year to help guide our future directions.

Centre for Population Health Western Sydney Local Health District

Framework Centre for Population Health Strategic Framework (2022-2024)

Our Strategic Framework 2022-2024 provides direction and leadership support on population health initiatives within WSLHD. It outlines the CPH’s vision, purpose, values and focus areas in line with its key functions: Prevention, Protection and Promotion, and aligns with the NSW Health Future Health Strategic Framework 2022-2032. Strategic Framework 2022 - 2024 Strategic Framework 2022 - 2024 Centre for Population Health Western Sydney Local Health District

“As we embrace a new CPH leadership team and transition back to our usual population health service offerings following the pandemic emergency response, the Strategic Framework is foundational in informing the work of the Centre.” - Centre for Population Health Director, Dr Shopna Bag.

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WSLHD Centre for Population Health Year in Review 2023

Health Promotion Framework and Strategy (2023-2025) Our inaugural WSLHD Health Promotion Framework and Health Promotion Strategy 2023-2025 guide WSLHD’s preventative population health strategies. The Framework describes our vision, goals and approach to health promotion which will shape our work for the longer term, while the Strategy provides clear direction for the coming two years. The western Sydney population is diverse; facing a complex set of cultural, social, economic and environmental health determinants. Things like rapid urban development, the impacts of climate change, rising living costs, and the shaping of our local food and built environments. Health Promotion plays a crucial role in keeping our community healthy and well, and particularly considering these challenges and their impact on health behaviours and health outcomes. The new Strategy embodies our commitment to reducing health inequities and achieving the best population impacts in the focus areas of healthy eating, active living, and tobacco and e-cigarette control.

Centre for Population Health Western Sydney Local Health District

Health Promotion Framework 2023

Centre for Population Health Western Sydney Local Health District

Health Promotion Strategy July 2023 - June 2025

Centre for Population Health Western Sydney Local Health District

Health Promotion in WSLHD

In our District

Over 1,000,000 residents

Our two-year vision: July 2023 - June 2025 Objectives Actions 1. Sharpen our strategic focus. 1.1. Described as a “heat bowl”, with a growing impact on daily living Population focus Maximise reach to contribute to population health Goal 1 Goal 2 Impacts on health in western Sydney The Western Sydney Local Health District (WSLHD) Health Promotion team sits within the Centre for Population Health. We deliver a comprehensive range of evidence-based work to improve health and wellbeing across the District. This Framework was developed by our team to drive and communicate future work. Health Promotion Framework & Strategy Snapshot 2023

Ensure the alignment of all our work to our Framework. Realign/invest/disinvest as necessary to achieve a better overall balance of work. 1.2. Consolidate relevant work and explore the potential for common or complementary strategies, messaging and indicators, such as for: • The First 2000 Days • Healthy built environments • Healthy food environments • Physical activity • Building the capacity of clinicians to embed health promotion prevention programs into service delivery • Responding to climate change. 2.1. Advocate to the Ministry of Health to shape statewide programs to better fit our local context. 2.2. Develop/revise and support quality improvement processes and systems for project planning and evaluation across all projects. 2.3. Embed community engagement more effectively throughout program planning and delivery. 3.1. Critically evaluate whether our population level work is achieving an appropriate level of population reach. Realign/invest/disinvest as necessary. 3.2. Improve the cultural relevance and cultural safety of all our work for the diverse communities who live across our District. 4.1. Critically evaluate the reach of our equity work to ensure it is reaching those who need it the most. Realign/invest/disinvest as necessary. 4.2. Critically evaluate the outcomes of our equity work to ensure it is making a difference. Realign/invest/disinvest as necessary. Goal 1 Our first goal is to shape local environments for better health. Many environmental factors have a significant impact on individual health behaviours yet are beyond individual control. Goal 2 Our second goal is to empower and enable people to make and sustain healthy choices. We employ evidence-based strategies to influence and support people to live healthier lives. This includes the promotion of Our priority health issues include but are not limited to: • Healthy eating • Active living • Smoking and vaping Our life stages approach includes but is not limited to: • Best start to life • Healthy ageing Those who need it the most include but are not limited to: • Aboriginal people • Diverse and disadvantaged groups who experience inequities Vibrant, diverse communities: 50% born overseas, 54% speak a language other than English, approximately 200 languages Almost 12,000 refugee and asylum seekers have settled in the past 10 years Highest birth rate in NSW; over 15,000 babies each year Childhood population (under 5 years) growing at more than double the NSW projected rate to 2041 (30% versus 14%) Number of people aged 65+ projected to grow at double the NSW projected rate to 2041 (67% versus 32%) Health Promotion Strategy July 2023 - June 2025 Centre for Population Health Western Sydney Local Health District 5.1. Increase our overall focus on upstream, healthy built and food environmental strategies. Vision 1: People are healthy and well We seek to improve health and wellbeing at a population level across our District, rather than working with one individual at a time. As we receive less than 1% of the WSLHD budget to do this work, we need to be strategic about how to achieve the best population impact. Our Framework provides an evidence-informed foundation to do so. Vision 2: Inequities in health and wellbeing are reduced Although our broad remit is population health, part of that is to ensure outcomes are achieved fairly across our communities. Access, opportunity, risk and outcomes in health and wellbeing can and do vary substantially across society. Our equity approach therefore has narrower focus: to invest in more specific, tailored work where it is needed to achieve a fairer balance across our communities. Population growing at a faster rate than NSW average; projected 400,000 additional residents by 2041 Over 16,000 Aboriginal people; one of the largest urban populations of Aboriginal people in Australia

Short on time? This Snapshot provides a summary of key highlights from both the Framework and Strategy.

Relatively low rates of cycling, walking and public transport use

Equity focus Focus more specifically on people and places where it is needed the most People Empower and enable people to live healthier lives

Places Shape environments to support better health and wellbeing

Relatively high proportion of unhealthy food environments

Vision 1 People are healthy and well

Centre for Population Health Western Sydney Local Health District

Population focus Maximise reach to contribute to population health

High-density housing increasing

2. Enable our work.

Rising costs of living impacts on already socioeconomically disadvantaged Health Promotion Framework 2023

are at the centre of everything we do Local People

3. Improve our capacity to achieve population level outcomes.

Vision 2 Inequities in health and wellbeing are reduced

Relatively high smoking prevalence in some suburbs

Equity focus Focus more specifically on people and places where it is needed the most

4. Improve our capacity to achieve equity outcomes.

Diverse cultural factors and attitudes impacting smoking and shisha use

Places Shape environments to support better

People Empower and enable people to live healthier lives

Our role is to work through partnerships in settings such as community facilities, early childhood services, schools, healthcare settings and with local government to shape

Socioeconomic disadvantage varies widely across and within local government areas.

Relatively high rates of illegal sales of e-cigarette (“vapes”) to younger people close to schools and transport hubs Partnerships and advocacy

Enablers:

5. Improve the focus of our work in places.

statewide health coaching services and smoking and vaping prevention. We coordinate healthy lifestyle groups for children, families and older people and work with others (such as health professionals) to further advocate and enable health behaviour change.

health and wellbeing

Evidence-informed practice

Team operations

Communication and engagement

6. Improve the focus of our work with people.

6.1. Shift the balance of our investments away from direct delivery. Where possible, work through others (eg. settings, partners) for better reach. If a direct approach is required, target it for an equity focus to justify the intensive cost. environments in ways that make healthy choices easier.

Relatively high passive smoke exposure in Aboriginal homes

Disproportionately impacted by the COVID-19 pandemic, compounded by complex socioeconomic factors

Centre for Population Health WSLHD – Health Promotion Framework and Strategy Snapshot

August 2023

7. Enhance and/or develop additional work to address the following priorities and gaps.

7.1. Smoking and vaping in pregnancy, especially with Aboriginal women for whom smoking and vaping rates are very high 7.2. Vaping, especially with young people 7.3. Primary prevention interventions to support healthy ageing 7.4. Physical activity strategies to increase active travel, reduce screentime and reduce sedentary behaviour 7.5. Healthy food environment strategies within our current settings/partners.

Centre for Population Health WSLHD – Health Promotion Framework and Strategy Snapshot

August 2023

Centre for Population Health Western Sydney Local Health District

August 2023 Gungurra, Building 68, Cumberland Hospital Campus. Fleet Street, North Parramatta New South Wales 2151 WSLHD-CentreForPopulationHealth@health.nsw.gov.au. Ph: (02) 9840 3603. Centre for Population Health website

WSLHD E-cigarette Action Plan (2023-2025) Led by our Centre for Population Health staff, and developed in collaboration with District staff, key partners and consumers, this new E-cigarette Action Plan will play a key role in addressing the challenges posed by e-cigarettes within WSLHD.

It focuses on three key action areas: 1.

Policy and regulation: We will establish and enforce clear guidelines to govern the sale and use of e-cigarette products within our community. Our commitment to a smoke-free environment includes the ban on the use of e-cigarettes in smoke-free public areas. 2. Community messaging and education: We will continue in our efforts to educate our community and enhance awareness of the risks associated with e-cigarette use. Empowering our community with knowledge is a priority in our strategy. 3. Clinical engagement and support: We will provide our clinical settings with training and resources to address e-cigarette related health issues effectively. This will enable us to offer best practice smoking and e-cigarette cessation support. The implementation will be driven by an overarching Governance Committee and three key Working Groups, each focusing on the action areas.

Western Sydney Local Health District E-cigarette Action Plan 2023-2025

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WSLHD Centre for Population Health Year in Review 2023

Healthy Places WSLHD Centre for Population Health Year in Review 2023 8

Health-promoting settings

HEALTH PROMOTION

HEALTH PREVENTION

Partnerships and advocating for healthy built environments CPH continues to partner with our local Councils to shape the built, natural and food environments that support people where they live, learn, work, and play to lead healthier and more active lives.

2023 outcomes:

Reviewed Plans and Policies on public exhibition and provided evidence-based submissions on the health impacts of the proposals. • 25 submissions were made on issues that ranged from walking and cycling strategies and other active transport initiatives; public domain plans; playground upgrades; crime prevention plans and Master Plans. Communicated and amplified the importance of a healthy built environment through various communication channels, such as: • 11 presentations on topics including healthy high density living for families with children; walking and safety; access to public amenities and citizen science. • 9 nextdoor posts targeting residents on health topics including heat safe messaging and bike workshops.

Creation of videos and radio interviews on heat preparedness and Library Health Month.

HEALTH PROMOTION

Health-promoting libraries As a trusted community setting, libraries provide the opportunity to promote health information, resources and programs directly to a range of community members. In 2023 we consolidated our work with the four Local Government Council Library Networks (25 Library branches) in our district. 2023 outcomes: • Library Health Month was successfully delivered for its seventh year. • In collaboration with libraries, a Health Promoting Libraries Checklist was updated and recirculated to compare progress with baseline data gathered in 2021. • Small grants were offered to libraries to support health promoting library environments. Reflections on how these long-standing partnerships can be strengthened are underway.

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROMOTION HEALTH PREVENTION

As a priority project since 2017 of our partnership with Blacktown City Council, this plan aims to increase community walking rates through: • Improved walkability of the environment • More walking opportunities • Awareness of opportunities to walk. Project evaluation started in 2022 with a review of walkability, continuing this year and into 2024 with: • Availability of public toilets review • A Community Walking Survey • A partnership evaluation. Evaluation of the Walking in Blacktown City Plan

2023 outcomes: 10% 2 485 7

increase in council managed public toilets open in daylight hours.

Public Amenities Network meetings annually to help facilitate this increase.

responses to the community survey. Results analysis underway.

walkability related surveys or submissions completed.

“I love the broad scope of my work and thinking about how built and natural environments contribute to health and wellbeing. Our homes, the places we live, work and play in, the Country we inhabit, are all places we are deeply attached to. I love that my role, in small measure, contributes to making them as health promoting as possible. It’s not just a desk job; our work involves a bit of everything, from thinking about tree coverage to how we move from destination A to B. It gives me great satisfaction to work in collaboration with key partners, who have a wealth of expertise that supports our work and to see our partners both within and outside of health, increasingly understand the importance of how the quality of places can contribute to improved health outcomes.”

- Helen Ryan, Coordinator Healthy Places team, Health Promotion.

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROMOTION HEALTH PREVENTION

Designing healthy higher-density living for families and children A draft Guide has been developed in partnership with City of Parramatta and expert input from Cities for Play and Hayball Architects, to address the specific needs of families with children living in high density. It provides design advice and best practice examples of how to enhance health and liveable outcomes for this demographic. It will be formally launched in early 2024.

2023 outcomes: • Stakeholder Engagement on the Draft Design Guide (May-August). • 19 local Councils and

Healthy Higher Density Living for Families with Children:

Design Guide (draft)

Living well after lockdown Health & wellbeing tips

Addressing the health needs of families living in high density housing

Engagement period: May - August 2023

Stakeholder Engagement

Stakeholders provided feedback via six engagement channels Stakeholders could choose their preferred feedback method/channel.

Despite an increasing number of families living in high density housing, to date no Australian city has a policy on family-friendly high density housing which signals a substantial gap within planning policy. (1) A draft Design Guide has been developed to address the specific needs of families living in high density housing to provide design advice and best practice examples of how to enhance liveable outcomes for this demographic. This project is a joint initiative of Western Sydney Local Health District’s (WSLHD) Centre for Population Health (CPH) and City of Parramatta (CoP); with Cities for Play and Hayball Architects engaged to provide expertise and advice. During May - August 2023 , key stakeholder groups who are likely to use the Design Guide, were engaged to review the draft version. This included: State Government Agencies, Local Councils - Planners and Urban Designers, Health Professionals, Academics, Architects and NGOs. The constructive feedback received from stakeholders will be used to strengthen the Design Guide, prior to submission to CoP for endorsement, and to inform the next steps of implementation. Stakeholder engagement: When and who?

Online surveys (n=43)

Workshops & Presentations (n=9)

1:1 interviews (n=4)

309 stakeholders provided comprehensive feedback which is being incorporated to strengthen the Guide. • A dashboard of results was developed and circulated to all stakeholders who participated in the engagement process.

Responses received across all stakeholder segments

Academic UNSW City of Sydney Council Transport for NSW Urban Designer Specialist with industry experience

259 attendees in total 19 Local Councils engaged

Urban Design Forum Western Sydney Councils Health Alliance NSW Healthy Built Environment Network Workshops/presentations included:

Emails (n=7)

Submissions (n=3)

Seven responses received via email were from Academia, State Government Agencies, Councils, Public Health and Planning experts

Direct comments (n=2)

City of Parramatta Cumberland City Council The Hills Shire Council

Two responses via direct comments on the document

A 52-page document with two key sections: Building Scale and Neighbourhood Scale.

Types of Stakeholders engaged (n = 309)

90%

Other stakeholders were from the Education and Disability sectors, Environmental Health and Community Development. Department of Planning and Environment and Government Architect NSW. of stakeholders were Health Professionals/Health Policy Makers and Local Council - Planners and Urban Designers of stakeholders were from State Government agencies - Transport for NSW,

Results Dashboard

Health Professional/Health Policy

This dashboard reports results of the comprehensive stakeholder engagement for the Healthy Higher Density Living for Families with Children: Design Guide (draft) and outlines recommendations for next steps.

Local Council - Planners/Urban Designers

3%

State Gov Agencies

Goal: Stakeholders understand the value of the Design Guide and provide constructive feedback.

Result: Achieved

Academia

Great post!

Industry/Architects

Stakeholder type

NGOs

496

100% Stated the Design Guide was helpful/very helpful**

100%

100% Agreed with the overall principles of the Design Guide**

31%

Other

Comments received about the Design Guide*

Of all comments were about ‘What is missing?’ from the Design Guide**

Reported the Design Guide would add value to their work**

0

20

40

60

Percentage (%) of stakeholders engaged

Tools of engagement

Capturing feedback

Objective: Stakeholders are identified and engaged appropriately about the Design Guide.

Result: Achieved

A FAQ was emailed to stakeholders with a PDF

Qualitative and quantitative survey responses were downloaded via Survey Monkey. Workshops, presentations and interviews were recorded, themed and analysed by two project officers. Comments from the survey, written submissions and all other engagement channels which related to specific sections of the draft Design Guide, were included in a corresponding spreadsheet. All “What is missing?”, positive and design/formatting related comments were respectively captured in separate spreadsheets.

For Design Guide Users

For Design Guide Users

of the draft Design Guide, and advice on how they could provide feedback. A 17 question online survey was emailed to key stakeholders. A Power Point presentation about the draft Design Guide was tailored for stakeholder groups.

Western Sydney Local Health District

309

259

43

19 Local Councils across NSW participated in engagement activities

Frequently asked questions Healthy Higher Density Living for Families with Children: Design Guide [DRAFT]

Frequently Asked Questions & Answers

Estimated number of stakeholders who participated in engagement activities

People attended nine workshops and presentations

Responses to the online survey

Information for stakeholders who may use the Design Guide

FAQs & Answers

5. Who is the Design Guide [DRAFT] for?

8. What will happen with my feedback? Stakeholder feedback will be reviewed and incorporated into the final Design Guide with the intention to submit the document to City of Parramatta Council for endorsement. Pending council approval, the final draft Design Guide will go on public exhibition. The final draft will reflect the feedback gathered from stakeholders and the broader community during this current consultation period. Following public exhibition, any further feedback will be considered and incorporated into the Design Guide before being returned to Council for final endorsement. 7. What stage is the project at? The project is now in the stakeholder engagement phase. We are seeking feedback from a variety of stakeholders who may use the draft Design Guide. Feedback is being collated using different methods, including an online survey. Part Two (Neighbourhood Scale), provides guidelines relating to neighbourhood scale of high density developments, which includes streets, public spaces and outdoor infrastructure. 3. Heenan, R. “Healthy Higher Density Living For Kids: The effects of high density housing on children's health and development: A literature review to inform policy development in Western Sydney”, Report No. 149. Melbourne: Australian Housing and Urban Research Institute, 2017. 2. Australian Bureau of Statistics. Table Generated Using Dwelling Characteristics, Dwelling Structure and Family Composition Databases, Findings Based on Use of ABS 2016 Census Data in Table Builder Basic. 1. Krysiak, N. Design and Planning Policy for Family-Friendly Apartment Living. Sydney: Policy Futures: A Reform Agenda; 2021. Part One (Building Scale) , outlines key design guidelines relating to the building scale which includes the apartment building and communal space. The document has been structured into two parts, and includes diagrams and photos to help illustrate key design concepts: References Advocating for improved high-density living environments for families with children. Informing the planning system via amending Development Control Plans (DCPs), state guidelines and/or other regulatory mechanisms. The draft Design Guide is intended to assist multi-unit residential developers, architects, urban designers, planners and consent authorities in the planning and design processes through: 6. What is in the Design Guide [DRAFT]?

1. Krysiak, N. Design and Planning Policy for Family-Friendly Apartment Living. Sydney: Policy Futures: A Reform Agenda; 2021. *Approximate total number of all comments from stakeholders about the draft Design Guide via all engagement channels. **Stakeholder online 17 question survey, N = 43

2

There is currently no Australian Design Guide to showcase best practice examples and provide guidelines to support the health of children and families living in high density housing. In Sydney, over 25 per cent of apartment households are families with children under the age of 15. These trends are visible not only in inner-city areas but also satellite cities such as Parramatta, where 45 per cent of pre school aged children live in high density housing. With more families raising their children in higher density housing (three storeys or more), designing liveable high-density environments suitable for children has never been more important. 2. Why do we need a Design Guide for Healthy Higher Density Living for Families with Children? 3. How does housing impact the health of children? Housing and the built environment are fundamental to human health and can directly impact a child’s early development. A child’s early years (0-5), are a critical time for physical, cognitive, social and emotional health and experiences during this time have been shown to have long term impacts on their health and wellbeing. Therefore, it is important to design environments that consider and apply all known protective factors, enabling children to thrive. 4. Who developed the Healthy Higher Density Living for Families with Children: Design Guide [DRAFT]? Building on the results of the Healthy High Density for Kids study, the draft Design Guide has been developed in a partnership between the Centre for Population Health, Western Sydney Local Health District (WSLHD); City of Parramatta (CoP); and Natalia Krysiak, Cities for Play (formerly from Hayball). 1 2 5 3,4 The draft Design Guide aims to showcase best practice projects and provide guidelines to support the health of children and families living in high density housing. The draft is currently being reviewed by people and organisations who may use the Design Guide in their work and/or are impacted by them. 1. What is the Healthy Higher Density Living for Families with Children: Design Guide [DRAFT]?

Results dashboard A dashboard reported results of the comprehensive stakeholder engagement for the draft Guide and outlined recommendation for next steps.

Children are a kind of indicator species, if we can build a successful city for children, we will have a successful city for everyone.

Experiences in a child's early years (0-5), is a critical time for physical, cognitive, social and emotional health. 5

Enrique Penalosa (Former Mayor of Bogota)

Stakeholder feedback to improve and strengthen the Draft Design Guide. lives of families living in higher density housing and environments. Designing spaces that can improve the

For more information:

Centre for Population Health Western Sydney Local Health District

Email: WSLHD CentreForPopulationHealth@health. nsw.gov.au

5. NSW Ministry of Health, The First 2000 Days, Conception to Age 5 Framework, Sydney: NSW Government, 2019. 4. Dockery A., Kendall G., Mahendran A., Ong R., & Strazdins L. Housing and children's development and well-being: a scoping study. AHURI Final Report No.149. Melbourne: Australian Housing and Urban Research Institute, 2021.

Scan the QR code, or click here to do the survey once you have read the Design Guide [DRAFT] or attended a workshop.

Phone: (02) 9840 3603

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROMOTION

Supporting healthy development of children aged 0-5

Professional development outcomes 2023: 401 eLearning completions (including from 16 newly trained services). 219 educators at 7 professional development online huddles. 57 educators attended a Fussy Eating webinar. 2 Fundamental Movement Skills through Dance workshop, with 65 participants. 2 Fundamental Movement Skills through Games workshops, with 41 educators attending. 31 educators from 8 Cumberland City Council ECEC services attended a Munch & Move workshop. 17 educators from 17 Blacktown City Council ECEC services attended a Munch & Move workshop. 25% increase in Blacktown Council service staff trained in Munch & Move after participation in staff training.

The evidence- and play-based Munch & Move program supports the healthy development of children attending Early Childhood Education Centres (ECEC) and Family Day Care Providers (FDCP) through practices related to healthy eating, physical activity, breast feeding and reducing screen time. Our Early Years team supports 475 ECEC and 19 FDCP across western Sydney to implement Munch & Move practices reaching approximately 32,000 local children and their families .

Service support Online, 1:1 service support with dedicated program support officer: 25 priority ECEC services (SEIFA Quintile 1 and 2). 30 newly trained services. 49 ECEC menu reviews. 3 new and improved bi-monthly service newsletters. 30 ECECs updated their physical activity and screen time policies for the 2023 Unplug & Play Policy Challenge.

Service reflection and consultation 130 services

completed a practice achievement survey.

2 Advisory Committee meetings held.

Sophia Cassano from the Early Years team.

“Menu planning is a difficult task for most – even dietitians at times! As part of the Munch & Move program, Early Childhood Education Centre directors are encouraged to work with their service cook or chef to develop a menu that complies with the NSW Caring for Children guidelines. As a Munch & Move support officer, we assist services in the menu planning process. I remember visiting a service in the Mount Druitt area, and sitting in the director’s office explaining and providing examples, I could see that she understood the information and felt confident to continue menu planning independently. This was very gratifying and a proud moment for me.” – Laura Atallah, Health Promotion Officer (Early Years, Munch & Move program)

Top 3 Munch & Move Practices achieved across ECECs and FDCP: 1. 2. Staff create a positive healthy eating environment (Practice 5): 94%

3.

Service monitors and reports on Healthy Eating and Physical Activity objectives annually as part of their continuous quality improvement process (Practice 16): 93%

Service provides a supportive Physical Activity environment (Practice 7): 90%

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROMOTION

HEALTH PROMOTION HEALTH PREVENTION

Supporting healthy primary school environments

The Live Life Well @ School statewide program supports primary teachers to create a healthy school environment where students can be active and eat well. In 2023, our Health Promotion team started re-engaging with local schools following a hold on this program during the pandemic. 2023 outcomes: • 34% of 227 primary schools in WSLHD responded to a survey asking about food, physical activity, screentime practices and the barriers to implementing healthy eating and active living strategies at school. The rich data received will shape the support offered to schools in 2024. • A School Open Play Space Mapping Study appraised the open play space available in primary schools in WSLHD against current guidelines and explored possible reasons for geospatial variability across the District. Results will be used as part of school support offered in 2024.

Tailored local support for western Sydney services Our Early Years team met face to-face with eight ECEC services that have 10% or more children enrolled who identify as Aboriginal or Torres Strait Islander. These meetings provided an opportunity to understand some of the barriers and enablers these services experience when implementing the Munch & Move program and will help to inform Munch & Move service support for 2024.

HEALTH PROMOTION

HEALTH PREVENTION

Partnering with health-promoting universities With a return of students to campus following COVID-19, in collaboration with Nepean Blue Mountains and South West Sydney Local Health Districts (LHDs), we renewed our long-standing partnership with Western Sydney University (WSU).

2023 outcomes: • 2 exploratory workshops, where joint strategic priorities of the LHDs and WSU were identified. • Preliminary work on Campus Shade Audits; a Healthy Campus Checklist; Campus Food Environments and Sexual Health training. • In November, the University and the three LHDs formalised their partnership by signing a third Memorandum of Understanding, along with the launch of the University’s new Wellbeing and Mental Health Strategy. 2024 will see joint Working Parties established to address a range of issues, including vaping prevention and on reducing health inequities amongst the student population.

L-R: Graeme Loy (Chief Executive, WSLHD), Mandy Williams (Director, Population Health and Chief Executive delegate, South West Sydney LHD), Helen Ryan (Coordinator, Healthy Places team, CPH, WSLHD), Ellen Brackenreg (Executive Director, Equity Safety Wellbeing, WSU, Emma Taylor (Mental Health and Wellbeing Clinical Manager, WSU), Eloise Milthorpe (Director Population Health and Chief Executive delegate, Nepean Blue Mountains LHD), Angelo Kourtis (Vice-President People and Advancement, WSU).

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROMOTION

HEALTH PREVENTION

Healthy food and drinks in Leisure Centres Blacktown City Council have introduced a Healthy Food and Drink Policy in five leisure and aquatic centres across Blacktown LGA. The initiative was launched recently by the Mayor of Blacktown. A high level of policy adoption across each site and positive engagement from consumers has been measured with an increase in the sale of healthier and a decrease in the sale of unhealthy food and drink choices.

Top: Blacktown Leisure Centre Stanhope. Bottom: Launch of the policy by the Mayor of Blacktown

HEALTH PROMOTION

HEALTH PROMOTION

HEALTH PREVENTION

Healthy food and drinks in Health facilities We are also striving for healthier food environments in our Health facilities to make the healthy food and drink choice the easy choice for staff and visitors. To measure progress by food outlets a statewide food and drink audit was completed by NSW Health in March. Compliance with the Healthy Food and Drink Policy was measured across 100 kiosks, cafes, vending machines and other retailer outlets in WSLHD facilities. Results showed a high level of sustained implementation of the policy, since it was launched in 2017.

Staff Active Travel - Greater Western Sydney Health Partnership

Actions from the Staff Travel Census (2021) have been addressed by the three Local Health Districts of Greater Western Sydney (Nepean Blue Mountains, South West Sydney and Western Sydney), in collaboration with Transport for NSW (TfNSW). These have included: • Finalisation of the Summary and Full Report, indicating staff modes of transport and key barriers and enablers to active transport. • Using a grant from TfNSW, development of three short videos of staff to promote active transport. In 2024 under the auspice of the WSLHD Sustainability Advisory Group, District-specific initiatives will be implemented to support staff active travel.

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WSLHD Centre for Population Health Year in Review 2023

Health protection (neighbourhoods & communities)

HEALTH PROMOTION

HEALTH PROTECTION

Climate risk and health – protecting health and maintaining services in a changing climate Climate risk is a threat to health and wellbeing that all organisations, services and communities are starting to evaluate and plan for. In western Sydney, heat is a significant public health risk with the number of days exceeding 35°C increasing at twice the rate of Sydney CBD. Members of the CPH team have undertaken the Climate Risk Ready course by Western Sydney University for NSW Government and are working with the Climate Risk Officer in NSW Health to support the whole-of-health Climate Risk and Opportunity Assessment. We are also working with Western Sydney Regional Organisation of Councils to support the community to prepare for an manage heat waves through Turn Down the Heat. This involves participation in the Greater Sydney Heat Taskforce which includes a range of targeted workshops and working groups to better prepare for extreme heat in our metropolitan area. In 2023 CPH conducted Business Continuity planning exercises to plan for how heat waves will affect our operations and to build heat risk into our planning.

HEALTH PROMOTION

HEALTH PROTECTION

Preparing for extreme heat and heatwaves Our collaboration on the Western Sydney Turn Down the Heat Strategy with Western Sydney Regional Organisation of Councils (WSROC) and local councils continued this year. 2023 outcomes: • Representation on the Heat Risk Methodology and Heatwave Management Guide Working Groups. • 7 Greater Sydney Heat Taskforce Heat Smart City Plan Workshops and related meetings attended. • For summer 2022-23: 11 extreme heat promotions to the community and 8 to clinicians. • For summer 2023-24: 9 extreme heat promotions to the community and 3 to WSLHD staff. More are planned for the coming summer.

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WSLHD Centre for Population Health Year in Review 2023

HEALTH PROTECTION

Housing and Health Advocacy and Support Program Our Environmental Health team collaborated with Narang Bir-rong, an Aboriginal non government organisation whose role is to support families at risk of separation, to improve housing conditions and child safety in the homes of client families. This included developing a culturally appropriate pathway for reporting housing maintenance issues to social housing providers, and further training is planned to improve skills and awareness of Narang Bir-rong workers in identifying housing maintenance issues that impact the health of their clients. 2023 outcomes: • A child safety resource pack developed for distribution to Narang Bir-rong clients. • Funding ($6,000) secured from NSW Health Aboriginal Environmental Health Unit for 52 child safety kits, for distribution to Narang Bir-rong clients in early 2024.

L-R Vickie Thomson, Helen Noonan, Daniel Bakr, Annie Truong, Damaris Jong at a 2023 NAIDOC event.

“The best thing about working as an Environmental Health Officer (EHO) is the variety of the things that come across our desk. In any one day we could be investigating the exposure source for a Legionnaires disease case; helping someone with their concerns about asbestos exposure; and then setting up or collecting mosquito traps in the urban bushland fringe parts of the District. Our favourite time of the year and also part of our role is attending NAIDOC and Aboriginal Children’s Day events with the Mr Germ handwashing program. The best part is bringing trainees and other new public health professionals along with us and seeing them dress up for the first time in the Mr Germ or Germinator costumes and entertaining and engaging with the kids. We have an amazing team of fellow EHOs; we share and explore and grow from each other’s knowledge and experiences every day.” – Helen Noonan, Annie Truong, Damaris Jong (Environmental Health team)

HEALTH PROMOTION HEALTH PREVENTION

HEALTH PROTECTION

Smoke-free outdoor dining in Parramatta

Our Environmental Health team is responsible for investigating non-compliance with the Smoke Free Environment Act and Regulations. In conjunction with our Smoking and Vaping Prevention team, we partnered with City of Parramatta to make all Council-owned footpath dining areas completely smoke-free.

Each child safety kit includes: • Fire blanket and first aid kit • Electrical outlet covers • Oven, safety cabinet and adjustable window locks • Door pinch guards • Corner cushions • Safe bath temperature thermometers and bath mats

2023 outcomes: 43 new signs on Council infrastructure along “Eat Street” Parramatta declaring outdoor dining areas are ‘No smoking, No vaping, No Shisha’.

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WSLHD Centre for Population Health Year in Review 2023