#1646_WSLHD_Centre for Population Health_YIR_PP

Year in Review 2022 Centre for Population Health

Western Sydney Local Health District

Foreword After an unprecedented and challenging two years for the Centre for Population Health, the start of 2022 saw a significant change with the retirement of our two Population Health leaders - Professor Stephen Corbett and Christine Newman. Their vision and legacy paved the way for the Centre’s new leadership team to progress population health priorities to a new era of ‘living with COVID-19’. Throughout this year the Centre has taken a journey of COVID-19 reflection and recovery, with updated priorities reflected in our Western Sydney Local Health District Centre for Population Health Strategic Framework 2022-2024. Previously disrupted health promotion and public health programs resumed, with teams recalibrating activities, incorporating valuable COVID-19 lessons, and leveraging the results of new and strengthened partnerships and engagement opportunities. A few examples of this included: • A Maternity Clinical Engagement strategy to support improved population health outcomes for pregnant women and their newborns. • Transitioning the COVID-19 Aboriginal Cultural Support model to enable community organisations to continue COVID-19 supports for the community. • Transitioning the WSLHD COVID-19 Outbreak Management Committees to support management of all acute respiratory illnesses in residential aged care facilities, with an established governance framework to enable annual winter preparedness planning or surges in COVID-19 activity. • Enhancing population health program reach through a community engagement model that is delivering Health Promotion programs to the Aboriginal community through new program partnerships with Aboriginal organisations. • Working with high schools to provide a catch-up program to students from 2020 who missed their vaccinations due to COVID-19. • The Health Promotion Framework and Strategy development (due for launch early 2023). • Re-establishing the joint partnership meetings with councils to continue collaborative efforts to create healthy food and built environments. I would like to thank the highly skilled and dedicated Centre for Population Health staff for their commitment and passion to delivering high quality programs and services and their ability to work collaboratively, flexibly and openly towards achieving better health outcomes for people in western Sydney. In my first year as Director, I am proud to share some key highlights and achievements of the Centre in this Year in Review , and as always, welcome any feedback on our programs and services.

Acknowledgement of Country We acknowledge the Darug people as the traditional custodians of the land covered by Western Sydney Local Health District and pay respect to Elders past, present and emerging.

Artwork by Leanne Tobin. Leanne’s artwork reflects the vibrancy and traditional motions of the dragonflies as they move through their journey of life.

Dr Shopna Bag MBBS Bsc(MED), MIPH, FAFPHM Director, Centre for Population Health December 2022

2

WSLHD Centre for Population Health

Contents

About the Centre for Population Health

4

Healthy People

7

Healthy Places

13

COVID-19 Response

25

Achievements

27

Conferences & Key Presentations

32

Publications

33

Future Directions

34

3

Year in Review 2022

About the Centre for Population Health

Our purpose We aim to promote and protect the health of all people living within the WSLHD, by working with people, places, and organisations. We do this by delivering health promotion, prevention and protection programs, and creating healthy environments to improve health outcomes and reduce avoidable hospitalisations. Our place in the health system Providing overarching leadership, engagement, and strategic direction for population health across the District, we work in partnership with local communities, organisations and the wider population health network to create healthy environments, policies and programs that support healthy choices. These partnerships are a key enabler to our work.

The Centre for Population Health (CPH) is a service within the Western Sydney Local Health District’s directorate of Integrated and Community Health (ICH).

4

WSLHD Centre for Population Health

Specialist support for western Sydney’s unique health needs Located within the Cumberland Hospital campus, CPH has approximately 49 full time equivalent staff who support the delivery of population health programs across western Sydney. Our workforce is drawn from a range of disciplines with expertise and skills in public health, health promotion, health equity, epidemiology, applied research, program development and evaluation, social marketing and communications, community engagement and capacity building. We have a diverse, evidence-based program of work, with priorities determined by State and Commonwealth strategic direction, the District’s Strategic Plan, local data and needs. The CPH is made up of two key business units - Health Promotion and the Public Health Unit, as well as staff who support the essential functions of business operations and administration, strategy, planning and engagement.

CPH structure

Director, Population Health

CPH Strategy, Planning & Engagement

CPH Operations

Public Health

Health Promotion

Administration

Communicable Diseases

Healthy Early Years

Aboriginal Community Engagement

Environmental Health

Healthy School Years

Immunisation

Healthy Adults

Public Health Response Epidemiology

Healthy Ageing

Healthy Places

Smoking and Vaping Prevention

CPH Executive team L-R: Dr Conrad Moreira (A/Director, Public Health), Dr Jessica Wells (A/Public Health Clinical Staff Specialist), Dr Shopna Bag (Director, Population Health), Bronnie Anderson-Smith (Manager, Strategy Planning & Engagement), Grace Navin (Manager, CPH Operations), Michelle Nolan (A/Director, Health Promotion).

5

Year in Review 2022

A snapshot of population health in Western Sydney Local Health District

Our population

Our environment

Our health

Our settings

We have one of the fastest growing populations in NSW which is estimated to reach 1,440,255 by 2030 More than 47% of our residents were born overseas, and 50% speak a language other than English at home (NSW rates are 30% and 27% respectively) We have one of the largest urban populations of Aboriginal people in Australia We are a young population with the largest number of children under 10 years of age in NSW

The number of 35+ degree days in western Sydney is increasing at twice the rate of the Sydney CBD We have 10 splash parks, 47 public swimming pool, 12 hospital pools, and 64 commercial pools to support heat mitigation and active living 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 In Parramatta, 62% of dwellings were medium to high density, compared to 20.1% in The Hills Shire, and 46% across Greater Sydney

For Cumberland LGA residents, there are 21% more preventable hospitalisations* than the rest of NSW Western Sydney is a diabetes hotspot with 13% of adults with diabetes compared to 11% across NSW

Our District has 100 sites and 4 hospitals that are supported by approximately 13,491 healthcare staff

534 early childhood education and care services, 468 are engaged in Munch & Move, which reaches approximately 32,000 children 221 primary schools, 170 have engaged in Live Life Well at School, reaching up to 124,000 students 110 high schools reaching approximately 42,700 students for school vaccinations

64 aged care settings reaching 6,270 residents

We work with TAFE and Western Sydney University to reach tertiary students and staff

Source: Centre for Population Health (2022). Centre for Population Health Strategic Framework 2022-2024 [in publication]. Western Sydney Local Health District. *Potentially Preventable Hospitalisations (PPH) are those conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management

6

WSLHD Centre for Population Health

Healthy People

7

Year in Review 2022

Best start to life Get Healthy in Pregnancy (GHiP) A free phone-based health coaching program for pregnant women which supports staying healthy from pregnancy to birth and beyond. It includes setting healthy lifestyle goals with the aim of sustaining improvements in healthy eating, physical activity, and healthy weight during pregnancy.

Between January – September 2022: 1,423 women were referred by a health professional to GHiP. 739 women commenced coaching services with a trained health coach.

Nursing and midwifery staff at Auburn, Blacktown and Westmead Hospitals have actively referred women to the program during 2022.

Reducing the effects of smoking and vaping on pregnancy and newborns The Smoking and Vaping Prevention team continues to support local implementation of the new Reducing the effects of smoking and vaping on pregnancy and newborn outcomes Policy Directive , released on 14 October 2022. The team will work closely with WSLHD Maternity services to build capacity among clinical staff to provide evidence-based smoking and vaping cessation support for patients.

Supporting pregnant women: 43

carbon monoxide Smokerlyser monitors distributed across maternity clinics in WSLHD.

Your personal journey to becoming a smoke free mum

Approximately 300 Aboriginal My Quit Journal resources will be distributed to support Aboriginal pregnant women to quit smoking.

2

Children’s Routine Growth Assessments

This year: 6 clinicians completed RGA “Train the Trainer” training. 6 equipment audits completed.

All children who attend NSW Health services have their height/length and weight measured – this is a Routine Growth Assessment (RGA). The Health Promotion team manages a WSLHD working group to facilitate the promotion and implementation of RGA at WSLHD facilities.

RGA measurement rate maintained at 67% (at September 2022) with some facilities meeting/exceeding the 70% NSW Health KPI for all face-to-face encounters. We promoted International Children’s Growth Awareness Day on 20 September.

Four year-old Elka having her height routinely measured at a WSLHD facility.

8

WSLHD Centre for Population Health

School age

E-cigarette training for Youth Health staff The Health Promotion team supported the delivery of e-cigarette/vaping training for 26 Youth Health staff in June 2022, with Professor Renee Bittoun, an expert in the field of nicotine addiction and smoking cessation leading the session. Staff built on their knowledge and understanding of e-cigarette harms and risks to young people, and skills to help support young people stop using e-cigarettes.

Youth perspectives on vaping prevention A Youth Voices: Unpacking Vaping poster competition in collaboration with Prevention Education and Research Unit (PERU) in June/July 2022 attracted 69 entries from 13 high schools. Open to all secondary students in western Sydney, the initiative aimed to increase knowledge and awareness of the harms of using e-cigarettes among young people.

Winners of WSLHD Youth Voices: Unpacking Vaping poster competition.

A survey of 26 entrants showed: All understood and believed that e-cigarettes were not safe and are harmful to health. 92% felt the competition provided them a voice and youth perspective on how e-cigarettes were affecting young people.

Professor Renee Bittoun.

“I’m extremely proud of our Integrated Community Health workforce and the demonstrated leadership, exceptional teamwork and commitment of our Centre for Population Health teams. They have not only protected and saved lives in response to COVID-19 and other infectious diseases, but also undertaken critical work in preventative health to ensure local health needs are addressed and met. We have another big year ahead and I know CPH will continue to deliver effective, meaningful programs and services to enrich the lives, health, and wellbeing of people in western Sydney.” - Jasmin Ellis, General Manager, WSLHD Integrated Community Health.

9

Year in Review 2022

Aboriginal Go4Fun This is a cultural adaptation of the Go4Fun program, designed with and for the Aboriginal community. We partnered with Kimberwalli (in Whalan) to deliver the program to local Aboriginal families in term four, 2022. Plans are underway to deliver at least three more programs in 2023.

Go4Fun Go4Fun is a healthy lifestyle program for children aged 7-13 years who are above a healthy weight, and their families. The 10-week program delivered by health professionals includes interactive family sessions on healthy eating, meal planning and label reading. Children also get active through different games and activities while parents discuss topics such as role modelling and problem solving at home. Up to February 2022, only Go4Fun Online was available due to COVID-19 restrictions. The Health Promotion team recommenced face-to-face Go4Fun programs from term 2, 2022.

202 families participated in Go4Fun this year. 11 new group leaders were trained to deliver Go4Fun.

Aboriginal Go4Fun group leaders L-R: Anna Kelly (CPH), Stacey Hopkins (CPH) and Alearah Donovan-Matthews (Kimberwalli).

NSW School Vaccination Program (SVP) The Immunisation team works in partnership with schools to offer the vaccines recommended for adolescents by the National Health and Medical Research Council in a school-based vaccination program. The SVP was impacted by school closures and student absenteeism due to COVID-19 resulting in a considerable drop in vaccine coverage and the need to provide catch-up opportunities to students who missed their vaccinations.

In 2022 school terms one and two alone, 30,350 vaccines were administered. A total of 49,000 vaccines were provided by the end of the school year.

10

WSLHD Centre for Population Health

Adults Monkeypox vaccination

Older adults

Healthy and Active for Life Online (HAL Online) for over 60s A free, 10-week online course to engage people 60+ years and Aboriginal people aged 45+ in healthy lifestyle changes. We collaborated with partners including Councils, older adults’ services, Workers and RSL clubs to recruit participants to

The Public Health Unit worked with Ministry of Health, Sexual Health Clinicians and Blacktown Vaccination Hub to assist with rollout of a Monkeypox Vaccination Hub at Blacktown Hospital and Sexual Health Clinic. This included advising on key public health issues and strategies for improved community engagement.

HAL Online. Targeted Facebook advertising also reached over 4,600 western Sydney residents aged 60 years and over.

Between January – December 2022: 136 people registered.

At least 200 people have received Monkeypox vaccination to date.

Pasifika Preventing Diabetes Programme (PPDP) A church-based, community-owned lifestyle modification program, focusing on detection, prevention and management of diabetes. PPDP is in its recruitment and baseline data collection phase which involves engagement with local church leaders and data collection for participants including diabetes blood testing, blood pressure, diet, physical activity lifestyle habits, medication use and level of understanding about diabetes. PPDP aims to have 48 churches (including

Participants who completed pre- and post-surveys reported some great improvements following their HAL Online experience:

23% +

9% increased fruit intake.

3,600 adults and 1,000 children aged 4-17 years) in the program.

In 2022: Data collected for 509 participants. Three churches have signed a Memorandum of Understanding to participate in PPDP.

increased vegetable intake.

89% became more confident about regular activities without becoming unsteady or falling. 100% intend to continue with some form of exercise following HAL online.

34% increased days of moderate physical activity. 85% intend to engage in other exercises/programs following HAL online.

PDPP Community Lifestyle Activators, Ronda Thompson (University of Sydney) and Makeleta Felila (CPH).

11

Year in Review 2022

Stepping On for over 65s

A free, seven-week falls prevention program for people 65 years and over living in the community. Face-to-face programs recommenced in March 2022, with participant recruitment via local Councils, retirement villages, older adults’ services and Library Health Month activities. Of participants who completed evaluations, all (100%) said: • they gained information/knowledge about falls prevention • they applied what they learned from the program in their daily life • the program increased their sense of wellbeing, self-esteem and independence.

Between March – December 2022: 14 face-to-face programs completed. 215 participants enrolled. 10 English and 4 Culturally and linguistically diverse programs. Average participant age range: 65-92 years. Pre and post assessments showed improvements in functional strength, balance and mobility.

Health Promotion Officer, Elise Harding, from our Healthy Ageing team.

“The best part of the Stepping On program is hearing from others’ experiences.” – Stepping On participant.

RESEARCH: Supporting older adults to keep physically active During 2021–22, we researched factors affecting physical activity maintenance among older culturally and linguistically diverse people who had completed the Stepping On program. The research highlighted the importance of: • timely information in preferred languages • location and convenience of physical activity opportunities • the positive impact of social support and friendship; and • preference for written and interpersonal assistance (rather than digital) from familiar sources. This research was conducted in collaboration with the Prevention Research Collaboration at the University of Sydney and WSLHD Multicultural Health Bilingual Community Educators.

28 interviews conducted in languages including English, Arabic, Hindi, Chinese and Punjabi.

82 people with an average age of 75 years took part in the research survey.

12

WSLHD Centre for Population Health

Community

Heat health

Heat Smart Western Sydney informs the community how to plan, prepare and respond

to heatwaves, with a focus on population groups vulnerable to heat impacts.

It is a collaborative project of the Western Sydney Turn Down the Heat Strategy , led by Western Sydney Regional Organisation of Councils. In our partnership role, we supported the development of a suite of consumer-tested resources in 10 languages, including two multilingual videos. Resources were shared with health professionals, councils, and other organisations, for dissemination to the community at the start of summer. Heat Smart Western Sydney is acknowledged by stakeholders and community members as instrumental in providing well-researched, relevant information to a wide range of vulnerable communities throughout western Sydney.

Heat Smart. A GUIDE FOR BUILDING HEATWAVE PREPAREDNESS IN COMMUNITY ORGANISATIONS

05_#1177_WSROC_Community Organisation Toolkit_6A.indd 1

11/10/21 10:57 am

13

Year in Review 2022

Library Health Month – September 2022 In partnership with the Library Services of Blacktown, Cumberland, Parramatta and The Hills, for its sixth year, Library Health Month (LHM) took place in 25 Libraries across our district. LHM aims to raise awareness of key health messages and free NSW Health programs. The initiative featured: • online and in-person health talks and activities, including Bilingual Community Educator programs in languages other than English • online promotion including a library health web-portal, hosting a range of health resources; animated videos, social media and newsletter articles • on site promotions including infotainment and other in-library displays. “It’s a fantastic use of library facilities to reach various community groups. Thankyou! The presentation was very helpful and encouraging.”

Sydney Thunder Cricket team representatives at Wentworth Point Library.

25 health talks held.

– Senior at Dural Library.

Healthy Ageing facilitator, Fran Hodgson, leading some strength and balance exercises at Dural Library.

From a survey of 41 library staff: 41% said LHM encouraged them to adopt healthier behaviours.

A survey of 52 library users showed:

77% said LHM was very helpful.

100% think LHM is a good idea.

“Thank you! This type of presentation helps people to get good ideas with lunch boxes for kids.”

– Parent at Auburn Library.

14

WSLHD Centre for Population Health

NAIDOC events 2022: “Get Up, Stand Up, Show Up” The Centre for Population Health (CPH) joined other WSLHD services and the community at three NAIDOC events in Emerton (27 September), Riverstone (29 September) and Kimberwalli (Whalan, 6 October). NAIDOC celebrates and recognises the history, culture and achievements of Aboriginal and Torres Strait Islander peoples. CPH team members representing Health Promotion, Environmental Health, Immunisation and Infectious Diseases spent time with the community, answering questions, playing fun games to raise awareness of positive health behaviours, and chatting about what we do and the free programs and services available. The Immunisation team was on hand with free flu vaccinations, and for parents requesting to check the immunisation status of their children. “It was great to celebrate my culture with my team and my community in western Sydney on such a special day for Aboriginal and Torres Strait Islander people.”

L-R: Aunty Margaret Farrell, Vickie Mason (Aboriginal Community Engagement Officer, CPH), Aunty Jenny Ebsworth, Sister Naomi, and Jasmin Ellis (General Manager, ICH).

L-R: CPH staff, Dr Conrad Moreira, Bronnie Anderson-Smith, Vickie Mason, Dr Shopna Bag, Michelle Nolan.

Jannawi Aboriginal Dance troupe performing at the Riverstone NAIDOC celebration.

- Vickie Mason, CPH Aboriginal Community Engagement Coordinator.

L-R: CPH staff at Riverstone NAIDOC celebrations - Rachael Graham (Healthy Adults Coordinator), Vickie Mason (Aboriginal Community Engagement Officer) and Bronnie Anderson-Smith (Manager Strategy, Planning and Engagement).

15

Year in Review 2022

Immunisation safety and reporting The Immunisation team actively investigates, reports and responds to adverse events following immunisation (AEFI) in western Sydney. This allows: • monitoring the safety of vaccines through regular surveillance • supporting clinicians with advice for further immunisation doses • building public confidence by demonstrating the safety of immunisation programs.

983 AEFI notifications were received and managed during the 2021-22 financial year, compared to pre-COVID-19 AEFI notifications of 41 in 2019-20.

Nextdoor online neighbourhood

In 2022:

1 in 11 western Sydney* households are on nextdoor. Over 40,400 local members can access our nextdoor page.

CPH uses the nextdoor neighbourhood network to proactively share health information relevant to the community. Posted information includes COVID- safety, managing COVID-19 symptoms at home, mental health and wellbeing, keeping active, and how to access free health programs and services.

118 CPH posts (Jan - Dec 2022). 322,750 total post views. Up to 12,470 views per post.

*Blacktown, Cumberland, Hills Shire, Parramatta Local Government Areas.

16

WSLHD Centre for Population Health

Encouraging physical activity and active travel Our team jumps at the opportunity to promote physical activity and active travel events!

Walk to Work Day 2 September 2022 – Healthy Places team. L-R: Elizabeth Leece, Helen Ryan, Karen McCavana.

Walk to Work Day

parkwalk at parkrun Healthy Places team member, Elizabeth Leece and her daughter.

Biketober 1–31 October 2022 – Public Health Unit Biketober champions. L-R: Dr Conrad Moreira, Bronnie Anderson-Smith, Caroline Scott, Dr Ben Silberberg.

17

Year in Review 2022

Healthy Places

18

WSLHD Centre for Population Health

Health promoting settings

Munch & Move This evidenced, play-based program supports the healthy development of children attending Early Childhood Education Centres (ECEC) and Family Day Care (FDC) through practices related to healthy eating, physical activity, breastfeeding and reducing screen time. Our Healthy Early Years team supports the local needs of 468 ECEC and 19 FDC providers across western Sydney, to reach approximately 32,000 children and their families. In a recent survey, 95 early childhood services provided feedback on their preferred modes of engagement with the Munch & Move program. In response, a new virtual support model was designed and piloted, which included online formats for a Reflective Practice Tool, professional development huddles and workshops/resources.

In 2022:

283 Participants at professional development huddles.

123 Reflective Practice Tools completed.

15 Newly trained services.

194 eLearning completions.

31 Fundamental movement skills workshop attendees.

10 Family Day Care providers attended a workshop.

19 Menu reviews

18 Cooks workshop attendees.

completed between October - November.

19

Year in Review 2022

Live Life Well @ School A program that supports teachers to create a healthy environment at school where children can be active and eat well. Our Healthy School Years team supports up to 221 schools and 124,000 students across western Sydney. In term four we supported schools with Healthy Lunchbox resources, including online and face-to-face presentations for parents preparing their children for Kindergarten.

30 schools used our Healthy Lunchbox suite of resources and presentations.

Increasing walking in Blacktown City

The Walking in Blacktown City 2017-2021 plan aims to aims to increase walking rates of the community by increasing the walkability of the environment, walking opportunities and awareness of opportunities to walk. It is a joint project in partnership with Blacktown City Council. Due to COVID-19, some components of the project continued into 2022. This year we promoted opportunities to walk, conducted a Healthy Streets Check of Marsden Park, facilitated Public Amenities Network meetings and provided feedback on strategies, plans, and designs with evaluation of the five-year project underway.

4 walking promotions via the COVID-19 Council areas Bulletin and district social media channels. 2 Public Amenities Network meetings. 5 feedback submissions.

Review of walkability complete.

Safe Active Streets In partnership with the City of Parramatta (CoP), the Safe Active Streets (Carlingford – Epping) project, is in its fourth and final year. Through annual surveys, the project measures the impact of street infrastructure improvements on the physical activity rates (walking, cycling) and social connection of residents. Council has created cooler streets by planting more than 100 trees in and around the area. They have also installed new footpaths, shared-paths and separated cycleways; installed traffic signals; and improved a number of pedestrian crossings. Our Healthy Places team will contribute to evaluation of pre- and post- intervention results over the four-year period and post intervention walkability audits in 2023.

您填写了 2022 年 Carlingford 和 Epping 邻里出 行调查表吗？ 2022 年调查表有中文版， 请扫描二维码查看。 2022 년 칼링포드 및 에핑 지역 이동수단 설문조사에 참여하셨나요? 관련 정보와 2022 년 설문조사가 한국어로 제공됩니다. 자세한 내용은 QR 코드를 통해 확인하십시오.

Have you completed the 2022 Carlingford and Epping Neighbourhood Travel Survey?

Complete the survey for your chance to win prizes Go to l.ead.me/travel-survey or use the QR code to complete the 2022 Carlingford and Epping Neighbourhood Travel Survey before Monday 5 December . The survey can be completed in English, Korean and Simplified Chinese. Submit your survey and enter the draw to win one of 10 x $50 gift cards. – valid for use at hundreds of stores. For more information: See cityofparramatta.co/epping-carlingford or contact City of Parramatta on 1300 617 058.

The annual neighbourhood survey is on again! City of Parramatta and NSW Health have created a short 10-minute survey on travel and how it relates to health and wellbeing in your neighbourhood. For the fourth year, the focus of our project area is in Carlingford and Epping (bound by Carlingford Road, Midson Road, Marsden Road, Pennant Hills Road, Jenkins Road, Moseley Street). If you live in the highlighted area and are over 18, we want to hear from you.

20

WSLHD Centre for Population Health

Dawson Mall Cigarette Butt Litter Prevention Project

This project aimed to increase cigarette butt binning rates in Dawson Mall, Mount Druitt, a suburb with the highest smoking rate in NSW and a major hotspot for cigarette butt litter. Infrastructure improvements, education and awareness of butt litter prevention, increasing community ownership, enforcement and consistent cleaning and maintenance of hotspot areas was undertaken in partnership with Blacktown City Council between April 2021 – February 2022. Cigarette butt binning rates increased by an average rate of 63% across four hotspot sites. New infrastructure installed to support litter prevention behaviours (ie. 4 designated smoking areas; 7 cigarette butt bins; 110 litter prevention and smoke-free signs).

Mount Druitt community champions, Terry Crawley (at left) and Rebecca Bell (at right).

Community consultation and support received from 82 local community members.

New Guide on Healthy High Density Living for Families with Children Building on the results of the Healthy High Density 4 Kids (HHD4K) qualitative study, in partnership with City of Parramatta, a joint working group including our Healthy Places team and Hayball Architects developed a draft Healthy Higher Density Living for Families with Children: A Design Guide . The draft Guide contains a suite of best practice drawings and guidelines to support the health of children and families living in high density housing. It will be circulated to stakeholders for input between February-April 2023, prior to completion.

21

Year in Review 2022

Health protection

Important Information about imported kohl, kajal and surma products KEY POINTS 1. Some people have become sick from using traditional Hashmi brand eye cosmetics. These cosmetics have been tested and found to have high levels of lead. 2. Lead is a dangerous metal. Even small amounts can make people sick, especially children. 3. Please do not use these eyeliners. Please see a doctor if you or your child has been using these cosmetics and you are worried about lead.

What is kohl, kajal and surma? Kohl, kajal and surma are eye cosmetics imported from India, Pakistan, Africa and the Middle East. Some of these products contain lead. Some people using these products have become sick due to lead poisoning. Why is lead dangerous?

Managing Acute Respiratory Infections outbreaks in aged care The Public Health Unit (PHU) continues to support local Residential Aged Care Facilities (RACFs) to manage acute respiratory illness outbreaks (caused by COVID-19 and other non-COVID-19 pathogens), as well as other sensitive settings (disability/group homes) that require support.

Lead is poisonous. Even small amounts can be dangerous. Lead can damage the brain, nervous system, reproductive system, kidneys and other parts of the body. Children and pregnant women who use products containing lead are especially at risk. If a child is exposed to lead in their mother’s womb or from a young age they can have lifelong problems with learning, growth, school performance and behaviour. How does lead from kohl, kajal or surma get into the body? When a person uses these products, some of the powder or liquid, with the lead, can get onto the hands. The person can then swallow the lead after touching their food or putting their hands in their mouths. Lead can also be absorbed through the eyes.

Which types of kohl, kajal and surma contain lead?

There are many types of kohl, kajal and surma and any of these products could contain lead. Recently, the following products were found to contain high levels of lead:

1 8 environmental investigations completed for children with notified high lead levels.

 Hashmi Surmi Special, made in Pakistan  Hashmi Kohl Aswad, made in Pakistan

These products were being sold in local grocery stores in western Sydney. Store owners have been advised to remove the products from their shelves, and not to sell them.

From 1 August 2021- 1 August 2022, PHU has managed a total of 195 COVID-19 outbreaks in 65 RACFs, comprising: 2,612 COVID-positive residents 1,613 COVID-positive staff 228 COVID-related hospitalisations 100 COVID-related deaths.

Lead exposure investigations

For children under 16 years, lead exposure is a notifiable condition, identified through a blood test showing excess lead level. When a notification is received, our Environmental Health team conducts an exposure assessment of the child’s environment. During 2022, we received eight notifications of children with high lead levels. Cases were investigated, with a variety of lead sources identified and removed. These included kajal/kohl eyeliner, Ayurvedic remedies, chipping lead paint, contaminated soil. Once the source of lead exposure was removed, the childrens’ lead levels gradually reduced and improved.

Online support webinars for RACF leaders and staff commenced in April 2020 to provide support and education during the COVID-19 pandemic. In July 2022 WentWest assumed faciliation of the webinars with our Public Health Unit providing an update at each session.

Webinar attendance averaged 30-40% of 65 RACFs.

Infectious Diseases Network Our Public Health Unit engaged with the state-wide Infectious Disease Network through monthly network meetings, presentation of overseas acquired infectious diseases data (in October 2022) and contribution to a ‘Communicating and working with Priority Populations’ workshop in partnership with WSLHD Multicultural Health (MH), in November 2022.

WSLHD Conference presenters, L-R: Fouzia Hamdard (MH), Dipti Zachariah (MH), Makeleta Felila (CPH), Dr Ben Silberberg (CPH), Monika Latanik (MH).

Dipti Zachariah (MH) presenting at the Infectious Diseases Network conference.

22

WSLHD Centre for Population Health

Floods and recovery help Up to 33 tourism businesses that provide a water supply to their customers along the Hawkesbury River were impacted by three flood events in 2021–22. In July 2022 our Environmental Health team provided advice and support to affected businesses to help with re-establishing a safe water supply before re-opening for visitors.

12 19 2

businesses agreed to a site visit and sampling of their water supply.

businesses received support information by email.

businesses closed permanently.

Building owners, and occupiers, safety: Legionnaire’s disease Legionnaire’s disease is a notifiable condition in the Public Health Act 2010 . The Public Health Unit received 25 notifications of people who had contracted Legionnaires’ disease during 2022. Our Environmental Health team investigated all cases in the search for a potential exposure site, which involved collecting records of water-cooling systems as well as inspections and sampling of high-risk locations. The team also worked with local government colleagues to ensure affected water-cooling systems were brought into a safe condition.

25 Legionella notifications investigated including environmental investigation and risk assessment.

Vaccine training for immunisation providers

Vaccines are sensitive medications that must be stored appropriately to ensure they are effective when administered to patients. Our Immunisation team investigates, manages, and supports providers of vaccinations in western Sydney to prevent ‘cold chain breaches’ (CCBs) in vaccine storage. Using thermostability data, our team manages any CCBs and supports the providers with training to improve their vaccine storage practices. Between June 2021 – July 2022, the team investigated 97 CCBs that resulted in vaccine wastage.

23

Year in Review 2022

E-cigarettes illegally on display.

Addressing cigarette and e-cigarette sales to minors The Environmental Health team conducted a review of all e-cigarette sales to minors complaints received from 1 July 2021 – 31 May 2022. Sixty nine percent (25/36) of reported complaints were about retailers selling e-cigarettes within 500 metres of a school or a transport hub. The team geocoded and mapped all retailer locations in proximity of schools and transport hubs. This enabled the team to focus retailer e-cigarette compliance checks in the vicinity of high-risk youth populations. Following on from the mapping, cigarette and e-cigarette sale to minors retailer surveys were conducted in July and October 2022. Sixty two of 64 retailers complied (97% compliance), with two retailers illegally selling e-cigarettes to the young volunteers (13-15 years of age) who took part in the surveys. After the surveys, retailers were provided information on the health harms and related penalties of selling to minors. Prosecution of the two retailers that sold to the minors is pending.

Minors approaching tobacconist as part of WSLHD compliance check.

Legend Sales to Minors Complaints

High

Low

Transport Hubs Primary Schools High Schools

Map showing local e-cigarette sales to minors complaints and school locations.

24

WSLHD Centre for Population Health

COVID-19 Response

Help with managing COVID-19 at home In response to community need, in March 2022 we launched a new COVID-19 health support guide to help western Sydney community members manage mild cases of COVID-19 at home. Informed by the community, our health partners, and local public health experts, the guide (housed centrally on the Western Sydney COVID-19 Community Resources website) provided information in a practical, easy-to-read way, including direct links to translated resources and information for Aboriginal and Torres Strait Islander people. Within a week of launch, the website attracted 2,113 new visitors. Insights from the development of this guide helped inform the Ministry of Health state-wide COVID-19 response.

Between March – April 2022, over 1,000 downloads of locally developed COVID-19 health support guide resources, including: COVID-19 health support guide: 554 downloads. Tips to keep your household safe when someone has COVID-19: 122 downloads. Help to manage mild to moderate COVID-19 symptoms at home: 184 downloads. COVID-19 symptoms and when to call for help: 98 downloads. Food support services for western Sydney: 50 downloads.

“The Managing COVID-19 at home guide is a perfect balance of information while also concise. There is enough information to be substantive and helpful, without being overwhelming. It’s easy to read.”

Resident - Cumberland Local Government Area.

25

Year in Review 2022

COVID-19 vaccination clinics for our Aboriginal community CPH Aboriginal Community Engagement Coordinator, Vickie Mason, together with the WSLHD COVID-19 Vaccination Outreach team, liaised with Aboriginal community organisations to help facilitate 101 culturally safe COVID-19 vaccination

Regular COVID-19 public health updates for community

Monthly public health and wellbeing Bulletins sent to 180+ subscribers from local councils, education, government, and non-government subscribers, as well as to over 1,700 subscribers from children’s settings, schools, and community.

clinics for Aboriginal community members.

101 clinics held between January – December 2022.

Local Government Environmental Health collaboration During the pandemic, our Environmental Health team, in collaboration with Nepean Blue Mountains LHD, engaged regularly with the eight Council Environmental Health teams across both LHDs. The aim was to keep Councils updated on any changes to COVID-19 Public Health Orders so they could support their local communities and businesses. on many stresses for my family. But after listening to the doctor, I feel more at ease.” - Attendee at vaccination clinic. “I was nervous about even listening to anything relating to the COVID-19 vaccination, as this topic has bought

COVID-19 - After Action Review The Public Health Unit participated in a state-wide Population Health- based pandemic after action review (AAR). This included a survey of 144 staff who took part in the WSLHD Public Health Unit response, and a half-day debrief session attended by 22 staff to gather insights on:

• Surveillance and reporting • Public Health workforce • Public Health governance • Case and contact management.

A detailed report was compiled with feedback and recommendations which contributed to a broader state-wide pandemic AAR report.

26

WSLHD Centre for Population Health

Achievements

27

Year in Review 2022

Awards

WSLHD Integrated and Community Health Achievements in Integrated & Community Excellence Awards 2022 For the Patient Experience Matters category: • Aboriginal Cultural Support for COVID-19 Cases & Families Project. Finalist – Public Health Unit. • Supporting Health & Wellbeing during COVID-19 via a New Equity Engagement Model. Winner – Centre for Population Health. Also, Winner of General Manager’s Award category. For the Exceptional People category: • Socially & Culturally Competent COVID-19 Case Investigators. Finalist – Centre for Population Health.

L-R: Director of Nursing & Midwifery, Juanita Taylor, and General Manager ICH, Jasmin Ellis present Health Promotion representatives Elissa Miller and Belinda Duckworth with the ICH General Manager’s Award.

Integrated and Community Health (ICH) Achievement in Community Excellence Awards Finalists.

“COVID-19 has shown us that a one-size-fits-all approach isn’t enough when communicating important health and wellbeing information. The equity engagement model allowed us to really listen to the community, rapidly and meaningfully, often through our trusted and established partners.”

- Population Health Program Officer, Belinda Duckworth.

28

WSLHD Centre for Population Health

Premier’s Awards 2022 FINALIST NSW Public Servant of the Year Award 2022

NSWMulticultural Health Communications Awards 2022

For the COVID-19 Response category: • COVID-19 Healthy@Home tip sheet . Finalist - WSLHD Health Promotion.

Watch video about the tip sheet

Centre for Population Health representatives, Belinda Duckworth and Dr Ling Lim recording a video about the tip sheet.

Dr Shopna Bag (Finalist) The NSW Public Servant of the Year award is for an individual who has demonstrated exemplary work and outstanding leadership in the NSW Government. CPH Director, Dr Shopna Bag was announced a finalist for the NSW Public Servant of the Year. Shopna is an extraordinary leader whose example of expertise delivered with care and compassion has stood out over the past year – particularly throughout the pandemic. Shopna consistently demonstrates a commitment to understanding the local western Sydney community and empathy towards all staff, patients and carers. She successfully engaged internal and external stakeholders, provided advice on the rapidly evolving COVID-19 guidelines, and informed the development of local policies and procedures to support compliance with guidelines in clinical and non-clinical areas across the health district.

Integrated and Community Health team representatives with the Healthy@Home tip sheet.

29

Year in Review 2022

Retirements

Associate Professor Stephen Corbett – Director, Centre for Population Health Retired January 2022

Christine Newman – Deputy Director, Centre for Population Health Retired February 2022 Christine is a beloved colleague with an impressive career that spans five decades in health – the highlights of which include making safety improvements to our roads, hospital grounds and medication containers. She spent almost 20 years of that career in population health, consequently gaining the title ‘Queen of Population Health’ from her colleagues. Throughout her many roles, Christine ensured the community was at the centre of all she did, as “at the heart of it all, it’s the people that count”. This rung especially true throughout the COVID-19 pandemic. “It is through her dedication, tireless support and fearless leadership that we have been able to navigate the storms to “With staff coming from all over the District to join Centre for Population Health, the feedback was unanimous that they valued the culture of the team, our teamwork and felt it one of the best teams they’ve worked in. “Her legacy and contributions to the success and achievements of the Centre are immeasurable,” said Dr Bag. More about Christine Newman. where we are today.” - Dr Shopna Bag, Director CPH.

When COVID-19 was declared a global pandemic, Stephen Corbett knew he had to delay his retirement and lend his expertise to the one-in-100-year event. “Over the last two exhausting years we have been engaged daily in debates about how to manage the pandemic in its many guises – from managing cases and their families to the bigger issues such as how to keep vital industries and institutions from buckling under pressure.” - A/Professor Stephen Corbett. After 18 years working with WSLHD including two years on the response to COVID-19, the Population Health Director retired in January 2022. His career began at the University of Queensland, where he graduated in 1975, followed by work and training in general practice in western Sydney, Wollongong, and London before an esteemed career in public, environmental and occupational health. Stephen established himself as Director of the Environmental Health Food and Nutrition Branch in NSW Health for 13 years before transitioning to WSLHD in 2003. Stephen has contributed greatly to his field, not only within his work with WSLHD, but with his academic research and his work with universities, as well as shaping the minds of students in his field. More about Stephen Corbett.

30

WSLHD Centre for Population Health

Formal qualifications attained

Bronnie Anderson-Smith Strategy, Planning & Engagement Manager – Public Health Officer Training Program

Jennifer Lampard Communicable Diseases Surveillance Nurse – Clinical Nurse Specialist 1 award

Penelope (Penny) Clark Clinical Nurse Consultant 3 Retired October 2022 After a 10-year posting in Public Health and a career in health spanning 40+ years, Clinical Nurse Consultant Penny Clark retired this year. Penny was the co-clinical lead for the Communicable Diseases Surveillance team, which investigates cases of infectious diseases (also called notifiable diseases) and outbreaks that occur in western Sydney. Penny first registered as a nurse in 1979 and took on a wide range of roles in health, including department manager for infection control (Blacktown Hospital), community/multicultural health settings at Fairfield, Cabramatta and Villawood, and nursing roles in the aged care setting. Penny was a great nurse advocate for both patients and colleagues, she made an impact on anyone who met her. “I am glad I chose to work in public health as it’s been both a pleasure and an honour to meet and collaborate with so many wonderful people

Jennifer Plaskett Health Promotion School Age Coordinator – Diploma in Leadership and Management

Dr Jessica Wells Public Health Physician – Fellow of the Australasian Faculty of Public Health Medicine

Melissa Mason Health Promotion Officer – Certificate IV in Leadership and Management

in WSLHD and Health Protection Network.” - Penny Clark.

31

Year in Review 2022

Conferences & Key Presentations

McKay, K., & Shaban, RZ. (2022, November 13-16). H ealthcare worker and consumer attitudes towards video- based monitoring of hand hygiene compliance: A pragmatic trial [Conference presentation]. Australian College for Infection Prevention and Control Conference, Sydney, Australia. Shaban RZ. (2022, October 18). Nursing-led innovation to combat the COVID-19 pandemic in our Residential Aged Care Facilities [Conference presentation]. Celebration of Nursing in the Community. Shaban, RZ. (2022, September 21). Return of Office Anxiety [Conference presentation]. The Royal Australasian College of Physicians. Shaban, RZ. (2022, June 15). Leading from the Front: Nursing and COVID-19 [Conference presentation]. Northern Sydney Local Health District Nursing & Midwifery Research and Innovation Conference, Sydney, Australia. Shaban, RZ. (2022, April 27). Leadership Insights COVID-19 Infection Prevention and Control Strategies with Communities – Residential Aged Care Facility Outbreak Response [Conference presentation]. Western Sydney Local Health District Nursing & Midwifery Leadership Workshop, Sydney, Australia. Shaban, RZ. (2022, April 1). Co-Designing COVID-19 Infection Prevention and Control Strategies with Communities - Residential Aged Care Facility Outbreak Response [Conference presentation]. Australian Institute of Health Service Management Masterclass: Managing Health Services During COVID-19, University of Tasmania, Sydney, Australia. Silberberg, B. (2022, May 4). Double trouble: Two rare notifiable diagnoses in a patient presenting with shock, fever and jaundice [Clinical presentation]. Medical Grand Rounds (Westmead), Sydney, Australia. Silberberg, B. (2022, October 12). Sore knees and red herrings in returned travellers: Local and imported arboviruses in NSW [Clinical presentation]. Interdepartmental Infectious Diseases/Microbiology Grand Rounds, Sydney, Australia. Sneesby, H. (2022, August 17). Lessons learned from the COVID-19 pandemic: How singing caused a COVID outbreak [Conference presentation]. Environmental Health Australia Annual State Conference, Newcastle, Australia.

Bag, S. (2022, February 17). COVID-19 Vaccination [Stakeholder presentation]. WSLHD Multicultural Health COVID-19 Community Champions webinar, Virtual. Bag, S. (2022, May 5). Public Health update: Living with COVID 19 [Clinical presentation]. Western Sydney General Practice Network Meeting, Virtual. Bag, S. (2022, July 22). NSW response - how was the response established in a PHU? What is needed for next time? [Conference presentation]. 2nd Australasian COVID-19 Conference, Sydney, Australia. Corbett, S. (2022, July 7). Co-evolution of Homo sapiens and Mycobacterium tuberculosis on the Tibetan Plateau [Conference presentation]. International Society for Evolution, Medicine and Public Health Conference, Lisbon, Portugal. Duckworth, B., & Miller, E. (2022, June 20-23). Enhancing community engagement during COVID-19 in Western Sydney: An equity engagement model [Virtual presentation]. Public Health Association of Australia Communicable Disease and Immunisation Conference, Sydney, Australia. Ip, S. (2022, April 6). Tackling cigarette butt litter in Western Sydney [Conference presentation]. 2022 Litter Congress, Sydney, Australia. Lay, R., Leece, E., & Smith, B. (2022, 28-29 November). Exploring the potential for citizen science to monitor and improve walkability in underserved communities [Virtual presentation]. Asia-Pacific Society for Physical Activity 2022 Conference, Melbourne, Australia. Lim, HL. (2022, June 20-23). Developing COVID vaccination information for CALD communities [Conference presentation]. Public Health Association of Australia Communicable Disease and Immunisation Conference, Sydney, Australia. Lim, HL. & Wells, J. (2022, May 4). IMD In All Its Splendour . [Clinical presentation]. Medical Grand Rounds (Westmead), Sydney, Australia. McBride, K. (2022, June 20-23). A training template for future surge capacity needs within Public Health Unit settings [Conference presentation]. Public Health Association of Australia Communicable Disease and Immunisation Conference, Sydney, Australia. McDermott, S., McNicholas, J., & Plaskett, J. (2022, June 21). Covid-19 health behaviours survey [Conference presentation]. University of Wollongong Early Start seminar – Implementers and researchers working together in the First 2000 Days and school-aged children, Sydney, Australia.

32

WSLHD Centre for Population Health