Sydney at risk of health challenges amid climate change, population boom
Emma Guiney lay in a hospital bed, crying as the rash throbbed. Days earlier, she developed a headache and flu-like symptoms while in Thailand. Thinking it was a hangover, she soldiered on.
But her energy levels plummeted when she returned to Australia. She was diagnosed with dengue fever. “To even do a load of washing I would need to have a three-hour sleep afterwards,” she says. It was three months before Ms Guiney, from St Peters, felt well. She won’t be returning to Thailand.
Despite most cases being isolated, dengue fever reaches as far south now as Rockhampton in central Queensland. In the coming decade, as Sydney’s climate warms, the city could get an increase in mosquito-borne diseases.
It’s just one of the health challenges we’ll face. The city’s population will swell to more than 5.8 million, a million of them over the age of 65. Chronic diseases such as diabetes will become more common and drug-resistant superbugs will rise.
Can Sydney’s health system keep up?
The risks of a warming climate
A warming climate carries the risk of more temperature-related deaths, especially among the young and elderly.
We could see an increase in mosquito-borne diseases as warm seasons extend and draw insects from regions to our north. Ross River virus outbreaks may become more common, with standing water in the Parramatta and Georges rivers creating hot spots for mosquito population growth. Exotic mosquitoes moving into Sydney’s backyards may bring a higher risk of dengue outbreaks.
“While most people think mosquitoes are nuisances, they don’t comprehend there are health risks associated with them,” Dr Cameron Webb from the University of Sydney’s Department of Medical Entomology says.
Scientists are developing strategies to address the threat, including the possibility of infecting mosquitoes with a parasite to stop their ability to spread the virus.
It seems like a dystopian reality, but there’s a growing threat from drug-resistant superbugs. Scientists say antibiotic resistance has grown over the past decades and the situation will worsen, particularly as antibiotics continue to be used across the medical and agricultural industries.
Dr Matthew Baker from the University of NSW’s School of Biotechnology and Biomolecular Sciences says that, while more research into antibiotic and bacteria behaviour is needed, solutions could include new drug combinations or highly targeted viruses to kill unwanted bacteria.
The ageing population
From 2030, the tail end of the Baby Boomer generation will move into retirement. The ageing population will require extensive resources to treat multiple illnesses, including dementia and cardiovascular disease, placing increasing pressure on the health system.
Obesity, cardiovascular disease and diabetes prevalence will grow in the next decade. The chief executive of Diabetes NSW and ACT, Sturt Eastwood, says that, unless the health system evolves to better manage chronic diseases, they “are going to absolutely swamp it”.
The Australian Institute of Health and Welfare estimates that, by 2030, 550,000 people nationally will have dementia, an increase of 46 per cent since 2018.
But Professor Robert Cumming from the University of Sydney’s School of Public Health says the reality could fall short of estimates, as future populations are better educated about ways to preserve their cognitive function.
By 2030, there will be greater emphasis on community and home-based care, allowing us to age in our own homes, and dementia-friendly communities. The latter, which are already being developed in Kiama, will see community members and staff educated to better help those with dementia.
It is hoped the recommendations of the aged care royal commission will have been implemented by 2030.
Rising health services demand
Western Sydney will bear the brunt of the population boom and the local health district is preparing by upgrading the emergency department and operating theatre capacity at major hospitals including Westmead and Campbelltown. Others, including Royal Prince Alfred Hospital ($750 million) and Prince of Wales Hospital ($720 million), will receive upgrades under the NSW government’s $10 billion investment in health infrastructure over the next four years.
Are there enough hospital beds?
Hospital bed availability will be a major challenge despite increased capacity. The 2019 Australian Infrastructure audit concluded that population growth is outpacing hospital bed availability nationally.
Admissions to hospital in NSW are likely to increase by about 20 per cent for men and 19 per cent for women between 2015 and 2028, placing significant pressure on bed capacity. Hospital authorities will not only need to add more beds, but will also face pressure to free beds by reducing the length of hospital stays where it is medically safe to do so.
NSW Health Minister Brad Hazzard says one way to reduce admissions to hospital is to better manage mental health issues as well as drug and alcohol addictions.
“We’re trying to take those people out of the emergency hospital system and put them into community health centres,” he says.
Mr Hazzard also says a greater focus is needed on aged care, particularly palliative care.
Labor’s health spokesman Ryan Park says all levels of government must work together over the next decade if the healthcare system is to cope.
“We don’t have a choice,” he says. “If we don’t, we’re not going to be able to manage the expectations people have of the health system. People rightly expect that in Australia and NSW, they will have access to a world-class healthcare system.”
The future of healthcare
The healthcare system will become smarter, with an increase in wearable devices, remote video consultations with doctors and closer links among the health industry, researchers and practitioners.
“Right now, for instance, clinicians can access real-time data on patients suffering strokes as they are taken by ambulance to hospital,” a spokesperson for NSW Health says. “These technologically advanced clinical tools will continue to help us speed up diagnosis and treatment options over the next 11 years through partnerships between NSW Health, innovators and researchers.”
The My Health Record, or a similar digital record system, is likely to become more common, says professor of eHealth at the Charles Perkins Centre Tim Shaw. But unlike the most recent roll-out of the program, the 2030 model will need to be more dynamic in data access and transfer between healthcare professionals, apps and consumers. It will also require stronger data and privacy protections and assurances for consumers.
“The information has to be in our hands so people can manage consent and share information,” he says. “Data will have to be owned by the individual.”
But as the health system digitises, there’s a risk of a digital health divide, Professor Shaw says. So, it will be key to ensure everyone has access to digital services and trusts them.
The Sydney Morning Herald is hosting a population summit on September 23. For more details and to view the list of speakers click here.
Laura is a journalist for The Sydney Morning Herald.