COVID-19: Impact on Regional Australia – Older Populations

How will COVID-19 affect regional areas with older populations?

COVID-19 will have wide-reaching effects on the health of regional Australian communities. Of these, some groups are more vulnerable to it than others, including older people.

Across regional Australia, some areas have a higher proportion of older people in their community than others. It is important for policymakers responding to COVID-19 to have an understanding of which communities have older populations so that support measures can be targeted early.

This research identifies Local Government Areas (LGAs) which have the highest proportion of older people. It looks at people aged 65 and older against the other age cohorts. In this assessment, we have identified the following LGAs as having the highest proportion of older people:

Table 1 – Regions with the oldest populations proportionally, 2016.

Local Government Area	State	Total residents	Residents aged 65 and over (no.)	Residents aged 65 and over (%)
Queenscliffe	VIC	2,859	1,164	41%
Victor Harbour	SA	14,660	5,750	39%
Yorke Peninsula	SA	11,057	3,592	32%
Barunga West	SA	2,534	820	32%
Glamorgan/Spring Bay	TAS	4,416	1,420	32%
Eurobodella	NSW	37,226	11,372	31%
Wyalkatchem	WA	517	156	30%
Mid-Coast	NSW	90,309	27,204	30%
Yankalilla	SA	5,165	1,500	29%
Tasman	TAS	2,375	688	29%

Table 1 shows that in Queenscliffe, a coastal region half an hour south of Geelong, 41 per cent of the population are 65 or older (1,164 individuals). The larger region of Victor Harbour has 39 per cent of the population aged 65 or older, which is a much larger number of individuals owing to the place’s bigger overall population (5,750 individuals). Both of these regions are popular retirement communities, drawing people from the nearby cities of Melbourne and Adelaide. South Australia has three of the top five regions with a high proportion of older people.

Geographically, the spatial distribution of older populations is very broadly along the New South Wales and Tasmanian coastlines, in Victoria’s Wimmera and southern Mallee, in South Australia’s peninsulas and Western Australia’s central-eastern Wheatbelt. For these regions, measures which go beyond council boundaries would be appropriate to make the best use of resources and ease community uptake.

In responding to COVID-19, regional health facilities may play a crucial role in the recovery of their residents. However, not every regional community has robust local health services, and many communities actually need more healthcare and social assistance workers.

As part of RAI’s health hot spot work [i], the proportion of healthcare and social assistance workers was calculated at the LGA level. It shows how many healthcare and social assistance workers are in the local workforce, compared to jobs in other industries. These results showed considerable variation between regions as well, with regions ranging from 43.8 per cent of their workforce in healthcare and social assistance (in Cherbourg, Queensland) through to some regions with 0 per cent (in 11 different regions).

In the face of COVID-19, RAI has looked at the intersection of these two datasets to identify where the regions with older populations intersect with places with a low healthcare and social assistance workforce. This selects the regions with the oldest populations (the top 40 per cent) and the regions with the lowest number of healthcare and social assistance workers in the workforce (bottom 40 per cent).

A Location Quotient (LQ) score was used as a statistical measure to show how significant the proportion of healthcare and social assistance jobs are in that region, compared to the national picture. LQ scores above one show regions which have an above-average number of those jobs, compared to the national average for a place of that size. Full methods are detailed in Appendix A.

The regions with older populations (top two quintiles) and the lowest proportion of healthcare and social assistance workers are:

Table 2 – The ten regions with the older populations and lowest proportion of healthcare and social assistance workers for a place of that size, 2016.

Local Government Area	State	Total population	Total jobs	Healthcare & Social Assistance jobs (no.)	Healthcare & Social Assistance jobs (%)	Healthcare LQ Score	Residents 65yrs+ (no.)	Residents 65yrs+ (%)
Central Highlands	TAS	2,150	631	23	4%	0.28	516	24%
Cue	WA	188	112	4	4%	0.28	516	24%
Cuballing	WA	849	196	5	3%	0.19	182	21%
Cranbrook	WA	1,091	479	11	2%	0.17	231	21%
Gingin	WA	5,226	1,829	41	2%	0.17	1,212	23%
Dowerin	WA	680	280	6	2%	0.16	136	20%
Wickepin	WA	718	297	6	2%	0.15	141	20%
West Arthur	WA	807	355	5	1%	0.11	154	19%
Shark Bay	WA	942	396	4	1%	0.11	154	19%
Sandstone	WA	80	40	0	0%	0	23	29%

The places with the highest proportion of older Australians and the lowest proportion of healthcare and social assistance workers are all regional places, not metropolitan places. Among these places, Western Australia features most strongly, with nine of the top 10 LGAs for older populations and lower health workforce. The top 10 regions overall also have small populations, with under 5,000 residents and 2,000 workers. This means that each individual older person or healthcare and social assistance worker has a greater impact on the region’s proportion.

When this data is mapped, the geographic spread shows some clumps of regions facing the same challenge of older populations and less healthcare and social assistance workers. These areas are mainly in Western Australia and Tasmania. On the other hand, parts of Victoria and along the New South Wales coastline have older populations but with higher proportions of healthcare and social assistance workers. Only the LGAs in the top two quintiles for age have been mapped in Map 2, meaning those left white have proportionally younger populations.

Other considerations in interpreting this data include the capacity of neighbouring regions. Many regional towns act as a service hub for surrounding smaller regions, and may already support the wider catchment with healthcare services. If impacted by COVID-19, some smaller regions may be able to continue accessing the healthcare and social assistance workers of their neighbouring regions. However, these regions may also find themselves stretched and potentially less able to support the broader population base.

Another health consideration for regions with older populations, and other groups that are more vulnerable to COVID-19, includes the availability of equipment to treat COVID-19 symptoms. Examples are the number of ventilators per person or personal protective equipment per healthcare worker.

These findings can support policymakers in creating localised policy responses which address the different needs of regions. Healthcare and social assistance, even before the COVID-19 pandemic, has been a growing and important sector to provide employment and development to regional Australia.

The sector is forecast to see the biggest increase in jobs of any industry in the coming years in regional Australia. An RAI report contains in-depth case studies in places of different sizes in regional Australia that have built a health precinct, a health network or a health sector business cluster to bolster the local health services and employment [ii]. This research provides evidence of best practice that is already being done in regional Australia to situate the health sector within wider economic and community development strategies.

APPENDIX A – METHOD

Identifying the older populations:

• ABS Census 2016 raw data: Place of Usual Residence, Local Government Area, Age in Five Year Groupings.
• People aged 65 and older as a proportion of the entire resident population.

Identifying the healthcare and Social Assistance workers:

• ABS Census 2016 raw data: Place of Work, Local Government Area, 1 digit ANZSIC Codes, by Industry of Employment.
• People in Healthcare and Social Assistance as a proportion of the local workforce, against the national average (using Location Quotient analysis).

Combining older populations and Healthcare and Social Assistance workers:

• Selection of the ‘older’ regions was done using the top two older quintiles, those with between 41 and 19 per cent aged 65 or older.
• Selection of the high, medium and low proportion of Healthcare and Social Assistance workers based on quintiles, where the highest two quintiles and lowest two quintiles comprised of the high and low category. The highest quintiles had between 50 and 13 per cent Healthcare and Social Assistance workers in the local workforce, whereas the lowest quintiles had between 10 and 0 per cent in their workforces.
• Mapping the intersection of the two highest quintiles of older populated regions and the corresponding proportion of Healthcare and Social Assistance workers.

[i] Lehmann A. and How G., 2019, Health Hotspots in Regional Australia: Building the Health Sector to Drive Growth. The Regional Australia Institute, Canberra.
[ii] Lehmann A. and How G., 2019, Collaborative Care: Community-led health sector diversification in regional Australia. The Regional Australia Institute, Canberra.