4.3 Foster regional Victorians’ health, wellbeing and inclusion
Health, education and community services need supporting infrastructure, such as suitable facilities, to enable effective service delivery.
Transport and digital services can improve access to services in regional areas, but many services also require personal interaction and face-to-face care and support, and often need to be locally delivered.
Fit for purpose infrastructure can also help foster local participation and improve community amenities. This includes infrastructure to help communities connect – from community facilities to parks, volunteer emergency services or civic infrastructure.1 Affordable, appropriate and well located housing supports social inclusion by improving access and proximity to services, facilities, jobs and transport.2
Diverse regional communities have complex needs
Every Victorian community includes some people experiencing poverty and socio-economic disadvantage.3 But regional Victoria has higher levels of disadvantage, exacerbated by many complex factors including industry restructuring, an older population, and greater exposure to climate change impacts.4 Eight of the top 10 most disadvantaged local government areas are in regional Victoria.5
People with complex needs require multiple and often overlapping services, such as health care, mental health services, disability support, homelessness services and early intervention and support for children and young people. The higher proportion of regional Victorians experiencing disadvantage translates into a higher potential demand for health and social services, compared with Melbourne.6
\19% of regional Victorians are aged over 64 years compared with 14% in Melbourne7
\15% of regional Victorians have asthma compared with 11% in Melbourne8
\19% of regional Victorian adults smoke tobacco compared with 14% in Melbourne9
\ An estimated 19% of regional Victorian adults have potentially harmful levels of alcohol consumption compared with 13% in Melbourne.10
Regional Victoria’s diverse and changing
demographic mix is likely to alter future
service demand. Ageing populations, most
notably in small rural communities, will
affect the scope and mix of services
needed.11 Conversely, some regional cities and peri-urban areas are experiencing rapid population growth, placing pressure on services and facilities.12 Strong Aboriginal population growth across regional Victoria will need to be matched by provision of culturally safe Aboriginal community-controlled services.13 The COVID-19 pandemic has further stimulated population growth in the regions, although it remains to be seen whether this is a long-term trend.14
Climate change is forecast to bring higher temperatures, more days of extreme heat, declining rainfall and more frequent catastrophic bushfires conditions to regional Victoria,15 further complicating the challenges facing local communities. Extreme heat, heatwaves and prolonged bushfire smoke exposure can have significant health impacts. For example, heatwaves cause more deaths each year than any other natural disaster.16 Risks are higher for regional Victoria’s older, more disadvantaged population.17
For these reasons, ‘cookie cutter’ infrastructure approaches will not work in regional Victoria.
Solutions must account for local differences and adjust to changing circumstances, such as changes in climate and community needs, over time.
Local, collaborative approaches tailor investment to different places, coordinate effectively across different levels of government and create opportunities for meaningful engagement with local communities — making them more successful in helping to address disadvantage.18
Infrastructure solutions and investment in regional Victoria must take into account the local and unique differences and be able to adjust to changing circumstances to promote thriving communities in our regions.
Delivering and accessing regional services is challenging
Local governments deliver many social and community services to regional communities, including child and family services, aged care, health care services and programs to foster social inclusion and improve wellbeing.19 But many regional councils, particularly in rural areas, have budgets constrained by small numbers of ratepayers with lower average incomes.20 They also need to fund multiple services to geographically dispersed towns with small, often high need populations.21
Victoria’s councils manage assets worth over $115 billion.22 They spend about $2 billion on infrastructure each year.23 Regional councils can struggle to afford the facility upgrades for accessible, safe infrastructure to support the many services their communities need. Selling assets can be difficult because they have few potential purchasers, and communities often feel strongly attached to facilities.24 Relatively dispersed populations and infrastructure can lead to higher service delivery and asset maintenance costs,25 often unattractive for private sector providers.26
Gelong and Wodonga have higher population growth and may be more financially sustainable than the smaller rural shires, but also have high and growing numbers of residents
experiencing disadvantage, and consequent service demand.27
Growth pressures in parts of regional Victoria are being made worse by a population shift triggered by the COVID-19 pandemic.28 Regional Victoria recorded its highest quarterly net population gain on record during the pandemic, a majority coming from Melbourne.29 However, longer-term population trends, and the implications for regional Victorian communities, are not yet clear.
Access barriers can compound service delivery challenges. Limited public or community transport options constrain service access in many places.30 Inadequate communications infrastructure and limited transport options make it harder for regional Victorians to reach employment, education, health and community services that help to address disadvantage.31
To respond to these pressures, local governments must innovate and flexibly manage service provision facilities. Despite each local area’s different challenges, all councils will need to better use and adapt their infrastructure to match the changing needs of their communities.
Well-located, affordable housing improves job and service access
As house prices have risen, fewer Victorians own their homes, especially those with lower incomes.32 Rents have also increased.33 The COVID-19 pandemic triggered a further increase in median rents in regional Victoria combined with a decline in vacancy rates, as more people have moved to the regions.34 Average weekly rents in regional Victoria are now closer to those in Melbourne, meaning very few properties are affordable and appropriate for most households on income support, with single people faring the worst.35 Well-located social housing, with good transport access, allows people to live close to jobs and services,36 and can provide access to housing where private local rental markets are unaffordable for very low income households. Existing social housing supply does not meet current demand, let alone future growth. More than 16,000 regional Victorian households are waiting for social housing, and the majority (59%) require urgent assistance.37 Demand for social housing, compared with the number of existing social housing dwellings, is higher in regional Victoria than in Melbourne,38 and yet regional Victorians more commonly face many of the difficulties which drive social housing demand.
The most frequent reasons Victorians seek homelessness support are financial difficulties, family violence, and experiencing a housing crisis.39
Regional Victorians are more likely to experience rental stress and are overrepresented in instances of family violence.
For example, 30% of regional Victoria’s renting households experience rental stress, compared with 26% in Melbourne,40 while 19 out of the top 20 local government areas for rates of family violence are in regional Victoria.41 Homelessness is increasing in the regions, rising by 4% from 2011 to 2016. Barwon and the Great South Coast have seen homelessness increase by 23% and 24% respectively over the same period.42
The type and size of social housing dwellings do not match either the current or future tenant need. For example, one-bedroom homes would have to nearly double to meet demand.43 Social housing is also inadequately adapted to help tenants cope with the impacts of climate change. Social housing tenants, many with multiple and complex needs, are particularly exposed and vulnerable to extreme heat.44
Recommendations to improve health, wellbeing and inclusion
Infrastructure Victoria considers the following recommendations would improve regional Victoria’s health, wellbeing and inclusion. These link with recommendations to better connect Victoria’s regions (see section 4.2) and align social infrastructure with service delivery more generally (see section 3.3).