Our place and people
Our home and Country
Western NSW Local Health District (WNSWLHD or the District) contains 22 Local Government Areas (LGAs), 7 of which are classified as remote or very remote. The District covers 31% of NSW, spanning a vast and diverse geographical area.
Our Aboriginal Nations are diverse, with Traditional Custodians including the Wiradjuri, Wailwan, Kamilaroi, Wongaibon, Ngemba, Barindji, Barundji, Gunu, Muruwari, and Barranbinya peoples.
Our population
An estimated 284,300 people live in WNSWLHD – a population that is both growing and ageing, shaped by the distinct character of our rural and regional communities.
Our people
- Higher fertility rate: 2.1 births per women, higher than the NSW average of 1.68.
- Median age: the median age is 44 for District and varies by location with 36 years in Bourke to 51 in Weddin, compared with 38 years across NSW.
- Older residents: 19.6% of residents are aged 65 and over, compared with 17.1% in NSW.
How we are changing
The population is projected to grow 8% by 2041 (vs 16% NSW), reaching close to 315,000 people. Growth will not be evenly spread across the district:
- Larger centres like Bathurst, Dubbo, Orange and Mudgee and the southern region are expected to expand.
- Central towns and LGAs in Western NSW are likely to remain stable.
- The remote north-west is projected to experience population decline.
The proportion of people aged 65+ is projected to rise, creating higher demand for aged and community care.
Priority populations
Across Western NSW, the strength of our people lies in their diversity, but this also means that health and wellbeing needs vary widely.
Aboriginal people: More than 41,000 people (14.5%) in WNSWLHD identify as Aboriginal, compared with 4.2% across NSW.
Our Aboriginal population is younger, with a median age of 24 years (vs 44 years for non-Aboriginal people). Health outcomes remain unequal, and many Aboriginal people continue to experience poorer health and shorter life expectancy. Closing this gap remains one of our most important responsibilities.
Migrant populations: About 5% of residents were born in non-English speaking countries (vs 23% NSW). Migration to regional centres is increasing, strengthening our workforce and cultural diversity. As these communities grow, access to culturally responsive health services will be increasingly important.
People experiencing poorer health outcomes in our District include our residents in remote communities, our socially disadvantaged populations, and males.
We also have groups with greater access barriers. These include but are not limited to people with a disability, the LGBTIQ+ community, survivors of sexual abuse, people living with mental illness and older persons.
Our challenges
People living in Western NSW face greater health challenges compared to others in the state, shaped by geography, access to healthcare, and socio-economic and psychosocial factors.
Compared with NSW overall, our residents experience greater social disadvantage, including lower levels of education and income, and fewer opportunities to access care.
Access to health care
There are fewer primary care and allied health providers across WNSWLHD, and travel times for many residents can be long, with limited transport options.
Access issues lead to delays in care, poorer outcomes, and greater pressure on emergency and acute services.
The rate of emergency department (ED) presentations per 100,000 people is the highest of all NSW Health districts, likely reflecting challenges in primary care access and higher overall health need. Between 2016 and 2024, GP attendances were 13% lower than the NSW average.
Access to mental health and drug and alcohol services is also a challenge, influenced by geographic isolation, workforce shortages and fragmented service pathways.
Health outcomes
These access challenges, combined with social and economic factors, contribute to poorer health outcomes across Western NSW.
Compared with NSW averages, our residents experience:
- shorter life expectancy,
- higher rates of chronic disease,
- more health risk behaviours such as smoking, poor nutrition, risky alcohol use.
Building the foundations for better health
Health challenges are not simply about individual choices, they are also shaped by broader conditions known as the social determinants of health: housing, education, employment, and access to transport and care. Improving health outcomes means addressing these underlying factors through collaboration across government, community, and health services.
Our focus for the future
To improve health and wellbeing across the District, we will continue to focus on:
- supporting healthy pregnancies and early childhood development,
- strengthening mental health and suicide prevention,
- preventing and managing chronic disease,
- reducing overweight and obesity.
Our strengths
Despite the challenges faced by our region, the people of Western NSW show remarkable resilience, connection, and pride in their communities.
This community strength, highlighted in the 2025 community health needs survey, is one of our greatest assets, helping people stay connected, adapt in times of crisis, and support one another’s wellbeing.
Encouragingly, many health outcomes are improving over time, including reduced mortality from preventable causes, lower cancer mortality and cardiovascular disease deaths, and decreased smoking during pregnancy among both Aboriginal and non-Aboriginal women.
Cardiovascular disease mortality has fallen by 32% (2011–2021), though there is still progress to be made with rates remaining 27% higher than NSW.
Rates of full immunisation for Aboriginal and non-Aboriginal children at age 5 are both above 95%, exceeding NSW averages.
- 71% of residents feel proud of their community.
- 74% say they can rely on friends, family, and neighbours for support when needed.
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