New health data has shown just how much a West Australian's home town can put their health at risk, hammering rates of obesity, risky drinking and physical inactivity down to specific areas.
The Australian Health Policy Collaboration of public health experts' extensive new dataset, unprecedented on this scale, is drawn from sources including the Australian Bureau of Statistics and Australian Institute of Health and Welfare.
WA country towns and Perth's outer suburbs are alarmingly over-represented in just about all categories modelled, while the affluent western suburbs stand in stark contrast.
In this multi-part series, WAtoday takes a closer look at some of those areas.
Cottesloe-Claremont-South
The bad news
- WA's highest rate of risky drinking: 31.5 per cent compared to 18.2 per cent national average
- Cottesloe-Claremont-South and Cottesloe-Claremont-Central had second and third highest cholesterol rates in the state, 38.6 and 38.5 per cent.
The good news
- Lowest inactivity rates in WA: 52.4 per cent did some kind of exercise in previous week
- Lowest smoking rate in WA: 7.5 per cent.
- Lowest rate of breast and colorectal cancer deaths WA. Rates of death from other cancers, and cardiovascular and respiratory system disease, also relatively low.
- Lowest suicide rate in the state.
- Tied with Duncraig/Hillarys/Sorrento/Marmion for second-lowest rate of diabetic adults in WA
The story
Kelly*, whose name has been changed to protect her privacy, has lived in Cottesloe with her husband and children for more than a decade.
Her experience of suburban life stands in sharp contrast to the areas previously profiled - Roebourne, Armadale and Kwinana.
"We live next to sublime beaches and amazing facilities," she said.
"We have got the ocean, the river and we live in between.
"We are lucky enough to also have amazing parks. We are really quite spoilt for choice."
Kelly said it was normal for people in the area to exercise daily life and having good public transport options and shady streets only made it easier to cycle to the city or walk to the train station to get to work, even in summer.
The closeness of schools to the area meant that most parents either walked their children to school or older children walked to bus stops and train stations by themselves to get to school.
"Living in Cottesloe, there is always someone walking around outside," she said.
"The bars being around the beaches make it very easy to exercise then grab a drink. People live fully, but then they exercise a lot to try to balance out their drinking.
"Kids or parents hear each other outside and go out to see what's going on. It's a street community. People are always out and headed to or from the beach."
But Cottesloe has a dark side, with WA's highest rates of risky drinking and dangerous cholesterol levels.
Kelly said many local parents had stressful jobs and it was normal to drink every night.
"It represents chill-out time, time off and release," she said.
"You'll also go over the road for a drink on a Friday afternoon as people around here know each other quite well. There are lots of dinner parties, gatherings. Someone new moves in and people tend to bring them in."
She said the 'social set' was also driving the high drinking levels.
"They are out socialising a lot, every night they are at events and functions, they are in the papers all the time," she said.
"The facilities make it easy for people to walk down the road and have a drink. The bars are right there. And the high level of income ... makes it even easier. The bars being around the beaches make it very easy to exercise then grab a drink. People live fully, but then they exercise a lot to try to balance out their drinking."
Even WA's most famous idylls have their dark side. Credit:Bohdan Warchomij
She said people in Cottesloe were "very conscious" of how they looked and how they were perceived.
"There is competition probably among females the most on how they look. There a bunch of girls in the area working out and partying all the time – living the high life, but countering that with the tradeoff," she said.
Australian Medical Association of WA GP spokesman Simon Torvaldsen said cholesterol depended on a combination of genetics and diet.
It was also linked to age, so he was unsurprised by the high rates in Cottesloe, an area people had to have amassed a "reasonable level of wealth" to move to.
Likewise, he associated the high levels of drinking with disposable income.
"And there are plenty of interesting statistics to show that the heavier drinkers are not always teenagers," he said.
"The 50-60 age group tend to drink more than young people. Alcohol consumption can be associated with high cholesterol, but it's also associated with obesity.
"So you might find there's a cohort of younger fitter active individuals, but also older, less fit, heavier drinkers. Fifty per cent having done some kind of activity in the preceding week could have just meant a walk to the shops."
He also cautioned that a low rate of cancer deaths also did not necessarily correspond to a lower rate of cancer.
People in affluent suburbs were well educated and probably made the most of good access to screening programs and treatments, so that cancer might - to Cottesloe residents - not always represent a death sentence.
Emma Young covers breaking news with a focus on science and environment, health and social justice for WAtoday.