This paper aimed to examine the utilisation of and preferences related to health care services by residents of a disadvantaged area and to identify factors associated with levels of current and future use. Data were collected from face-to-face structured interviews of randomly selected residents of a disadvantaged local government area in 2003-04. Information about respondents' health and socioeconomic status and patterns of use and preferred features of health care was analysed in PASW Statistic 17. Chi-square statistics were used to examine differences in utilisation by sex and simple logistic regression provided sex specific age-adjusted odds ratios about frequent visits. Most respondents (95%) attended a 'usual' general practitioner (GP) service and about two-fifths had obtained other health care in the last 12 months. The median number of visits was four and most providers offered bulk billing (83%). Less common were visits to the dentist (32%), emergency department (14%), specialists (29%) and the hospital (5%). Providers' skills and traits, physical access and bulk billing were key considerations for men and women when choosing a health care provider. Disadvantaged communities want skilled practitioners who reflect their demographic mix and are located at convenient and accessible clinics, which preferably bulk bill. Apart from GP visits, this group appears to make only moderate use of specialists and emergency departments, and little routine use of other primary health services.

Arthropods are the cause of considerable human morbidity. In spite of numerous text books and reviews published on arthropods of medical importance, this is the first paper in the world to present a comprehensive review of specimens sent to a medical entomology laboratory over an extended period. The Department of Medical Entomology at Westmead Hospital is the New South Wales reference laboratory for arthropods of medical importance. In the years 1988–2017, there were 5655 samples submitted for identification. Some 25 orders, 188 families and 177 different genera were recorded, with 170 unique species. The most common specimens included the Australian paralysis tick Ixodes holocyclus (708 specimens submitted), the bird mite Ornithonyssus bursa (506), bed bugs Cimex spp. (149), moth flies Clogmia spp. (135), head lice Pediculus capitis (105), pubic lice Pthirus pubis (91) and scabies Sarcoptes scabiei (57). In 1211 samples submitted, there was no evidence for any life stages of arthropods. For these common samples, data analysed included yearly and seasonal trends, female vs. male patient submissions and the age classes of the patients. Some species such as I. holocyclus, O. bursa, Cimex spp., Clogmia spp. and P. capitis demonstrated strong seasonal trends. In the case of the female vs. male patients, there were significant differences in submissions with O. bursa, P. capitis, P. pubis and with the samples containing no arthropod evidence. Of these, only with P. pubis did more males submit than females. Younger ages classes (<10 years) were more associated with I. holocyclus and P. capitis, older patients >70 years) with scabies, mature females (50–69 years) with samples containing no evidence of arthropods and middle‐aged adults (40–69) with the remainder of the common samples. Key diagnostic features are included for some of the more challenging arthropod species to distinguish and as well as case studies provided of situations involving unique or unusual infestations. The data provides useful information on the risks that arthropods of medical importance pose to the community and will refine educational programs.

The territory of a Local Health District (LHD) comprises multiple local government areas (LGAs). The recent amalgamation of several LGAs in metropolitan Sydney has resulted in two new LGAs being expanded across multiple LHDs, resulting in nonconcordance of boundaries. Here, we discuss the implications for planning health activities and service delivery, and ways to address them.