An increasingly ageing population, and projected changes in where some people will live in parts of Otago-Southland are among future challenges highlighted in the draft southern strategic health services plan.
The just-released draft plan notes that the Southern District Health Board served an estimated resident population of 308,600 in Otago-Southland.
And the board covered the largest geographical DHB area in the country, at more than 62,356sq km.
Overall life expectancy at birth in the district was 81 years, which was slightly lower than the national average (81.2 years).
Given the ''relatively low deprivation levels'' in the district, a better result might be expected, the plan document suggested.
Older people comprised a ''growing proportion'' of the Southern district population, with nearly 15% aged 65 and over.
This figure was expected to rise to 23.8% by 2031.
The district population was ''mainly European and slightly older than the national average'' and the district's ''average deprivation level'' was also lower than the national average.
Only 13% of the overall district population were in the ''most deprived'' group, well below the 20% national average.
Small pockets of high deprivation, such as in South Dunedin, Bluff and Mataura, were ''hidden'' by neighbouring areas that were less deprived.
The Southern district population grew 4% from 2006 to 2013, lower than the national average (6.2%).
And overall district population growth was expected to ''slow markedly'' between this year and 2031.
In contrast, the Otago Central and Queenstown areas were expected to grow significantly, with resident numbers rising by 23% and 30%, respectively, over the next 18 years.
Queenstown's population was expected to rise from 20,230 last year to 26,400 in 2031.
This shift would reflect ''potentially greater demand for health care services'' in these areas in the future.
By contrast, the populations of Gore, Waitaki, Southland and Invercargill were expected to fall.
A quarter of Otago-Southland adults (25.1%) in 2011-12 were estimated to be hazardous drinkers, significantly higher than the national average of 17%, and higher than any other of the large DHBs, the plan noted.
People from the Southern district replying to a national health survey had reported higher anxiety or depressive disorders than the national average: 8%, compared with 5.7% nationally.
Women in the district were almost twice as likely to be under psychological distress as males, ''putting them at higher risk''.
In the SDHB, 29.8% of all adults over 15 years were classified as obese, higher than the national average (28.4%).
Two-thirds of adults in the district reported meeting recommended physical exercise levels in 2011-12, much higher than the national average.
The Southern health system also faced a ''specific'' challenge with ''funding and delivering services to a large and sparsely populated geographic area'', the plan noted.
