Point Piper may be Sydney’s most prestigious postcode, but when it comes to health opportunities, Pennant Hills has the edge.

That’s according to a new study comparing Sydney’s 569 suburbs based on 10 factors that either help or hinder a healthy lifestyle, including walkability, open space, access to hospitals, alcohol and fast food.

With high scores across most indicators, suburbs north of the harbour bridge reign supreme, according to the study authored by Deloitte Access Economics and Tract Consultants.

More concerning is the clear divide of health opportunities between the east and west, raising questions over the adequacy of Sydney’s planning and the creep of urban sprawl.

Overall Suburb Health 5 Stars (Healthiest) 4.5 Stars 4 Stars 3.5 Stars 3 Stars 2.5 Stars 2 Stars 1.5 Stars 1 Star 0.5 Stars

Domain Healthy Sydney co-author and senior principal planner at Tract Consultants Adam Terrill said the study “shines a light on why some places are more healthy than others”.

“This is not to say that you can’t lead a healthy lifestyle in a suburb deemed unhealthy, just that its urban environment makes it harder for residents to do this,” he said. “It measures the potential of a suburb to provide a healthy lifestyle, but it doesn’t tell us about the actual health characteristics of the people who live in that suburb.”

The study assigned a star rating to each suburb, with 32 achieving five stars. Alongside Pennant Hills, North Epping also scored top marks, thanks to open space and tree cover, a low density of fast food outlets, good access to hospitals and a high volunteering rate, which was adopted as a metric for social connectivity.

Macquarie Park outperformed popular Bondi and Bronte by a long shot, ranking better for access to allied health services, fresh food, open space and tree cover, with residents also more likely to walk or ride a bike as part of their commute.

Roseville, Mosman and Mount Kuring-Gai were top of the list. They did not score well for active transport, but ranked highly for access to open space, volunteering, tree cover, access to health services and had a low density of fast food and bottle shops. Among the most affluent suburbs to score top marks were Tamarama, Darling Point, Watson Bay and Lavender Bay.

While no suburbs in western or south Sydney scored five stars, major centres such as Liverpool and Parramatta performed strongly. Experts say the challenge is extending opportunities to the suburbs between.

Although limiting urban sprawl and increasing density was flagged by experts as a key way to improve health opportunities, Planning Minister Anthony Roberts told Domain that Sydney needed to have a diversity of housing stock — hence continued development on the city’s fringes.

“People want and continue to purchase properties [on the outskirts of Sydney],” he said, but noted a rebalancing of Sydney around three centres — the CBD, Parramatta and Western Sydney airport — would allow people to live closer to where they work, and reduce sprawl.

Suburbs with the lowest scores were overwhelmingly in the city’s west and south west, with Glendenning, Blackett and West Hoxton among the bottom performers.

“It does mirror the socio-economic map of Sydney,” said Professor Susan Thompson, from the University of NSW’s City Futures Research Centre. “While Sydney’s western suburbs may be more affordable … they’re not cheap in terms of the long commute and the problems that means for health.”

“[The divide] also mirrors where we’ve got a lot of new residential sites, where there has been a tendency to cut all the trees down because that’s the easiest, quickest and presumably most efficient way to build houses, but ultimately it’s not efficient … it’s causing all these health problems which, as a community, we have to pay for.”

It wasn’t all bad news for people on the fringe of greater Sydney. Despite being 72 kilometres from the CBD, Springwood in the Blue Mountains scored top marks for open space and tree cover, and high scores for volunteering and access to health services. It ranked higher than the likes of Kirribilli, Cremorne Point and Vaucluse.

Co-author Daniel Terrill said improving infrastructure to facilitate active transport was key to improving health outcomes.

“Sometimes it isn’t about more infrastructure, but using what we have in better ways, or being smarter in how we use it to encourage use,” he said. “For example, fixing gaps in an otherwise continuous cycling or running path can be a cost effective way to drastically increase use across an entire network.”

Mr Roberts said that in previous decades there had been a lack of masterplanning or focus on liveability, which had impacted things like the provision of public open space. He said new communities were being designed with the health of residents in mind, while a lack of adequate open space in existing neighbourhoods was being addressed with new strategic plans by local councils.

“Health is critical, it’s about delivering communities where we recognise as a government now, that just as infrastructure such as roads, footpaths and transport are critical, so is open space and liveability.”

The study is not without limitations — for one, the large backyards enjoyed in Point Piper (which scored 2.5 stars) do not count towards public open space — and the complexities of how the built environment impacts mental health is hard to measure.

“Social indicators that influence mental-health outcomes are important but notoriously difficult to measure, such as feelings of community and belonging,” said Tract’s Mr Terrill.