Cohort Profile: The Australian Longitudinal Study of Ageing (ALSA)

In response to the expressed need for more sophisticated and multidisciplinary data concerning ageing of the Australian population, the Australian Longitudinal Study of Ageing (ALSA) was established some two decades ago in Adelaide, South Australia. At Baseline in 1992, 2087 participants living in the community or in residential care (ranging in age from 65 to 103 years) were interviewed in their place of residence (1031 or 49% women), including 565 couples. By 2013, 12 Waves had been completed; both face-to-face and telephone personal interviews were conducted. Data collected included self-reports of demographic details, health, depression, morbid conditions, hospitalization, gross mobility, physical performance, activities of daily living, lifestyle activities, social resources, exercise, education and income. Objective performance data for physical and cognitive function were also collected. The ALSA data are held at the Flinders Centre for Ageing Studies, Flinders University. Procedures for data access, information on collaborations, publications and other details can be found at [http://flinders.edu.au/sabs/fcas/].Australian Research Council ARC (DP0879152 and 130100428; LP669272 and 100200413

Developing a screening tool to recognise social determinants of health in Australian clinical settings

© 2018 Browne-Yung et al. This article is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms. See: www.creativecommons.org/licenses/by-nc-sa/4.0/Objective and importance of study: The importance of social determinants for individual health recovery outcomes is well recognised in public health. However, no succinct social health screening (SHS) tool exists that has beendeveloped with information from clinicians and patients. This proof-of-concept study asked health consumer advocates, patients and clinicians about their attitudes towards social determinants of health (SDH) and the usefulness of an SHS tool for collecting these data for use in clinical settings. We then developed a streamlined SHS tool to bring this knowledge to clinicians, and conducted a proof-of-concept trial to check its acceptability with patients and clinicians. Methods: This qualitative study had two stages. Stage 1 involved focus groups with health consumer advocates and interviews with clinicians about the draft SHS tool. Stage 2 involved refining the SHS tool and piloting it with 50 new patients in anxiety disorder and sleep disorder clinics, which often treat patients living in disadvantaged socio-economic conditions. The tool was evaluated by patients and clinicians. The data were analysed using framework analysis. Results: All interviewees were positive about the benefits of addressing SDH in clinical practice to help reduce health inequities. We developed and refined an SHS tool that could be completed by patients (‘self-complete’). Conclusion: The response to introducing an SHS tool in clinical settings was positive. Further piloting across diverse clinical settings is required to determine efficacy. This tool promotes public health equity outcomes by improving clinician understanding of individual social circumstances, and has the potential to provide useful epidemiological data on SDH

Creating political will for action on health equity: practical lessons for public health policy actors

Background Despite growing evidence on the social determinants of health and health equity, political action has not been commensurate. Little is known about how political will operates to enact pro-equity policies or not. This paper examines how political will for pro-health equity policies is created through analysis of public policy in multiple sectors. Methods Eight case studies were undertaken of Australian policies where action was either taken or proposed on health equity or where the policy seemed contrary to such action. Telephone or face-to-face interviews were conducted with 192 state and non-state participants. Analysis of the cases was done through thematic analysis and triangulated with document analysis. Results Our case studies covered: trade agreements, primary healthcare (PHC), work conditions, digital access, urban planning, social welfare and Indigenous health. The extent of political will for pro-equity policies depended on the strength of path dependency, electoral concerns, political philosophy, the strength of economic and biomedical framings, whether elite interests were threatened and the success or otherwise of civil society lobbying. Conclusion Public health policy actors may create political will through: determining how path dependency that exacerbates health inequities can be broken, working with sympathetic political forces committed to fairness; framing policy options in a way that makes them more likely to be adopted, outlining factors to consider in challenging the interests of elites, and considering the extent to which civil society will work in favour of equitable policies. A shift in norms is required to stress equity and the right to health.This research was funded by the Australian National Health & Medical Research Council Centre for Research Excellence Grant APP107804

Facilitating research participation of low income individuals in contrasting socio‐economic neighbourhoods

This article appeared in a journal published by Wiley-Blackwell. Under Wiley's copyright, mandated authors are not permitted to make work available in an institutional repository.No abstract is available for this article.Australian National Health & Medical Research Counci

'Faking til you make it': Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing

This article appeared in Social Science and Medicine, published by Elsevier Ltd. Under Elsevier's copyright, mandated authors are not permitted to make work available in an institutional repository.People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 individuals living in contrasting socio-economic areas and in-depth interviews with a new sample of 24 individuals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between individuals' varying resources of economic, social and cultural capital. This included an examination of individual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an individual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of ‘low income’ as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee access to potentially beneficial social networks.NHMRC ARC This research was supported by a National Health and Medical Research Council grants (22913 & 974009) and the Australian Research Council through the Federation Fellowship (FF0883216) of Prof Fran Baum

Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings.

This article appeared in a journal published by Elsevier Ltd. Under Elsevier's copyright, mandated authors are not permitted to make work available in an institutional repository.This project was funded by the Australian National Health and Medical Research Council (NHMRC, Project grant 324725) and the Australian Cooperative Research Centre for Aboriginal Health (Project SD 142). It was also supported by NHMRC project grant 324724, Prof Baum's Australian Research Council (ARC) Federation Fellowship and Dr Ziersch's ARC Future Fellowship