Access to general practitioner services amongst underserved Australians: a microsimulation study

<p>Abstract</p> <p>Background</p> <p>One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia.</p> <p>Methods</p> <p>Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need.</p> <p>Results</p> <p>It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities.</p> <p>Conclusion</p> <p>Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services.</p

Health-care reform in Australia: advancing or side-stepping?

No Abstract

Nutrition in remote Aboriginal communities: Lessons from Mai Wiru and the Anangu Pitjantjatjara Yankunytjatjara Lands

© 2015 The Authors. Objective: To examine the impact of efforts to improve nutrition on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands from 1986, especially in Mai Wiru (good food) stores. Methods: Multiple methods were employed. Literature was searched systematically. In 2012, the store-turnover method quantified dietary intake of the five APY communities that have a Mai Wiru store. The price of a standard market basket of basic foods, implementation of store nutrition policy requirements and healthy food checklists were also assessed in all seven APY community stores at intervals from 2012. Results were compared with available data from 1986. Results: Despite concerted efforts and marked achievements, including decreased intake of sugar, increased availability and affordability of healthy foods (particularly fruit and vegetables) and consequent improvement in some nutrient intakes, the overall effect has been a decrease in total diet quality since 1986. This is characterised by increased supply and intake of discretionary foods high in saturated fat, added sugar and salt, particularly sugar sweetened beverages, convenience meals and take-away foods. Conclusions: The documented improvements confirm that residing in these communities can help Aboriginal residents exert control over key aspects of their food supply. However, the overall findings reflect broader changes to the general Australian food supply, and reinforce the notion that, in the absence of supportive regulation and market intervention, adequate and sustained resources are required to improve nutrition and prevent diet-related chronic disease on the APY Lands. Implications: This study also provides insights into food supply/security issues affecting other remote communities and wider Australia

Arthritis and the risk of falling into poverty: a survival analysis using Australian data

Objective: Low income is known to be associated with having arthritis. However, no longitudinal studies have documented the relationship between developing arthritis and falling into poverty. This paper focuses upon Australians who develop arthritis to determine if they have an elevated risk of falling into poverty.\ud \ud Methods: Survival analysis using Cox regression models applied to nationally representative, longitudinal survey data between the years 2007 and 2012 for Australian adults aged 21 years and over.\ud \ud Results: The hazard ratio for falling into income poverty for females who develop arthritis is 1.51 (95% CI: 1.50 – 1.53), and for males the hazard ratio for falling into income poverty is 1.22 (95% CI: 1.21 – 1.23), relative those who never developed arthritis. The hazard ratio for falling into multidimensional poverty for females who develop arthritis is 1.87 (95% CI: 1.84 – 1.90) and for males the hazard ratio is 1.29 (95% CI: 1.29 – 1.30).\ud \ud Conclusion: Developing arthritis increases the risk of falling into income poverty and multidimensional poverty. The risk for income and multidimensional poverty is higher for females. Given the high prevalence of arthritis, the condition is an overlooked driver of poverty