Emerging cancer incidence, mortality, hospitalisation and associated burden among Australian cancer patients, 1982 - 2014: an incidence-based approach in terms of trends, determinants and inequality

Objective Cancer is a leading killer worldwide, including Australia. Cancer diagnosis leads to a substantial burden on the individual, their family and society. The main aim of this study is to understand the trends, determinants and inequalities associated with cancer incidence, hospitalisation, mortality and its burden over the period 1982 to 2014 in Australia. Settings The study was conducted in Australia. Study design An incidence-based study design was used. Methods Data came from the publicly accessible Australian Institute of Health and Welfare database. This contained 2 784 148 registered cancer cases over the study period for all types of cancer. Erreygers' concentration index was used to examine the magnitude of socioeconomic inequality with regards to cancer outcomes. Furthermore, a generalised linear model was constructed to identify the influential factors on the overall burden of cancer. Results The results showed that cancer incidence (annual average percentage change, AAPC=1.33%), hospitalisation (AAPC=1.27%), cancer-related mortality (AAPC=0.76%) and burden of cancer (AAPC=0.84%) all increased significantly over the period. The same-day (AAPC=1.35%) and overnight (AAPC=1.19%) hospitalisation rates also showed an increasing trend. Further, the ratio (least-most advantaged economic resources ratio, LMR of mortality (M) and LMR of incidence (I)) was especially high for cervix (M/I=1.802), prostate (M/I=1.514), melanoma (M/I=1.325), non-Hodgkin's lymphoma (M/I=1.325) and breast (M/I=1.318), suggesting that survival inequality was most pronounced for these cancers. Socioeconomically disadvantaged people were more likely to bear an increasing cancer burden in terms of incidence, mortality and death. Conclusions Significant differences in the burden of cancer persist across socioeconomic strata in Australia. Policymakers should therefore introduce appropriate cancer policies to provide universal cancer care, which could reduce this burden by ensuring curable and preventive cancer care services are made available to all people

HIV/AIDS, growth and poverty in KwaZulu-Natal and South Africa: Integrating firm-level surveys with demographic and economywide modeling

"This paper estimates the economic impact of HIV/AIDS on KwaZulu-Natal (KZN) and the rest of South Africa (RSA). We extend previous studies by employing an integrated analytical framework that combines the following: firm-level surveys of workers' HIV prevalence by sector and occupation; a demographic model that produces both population and workforce projections; and a regionalized economywide model linked to a survey-based micro-simulation module. This framework permits a full macro-microeconomic assessment. The results indicate that HIV/AIDS greatly reduces annual economic growth, mainly by lowering the long-term rate of technical change. However, the impacts on income poverty are small, and inequality is reduced by HIV/AIDS. This is because high unemployment among low-income households minimizes the economic costs of increased mortality. In contrast, slower economic growth hurts higher-income households despite the lower prevalence of HIV among these households. We conclude that the increase in economic growth achieved through addressing HIV/AIDS is sufficient to offset the population pressure this move will place on income poverty. Moreover, incentives to mitigate HIV/AIDS lie not only with poorer infected households, but also with uninfected higher-income households. Our findings reveal that HIV/AIDS will place a substantial burden on future economic development in KZN and RSA, confirming the need for policies to curb the economic costs of this pandemic." from authors' abstractHIV/AIDS, Growth, Poverty, Development strategies, KwaZulu-Natal,

A comparative evaluation of two interventions for educator training in HIV/AIDS in South Africa

The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Life Skills Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators’ knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the selfefficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Life Skills Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks

The changing relationship between health burden and work disability of Australian cancer survivors, 2003–2017: Evidence from a longitudinal survey

Background The purpose of this study was to examine the relationship between the cancer health burden and the magnitude of work disability on cancer survivors in Australia from 2003 to 2017. Methods A longitudinal prospective study design was undertaken among cancer patients using data from the Household, Income and Labour Dynamics in Australia survey. The longitudinal effect was captured using a fixed effect multinomial logistic regression model, which predicted changes in the relationship between cancer burden and work disability level controlling for socio-demographic, lifestyle and life conditions predictors. Results The prevalence of long-term disability among cancer survivors was 50%, with 18% of patients experiencing extreme work disability. The magnitude of disability levels increased significantly with the level of health burden. Cancer survivors who faced a severe health burden were at 5.32 times significantly higher risk of having work disability compared with patients who had no health burden. Other potential predictors, such as older patients (relative risk ratio, RRR = 1.82; 95% CI: 1.57, 5.87), those engaged in lower levels of physical activities (RRR = 1.91; 95% CI: 1.07, 3.40), those who drink alcohol (RRR = 1.29; 95% CI: 1.15, 1.49), and poor socioeconomic status (RRR = 1.28; 95% CI: 1.16, 2.23) were all significantly associated with extreme work disability. Conclusion A substantial proportion of cancer survivors experienced work disability which was more pronounced with the magnitude of the cancer health burden. The different dimensions of disability might be prevented by introducing cancer survivor-specific evidence-based interventions, and incorporating comprehensive social support. Recommendations to improve public health policy aimed at reducing population-level unhealthy lifestyle behaviours include: using these findings to better outline the management of a sequelae course of treatment for cancer survivors; and identifying those who should undergo more intensive physical rehabilitation aimed at reducing their work disability level

HIV/AIDS, growth and poverty in KwaZulu-Natal and South Africa: an integrated survey, demographic and economy-wide analysis

Background: This paper estimates the economic impact of HIV/AIDS on the KwaZulu-Natal province and the rest of South Africa. Methods: We extended previous studies by employing: an integrated analytical framework that combined firm surveys of workers' HIV prevalence by sector and occupation; a demographic model that produced both population and workforce projections; and a regionalized economy-wide model linked to a survey-based micro-simulation module. This framework permits a full macromicroeconomic assessment. Results: Results indicate that HIV/AIDS greatly reduces annual economic growth, mainly by lowering the long-run rate of technical change. However, impacts on income poverty are small, and inequality is reduced by HIV/AIDS. This is because high unemployment among low-income households minimises the economic costs of increased mortality. By contrast, slower economic growth hurts higher income households despite lower HIV prevalence. Conclusion: We conclude that the increase in economic growth that results from addressing HIV/AIDS is sufficient to offset the population pressure placed on income poverty. Moreover, incentives to mitigate HIV/AIDS lie not only with poorer infected households, but also with uninfected higher income households. Our findings reveal the substantial burden that HIV/AIDS places on future economic development in KwaZulu-Natal and South Africa, and confirms the need for policies to curb the economic costs of the pandemi

South Africa's private sector investment in training and its erosion as a result of HIV and AIDS

South Africa’s economic prospects depend on the productivity of its labour, and productivity can only be maximised when the labour force possess the appropriate skills. Business is playing its part by offering training opportunities to employees. Collectively, they are spending more than the government’s mandated level on training. However, the HIV and AIDS epidemic is eroding this investment in southern Africa where the HIV epidemic is at its worst. While there has been empirical work that provides estimates on the cost of HIV and AIDS to business, there is very little data on the actual amounts large companies spend on training, and how much of this investment is eroded as a result of HIV and AIDS deaths. Using an estimate of the HIV and AIDS death rate in the private sector and survey data which identifies training expenditure by sector, the authors estimate the extent to which HIV and AIDS has potentially eroded this investment. The loss for all sectors was estimated at almost R10 million (R9,871,732) during the study year, which equates to USD1,183,661 per annum. This amount represented on average 0.73 per cent of the actual investment in training. The real costs of HIV and AIDS on business, which includes absenteeism, declining productivity and other costs are difficult to quantify, but they are likely to significantly exceed this lost training investment as a result of increasing morbidity and mortality rates due to HIV. It is therefore in a company’s best interest to: (1) ensure that a sound HIV and AIDS policy is in place; (2) invest in effective prevention programmes; and (3) provide the appropriate ARV treatment to infected employees if this treatment is not easily accessible through the public health sector

Estimating the relationship between grain crop consumption in Australia and environmental sustainability

The whole food system which involves agricultural production, food processing and packaging, distribution and retail as well as consumption requires inputs such as land, water, fertiliser, pesticides, herbicides and energy, which are responsible for environmental degradation. The main aim of this paper is to determine the size of the ecological footprint of grains consumption in Australia for evaluating the level of environmental sustainability. The ecological footprint methodology permits the monitoring of dominant threats to sustainability. One of the benefits of ecological footprint methodology is its capacity to distinguish between resources consumed and resources available and then reveal how ecologically sustainable those consumption patterns are. The study begins with an analysis of the ecological footprint of grain crops consumption, then analyses the biocapacity. The study concludes by making a comparison between ecological footprint and biocapacity and then assessing its sustainability of grain crops consumption. The paper uses both local and global yield data in terms of global hectare and local hectare respectively with inter-temporal time-series yield factors. This paper also uses production and consumption data on various grain crops. The refined method of determining the ecological footprint has provided a new assessment tool to gain insights into the environmental impacts of grain crops consumption. This method in this study had also highlighted the contribution of the EF as an indicator of environmental sustainability. Results indicate that the ecological footprint of grain consumption in Australia only exceeds biocapacity when the energy requirements of these crops are included in the evaluation. This study also reveals that that Australia’s grain consumption is unsustainable at the national scale, and still below the world-average ecological appropriation level. The size of the revealed ecological footprint are responsible for the amount of the grain consumption, energy inputs, the size of the population, the degree of carbon dioxide equivalent (CO2-e) gas emissions, and the amount of other farm inputs. This paper highlights the environmental significance of the ecological footprint of grain crops consumption in Australia. This paper also reinforces how intensely a sustainable future depends on the reshaping of the Australian grain industry. Finally, this paper discusses some of the implications of the method presented here for future footprint calculations and environmental sustainability. If Australia wants to shift to a smarter, more sustainable agricultural future; it must strive to shift to lower impact products and services, to increase the efficiency of the production through reducing energy inputs

Selection of private or public hospital care: examining the care-seeking behaviour of patients with private health insurance

Background This study aimed to examine the healthcare-seeking (hospital, primary and preventive care) and healthcare utilisation behaviour of patients with private health insurance (PHI) in Australia. It also aimed to examine the socioeconomic, demographic and lifestyle factors that influence the choice of hospital care in Australia. Method A logistic regression model with repeated measure t-test and Pearson’s Chi-square test were used to identify the factors that affect the choice of care. Data from waves 9 (2009) and 13 (2013) of the nationally-representative Household, Income and Labour Dynamics in Australia (HILDA) survey were used in the analysis. Results Patients with PHI had a higher number of hospital nights’ stay despite having a lower number of hospital admissions than those without private cover. Significant disparities were identified in preventive and specialist care use between patients with cover and without cover. No significant variations were observed in healthcare utilisation for PHI patients before and after dropping PHI. One in four patients chose to use public hospitals despite holding PHI cover. Moreover, those insured and from lower socioeconomic backgrounds and those who were younger and without long-term health conditions showed a higher probability of selecting public rather than private care. Conclusions It is evident that PHI cover encourages people to use private care. However, a considerable number of PHI patients are using public care, even though eligible for private care may indicate consumer information asymmetry

Assessing the determinants of rice farmers' adaptation strategies to climate change in Bangladesh

Purpose - This paper examines rice farmers' selection of adaptation strategies to cope with and offset the effects of climate change and the determinants of those selections in Rajshahi, a severely drought-prone district of Bangladesh. Design/methodology/approach - Farm level micro-data was obtained from 550 rice growers in the 2010-2011 farming season. A multinomial logit (MNL) model was utilised to assess the determinants of adaptation strategies practised by farmers in response to climate change. Findings - Results from the MNL model indicate that gender, age, education of household heads, household assets, annual farm income, farm size, tenure status, farmer-to-farmer extension, access to credit, access to subsidy, and access to electricity, all affect farmers' selection of adaptation strategies for climate change. Originality/value - This is the first study of its kind to analyse the determinants of adaptation strategies for climate change by farmers in drought-prone areas of Bangladesh. This study provides direction for policy makers in order to strengthen the adaptation strategies of farmers and guide policies accordingly. These strategies have the potential to minimise the adverse effects of climate change

Corporate social responsibility reporting of international oil companies in Nigeria:an historical materialism analysis

Purpose: This study aims to identify factors influencing corporate social responsibility reporting (CSRR) practices of international oil companies (IOCs) in Nigeria. It aims at distinguishing CSRR levels by examining both the quantity and quality of reporting. Design/methodology/approach: The paper analyses annual reports through content analysis. CSRR extent and type are measured by the number of sentences. CSRR are further classified into three subcategories according to whether they are negative, neutral or positive reports and then their proportions compared through descriptive analysis. Findings: For the extent and quality of CSRR, community was the most reported category. The majority of the total CSRR in the IOCs is positive with little evidence of negative news. None of the IOCs in the sample reported on the environment in their annual reports. Research limitations/implications: The measurement of CSRR focuses only on annual reports, without consideration of other reporting media such as standalone reports and corporate websites. CSRR are assumed to be voluntary for the companies and they may choose not to report any information in annual reports, as there are no regulations or reporting guidelines in Nigeria to be followed. Practical implications: The results reveal the absence of environmental reporting in the CSRR of IOCs in Nigeria suggests that they are less concerned with meeting local demands for accountability. The study recommends the need for regulatory intervention on the part of the Nigerian Government. Social implications: The findings of study indicate that predominant existence of positive CSRR news among all the IOCs suggests there’s an attempt to encourage stakeholders and the public to believe that they are conscious of society and the environment. Originality/value: The main contribution of this study lies in identifying the factors that have led to diversity and uniqueness in CSRR in IOCs. As such, this study seeks to contribute to the development of understanding multiple factors that could give rise to changing patterns of CSRR