Use, access to, and impact of Medicare services for Australian women: findings from the Australian Longitudinal Study on Women’s Health

This major report from the Australian Longitudinal Study on Women’s Health (also known as Women’s Health Australia) adopts a life course approach to investigate changes in women’s health and health service use change across life stages. Women’s survey data were linked to Medicare Benefits Scheme (MBS) data, enabling analysis of women’s health, health behaviours and social circumstances over time, and how these relate to health care use at different life stages. Using these data, the report provides detailed information on how and when women use health services, and their costs, throughout the women’s life course

Anti-stigma interventions in low-income and middle-income countries: a systematic review

Background Stigma exacerbates power imbalances and societal disparities, significantly impacting diverse identities and health conditions, particularly for low and middle-income countries (LMICs). Though crucial for dismantling harmful stereotypes, and enhancing healthcare utilisation, existing research on anti-stigma interventions is limited with its condition-focused approach. We aimed to thoroughly evaluate peer-reviewed and non-peer-reviewed literature for a comprehensive review of anti-stigma interventions for diverse identities and all health conditions in LMICs. Methods This review systematically explored peer-reviewed and non-peer-reviewed literature, in ten electronic databases up to January 30, 2024, covering all anti-stigma interventions across various stigmatised identities and health conditions in LMICs. Quality assessment for this systematic review was conducted as per Cochrane Collaboration’s suggested inclusions. The review was registered with PROSPERO (Registration: 2017 CRD42017064283). Findings Systematic synthesis of the 192 included studies highlights regional imbalances, while providing valuable insights on robustness and reliability of anti-stigma research. Most studies used quasi-experimental design, and most centred on HIV/AIDS or mental health related stigma, with very little work on other issues. Certain high-population LMICs had no/little representation. Interpretation The interventions targeted diverse segments of populations and consequently yielded a multitude of stigma-related outcomes. However, despite the heterogeneity of studies, most reported positive outcomes underscoring the effectiveness of existing interventions to reduce stigma

Workforce participation patterns over the life course and the association with chronic diseases – a gendered approach

Research Doctorate - Doctor of Philosophy (PhD)‘Population ageing’ raises many challenges for governments, such as continued and prolonged workforce participation of men and women over their life course. This research aimed to i) identify and compare workforce participation patterns of men and women over the life course; ii) investigate the associations between workforce participation patterns, early life factors and adult life factors over the life course; iii) explore longitudinal associations between chronic diseases and workforce patterns, while considering the influence of various health and socio-demographic factors. Three different data sources – the ‘45 and Up Study’, the Australian ‘Life History and Health Survey’ and the ‘Australian Longitudinal Study on Women’s Health’ were used. Latent class analysis (LCA), LCA with classify-analyse approach, logistic regression and multinomial regression were used in five different studies to identify and explore patterns of workforce participation and its different associations over the life course, with a gendered perspective. Findings from the studies indicate that workforce participation patterns over the life course are very different for men and women. While men were found to be mostly engaged in full time paid work, women were more likely to work part time. Also, many men may decrease work after age 55, and many women had lower workforce participation over the life course. The work patterns of young women without children were very similar to men – majority working full time. Chronic diseases (diabetes, asthma, depression and arthritis) and other early and adult life factors were associated with work patterns. However, these associations varied by gender and also dependent on how men and women responded to their long term health issues and various circumstances affecting them over the life course. Therefore, it is important to consider the role of gender in shaping workforce patterns and their association with chronic diseases over the life course

Employment Status and Chronic Diseases: A Cross-sectional Study among 60-64 Year-old Men and Women

This study aims to investigate the association between chronic conditions [diabetes, asthma, and arthritis] and current employment status for men and women aged 60 – 64 years old. The study used the baseline data from the NSW 45 and Up Study, restricted to 41,754 participants aged 60 -64 years old. The participants were prioritized into mutually exclusive employment categories – full time employed, part time employed, self-employed, disabled/sick, and not in paid work. The association between current employment status and chronic conditions was evaluated separately for men and women, before and after adjustment for relevant groups of covariates [socio-demographic factors, health risk factors, and health capacity factors]. Current employment was associated with having a chronic disease, specifically diabetes, asthma, or arthritis. Participants who were not in paid work or disabled/sick were more likely to report chronic conditions; while having some form of paid employment was associated with decreased risk of having a chronic condition [diabetes or arthritis]. However, this effect diminished once socio-demographic conditions, health risk factors [smoking, BMI, alcohol] and health capacity factors [SF-36 physical function and needing help for daily tasks] were taken into account. There were significant associations between different employment patterns and chronic diseases [diabetes and arthritis]. Better understanding of these associations and related risk factors could inform policies and guidelines for preventing the decline in employment in males and females of pre-retirement age

Women, work, and illness: a longitudinal analysis of workforce participation patterns for women beyond middle age

Background: Labor policies and economic incentives encourage women to work beyond middle age. However, women exhibit complex patterns of workforce participation over this life stage. This study examined transitions in and out of paid work across the life course of middle-aged women over a 14-year period and investigated associations between work and chronic diseases. Methods: Latent class analysis identified dominant workforce participation patterns among 11,551 middle-aged women from the 1946-1951 birth cohort of Australian Longitudinal Study on Women's Health. Multinomial logistic regression examined associations between work patterns and chronic diseases (diabetes, asthma, depression, and arthritis), while adjusting for health risk factors, sociodemographic factors and competing activities. Results: Five latent classes were identified: "mostly in paid work" (48%), "early paid work" (9.4%), "increasingly paid work" (8.9%), "gradually not in paid work" (11.4%), and "mostly not in paid work" (22.3%). Results showed that women with chronic diseases (diabetes, asthma, depression, and arthritis) were less likely to be in paid work. These associations remained mostly unchanged after adjustments for other factors. Conclusions: The findings of this study provide better understanding of workforce participation patterns in women's late working life. This has important implications for policy design, aimed to engage middle-aged women in paid employment for longer in spite of chronic diseases and their complications. We suggest that there is a need for work place programs that support people with chronic diseases. Policies are also needed to facilitate better prevention and management of chronic health issues over the life course for women, in order to encourage workforce participation over later years

A gendered approach to workforce participation patterns over the life course for an Australian baby boom cohort

Population ageing and its future implications for governments and individuals have been central to much policy debate and research targeted to retain older people in the workforce. This study identified workforce participation patterns across the adult life course for women and men entering later life, and explored the influences of various early and adult life socio-demographic circumstances. Data were collected from 1261 men and women aged 60 to 64. years in the Life History and Health (LHH) Survey (a sub-study of the Sax Institute's 45 and Up Study, Australia) in 2010-11. LHH provides detailed information on personal histories of paid work, socio-economic resources from childhood (number of books and father's occupation) and adult life factors such as educational attainment, marital histories, childcare and informal caring. Latent class analysis (LCA) was undertaken to identify patterns of workforce participation for participants across their adult life. Significant gender differences were confirmed. Further analysis (LCA with covariates) showed that women who reported having books during childhood, and those who had post-school qualification, were more likely to have mostly been in paid work and less likely to have not been in paid work; while ever partnered women had significantly higher odds of increasing part time work over time. Men who had reported ever having had informal caring activities were likely to have had decreasing participation in paid work over time, and were highly likely to be not in paid work after 55. years. Ever partnered status was protective for being in paid work for men. These findings indicate the need for gender-specific policies and strategies to enable continued workforce participation throughout adult life and into later working years, particularly for people who had fewer social or economic opportunities earlier in life

Exploring workforce participation patterns and chronic diseases among middle-aged Australian men and women over the life course

Objective: This study identified associations between chronic diseases (diabetes, asthma, depression, and arthritis) and workforce participation patterns with a gendered perspective. Method: We used data from 1,261 middle-aged participants of the Australian Life Histories and Health (LHH) Survey, aged 60 to 64 years in 2011. Latent class analysis identified dominant workforce patterns and associations between chronic diseases and these patterns were explored by multinomial regression models. Results: Diabetes, asthma, depression, and arthritis were less prevalent in men and women in class "mostly full-time work," compared with other workforce patterns. The odds of "mostly full-time work" were lower for men reporting depression or arthritis, whereas among women, depression was associated with "increasing part-time work" after adjusting early and adult life factors. Discussion: The results strengthen the importance of gender focused policies aimed to promote and preserve health of young and middle-aged workers, and creating supportive environment for those with chronic health issues over the life course

Are custodial-based mothers and children's units evaluated, effective and aligned with a human rights-based approach? – A systematic review of the evidenceResearch in context

Summary: Background: Special considerations are warranted for incarcerated mothers and their children, as both experience substantial health and social disadvantage. Children residing in custodial settings are at risk of not having access to the equivalence of education, healthcare and socialisation commensurate to that of children living in the community. This systematic review describes the existing evidence regarding underpinning theories, accessibility, and the effectiveness of custody-based Mothers and children's units (M&Cs) globally. Methods: A systematic database search was conducted on May 1, 2023, of PsycINFO, Scopus, Sociology Ultimate and Web of Science (January 1, 2010, and May 1, 2023). Findings: Our systematic synthesis reveals evidence gaps related to best practice guidelines that align with a human right-based approach, and evaluations of the impact of the prison environment on mothers and their children. Interpretation: These findings support re-design of M&Cs using co-design to develop units that are evidence-based, robustly evaluated, and underpinned by the ‘best interest of the child’. Funding: This systematic review was conducted as part of a broader review into M&C programs commissioned and funded by Corrective Services NSW, Australia (CSNSW), a division of the Department of Communities and Justice, as part of the NSW Premier's Priority to Reduce Recidivism within the Women as Parents workstream. No funding was received for this review

Developing best practice principles for the provision of programs and services to people transitioning from custody to the community: study protocol for a modified Delphi consensus exercise

Introduction There is a lack of standard nomenclature and a limited understanding of programmes and services delivered to people in prisons as they transition into the community to support their integration and reduce reoffending related risk factors. The aim of this paper is to outline the protocol for a modified Delphi study designed to develop expert consensus on the nomenclature and best-practice principles of programmes and services for people transitioning from prison into the community.Methods and analysis An online, two-phase modified Delphi process will be conducted to develop an expert consensus on nomenclature and the best-practice principles for these programmes. In the preparatory phase, a questionnaire was developed comprising a list of potential best-practice statements identified from a systematic literature search. Subsequently, a heterogeneous sample of experts including service providers, Community and Justice Services, Not for Profits, First Nations stakeholders, those with lived experience, researchers and healthcare providers will participate in the consensus building phase (online survey rounds and online meeting) to achieve consensus on nomenclature and best-practice principles. Participants will indicate, via Likert scale, to what extent they agree with nomenclature and best-practice statements. If at least 80% of the experts agree to a term or statement (indicated via Likert scale), it will be included in a final list of nomenclature and best-practice statements. Statements will be excluded if 80% experts disagree. Nomenclature and statements not meeting positive or negative consensus will be explored in a facilitated online meeting. Approval from experts will be sought on the final list of nomenclature and best-practice statements.Ethics and dissemination Ethical approval has been received from the Justice Health and Forensic Mental Health Network Human Research Ethics Committee, the Aboriginal Health and Medical Research Council Human Research Ethics Committee, the Corrective Services New South Wales Ethics Committee and the University of Newcastle Human Research Ethics Committee. The results will be disseminated via peer-reviewed publication