Differences in health behaviours between immigrant and non-immigrant groups: a protocol for a systematic review

Health behaviours are important determinants of health and adoption of unhealthy behaviour is considered as one of the mechanisms through which immigrants\u27 health changes over time in the host country. The change in health behaviours over time can contribute either to improving or worsening the overall health status of immigrants. Despite being the important mediators for the change in overall health status and chronic health conditions, no previous review (either general or systematic) has examined differences in key health behaviours simultaneously between immigrants and non-immigrants. This study aims to provide a systematic overview of the current global literature on differences in key health behaviours (that is, tobacco smoking, physical activity and alcohol drinking) between immigrant and non-immigrant groups

Gender differences in self-reported health and psychological distress among New Zealand adults

Background: Previous research that examines gender differences in health does not rigorously assess the gender-related differential ‘exposure’ and differential ‘vulnerability’ hypotheses; i.e., does not try to identify the ‘direct’ (unmediated) effect of gender or quantify the relative importance of different risk factors for each gender. Objective: I test the hypothesis that gender differences in health (self-assessed health (SAH) and psychological distress (PD)) are due to indirect or mediating effects via socioeconomic and behavioural factors, and are not a direct effect of gender on health. Methods: Data (N = 18,030) from the third wave of the Survey of Family, Income and Employment (SoFIE) and multivariate logistic regression analyses are used to test gender differences in SAH and psychological distress. Results: The analyses show that women are less likely to report poor self-assessed health but more likely to report moderate-to-high psychological distress. Differential exposure of men and women to the determinants of health did not completely account for gender differences in health. Gender-specific differences in vulnerability were found only in the direct effects of age, and employment status. Conclusions: These results suggest that much, but not all, of the association between gender and health is mediated by socioeconomic factors. Contribution: This paper extends the literature on gender differences in health through a detailed empirical examination of the differential exposure of men and women to sociodemographic, socioeconomic, and health behaviour factors (i.e., indirect effects), and the differential vulnerability of women and men to this exposure (i.e., direct effects)

Migrants are healthier than the average Australian, so they can’t be a burden on the health system

[Extract] Developed economies, including Australia, have increasingly been using international migration to compensate for demographic trend and skill shortages. Australia has one of the highest proportion of overseas-born people in the world: an estimated 26% of the total resident population was born overseas. This is expected to increase over the next decade

Remote area nurses' experiences of workplace safety in very remote primary health clinics: A qualitative study

Aim: To explore Remote Area Nurses' experiences of the implementation of workplace health and safety policies and risk mitigation strategies in Australian very remote primary health clinics. Design: This qualitative study used online semi-structured interviews, with participants purposively sampled to maximize variation in work location and service type. Data were analysed using a reflexive thematic analysis approach. Coding was carried out inductively, with NVivo 12 aiding data management. Setting: The interviews were conducted from 24 Februrary 2021 to 06 March 2021 with Remote Area Nurses from very remote primary health clinics in Australia. Participants: Fifteen Remote Area Nurses participated in the study. Results: Thematic analysis revealed varied approaches to workplace safety among the different health services and regions. While the spread of ‘never alone’ policies in many clinics addressed one of the significant risks faced by Remote Area Nurses, gaps remained even for hazards specifically highlighted in existing work health and safety legislation. Meaningful collaboration with staff and the community, local orientation, preparation for the role and providing quality care were protective factors for staff safety. Understaffing, unsafe infrastructure and inadequate equipment were common concerns among Remote Area Nurses. Conclusion: Health services need to prioritize workplace safety and take a continuous quality improvement approach to its implementation. This will include ensuring safety strategies are appropriate for the local context, improving infrastructure maintenance, and establishing sustainable second responder systems such as a pool of drivers with local knowledge. Implications for the Profession: Poor personal safety contributes to burnout and high turnover of staff. Nurses' insights into the barriers and enablers of current workplace safety strategies will aid policymakers and employers in future improvements

Exploring the associations between the perception of water scarcity and support for alternative potable water sources

This study examines the association between the perception of water scarcity and support for alternative water sources in general, and specifically desalination and recycled water. It also examines the mediating role that perception of climate change has on the aforementioned association. A 46-item survey (n = 588) was conducted in the Geelong region of Australia. Logistic regression was used to determine the independent association between perceived water scarcity and socio-demographic factors, with support for alternative water sources, desalination and recycled water. 82% of respondents supported undefined 'alternative water sources'. However, support for specific alternatives was lower (desalination: 65%; recycled water: 40.3%). Perception of water scarcity was significantly associated with increased odds of support for alternative water sources (OR 1.94, 95% CI: 1.25-3.00) and support for recycled water (OR 2.32, 95% CI: 1.68-3.31). There was no significant relationship between perception of water scarcity and support for desalination (OR 0.959 95% CI: 0.677-1.358). Climate change was found to mediate perceived water scarcity and support for alternative sources (OR 1.360, 95% CI: 0.841-2.198). The mediation of the relationship between perceived water scarcity and support for recycled water by climate change was not strong. These results facilitate enhanced community engagement strategies

Is cost-related non-collection of ? Findings from a large-scale longitudinal study of New Zealand adults

Objective: To investigate whether cost-related noncollection of prescription medication is associated with a decline in health. Settings: New Zealand Survey of Family, Income and Employment (SoFIE)-Health. Participants: Data from 17 363 participants with at least two observations in three waves (2004-2005, 2006-2007, 2008-2009) of a panel study were analysed using fixed effects regression modelling. Primary outcome measures: Self-rated health (SRH), physical health (PCS) and mental health scores (MCS) were the health measures used in this study. Results: After adjusting for time-varying confounders, non-collection of prescription items was associated with a 0.11 (95% CI 0.07 to 0.15) unit worsening in SRH, a 1.00 (95% CI 0.61 to 1.40) unit decline in PCS and a 1.69 (95% CI 1.19 to 2.18) unit decline in MCS. The interaction of the main exposure with gender was significant for SRH and MCS. Non-collection of prescription items was associated with a decline in SRH of 0.18 (95% CI 0.11 to 0.25) units for males and 0.08 (95% CI 0.03 to 0.13) units for females, and a decrease in MCS of 2.55 (95% CI 1.67 to 3.42) and 1.29 (95% CI 0.70 to 1.89) units for males and females, respectively. The interaction of the main exposure with age was significant for SRH. For respondents aged 15-24 and 25-64 years, noncollection of prescription items was associated with a decline in SRH of 0.12 (95% CI 0.03 to 0.21) and 0.12 (95% CI 0.07 to 0.17) units, respectively, but for respondents aged 65 years and over, non-collection of prescription items had no significant effect on SRH. Conclusion: Our results show that those who do not collect prescription medications because of cost have an increased risk of a subsequent decline in health

Why patients attend emergency department for primary care type problems: views of healthcare providers working in a remote community

Introduction: Emergency department (ED) utilisation continues to increase, particularly for primary care presentations that do not require high level ED services. The reasons for this are complex, and research has focused on patient perspectives in choosing where to seek care rather than those of ED and general practitioner (GP) providers. This study aimed to address this gap by exploring the views of ED and GP providers regarding ED utilisation for primary care type health conditions in a small, remote Australian city with perhaps unique population demographics and service configuration. Methods: Service providers from the ED and general practice clinics were invited to participate in focus groups and semi-structured interviews exploring their views on ED utilisation for primary-care-type health presentations. The data were analysed using thematic content analysis. Results: In total, 24 healthcare providers (five GPs, seven ED practitioners, seven community nurse navigators, four Aboriginal and Torres Strait Islander Health Workers and one Indigenous Liaison Officer) participated in focus groups discussion and interviews. The analysis identified three themes: access and logistic barriers, rational decision-making and self-perceived urgency. While there was some overlap in the healthcare providers’ perceptions, there were also strong differences between ED and GP groups. In particular, the ED group believed that GP services are less accessible for urgent appointments, whereas GPs believed that such arrangements were in place. Both groups agreed on the need for clear communication between the ED and general practice. Conclusion: ED and GP providers demonstrate similarities and differences in understanding patients’ reasons for choosing which service to access. The differences may stem from ED providers’ focus on offering a rapid resolution of acute presentations and GP providers’ focus on offering comprehensive and continuing care. Effective communication between general practice and the ED services and clearer referral pathways may help in reducing ED utilisation for less urgent primary-care-type problems