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

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

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

\u27Everybody has settled in so well\u27: How migrants make connections and build social capital in Geelong

Australian and Victorian Government policies encourage settlement&nbsp;in regional areas for international migrants, refugees and internal&nbsp;migrants. Migrants to regional areas are diverse in terms of their&nbsp;area or country of origin, skills and occupation, family status&nbsp;and other demographic characteristics. The regional cities to&nbsp;which they migrate are also varied in terms of their community&nbsp;resources, social and cultural capital. The objective shared by all&nbsp;of these cities is for migrants to engage successfully with their&nbsp;new communities. Just how this occurs is the subject of debate&nbsp;and a lack of clarity. This therefore calls for a sound, theoretically&nbsp;informed understanding of how employers and community groups&nbsp;(formal and informal) can effectively assist migrants to make&nbsp;social connections in regional cities, and practical strategies which&nbsp;respond to these insights. The well-established social determinants&nbsp;of health tell us that the more socially included, connected and&nbsp;stable workforce and their families are, the better will be their&nbsp;physical and mental health and wellbeing.People in Australia generally move to live near family and friends;&nbsp;for better access to work or work opportunities; or to live in an&nbsp;attractive neighbourhood. Policies and programs intended to assist&nbsp;with settlement tend to be short term and project based. Good&nbsp;practice in assisting migrants make social connections however&nbsp;is long term and embedded into the community. Workplaces and&nbsp;community groups that are already established, and groups that&nbsp;migrants or others tend to form naturally, are good examples of&nbsp;such best practice. Workplaces, local government, institutions&nbsp;such as schools, community spaces and other organisations can&nbsp;also assist in the settling in process and can complement formal&nbsp;and informal community groups, once a sound evidence base is&nbsp;established.This is the second paper to emerge from a research project&nbsp;running over 2011-2012 at the Alfred Deakin Research Institute&nbsp;(ADRI), Deakin University in Geelong. The first Working Paper&nbsp;(No. 32) (Jackson et al., 2012) located the research theoretically.&nbsp;This second Working Paper will report on the research itself,&nbsp;its methods and outcomes as well as policy implications. The&nbsp;first section of this paper will briefly outline the project before&nbsp;considering those who have migrated to Geelong in the past two&nbsp;to five years: to investigate why they moved to Geelong; how&nbsp;they made connections and with whom; and, what was the value&nbsp;of those connections (Section 2). The third section of the paper&nbsp;examines how employers, non-government organisations (NGOs)&nbsp;and other facilitators effectively assist migrants to make social&nbsp;connections. The fourth and fifth sections look at the barriers to&nbsp;making connections but also those things &ndash; organisation and&nbsp;policies - that facilitated settling in. Section six summarises the&nbsp;findings and makes a series of policy recommendations for&nbsp;individuals, organisations and government on how to better the&nbsp;prospects for migrant in regional centres.</div

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

Global variation in hand hygiene practices among adolescents: the role of family and school-level factors

While appropriate hand hygiene practices (HHP) are protective against infections, the paucity of evidence on global estimates and determinants of HHP in adolescents limits effective design and planning of intervention to improve HHP in young people. We examined the prevalence and correlates of HHP in adolescents. We used nationally representative data from the Global School-based Student Health Survey (2003–2017) from 92 countries. HHP were categorized as “appropriate”, “inappropriate” and “lacking” based on the information about “hand washing before eating”, “hand washing after using the toilet”, and “hand washing with soap”. Multinomial logistic regression analyses were used to assess the role of socio-demographic, health, lifestyle, school, and family-related variables in HHP. Among 354,422 adolescents (13–17 years), only 30.3% were found to practice appropriate hand hygiene. Multivariable models suggest that sedentary behavior (adjusted relative risk ratio (ARRR) 1.41, 95% CI 1.31–1.51)), and bullying victimization (ARRR 1.20, 95% CI 1.10–1.30) promoted inappropriate HHP. In contrast, parental supervision (ARRR 0.55, 95% CI 0.50–0.59) and parental bonding (ARRR 0.81, 95% CI 0.75–0.87) were protective against inappropriate HHP. From a policy perspective, hand hygiene promotion policies and programs should focus on both school (bullying, exercise) and family-level factors (parental supervision and parental bonding) factors