Explaining Social Inequality In Population Oral Health Using A Multilevel Approach
Funder
National Health and Medical Research Council
Funding Amount
$103,500.00
Summary
Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also assoc ....Our preliminary research demonstrated a social gradient in the oral health of Australian adults. Adults who occupy higher positions on the social hierarchy experienced less disease and symptom experience, enhanced quality of life, and better self-rated oral health. Not only were associations made between social position and oral health, but a range of other factors such as personal control, social support, stress, life satisfaction, and workplace and childhood social environments were also associated with oral wellness. This work is new Australian research and is yet to be published. In an expansion of this project, we move from describing oral health inequalities and identifying their social determinants to provide a better understanding of pathways to population oral health. In doing so we shift the focus from the individual to the social context in which individuals live. We suggest that characteristics of social environments contribute independently to the variation in oral health outcomes accounted for by the characteristics of the residents themselves. In particular, we seek to demonstrate that social cohesion (the social integration, trust, and reciprocity within an area) influences conditions linked to oral health. Previous research has demonstrated variation in health according to area. Such studies are able to demonstrate a clustering of health, but are not able to distinguish whether observed social patterns in health reflect characteristics of residents or some feature of the area itself. Such conclusions require multilevel statistical models designed to separate individual effects from contextual effects while simultaneously examining interactions between both levels. Oral health is ideally suited as a proxy for general health because of the ubiquity of dental diseases, the broad utilisation of dental services within the population, and the shared risk factors between oral disease and a wide range chronic health conditions.Read moreRead less
Reducing Maternal Depression Two Years After Birth: Follow-up Of A Cohort Within A Community Randomised Trial
Funder
National Health and Medical Research Council
Funding Amount
$359,920.00
Summary
Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Suppo ....Maternal depression following childbirth is a significant public health issue. Previous Victorian research has found that 15-17% of women experience depression 6-9 months after birth, and of those depressed then, 30% are likely still to be depressed or depressed again two years after the birth. In 1998 16 Victorian municipalities began participating in the first ever community randomised trial of prevention and early intervention in depression - PRISM (Program of Resources, Information and Support for Mothers). PRISM involves eight areas participating in a range of primary care and community based strategies designed to mobilise appropriate community support for mothers and children with a view to reducing maternal depression and improving maternal physical health and recovery after birth. The other eight areas are participating as comparison communities. Evaluation in PRISM is assessing major health outcomes for mothers and wider community benefits (flow-on effects) of the intervention program. Process and impact evaluation has also been undertaken to document and assess the different program elements and enhance the reproducibility of the program if successful. All women giving birth in the 16 areas are currently being surveyed six months after birth (from August 2000-February 2002). Within PRISM it is now proposed to follow-up women again two years after birth, to assess the impact of the intervention program on: *recovery from depression among the group of mothers in both intervention and comparison areas who were depressed six months after birth; and *the overall prevalence of depression and physical ill-health in all mothers. This follow-up study has the capacity to provide infromation on the poorly documented natural history of maternal depression from birth through the next two years in a large sample, including both urban and rural residents.Read moreRead less
Contextual Influences On Children's And Adolescent's Physical Activity
Funder
National Health and Medical Research Council
Funding Amount
$440,950.00
Summary
Physical inactivity has been linked to several chronic health conditions among children and adolescents. However, there has been no research that has examined the long-term physical activity habits of Australian children and how these habits change as children move into adolescence. In addition, there is only limited information regarding the factors that influence children's physical activity. This study aims to examine changes in physical activity and sedentary behaviours, such as television v ....Physical inactivity has been linked to several chronic health conditions among children and adolescents. However, there has been no research that has examined the long-term physical activity habits of Australian children and how these habits change as children move into adolescence. In addition, there is only limited information regarding the factors that influence children's physical activity. This study aims to examine changes in physical activity and sedentary behaviours, such as television viewing and computer use, that occur over three years, and also over five years, among children aged 5-6 years and 10-12 years in 2001 (baseline). As such, this study will provide information about children's physical activity habits through primary school and from late primary school to the end of secondary school. The study will also examine the influence of the family and neighbourhood environment on changes that occur in physical activity and sedentary behaviour over that time. This study is significant because it will provide information on the critical transition period between primary and secondary school. The study will identify when changes in these health behaviours occur, the extent of these changes, and the influence of factors in the family environment and the local neighbourhood on changes in these behaviours. Such information is vital to inform the development of strategies to promote and maintain health-enhancing physical activity levels and reduce sedentariness among children.Read moreRead less
Case-control Studies Of Completed And Attempted Suicide In Young People In NSW
Funder
National Health and Medical Research Council
Funding Amount
$819,000.00
Summary
Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental fact ....Youth suicide rates have been increasing dramatically over the last three to four decades. The causes and determinants of these suicide rate changes remain unclear, as do the causes and determinants of the suicides themselves. Despite a range of risk factors being identified by researchers, predicting an individual suicide is difficult due to the range of factors involved and the complex interactions between them. This study will investigate associations between individual and environmental factors for both completed suicides and suicide attempts in young people aged 18-34 years living in NSW. The study will be undertaken in Sydney, Newcastle and in identified rural areas. The study is embedded in existing treatment, counselling and support services and will aid their improvement and augmentation. Cases of suicide and attempted suicide will be compared with community controls, and also completed suicides with attempted suicides, to identify potentially modifiable risk factors associated with suicidal behaviour. This will provide more comprehensive information relating to how various risk factors interact and influence suicidal behaviour, including in rural areas with significant Aboriginal and Torres Strait Islander communities. Information from this study will improve prevention initiatives and assist with community strategic development and provide evidence to enhance current health service and coronial interventions.Read moreRead less
A Prospective Study Of Health, Social And Forensic Outcomes In Young Offenders.
Funder
National Health and Medical Research Council
Funding Amount
$189,000.00
Summary
In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences ....In our environment of increasing illicit drug abuse and violent crime, there is an urgent need to gain an understanding of the forensic, health and social factors leading to offending by young people in Australia. Little research has been conducted worldwide looking at the health profile of young people offending across the entire spectrum of seriousness, and we could not find any studies examining this population in Australia. Most reports concern offenders who have received custodial sentences, the most serious end of the offending spectrum. Furthermore, overseas studies are of limited usefulness in the Australian context, as it is difficult to apply observations from communities where the social, ethnic and crime profile may be markedly dissimilar. We propose to interview 450 young people immediately after they obtain their first sentence, usually a community-based order. The problems we will ask about include depression and anxiety, heavy alcohol consumption, heavy use of cannabis and other illegal drugs, deliberate self harm, sexual risk taking behaviour and offending behaviour. We will also ask about the social circumstances, friends and family structure and support. We will then repeat this interview six months later. In addition, we will monitor the participants' compliance with their order, treatment programs they may be on and re-offending until the end of data collection. The study will give us the basis to examine continuity and inter-relationship between problems such as depression and substance abuse, social factors and continued offending. Further, the study will establish a framework to follow-up these young offenders in the medium and long-term. The development of this sound and thorough research program will provide a rational basis for the planning of preventative interventions, aimed at improving the health and welfare and at reducing recidivism in this marginalised and often disadvantaged group of young people.Read moreRead less
Determinants Of Area-level Inequalities In Colorectal Cancer Survival: A Multilevel Study
Funder
National Health and Medical Research Council
Funding Amount
$387,191.00
Summary
Survival times for people diagnosed with colorectal cancer depend on where people live; typically lower in rural and socio-economically disadvantaged areas. However we know very little about why these inequalities exist. This study, the first of its type in Australia, examines how much of the survival inequalities are due to the characteristics of individuals, and how much is due to the characteristics of the area itself. This will increase our capacity to intervene to reduce these inequalities