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A Multilevel Study Of Socioeconomic Position And Physical Activity: Environmental And Individual-level Determinants
Funder
National Health and Medical Research Council
Funding Amount
$429,000.00
Summary
Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited ....Regular physical activity offers many health benefits, whereas inadequate activity is a leading cause of premature death and disability and a major contributor to the increasing prevalence of overweight and obesity. Socioeconomically disadvantaged groups are least likely to be physically active, and they experience higher rates of death and morbidity for conditions directly linked to inactivity. Currently, our understanding of why socioeconomic groups differ in their physical activity is limited, and very little research has investigated this issue. This study will investigate why socioeconomic groups differ in their physical activity, by examining the influence of neighbourhood and individual-level factors. Neighbourhood factors include people's access to recreational facilities such as swimming pools, tennis courts, golf clubs, gyms, local parks, walking and bicycle paths; prices for entry to recreational facilities and opening hours; physical characteristics of the neighbourhood including public transport, presence of footpaths and street lighting, speed limits on local streets, availability of local services such as shops and schools, and; aesthetic characteristics, such as the presence and size of parks and green spaces, and traffic density. Individual factors include personal enjoyment, knowledge, confidence, type of occupation and hours worked, family responsibilities, age, health status, and whether other family member or friends engage in physical activity. A major aim of the study is to determine whether environmental or individual factors are more important in influencing participation in physical activity. The study will produce new knowledge to inform future public health strategies directed at increasing physical activity among socioeconomically disadvantaged groups, and these will have the potential to reduce socioeconomic health inequalities, as well as contribute to an overall reduction of the disease burden attributable to chronic conditions.Read moreRead less
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
Identifying And Prioritising Points For Intervention To Reduce Cardiovascular Disease Inequalities In Australia
Funder
National Health and Medical Research Council
Funding Amount
$550,669.00
Summary
This project investigates inequalities in cardiovascular disease risk, incidence, healthcare and outcomes, focussing on socio-economic status, rurality, mental health and Aboriginality. It will work with partner organisations and use a range of data sources - including representative population data, clinical datasets, large scale linked data and qualitative data - to better understand variation in cardiovascular disease, to reduce inequalities and improve outcomes.
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
Allostatic Mediators Of Socioeconomic Inequalities In Periodontitis Among Australian Adults
Funder
National Health and Medical Research Council
Funding Amount
$368,000.00
Summary
Periodontal (gum) disease is a significant cause of tooth loss among adults in Australia. Bacteria (germs) that stick to teeth in dental plaque are the primary cause of gum disease. However, the amount of damage caused to the gums depends heavily on the body's immune system which fights infection throughout the body. Like many other health conditions, gum disease occurs at a higher rate in people in a relatively low socioeconomic-position (SEP) compared to people from high SEP. Studies of other ....Periodontal (gum) disease is a significant cause of tooth loss among adults in Australia. Bacteria (germs) that stick to teeth in dental plaque are the primary cause of gum disease. However, the amount of damage caused to the gums depends heavily on the body's immune system which fights infection throughout the body. Like many other health conditions, gum disease occurs at a higher rate in people in a relatively low socioeconomic-position (SEP) compared to people from high SEP. Studies of other health conditions have shown that psychosocial stress (eg. job strain, financial stress) disproportionately affects people in low SEP groups. Stress, in turn, is known to alter the body's defense mechanisms, including the immune system, contributing to higher rates of conditions such as heart disease. Researchers have used the term allostatic load to describe this failure of the body's defense system under stress. Stress has also been suggested as a contributing factor in gum disease. This study will investigate whether this sequence of events producing allostatic load also plays a role in gum disease. We will study a random sample of 610 Australian adults from the full range of SEP backgrounds. We will ask them about their experience of daily stress, and measure their levels of gum disease and dental plaque. We will also collect samples of fluid from around their gums to measure quantities of two chemicals that indicate the activity of immune defense mechanisms in the gums. We will analyze these results to determine whether stress affects the body's responses to dental plaque, and whether that response accounts for differences in levels of gum disease between SEP groups. Results from this study will pinpoint the role of common bodily defense mechanisms in the development of gum disease. These results may help to identify sources of stress that, if controlled, could reduce rates of gum disease and other conditions affected by allostatic load.Read moreRead less
Factors Contributing To Socioeconomic Gradients In Children's Oral Health Between 1993 And 2003
Funder
National Health and Medical Research Council
Funding Amount
$79,532.00
Summary
The NHMRC and the Australian National Oral Health Plan have identified health inequalities as a critical health issue. Dental caries in children increasingly has become concentrated in disadvantaged population groups. While previous studies have documented socioeconomic gradients in oral health, few have sought to explain the reasons underlying those inequalities. By taking advantage of two existing datasets of child oral health in Australia, collected in 1992 and 2002, we will be able to quanti ....The NHMRC and the Australian National Oral Health Plan have identified health inequalities as a critical health issue. Dental caries in children increasingly has become concentrated in disadvantaged population groups. While previous studies have documented socioeconomic gradients in oral health, few have sought to explain the reasons underlying those inequalities. By taking advantage of two existing datasets of child oral health in Australia, collected in 1992 and 2002, we will be able to quantify change in socioeconomic inequalities in oral health, and identify population-wide exposures to preventive practices and social circumstances that may have contributed to that change.Read moreRead less
A Multi-level Study Of Socioeconomic Status And Healthy Food Purchasing Behaviour
Funder
National Health and Medical Research Council
Funding Amount
$173,492.00
Summary
Socioeconomically disadvantaged groups have the highest rates of death and ill-health for diet-related diseases (eg. coronary heart disease, some cancers). Our understanding of the dietary practices which may contribute to these outcomes, however, is limited. This project focuses on this issue by examining the relationship between socioeconomic status and food purchasing behaviour. Studies investigating this relationship have found that disadvantaged social groups are least likely to purchase fo ....Socioeconomically disadvantaged groups have the highest rates of death and ill-health for diet-related diseases (eg. coronary heart disease, some cancers). Our understanding of the dietary practices which may contribute to these outcomes, however, is limited. This project focuses on this issue by examining the relationship between socioeconomic status and food purchasing behaviour. Studies investigating this relationship have found that disadvantaged social groups are least likely to purchase foods which are important for long-term health. The reasons for this association, however, remain unclear. Research into the general determinants of food purchasing behaviour shows that food choices are influenced by the intra-personal characteristics of individuals (eg. knowledge and beliefs), interactions between individuals sharing the same context (eg. relations between parents and children), economic and material factors (eg. income, access to a car) and features of the wider physical environment (eg. availability of healthy food and public transport). What is clear from this evidence, is that food choice is influenced by factors which operate at multiple levels. This project aims to collect data simultaneously from each level, and determine whether (and to what extent) factors operating at each level differentially influence the food purchasing behaviours of socioeconomic groups. This study (i) will contribute to our understanding of why socioeconomic groups differ in their health status, (ii) is consistent with the goals and recommendations of numerous government reports, each of which calls for a a reduction in health inequalities, (iii) represents a methodological advance on previous research, and (iv) will generate the information necessary to develop innovative and appropriately targeted health promotion and health education campaigns.Read moreRead less
Mortality, Morbidity And Income Inequality In Australia
Funder
National Health and Medical Research Council
Funding Amount
$232,175.00
Summary
Evidence has been accumulating for some time indicates that an individual's life expectancy is affected by their socioeconomic circumstances. In general, it appears that people with higher incomes tend to live longer. More recently, some evidence has suggested that life expectancy is affected not only by a person's income level but also by their relative position in the income distribution. Some studies have found that, when income is more unequally distributed, mortality rates tend to be higher ....Evidence has been accumulating for some time indicates that an individual's life expectancy is affected by their socioeconomic circumstances. In general, it appears that people with higher incomes tend to live longer. More recently, some evidence has suggested that life expectancy is affected not only by a person's income level but also by their relative position in the income distribution. Some studies have found that, when income is more unequally distributed, mortality rates tend to be higher and life expectancy lower. Several explanations for this association have been advanced. One is that the association is a statistical artifact. Another is social-psychological, arguing that a sense of relative deprivation and social exclusion increases susceptibility to a variety of conditions. A third explanation is couched in terms of social capital, a term that refers to various forms of participation in voluntary organisations which strengthen community life. A fourth argues that it is material deprivation that is the underlying cause - income inequality is found in communities characterised by lower levels of provision of social infrastructure such as schools, libraries, and health services. The main purpose of this research project is to investigate the association between morbidity, mortality, income, and income inequality in Australia. The project will attempt to find which of the several explanations just discussed are supported by Australian evidence. The results of the project will enhance our understanding of the relationship between socioeconomic status and health, and will have implications for the design of different policies aimed at ameliorating the effects of income inequality on health.Read moreRead less
The Role Of Health In Poverty Entrenchment: A New Measure Of Long-term Multidimensional Poverty For Australia
Funder
National Health and Medical Research Council
Funding Amount
$365,562.00
Summary
I am a health economist focused on exploring the disadvantage produced when individuals develop a health condition. This project will initially create a new multidimensional measure of long term poverty. It will then use this measure to look at how different health conditions affect the experience of long term poverty.
Identifying Social Pathways To Enhanced Life Outcomes In Aboriginal And Torres Strait Islander Children
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
This fellowship broadly aims to elucidate the social pathways to good and poor physical and mental health outcomes in Aboriginal and Torres Strait Islander children in Australia. This will identify the most salient social factors that drive ill health, disease and mortality, and improve population health strategies that aim to prevent poor health outcomes in early life. In doing so, I hope to support policies that can increase the pace of change toward health equity in Australia.