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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
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
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
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
RCT Of An Intervention To Improve The Health Of Adolescents With Intellectual Disability.
Funder
National Health and Medical Research Council
Funding Amount
$803,146.00
Summary
A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of ....A high number of people with intellectual disability die at a younger age than the general population - 5 to 20 years younger. The standard of their health is low compared with others. They experience high levels of unrecognised disease and do not receive health promotion or health screening. As they comprise 2.7% of our population (502,000 Australians) - this situation is unjust and should be rectified. The barriers to good health for them include communication difficulties, impaired recall of significant health information, negative social attitudes and inadequate training about disability for health service providers. This project is an attempt to minimise some of these barriers by examining the use of a Health Intervention Package. We want to give young people with intellectual disabilty the chance of similar health standards to the rest of the population. This package includes a comprehensive health review, a diary for collecting and storing health information, and advocacy training. We specifically want to examine if adolescents with intellectual disabilty using this package will receive better healthcare and improved health outcomes. We envisage that if successful, the intervention will establish good health practices for the rest of the young person's life. This group of young people is particularly at risk as they move from care provided by specialist paediatricians to accessing General Practitioners' services. To achieve this, the study will seek to recruit 1000 young people (and their parents and teachers) in Special Schools in Queensland. We have already shown that the comprehensive health review does improve health outcomes adults with intellectual disabilty, and the health information and advocacy training has received very positive evaluation. We now need to investigate the effect of both these processes in adolscence and establish if evidence exists to support wider implementation throughout the sector.Read moreRead less
Health Status And Development Among Aboriginal Infants In An Urban Community.
Funder
National Health and Medical Research Council
Funding Amount
$436,650.00
Summary
This research is a descriptive study of the health outcomes of Aboriginal infants, born at Campbelltown Hospital. The research will build on Centre for Health Equity's (CHETRE) work, since 1997, with the Aboriginal community, Aboriginal Medical Service (AMS) and Area Health Services (AHS) in the region to develop and advocate for services to address the needs of Aboriginal and other disadvantaged communities. CHETRE has supported the Aboriginal workers to develop additional services for Aborigin ....This research is a descriptive study of the health outcomes of Aboriginal infants, born at Campbelltown Hospital. The research will build on Centre for Health Equity's (CHETRE) work, since 1997, with the Aboriginal community, Aboriginal Medical Service (AMS) and Area Health Services (AHS) in the region to develop and advocate for services to address the needs of Aboriginal and other disadvantaged communities. CHETRE has supported the Aboriginal workers to develop additional services for Aboriginal women, such as the Aboriginal Home Visiting Team (AHV) and assisted with evaluation of these services. The AHV management comprises representatives from AMS, AHS, the Aboriginal community and CHETRE, and will provide advice and oversight for this project. The AHV developed from community concern about health status of Aboriginal infants and provides ante and postnatal care to infants and mothers. As a part of this service Aboriginal infants are systematically identified by the AHS. Further development of services is limited by lack of information on health status, use of health services, or achievement of developmental milestones by Aboriginal infants in an urban community and the assumption that outcomes are a factor of disadvantage. The researchers intend to describe in meticulous detail obstetric outcomes for 150 Aboriginal infants and their mothers born in 2004-5 and the health and development outcomes of the infants at 12 months. Baseline information on birth weight, Apgar score and obstetric history will be collected from maternal report at 2-3 week post-delivery and from routine data collections. Infants and their mothers will be followed up prospectively with further data collection points at 6 months and 12 months. Information on health status, health service use, and achievement of developmental milestones will be obtained by measurement and maternal report. An assessment by a paediatrician will be undertaken at 12 months.Read moreRead less