ORCID Profile
0000-0001-6600-2568
Current Organisation
Flinders University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Policy and Administration | Urban And Regional Studies | Urban and Regional Planning not elsewhere classified | Labour Economics | Public Health And Health Services Not Elsewhere Classified | Health and Community Services | Public Policy | Health Policy | Urban Policy | Public Health and Health Services not elsewhere classified | Social Theory |
ANZSRC Socio-Economic Objective (SEO)
Social Structure and Health | The distribution of wealth | Changing work patterns | Public Health (excl. Specific Population Health) not elsewhere classified | Expanding Knowledge through Studies of Human Society | Other social development and community services | Health and Support Services not elsewhere classified | Political science and public policy | Social structure and health | Health status (e.g. indicators of “well-being”) | Regional planning
Related Links
Publications
Interagency collaboration in primary mental health care: lessons from the Partners in Recovery program
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Involvement in civil society groups: Is it good for your health?
Publisher: BMJ
Date: 06-2004
Abstract: To determine the involvement in civil society groups (CSGs) and the impact of this on health. Case study, cross sectional, self completion questionnaire, and semi-structured interviews. Residents in two suburbs in Adelaide, South Australia. Every household (1038) received a questionnaire asking the adult with the next birthday to complete it. A total of 530 questionnaires were returned. Sixteen questionnaire respondents were also interviewed. 279 (53%) questionnaire respondents had been involved in a CSG in the past 12 months, 190 (36%) in locally based CSGs, and 188 (35%) in CSGs outside the area. Eleven of the 16 interviewees had been involved in a CSG. A path analysis examined the relation between demographic variables, CSG involvement, and mental and physical health, as measured by the SF-12. Physical health was negatively associated with CSG involvement and older age, and positively associated with working full time or part time and higher education level. Mental health was positively associated with older age, working full time or part time, and higher income but negatively associated with having a child under 18, speaking a language other than English and higher education level. Very few interviewees made a direct link between CSGs and positive in idual health outcomes, though some positive community level outcomes were noted. More consistent were reports of the detrimental effects of CSG involvement on mental and physical health. Involvement in CSGs was significant but not always positive for health. It is possible that CSG involvement is good for a community but not necessarily for the in idual.
Precarious employment, psychosocial working conditions, and health: Cross‐sectional associations in a population‐based sample of working Australians
Publisher: Wiley
Date: 28-02-2013
DOI: 10.1002/AJIM.22176
Abstract: Precarious employment has been associated with poor health, but the potential mechanisms are unclear. We examined the relationships between precarious employment and health, and investigated psychosocial working conditions as potential mediators. A cross-sectional population-based survey was conducted in South Australia in 2009 (N = 1,016 employed). SF-12 measures of mental and physical health were modeled using logistic regression in relation to employment arrangement, controlling for socio-demographics, years in job and psychosocial working conditions. There was no association between casual full-time or part-time employment and poor mental health in multivariate analyses. Conversely, there was a significant association between casual full-time employment and poor physical health (compared to permanent full-time workers, OR = 3.14, 95% CI 1.26-7.85). The association with physical health was unaffected by adjustment for psychosocial working conditions. Casual full-time employment was strongly associated with poor physical health but not with poor mental health. This association was not mediated by the psychosocial working conditions measured in this study, but may be related to other (unmeasured) working conditions.
HIV prevention and sexual health services for sex workers in the UK
Publisher: SAGE Publications
Date: 03-2001
DOI: 10.1177/001789690106000104
Abstract: Background Sex workers were targeted for HIV prevention work from the mid-1980s and budgets were allocated for services and projects with a specific component of HIV prevention. We look at changing trends in service provision in the UK during the 1990s. Methods Two surveys of services for sex workers were conducted: one in 1995 and the other in 1999. We documented different approaches to health promotion through questionnaire and telephone interview at these two points in time, as well as associated funding and support. Results Eighty-one services were identified in 1995 and 124 in 1999. There was an increase in services for young people and those based in genitourinary medicine clinics. Most services conducted outreach and shared a common approach to health promotion, based on harm minimisation. Funding did not change significantly and the major source of support continued to be local health authorities. Conclusion Despite the fact that sex workers are no longer a general priority for HIV prevention work, services have proved to be surprisingly resilient. Projects have developed a holistic approach, linking community intervention to specific health promotion, a model that may prove useful for new government initiatives in relation to health inequalities and social exclusion.
Public housing renewal and social determinants of health
Publisher: Informa UK Limited
Date: 11-08-2016
DOI: 10.1080/10852352.2016.1197715
Abstract: This article draws on the concept of residential context of housing and its relationship to health. It considers a bundle of changes through implementation of a housing renewal initiative as part of the Carlton Housing Estate Upgrading Project in Melbourne, Australia. Beyond the quality and appropriateness of the housing, pertinent factors explored include social networks, safety and security, and green open space. Data collection for the research project included in-depth interviews with public housing tenants, private residents, and service providers who live on and service the estate, as well as neighborhood observations and participation in on-site events. A key finding was that the relational processes of how tenants were related to by others-specifically, the way housing was reallocated during the processes of renewal-affected social housing tenants' self-perceived health and well-being.
I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia
Publisher: Springer Science and Business Media LLC
Date: 08-08-2008
‘Faking til you make it’: Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.SOCSCIMED.2013.02.026
Abstract: People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 in iduals living in contrasting socio-economic areas and in-depth interviews with a new s le of 24 in iduals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between in iduals' varying resources of economic, social and cultural capital. This included an examination of in idual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an in idual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of 'low income' as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee access to potentially beneficial social networks.
A qualitative study of the interactions among the psychosocial work environment and family, community and services for workers with low mental health
Publisher: Springer Science and Business Media LLC
Date: 03-09-2013
On and off the field: a Bourdieuian perspective on the significance of sport to urban Aboriginal Australians
Publisher: Informa UK Limited
Date: 12-2014
Neighbourhood ‘Social Infrastructure’ for Health: The Role of Social Capital, Fear of Crime and Area Reputation
Publisher: Elsevier
Date: 2011
General Motor Holden's closure in Playford, South Australia: Analysis of the policy response and its implications for health
Publisher: Wiley
Date: 20-06-2019
Policy environments and job loss: Lived experience of retrenched Australian automotive workers
Publisher: SAGE Publications
Date: 06-09-2013
Abstract: Job loss has negative consequences for health and evidence shows that the agency of workers experiencing job loss is affected by labour market and welfare policy. The policy environment into which workers emerge after losing their jobs strongly influences the way job loss and its aftermath is experienced. This article draws on findings from two waves of in-depth semi-structured interviews with 33 retrenched South Australian automotive workers. It discusses how, within the context of Australian welfare and industrial policy, workers experienced the consequences of mass job losses that occurred at Mitsubishi Motors during 2004 and 2005. Key findings include largely negative experiences associated with negotiating welfare-to-work policy, and a more precarious employment environment further entrenched under industrial relations policy. Job loss is both a personal and a structural story and we use an agency and structure perspective to examine how workers’ agency was enabled, but more often constrained, by policy.
Lessons from medicare locals for primary health networks
Publisher: AMPCo
Date: 07-2017
DOI: 10.5694/MJA16.00720
Housing in Place: Housing, Neighbourhood and Resettlement for People from Refugee and Asylum Seeker Backgrounds in Australia
Publisher: Springer Science and Business Media LLC
Date: 24-02-2023
DOI: 10.1007/S12134-023-01008-W
Abstract: Housing is an important part of building a new life for people from refugee and asylum seeker backgrounds. However, relatively little is known about how housing and neighbourhood experiences affect resettlement and integration. This paper explored experiences of housing and neighbourhood for refugees and asylum seekers in South Australia, Australia. A survey was completed by 423 participants, recruited through service providers, community networks and snowball s ling. Data was analysed using frequencies, chi-square analyses and multivariate logistic regression. The study identified aspects of housing and neighbourhood that were important to participants, as well as highlighting key problems. Housing satisfaction and neighbourhood satisfaction were positively associated, but housing satisfaction was lower than neighbourhood satisfaction. Both were significantly associated with overall satisfaction with life in Australia, although only neighbourhood satisfaction remained significant in the final multivariate model (alongside region of origin, visa and financial situation). Overall, the findings suggest that where housing is situated may be more important for resettlement satisfaction and integration than the housing itself. Policy and practice implications of the findings are discussed, alongside considerations for conceptualising integration.
The ‘Seven deadly sins’ of rejected papers
Publisher: Elsevier BV
Date: 02-2016
Perceptions of Neighbourhood Disorder and Reputation: Qualitative Findings from Two Contrasting Areas of an Australian City
Publisher: Informa UK Limited
Date: 15-08-2011
The Role of Schools in Identifying and Referring Refugee Background Young People Who Are Experiencing Mental Health Issues
Publisher: Wiley
Date: 20-12-2020
DOI: 10.1111/JOSH.12862
Abstract: Refugee background young people are at increased risk of mental health problems. In countries of refugee resettlement, schools are important sites where mental health difficulties can be identified and service access facilitated however, little is known about how best to support these practices within schools. This article explores school and mental health service providers' perspectives on mental health challenges and referral pathways for refugee youth in South Australia. It draws on semi-structured in-depth interviews with 17 secondary school staff and 10 mental health service providers, which were analyzed thematically. Key challenges for school staff in identifying mental health issues were understanding behaviors, overcoming stigma, cultural and linguistic barriers, engaging with parents, staff preparation and training, and embeddedness within Western understandings of mental health. There was also limited awareness of appropriate mental health services and referral pathways. Service providers recognized schools' key role in identifying mental health issues for refugee students. Enhanced training and support is required for teachers to identify and refer students who might be experiencing mental health issues. "On-site" school services, bi-cultural workers, and increased knowledge of existing within-school supports and referral pathways to external services would enhance outcomes for refugee students.
Facilitating research participation of low income individuals in contrasting socio‐economic neighbourhoods
Publisher: Elsevier BV
Date: 08-2012
Regional primary health care organisations and migrant and refugee health: the importance of prioritisation, funding, collaboration and engagement
Publisher: Elsevier BV
Date: 04-2020
Workplace bullying a risk for permanent employees
Publisher: Elsevier BV
Date: 04-2012
DOI: 10.1111/J.1753-6405.2011.00780.X
Abstract: We tested the hypothesis that the risk of experiencing workplace bullying was greater for those employed on casual contracts compared to permanent or ongoing employees. A cross-sectional population-based telephone survey was conducted in South Australia in 2009. Employment arrangements were classified by self-report into four categories: permanent, casual, fixed-term and self-employed. Self-report of workplace bullying was modelled using multiple logistic regression in relation to employment arrangement, controlling for sex, age, working hours, years in job, occupational skill level, marital status and a proxy for socioeconomic status. Workplace bullying was reported by 174 respondents (15.2%). Risk of workplace bullying was higher for being in a professional occupation, having a university education and being separated, orced or widowed, but did not vary significantly by sex, age or job tenure. In adjusted multivariate logistic regression models, casual workers were significantly less likely than workers on permanent or fixed-term contracts to report bullying. Those separated, orced or widowed had higher odds of reporting bullying than married, de facto or never-married workers. Contrary to expectation, workplace bullying was more often reported by permanent than casual employees. It may represent an exposure pathway not previously linked with the more idealised permanent employment arrangement. A finer understanding of psycho-social hazards across all employment arrangements is needed, with equal attention to the hazards associated with permanent as well as casual employment.
Australian Aboriginal Urban Residents’ Satisfaction with Living in Their Neighbourhood: Perceptions of the Neighbourhood Socio-cultural Environment and Individual Socio-demographic Factors
Publisher: SAGE Publications
Date: 19-12-2011
Abstract: This paper draws on survey data from 143 Aboriginal participants living in Adelaide, South Australia, to examine factors associated with Australian Aboriginal urban residents’ satisfaction with living in their neighbourhoods. Associations were examined between neighbourhood satisfaction, in idual socio-demographic measures and perceptions of the neighbourhood socio-cultural environment (including experiences of racism in the neighbourhood, perceived tolerance in the neighbourhood, perceived neighbourhood cohesion, trust in other neighbourhood residents and perceived neighbourhood safety). Staged multivariate logistic regression models led to a final model where trust in people in the neighbourhood and perceived safety in the neighbourhood were significant predictors of neighbourhood satisfaction. Experience of racism in the neighbourhood was a significant predictor in earlier steps in the model, but did not remain significant. Understanding factors contributing towards Aboriginal residents’ satisfaction with living in neighbourhoods is important in informing neighbourhood-based policies and programmes to enhance the well-being of Aboriginal residents in Australian cities.
Inequalities in social capital and health between people with and without disabilities
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.SOCSCIMED.2014.12.009
Abstract: The poor mental and physical health of people with disabilities has been well documented and there is evidence to suggest that inequalities in health between people with and without disabilities may be at least partly explained by the socioeconomic disadvantage (e.g. low education, unemployment) experienced by people with disabilities. Although there are fewer studies documenting inequalities in social capital, the evidence suggests that people with disabilities are also disadvantaged in this regard. We drew on Bourdieu's conceptualisation of social capital as the resources that flow to in iduals from their membership of social networks. Using data from the General Social Survey 2010 of 15,028 adults living in private dwellings across non-remote areas of Australia, we measured social capital across three domains: informal networks (contact with family and friends) formal networks (group membership and contacts in influential organisations) and social support (financial, practical and emotional). We compared levels of social capital and self-rated health for people with and without disabilities and for people with different types of impairments (sensory and speech, physical, psychological and intellectual). Further, we assessed whether differences in levels of social capital contributed to inequalities in health between people with and without disabilities. We found that people with disabilities were worse off than people without disabilities in regard to informal and formal networks, social support and self-rated health status, and that inequalities were greatest for people with intellectual and psychological impairments. Differences in social capital did not explain the association between disability and health. These findings underscore the importance of developing social policies which promote the inclusion of people with disabilities, according to the varying needs of people with different impairments types. Given the changing policy environment, ongoing monitoring of the living circumstances of people with disabilities, including disaggregation of data by impairment type, is critical.
Service providers' views of community participation at six Australian primary healthcare services: Scope for empowerment and challenges to implementation
Publisher: Wiley
Date: 30-04-2016
DOI: 10.1002/HPM.2253
Abstract: Community participation is a key principle of comprehensive primary health care (PHC). There is little literature on how community participation is implemented at Australian PHC services. As part of a wider study conducted in partnership with five South Australian PHC services, and one Aboriginal community controlled health service in the Northern Territory, 68 staff, manager, regional health executives, and departmental funders were interviewed about community participation, perceived benefits, and factors that influenced implementation. Additional data were collected through analysis of policy documents, service reports on activity, and a web-based survey completed by 130 staff. A variety of community participation strategies was reported, ranging from consultation and participation as a means to improve service quality and acceptability, to substantive and structural participation strategies with an emphasis on empowerment. The Aboriginal community controlled health service in our study reported the most comprehensive community participation. Respondents from all services were positive about the benefits of participation but reported that efforts to involve service users had to compete with a centrally directed model of care emphasising in idual treatment services, particularly at state-managed services. More empowering substantive and structural participation strategies were less common than consultation or participation used to achieve prescribed goals. The most commonly reported barriers to community participation were budget and lack of flexibility in service delivery. The current central control of the state-managed services needs to be replaced with more local management decision making if empowering community participation is to be strengthened and embedded more effectively in the culture of services.
Commissioning and equity in primary care in Australia: Views from Primary Health Networks
Publisher: Hindawi Limited
Date: 12-06-2018
DOI: 10.1111/HSC.12464
Abstract: This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks (PHNs) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHNs which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services. This paper addresses perceptions of 23 senior staff, 11 board members and 21 members of clinical and community advisory councils or health priority groups from six case study PHNs on the impact of commissioning on equity. Participants view the collection of population health data as facilitating service access through redistributing services on the basis of need and through bringing objectivity to decision-making about services. Conversely, participants question the impact of the political and geographical context and population profile on capacity to improve service access and equity through service commissioning. Service delivery was seen as fragmented, the model is at odds with the manner in which Aboriginal Community Controlled Health Organisations (ACCHOs) operate and rural regions lack services to commission. As a consequence, reliance upon commissioning of services may not be appropriate for the Australian primary healthcare context.
Health implications of access to social capital: findings from an Australian study
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.SOCSCIMED.2005.01.015
Abstract: This paper considers the health implications of access to social capital (SC) using data from a survey of households in two suburbs in Adelaide, Australia. SC was conceptualised as comprising 'infrastructure'--the networks and values that facilitate access to resources and 'resources'--the resources available through this infrastructure. Questionnaires were delivered to all households in the area, asking the adult with the next birthday to complete it. In all, 530 (50%) were returned. A partial least-squares path analysis was undertaken using demographic, SC and health latent variables, and a measure of perceived relative advantage. Three infrastructure (values, formal networks and informal networks) and four resource (help, acceptance by neighbours, civic activities and feelings of control) variables were considered. Mental and physical health were measured using the SF-12. The values variable was associated with all the resource variables, the informal networks variable was related to help, and the formal networks variable was associated with civic actions. There were significant sociodemographic differences in a number of the infrastructure and resource variables, as well as mental and physical health. Those who were better off materially also had greater access to elements of SC, and reported better health. Values, informal networks, help, and control were all directly or indirectly positively associated with better mental health. No SC variables were associated with physical health. Perceived relative advantage was positively associated with a number of SC variables and also mental and physical health. The implications for health promotion are discussed.
Who participates? Socioeconomic Factors Associated with Women's Participation in Voluntary Groups
Publisher: Wiley
Date: 09-2008
Understanding oral health help‐seeking among Middle Eastern refugees and asylum seekers in Australia: An exploratory study
Publisher: Wiley
Date: 04-03-2020
DOI: 10.1111/CDOE.12524
Relapse into Undernutrition in a Nutritional Program in HIV Care and the Impact of Food Insecurity: A Mixed-Methods Study in Tigray Region, Ethiopia
Publisher: MDPI AG
Date: 16-01-2021
Abstract: The relapse into undernutrition after nutritional recovery among those enrolled in a nutritional program is a common challenge of nutritional programs in HIV care settings, but there is little evidence on the determinants of the relapse. Nutritional programs in HIV care settings in many countries are not well designed to sustain the gains obtained from enrolment in a nutritional program. This study examined relapse into undernutrition and associated factors among people living with HIV in the Tigray region of Ethiopia. The study employed a mixed-methods approach, involving quantitative and qualitative studies. Among those who graduated from the nutritional program, 18% of adults and 7% of children relapsed into undernutrition. The mean time to relapse for adults was 68.5 months (95% CI, 67.0–69.9). Various sociodemographic, clinical, and nutritional characteristics were associated with a relapse into undernutrition. A considerable proportion of adults and children relapsed after nutritional recovery. Food insecurity and poor socioeconomic status were a common experience among those enrolled in the nutritional program. Hence, nutritional programs should design strategies to sustain the nutritional gains of those enrolled in the nutritional programs and address the food insecurity which was reported as one of the contributors to relapse into undernutrition among the program participants.
Conducting Ethical Research with People from Asylum Seeker and Refugee Backgrounds
Publisher: Springer Singapore
Date: 2019
Health and wellbeing impacts of experiences of public spaces for young people from refugee backgrounds in Australia
Publisher: Elsevier BV
Date: 12-2023
Social capital and health in rural and urban communities in South Australia
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1111/J.1753-6405.2009.00332.X
Abstract: This paper seeks to compare the relationships between social capital and health for rural and urban residents of South Australia. Using data from a South Australian telephone survey of 2,013 respondents (1,402 urban and 611 rural), separate path analyses for the rural and urban s les were used to compare the relationships between six social capital measures, six demographic variables, and mental and physical health (measured by the SF-12). Higher levels of networks, civic participation and cohesion were reported in rural areas. Education and income were consistently linked with social capital variables for both rural and urban participants, with those on higher incomes and with higher educational achievement having higher levels of social capital. However, there were also differences between the rural and urban groups in some of the other predictors of social capital variables. Mental health was better among rural participants, but there was no significant difference for physical health. Social capital was associated with good mental health for both urban and rural participants, but with physical health only for urban participants. Higher levels of social capital were significantly associated with better mental health for both urban and rural participants, but with better physical health only for urban participants. The study found that social capital and its relationship to health differed for participants in rural and urban areas, and that there were also differences between the areas in associations with socioeconomic variables. Policies aiming to strengthen social capital in order to promote health need to be designed for specific settings and particular communities within these.
STI prevention and the male sex industry in London: evaluating a pilot peer education programme
Publisher: BMJ
Date: 12-2000
DOI: 10.1136/STI.76.6.447
Abstract: To evaluate the effectiveness of a pilot peer education STI prevention programme with male sex workers. A process and outcome evaluation of the pilot programme undertaken in three London male escort agencies, using a quasi-experimental design. Workers in three London escort agencies, including 88 who completed a questionnaire, five peer educators, and a further 16 men (including management) working in two of these agencies. A peer education STI prevention programme run by the Working Men Project (WMP), a specialist sexual health service for male sex workers, was piloted in two London escort agencies. Five male sex workers participated in a 2 day peer education training programme. They then returned to their respective agencies to disseminate information and condoms, in an attempt to influence norms of behaviour. An outcome evaluation aimed to assess changes in STI related knowledge, high risk sexual behaviour, and attendance at a sexual health service. A pre-intervention questionnaire assessing variables such as STI related knowledge, sexual behaviour, and demographic information was administered in both agency A and agency B and a third agency, C, which acted as a control. Ten weeks after the peer educators returned to their agencies, the same questionnaire was administered in the same agencies. Peer educator referrals to the WMP were also recorded over this time period. The process evaluation involved interviews and focus groups with peer educators, and the completion of diaries about their experiences in the role. A further 16 men working in the agencies (including managers and an owner) were interviewed about their experience of the programme. Participant observation was also undertaken through regular outreach work to the agencies. 57 men completed the questionnaire at time 1 and 44 at time 2. Unfortunately, only 13 of these were matched, precluding any meaningful analysis of change in STI related knowledge and sexual behaviour. The questionnaire provided a profile of the men working in the agencies. Of the 88 men who completed the questionnaire at least once, the majority were homosexual, and in their late teens/early 20s. Most were of a "white" ethnic group, though there was some range within these categories. Most preferred to speak English and education levels were high. Relative STI knowledge revealed a high understanding of HIV and hepatitis B, moderate understanding of gonorrhoea, syphilis, genital warts and herpes, and little knowledge of non-specific urethritis (NSU) or chlamydia. Sexual behaviour suggested a highly sexually active population with both male and female paying and non-paying partners. Condom use was highest for paying partners, particularly for anal sex. Condom use for oral sex with all partners was less consistent, and condom use for all types of sex with regular partners was lower than with other partners. The small number of men engaging in vaginal sex with paying and regular partners were less likely to use condoms. 26 new patients registered at the WMP as a result of peer educator referrals, representing 65% of all new contacts over the study period. The process evaluation revealed that while the training programme was considered adequate and while peer educators felt the programme and their roles to be a success, their experience of the role was difficult. The role of management support was crucial in supporting the programme. The assumption that "peers" are particularly effective educators was not borne out by the results. While peers were considered suitable to discuss some aspects of the industry, many preferred to consult "professionals" about health related matters. The concept of "peers" was problematic with most of the men drawing "peers" from subgroups within the agencies. Other constraints on behaviour such as a lack of power, particularly with regard to a lack of management support, or poverty, had a substantial impact on behaviour which were not influenced by the peer educators. The study illustrated the difficulties of utilising quasi-experimental evaluation methodology with this client group. It also demonstrated the limitations of peer education based on information provision health education models which focus on in idual behaviour change. Suggestions are given for future interventions.
Deindustrialising economies, plant closures and affected communities: Identifying potential pathways to health inequities
Publisher: Wiley
Date: 15-12-2022
DOI: 10.1002/HPJA.564
Abstract: Deindustrialisation and transitions from traditional manufacturing to new technologies and service industries in many high‐income countries including Australia has resulted in rising employment insecurity, unemployment and increased income and health inequities. In this paper, we explore potential impacts of an automotive plant closure on health in a disadvantaged area of South Australia. Our aim was to examine how prevailing factors affecting social and health inequity might be further affected following the plant closure and to identify levers for potential policy responses. In workshop discussions with 28 policy and 14 community stakeholders through an iterative process participants discussed how existing factors contributing to community social and health inequity might be worsened (or remediated) by the looming economic shock from the plant closure. We identified eight key themes highlighted in the workshops. In particular local economic investment, availability of job opportunities, and appropriate training were identified as key factors influencing in idual financial security, which was in turn linked to social and health impacts. The pathways mapped between the plant closure and social and health equity impacts highlighted differential potential impacts on in iduals and the community, and identified policy levers to reduce adverse health outcomes resulting from economic shocks such as the closure of a major employer. The study highlighted a broad range of intersecting factors affecting the health of the local community that policy responses to the plant closure needed to address to promote health and health equity. This included novel factors identified by community members, reinforcing the importance of including community perspectives when constructing policy responses.
FKRP-dependent glycosylation of fibronectin regulates muscle pathology in muscular dystrophy
Publisher: Springer Science and Business Media LLC
Date: 19-05-2021
DOI: 10.1038/S41467-021-23217-6
Abstract: The muscular dystrophies encompass a broad range of pathologies with varied clinical outcomes. In the case of patients carrying defects in fukutin-related protein (FKRP), these erse pathologies arise from mutations within the same gene. This is surprising as FKRP is a glycosyltransferase, whose only identified function is to transfer ribitol-5-phosphate to α-dystroglycan (α-DG). Although this modification is critical for extracellular matrix attachment, α-DG’s glycosylation status relates poorly to disease severity, suggesting the existence of unidentified FKRP targets. Here we reveal that FKRP directs sialylation of fibronectin, a process essential for collagen recruitment to the muscle basement membrane. Thus, our results reveal that FKRP simultaneously regulates the two major muscle-ECM linkages essential for fibre survival, and establishes a new disease axis for the muscular dystrophies.
Case study of a decolonising Aboriginal community controlled comprehensive primary health care response to alcohol‐related harm
Publisher: Elsevier BV
Date: 12-2019
Abstract: This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches. Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities b) 29 interviews with staff and board members c) six interviews with advocacy partners and d) community assessment workshops with 13 service users. The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people's control, providing culturally safe services, addressing racism, and advocating to government and industry. This case study provides an ex le of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.
Neighbourhood, Disorder, Safety and Reputation and the Built Environment: Perceptions of Low Income Individuals and Relevance for Health
Publisher: Informa UK Limited
Date: 02-01-2016
Education across the life-course and hypertension in adults from Southern Brazil
Publisher: FapUNIFESP (SciELO)
Date: 08-2020
DOI: 10.1590/1413-81232020258.31152018
Abstract: Abstract The present study examines the association between life-course socioeconomic position (SEP) and hypertension (SAH), focusing on the health impacts of childhood SEP (SEPc), adult SEP (SEPa), as well as SEP mobility. Data from the Brazilian EpiFloripa Cohort Study (n = 1,720 56% women 55% = 30 years) were analyzed. SAH was determined by the average of two measures of systolic and diastolic blood pressure, previous medical diagnosis or use of anti-hypertensive medication (43% of the s le was hypertensive). The main independent variables were: SEPa – participants’ level of education SEPc – parental educational attainment and SEP mobility – the socio-economic trajectories from SEPc to SEPa. Five logistic regressions models were adjusted for sex, age or income, and were compared among each other. High SEPa was associated with a 37% reduction in the odds of SAH compared to low SEPa. High SEP over the life course was associated with 34-37% lower odds of SAH compared to persistent low SEP. Mobility models explained more of the outcome variance than the sensitive period model. The results reinforce the importance of education in the risk of SAH and the relevance of a socioeconomic mobility approach for the analysis of social inequalities in health.
Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study
Publisher: Springer Science and Business Media LLC
Date: 13-11-2020
DOI: 10.1186/S12889-020-09724-Z
Abstract: There has been a recent focus on resettlement of migrants and refugee in rural settings in Australia and elsewhere. Rural resettlement is seen as an opportunity to revitalise rural communities, to fill the needs of employers in these areas, and to provide a welcoming community within which new arrivals can integrate and settle. However, challenges to rural resettlement have been identified including difficulties securing employment, discrimination and social isolation. These challenges can affect resettlement outcomes including health and wellbeing, though relatively little research has examined these links. In this paper we explored experiences of people from refugee background settling in a rural Australian town, examining interconnections between social determinants of health (SDH) and integration. Face-to-face interviews were conducted with 44 participants from Southeast Asia and Africa in a rural setting in South Australia, covering experiences of resettlement and impacts on health and wellbeing. Participants were recruited through existing connections within the community and snowball s ling. Audio recorded data were transcribed verbatim and analysed using framework thematic analysis. The study findings revealed a mixture of settlement experiences for participants across a range of elements of SDH and integration. A sense of safety and some elements of social connectedness and support were key enablers for integration and health and wellbeing, with main challenges including limitations in employment opportunities, mismatched education provision, experiences of discrimination and constrained access to services. Challenges experienced by refugees resettled in rural areas can affect integration, health and wellbeing and subsequent onward migration intentions. Attention to broader socioeconomic, cultural and environmental conditions, alongside tailored settlement support policies and practices for in idual rural resettlement sites, is required to support integration and health and wellbeing.
Contextual and individual level factors influencing nutritional program effectiveness in HIV care setting in Tigray region, northern Ethiopia: Mixed methods study
Publisher: Public Library of Science (PLoS)
Date: 27-04-2020
Exploring the Relationship between Housing and Health for Refugees and Asylum Seekers in South Australia: A Qualitative Study
Publisher: MDPI AG
Date: 08-09-2017
‘Having a good friend, a good neighbour, can help you find yourself’: social capital and integration for people from refugee and asylum-seeking backgrounds in Australia
Publisher: Informa UK Limited
Date: 22-03-2023
Discrimination: A health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia
Publisher: Springer Science and Business Media LLC
Date: 28-01-2020
DOI: 10.1186/S12889-019-8068-3
Abstract: Research has shown that discrimination is harmful to health, but there is relatively little known about discrimination experienced by people from refugee and asylum-seeking backgrounds in resettlement countries and associated health effects. This qualitative-focused mixed methods paper reports on discrimination experienced by refugees and asylum seekers, responses to discrimination, and impacts on health. As part of a broader study of housing, social inclusion and health, surveys were completed by 423 adult refugees and asylum seekers living in South Australia who had been in Australia for up to 7 years. The survey included questions on discrimination based on skin colour, ethnicity and religion, as well as questions on hope, trust, belonging, sense of control and health (including the SF-8). Semi-structured interviews were conducted with 65 survey participants, purposively s led by visa status, continent and gender, further exploring experiences of discrimination. These and survey open-ended responses were analysed thematically. Twenty-two percent of survey participants reported experiences of discrimination since arriving in Australia (14% in the last year), and 90% of these felt that discrimination had harmed their health. Key settings of discrimination were public transport, within the neighbourhood, and in relation to employment. Those who reported discrimination had significantly worse mental health ( p .000) but not physical health. Discrimination was also associated with less sense of belonging ( p = .001), lower levels of trust ( p = .038), reduced sense of control ( p = .012) and less hope ( p = .006). Incidents described in interviews and the open-ended survey responses included incivility, physical assault, and denial of services, experienced across intersecting characteristics of race/ethnicity, religion, gender and visa status. Responses to discrimination spanned affective, cognitive and behavioural dimensions, ranging across types of experience, participant characteristics and context, with most in iduals reporting multiple response types. While some of the responses were reported by participants as protective of health, participants’ reflections indicated significant negative impacts on mental health in particular. Discrimination featured in the resettlement experiences of a significant number of refugees and asylum seekers, with participants reporting clear negative impacts on mental health. Addressing discrimination is a key resettlement and health issue requiring urgent action.
‘I really want to work for me to feel good myself ‘: Health impacts of employment experiences for women from refugee backgrounds in Australia
Publisher: Elsevier BV
Date: 06-2023
Experiences of Tenants’ Relocation in the Carlton Public Housing Estate Redevelopment, Melbourne
Publisher: Informa UK Limited
Date: 19-08-2018
Life after work: older Australians' experiences of early exit from the workforce
Publisher: Wiley
Date: 12-2011
The governance of primary mental health planning by Primary Health Networks
Publisher: Wiley
Date: 16-07-2019
DOI: 10.1002/AJS4.71
Negative consequences of community group participation for women's mental health and well-being: Implications for gender aware social capital building
Publisher: Wiley
Date: 05-2009
DOI: 10.1002/CASP.988
Support for tenure mix by residents local to the Carlton Housing Estate, Melbourne, Australia
Publisher: Informa UK Limited
Date: 14-07-2018
A Longitudinal Study of the Mental Health Impacts of Job Loss
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2014
Creating Political Will for Action on Health Equity: Practical Lessons for Public Health Policy Actors
Publisher: Maad Rayan Publishing Company
Date: 05-12-2020
Abstract: Background: Despite growing evidence on the social determinants of health and health equity, political action has not been commensurate. Little is known about how political will operates to enact pro-equity policies or not. This paper examines how political will for pro-health equity policies is created through analysis of public policy in multiple sectors. Methods: Eight case studies were undertaken of Australian policies where action was either taken or proposed on health equity or where the policy seemed contrary to such action. Telephone or face-to-face interviews were conducted with 192 state and non-state participants. Analysis of the cases was done through thematic analysis and triangulated with document analysis. Results: Our case studies covered: trade agreements, primary healthcare (PHC), work conditions, digital access, urban planning, social welfare and Indigenous health. The extent of political will for pro-equity policies depended on the strength of path dependency, electoral concerns, political philosophy, the strength of economic and biomedical framings, whether elite interests were threatened and the success or otherwise of civil society lobbying. Conclusion: Public health policy actors may create political will through: determining how path dependency that exacerbates health inequities can be broken, working with sympathetic political forces committed to fairness framing policy options in a way that makes them more likely to be adopted, outlining factors to consider in challenging the interests of elites, and considering the extent to which civil society will work in favour of equitable policies. A shift in norms is required to stress equity and the right to health.
The relationship between employment and health for people from refugee and asylum-seeking backgrounds: A systematic review of quantitative studies
Publisher: Elsevier BV
Date: 06-2022
Differing Levels of Social Capital and Mental Health in Suburban Communities in Australia: Did Social Planning Contribute to the Difference?
Publisher: Informa UK Limited
Date: 18-02-2011
Racism, social resources and mental health for Aboriginal people living in Adelaide
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1111/J.1753-6405.2011.00681.X
Abstract: This paper examines whether reported experience of racism by Aboriginal people living in Adelaide is negatively associated with mental health, and whether social resources ameliorate the mental health effects of racism. Face-to-face structured and semi-structured interviews were conducted with 153 Aboriginal people. Data on self-reported experiences of racism (average regularity of racism across a number of settings, regular racism in at least one setting), social resources (socialising, group membership, social support, talking/expressing self about racism), health behaviours (smoking, alcohol), socio-demographic (age, gender, education, financial situation) and mental health (SF-12 measure) are reported. Separate staged linear regression models assessed the association between the two measures of racism and mental health, after accounting for socio-demographic characteristics and health behaviours. Social resource variables were added to these models to see if they attenuated any relationship between racism and mental health. The two measures of racism were negatively associated with mental health after controlling for socioeconomic factors and health behaviours. These relationships remained after adding social resource measures. Non-smokers had better mental health, and mental health increased with positive assessments of financial situation. Reducing racism should be a central strategy in improving mental health for Aboriginal people.
Strife of Interests: Constraints on integrated and co-ordinated comprehensive PHC in Australia
Publisher: Elsevier BV
Date: 03-2020
Neighbourhood ‘Social Infrastructure’ for Health: The Role of Social Capital, Fear of Crime and Area Reputation
Publisher: Elsevier
Date: 2011
“It is not an acceptable disease”: A qualitative study of HIV-related stigma and discrimination and impacts on health and wellbeing for people from ethnically diverse backgrounds in Australia
Publisher: Springer Science and Business Media LLC
Date: 23-04-2021
DOI: 10.1186/S12889-021-10679-Y
Abstract: People from ethnically erse backgrounds living with HIV are susceptible to adverse health and wellbeing outcomes, particularly as a consequence of HIV-related stigma and discrimination (HSD), though relatively little is known about experiences in Australia. This paper reports on HSD in ethnically erse communities in South Australia and impacts on health and wellbeing. Interviews and focus groups were conducted with 10 in iduals living with HIV from ethnically erse backgrounds, 14 ethnically erse community leaders, and 50 service providers. Data were analysed thematically. Findings indicated that HIV is a highly stigmatised condition in ethnically erse communities due to fear of moral judgment and social isolation, and was experienced at the intersections of gender, sexual orientation, religion, culture, and immigration status. Experiences of HSD were damaging to health and wellbeing through non-disclosure, reduced social support, delayed testing, service access barriers, impacts on treatment adherence, and directly to mental health. Actions addressing the impacts of HSD on people from ethnically erse backgrounds are crucial.
Neighbourhood Life, Social Capital and Perceptions of Safety in the Western Suburbs of Adelaide
Publisher: Wiley
Date: 06-2007
Reducing research waste and improving research impact
Publisher: Elsevier BV
Date: 08-2015
South Australia's quiet multiculturalism: Elite perspectives of the policy success of immigrant multiculturalism from 2007 to 2017
Publisher: Wiley
Date: 13-01-2022
Abstract: Despite the long‐standing connection between South Australia and the national development of immigrant multiculturalism, epitomised through the role of Premier Don Dunstan, recent policy developments have not yet been studied at the state level. This article evaluates the development and ‘policy success’ of multiculturalism in South Australia from 2007 to 2017, a period characterised by the so‐called ‘backlash against multiculturalism’ in many liberal democracies. The study is based on interviews with policymakers and policy stakeholders, triangulated against policy documentation and other grey literature. Overall, policy efforts by successive state governments can be characterised as ‘quiet multiculturalism’, in that they have become entrenched as the political norm. Multiculturalism tends not to be politically contentious, leaving policymakers to implement policies without much fanfare. At the same time though, there is a risk of fragility. Deeper structural barriers to equal opportunity may be overlooked due to an attitude that existing policies promoting ‘access and equity’ are sufficient or can be scaled down.
Positive and negative impacts of job loss on family life: the perceptions of Australian car workers
Publisher: Wiley
Date: 12-2011
Do perceived neighbourhood cohesion and safety contribute to neighbourhood differences in health?
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.HEALTHPLACE.2009.02.013
Abstract: This paper reports on a survey (N=3344) and in-depth interviews (N=80) from four socio-economically contrasting postcode areas in Adelaide. Logistic regression was used to examine locational differences in self-rated health, controlling for demographic, socio-economic factors, health behaviours, in idual social capital (social networks, support, reciprocity, trust) and perceived neighbourhood cohesion and safety. Statistically significant locational differences in health emerged. Perceived neighbourhood cohesion and safety accounted for this difference. Interviews explored perceptions of cohesion and safety and found that they were intricately related and varied between the areas. The implications of the findings for understanding locational differences in health are discussed.
Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.SOCSCIMED.2013.08.002
Abstract: Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing.
Responding to racism: Insights on how racism can damage health from an urban study of Australian Aboriginal people
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.SOCSCIMED.2011.06.058
Abstract: This paper examines responses to racism and the pathways through which racism can affect health and wellbeing for Aboriginal people living in an urban environment. Face-to-face interviews were conducted in 2006/07 with 153 Aboriginal people living in Adelaide, Australia. Participants were asked about their experience of, and responses to, racism, and the impact of these experiences on their health. Racism was regularly experienced by 93% of participants. Almost two thirds of people felt that racism affected their health. Using a thematic analysis with a particular focus on how agency and structure interacted, a number of key reactions and responses to racism were identified. These included: emotional and physiological reactions and responses such as gaining support from social networks confronting the person/situation ignoring it avoiding situations where they might experience racism 'minimising' the significance or severity of racism or questioning whether incidents were racist and consuming alcohol, tobacco and other drugs. A further theme was a conscious decision to not 'allow' racism to affect health. Our study found that most people used more than one of these coping strategies, and that strategies were selected with an awareness of positive and negative health impacts. While in iduals demonstrated substantial agency in their responses, there were clear structural constraints on how they reacted and responded. We found that not only was racism potentially detrimental to health, but so too were some responses. However, while some strategies appeared 'healthier' than others, most strategies entailed costs and benefits, and these depended on the meanings of responses for in iduals. This paper concludes that initiatives to promote health-protective responses to racism need to consider structural constraints and the overarching goal of reducing systemic racism.
A mixed methods systematic review of studies examining the relationship between housing and health for people from refugee and asylum seeking backgrounds
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.SOCSCIMED.2018.07.045
Abstract: Housing is an important social determinant of health and a key element of refugee integration into countries of resettlement. However, the way in which housing may affect mental and physical health for refugees and asylum seekers has not been systematically examined. This systematic review aimed to explore the effects of housing on health and wellbeing for this population, in order to identify key pathways for public health interventions. The review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Social Care Institute for Excellence (SCIE) guidelines. We identified publications through a search of Medline, PsychInfo, Scopus, Web of Science, Embase, CINAHL, Cohrane Library, Google, ProQuest, OpenGrey, MedNar and WHOLIS. Eligibility criteria included: publication in English between 1997 and 2017, with findings pertaining to the relationship between housing and health for refugees and/or asylum seekers. Out of 2371 items, 25 papers were included with a further five identified through reference lists. Eleven of the papers explored housing and health for those refugees and asylum seekers living within refugee c s, with 19 focusing on countries of resettlement. All studies identified housing issues for refugees and asylum seekers, with physical housing conditions particularly poor in refugee c s, and issues of affordability, suitability, insecure tenure and mobility as well as difficulties securing housing also highlighted in countries of resettlement. Consistent relationships were found between physical aspects of housing and physical and mental health, with other aspects of housing such as safety and overcrowding linked to mental health. There were a number of methodological issues with most of the studies, making it difficult to specify precise pathways. However, improvements to housing quality particularly in refugee c s, and targeted housing interventions more generally for refugees and asylum seekers would likely have an important public health benefit.
Neighbourhood life and social capital: the implications for health
Publisher: Elsevier BV
Date: 2005
DOI: 10.1016/J.SOCSCIMED.2004.04.027
Abstract: Social capital has been linked to health outcomes, though there are some inconsistencies in the research and the link is dependent on the measures of social capital and health used. In this paper, we argue that social capital is multifaceted and its relationship with health is complex. We explore the relationship between a number of elements of neighbourhood life and neighbourhood-based social capital, and health, using both qualitative and quantitative methods. The paper reports on a study of the Western suburbs of Adelaide and the analysis of 2400 questionnaires and 40 in-depth interviews. A partial least-square path analysis was undertaken with the questionnaire data. It considered the impact of perceptions of the physical environment, neighbourhood connections, neighbourhood trust, reciprocity, perceived safety and local civic action, and a number of demographic variables, on physical and mental health as measured by the SF-12. Of the neighbourhood-related variables, only perceived neighbourhood safety was related to physical health, with neighbourhood safety and neighbourhood connections related to mental health. Of the demographic variables, higher-income level and educational achievement were related to better physical and mental health. In addition, physical health was lower and mental health higher within older age groups. The inter-relationships between the neighbourhood variables and demographic differences in experience of neighbourhood were also examined. The thematic analysis of the interviews linked a number of social aspects of neighbourhood, the physical neighbourhood environment, perceptions of safety, civic activities and availability of local services, to health outcomes. The paper concludes that there is a need for more complex measures of social capital and that socio-economic factors are of relatively greater importance in determining health.
Temporary Refugee and Migration Visas in Australia: An Occupational Health and Safety Hazard
Publisher: SAGE Publications
Date: 28-01-2021
Abstract: Employment and work-related exploitation and discrimination are important social determinants of health. However, little is known about the experiences of people on temporary visas in Australia, particularly those on refugee visas. This article reports on a study of people living on temporary visas in South Australia and their experiences of workforce exploitation and discrimination and impacts on health. Interviews were conducted with 30 people: 11 on non-refugee temporary visas and 19 on refugee temporary visas. Data was analyzed thematically. Analysis identified experiences of exploitation and discrimination in the Australian labor market that included difficulties securing work, underpayment, overwork, and hazardous workplaces. These experiences had negative health effects, particularly on mental health. None had made a formal complaint about their treatment, citing the precarity of their visas, difficulties finding an alternative job, and lack of knowledge about what to do. The impacts were especially evident for refugees who were also grappling with pre-settlement trauma and ongoing uncertainties about their future protection. Overall, these findings of discrimination and exploitation in the workplace and subsequent ill health highlight the pervasive impact of neoliberal agendas and stress the need for industrial, immigration, and welfare reform to protect workers on temporary visas.
From causes to solutions - insights from lay knowledge about health inequalities
Publisher: Springer Science and Business Media LLC
Date: 31-01-2011
Abstract: This paper reports on a qualitative study of lay knowledge about health inequalities and solutions to address them. Social determinants of health are responsible for a large proportion of health inequalities (unequal levels of health status) and inequities (unfair access to health services and resources) within and between countries. Despite an expanding evidence base supporting action on social determinants, understanding of the impact of these determinants is not widespread and political will appears to be lacking. A small but growing body of research has explored how ordinary people theorise health inequalities and the implications for taking action. The findings are variable, however, in terms of an emphasis on structure versus in idual agency and the relationship between being 'at risk' and acceptance of social/structural explanations. This paper draws on findings from a qualitative study conducted in Adelaide, South Australia, to examine these questions. The study was an integral part of mixed-methods research on the links between urban location, social capital and health. It comprised 80 in-depth interviews with residents in four locations with contrasting socio-economic status. The respondents were asked about the cause of inequalities and actions that could be taken by governments to address them. Although generally willing to discuss health inequalities, many study participants tended to explain the latter in terms of in idual behaviours and attitudes rather than social/structural conditions. Moreover, those who identified social/structural causes tended to emphasise in idualized factors when describing typical pathways to health outcomes. This pattern appeared largely independent of participants' own experience of advantage or disadvantage, and was reinforced in discussion of strategies to address health inequalities. Despite the explicit emphasis on social/structural issues expressed in the study focus and framing of the research questions, participants did not display a high level of knowledge about the nature and causes of place-based health inequalities. By extending the scope of lay theorizing to include a focus on solutions, this study offers additional insights for public health. Specifically it suggests that a popular constituency for action on the social determinants of health is unlikely to eventuate from the current popular understandings of possible policy levers.
Stigma and discrimination: Barriers to the utilisation of a nutritional program in HIV care services in the Tigray region, Ethiopia
Publisher: Springer Science and Business Media LLC
Date: 10-06-2020
DOI: 10.1186/S12889-020-09040-6
Abstract: In Ethiopia, stigmatising attitudes towards people living with HIV have reduced over time. This is mainly due to improved HIV knowledge and the expansion of access to HIV care and support services. However, HIV stigma and discrimination remain a key challenge and have negative impacts on access to and utilisation of HIV services including nutritional programs in the HIV care setting. A small number of studies have examined the experience of stigma related to nutritional programs, but this is limited. This study explored HIV status disclosure and experience of stigma related to a nutritional program in HIV care settings in Ethiopia and impacts on nutritional program utilisation. As part of a larger study, qualitative in-depth interviews were conducted with 20 adults living with HIV, 15 caregivers of children living with HIV and 13 program staff working in the nutritional program in three hospitals in the Tigray region of Northern Ethiopia. Framework thematic analysis was employed to analyse the data and NVivo 11 was used to analyse the qualitative interview data. This study is presented based on the consolidated criteria for reporting of qualitative research (COREQ). The study found varying levels of positive HIV status disclosure, depending on who the target of disclosure was. Disclosing to family members was reported to be less problematic by most participants. Despite reported benefits of the nutritional program in terms of improving weight and overall health status, adults and caregivers of children living with HIV revealed experiences of stigma and discrimination that were lified by enrolment to the nutritional program and concerns about unwanted disclosure of positive HIV status. This was due to: a) transporting, consuming and disposing of the nutritional support (Plumpynut/sup) itself, which is associated with HIV in the broader community b) required increased frequency of visits to HIV services for those enrolled in the nutritional program and associated greater likelihood of being seen there. There was evidence of concerns about HIV-related stigma and discrimination among in iduals enrolled in this program and their family members, which in turn negatively affected the utilisation of the nutritional program and the HIV service more broadly. Stigma and discrimination are a source of health inequity and undermine access to the nutritional program and other HIV services. Nutritional programs in HIV care should include strategies to take these concerns into account by mainstreaming stigma prevention and mitigation activities. Further research should be done to identify innovative ways of facilitating social inclusion to mitigate stigma and improve utilisation.
Local Community Group Participation: Who Participates and What Aspects of Neighbourhood Matter?
Publisher: Informa UK Limited
Date: 19-10-2011
Healthcare-seeking behaviours for sexually transmitted infections among women attending the National Institute of Dermatology and Venereology in Vietnam
Publisher: BMJ
Date: 10-05-2007
A Framework to Determine the Extent to Which Regional Primary Healthcare Organisations Are Comprehensive or Selective in Their Approach
Publisher: Maad Rayan Publishing Company
Date: 05-10-2020
Abstract: Background: There is an increasing emphasis on the importance of comprehensive primary healthcare (CPHC) in improving population health and health equity. There is, therefore, a need for a practical means to determine how comprehensive regional primary healthcare organisations (RPHCOs) are in their approach. This paper proposes a framework to provide such a means. The framework is then applied to assess the comprehensiveness of Australian RPHCOs. Methods: Drawing on a narrative review of the broader literature on CPHC versus selective primary healthcare (SPHC) and ex les of international models of RPHCOs, we developed a framework consisting of the key criteria and a continuum from comprehensive to selective interventions. We applied this framework to Australian RPHCOs using data from the review of their planning documents, and survey and interviews with executive staff, managers, and board members. We used a spidergram as a means to visualise how comprehensive they are against each of these criteria, to provide a practical way of presenting the assessment and an easy way to compare progress over time. Results: Key criteria for comprehensiveness included (1) focus on population health (2) focus on equity of access and outcomes (3) community participation and control (4) integration within the broader health system (5) inter-sectoral collaboration and (6) local responsiveness. An examination of Australian RPHCOs using the framework suggests their approach is far from comprehensive and has become more selective over time. Conclusion: The framework and spidergram offer a practical means of gauging and presenting the comprehensiveness of RPHCOs, and to identify gaps in comprehensiveness, and changes over time.
The interplay between structure and agency in shaping the mental health consequences of job loss
Publisher: Springer Science and Business Media LLC
Date: 06-02-2013
Deliberately Casual? Workers' Agency, Health, and Nonstandard Employment Relations in Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2013
Social capital
Publisher: BMJ
Date: 05-2003
Abstract: This glossary aims to provide readers with some of the key terms that are relevant to a consideration of the relevance of social capital for health, and to introduce some of the debates on the concepts.
Collaborative population health planning between Australian primary health care organisations and local government: lost opportunity
Publisher: Elsevier BV
Date: 02-2019
Abstract: To examine the strength and extent of collaborations between primary health care organisations and local government in population health planning. Methods included: a) online surveys with Medicare Locals (n=210) and Primary Health Networks (n=66), comparing the two using two-level mixed models b) interviews with Medicare Local (n=50) and Primary Health Network (n=55) executives c) interviews with members of local government associations and Primary Health Network board members with local government experience (n=7) and d) review of 54 Medicare Local and 31 Primary Health Network publicly available annual reports. Despite partnership being a policy objective for Medicare Locals/ Primary Health Networks, they reported limited time and financial support for collaboration with local government. Organisational capacity and resources, supportive governance and public health legislation mandating a role for local governments were critical to collaborative planning. Local government has the potential to tackle social factors affecting health therefore, their inclusion in population health planning is valuable. Legislative mandates would help to achieve this, and PHNs require a stronger Federal Government mandate backed by sufficient resources and a governance structure that supports collaboration. Implications for public health: Improving primary health care and local government collaboration has great potential to improve the quality of health planning and action on social determinants, thus advancing population health and health equity.
Related Organisations
Related Funding Activities
ARC Future Fellowships - Grant ID: FT120100150
Start Date: 12-2012
End Date: 03-2019
Amount: $634,236.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP130100782
Start Date: 03-2014
End Date: 12-2017
Amount: $157,000.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP0454907
Start Date: 01-2005
End Date: 12-2008
Amount: $201,000.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP100100526
Start Date: 2010
End Date: 12-2013
Amount: $99,000.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP0562288
Start Date: 05-2006
End Date: 05-2009
Amount: $308,558.00
Funder: Australian Research Council
View Funded Activity