ORCID Profile
0000-0003-1336-6493
Current Organisation
University of Melbourne
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Social epidemiology | Epidemiology | Social and Cultural Geography | Human Geography | Urban and Regional Studies (excl. Planning) | Dentistry not elsewhere classified | Social determinants of health
Expanding Knowledge through Studies of Human Society | Ethnicity, Multiculturalism and Migrant Development and Welfare | Health Related to Specific Ethnic Groups |
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 10-2021
Publisher: Wiley
Date: 25-03-2019
DOI: 10.1111/CDOE.12455
Abstract: This study aimed to test associations between a municipal social development indicator and indicators of public dental services examine differences in the achievement of public dental services goals between fluoridated and nonfluoridated municipalities and, quantify contribution of a municipal social development indicator in estimated mean differences in the public dental services indicators between fluoridated and nonfluoridated municipalities. A secondary analysis of data from 293 municipal dental health services records from Southern Brazil between 2010 and 2015 was conducted. Multivariable log-binomial regression models were fitted to test the associations between municipal Human Development Index (HDI) and multiple public dental services indicators (proportion of public dental health service coverage, the proportion of tooth extraction among all clinical procedures, and monthly participation in supervised tooth brushing). Cut-off points for outcomes were based on state goals for public dental services. Blinder-Oaxaca decomposition analyses were performed to quantify the relative contribution of HDI in the differences in outcomes according to the municipal water fluoridation status. Municipalities within the lowest tertile of HDI had 66% lower prevalence of having insufficient public dental health service coverage (less than state goals)than those in the highest tertile of HDI (PR: 0.44 95% CI: 0.24, 0.50). Municipalities with lowest HDI had nearly 30% higher prevalence of failing the state goals regarding the proportion of extraction and supervised tooth brushing (PR: 1.30 95% CI: 1.20, 1.40 and PR: 1.34 95% CI: 1.23, 1.45, respectively). Mean public dental health service coverage was higher in nonfluoridated municipalities than fluoridated municipalities, and municipal HDI explained 36% of the total estimated mean difference. This study found associations between municipal social development and public dental services indicators in Southern Brazil. However, higher HDI was associated with lower public dental health service coverage, lower proportion of extraction and higher coverage of supervised tooth brushing [Correction added on 2 April 2019, after first online publication: In the preceding sentence, the text "but with a higher proportion of extraction and supervised tooth brushing" was changed to "lower proportion of extraction and higher coverage of supervised tooth brushing"]. Municipal HDI contributed significantly towards the gap in public dental coverage between fluoridated and nonfluoridated municipalities, favoring nonfluoridated municipalities. These findings have important policy implications for reducing oral health inequalities as it highlights the interplay between key oral health policies and their distribution according to municipal social development.
Publisher: Springer Science and Business Media LLC
Date: 04-04-2017
Publisher: SAGE Publications
Date: 10-10-2022
DOI: 10.1177/00220345221126713
Abstract: Evidence suggests that dental caries is associated with chronic and acute malnutrition, manifested as stunting and wasting in children. However, studies have not always appropriately accounted for confounding factors or for the temporal ordering between exposure and outcome. This study examined relationships between the development of caries lesions with subsequent stunting and wasting outcomes using data from a population-based cohort in Cambodia. Caries incidence was assessed based on the presence of a new cavitated carious lesion or a new pulpally involved lesion across a 6-mo observation period. Anthropometric measurements were taken at regular intervals. Effects of carious lesions on stunting and wasting were assessed using inverse probability treatment weighting, adjusting for potential confounders, using z scores for height-for-age (HAZ) and weight-for-height (WHZ) as outcomes. In total, 894 children (mean age 20 mo at baseline) were followed over 2 y. At baseline, 350 (39.1%) were identified as having stunting malnutrition. At follow-up, 58 (6.5%) had a new pulpally involved lesion. There was no association between incidence of cavitated or pulpally involved carious lesions at follow-up and stunting (relative risk [RR] = 1.06 95% confidence interval [CI]: 0.75, 1.50). The incidence of pulpally involved carious lesions had an effect on wasting prevalence (WHZ −2 RR = 1.35 95% CI: 0.70, 2.62) and WHZ scores (average treatment effect = −0.294 95% CI: −0.538, −0.050). This study offers evidence that the development of pulpally involved carious lesions has an effect on WHZ scores. Oral health promotion and clinical prevention and management of dental caries should be explored as interventions to promote normal growth and development among preschool children, particularly in low-income settings.
Publisher: Public Library of Science (PLoS)
Date: 24-01-2018
Publisher: Elsevier BV
Date: 05-2021
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.AMEPRE.2019.03.018
Abstract: This study reviews collective evidence on the longitudinal impact of housing disadvantage (based on tenure, precarity, and physical characteristics) on mental health. It is focused on temporally ordered studies where exposures preceded outcomes, a key criterion to establishing causal evidence. A systematic review of evidence on housing disadvantage and mental health was performed. The literature search used six electronic databases including MEDLINE (PubMed and Ovid platform), Embase, PsycINFO, Web of Science, SciELO, and Sociological Abstracts. Population-based longitudinal studies where exposure to housing disadvantage (excluding exposure to homelessness) preceded mental health were included. Methodologic quality of selected studies was examined using the Newcastle-Ottawa Quality Assessment Scale. Because of definitional and methodologic heterogeneity among studies, narrative synthesis rather than meta-analysis was used to summarize research findings. Of the 1,804 unique titles identified in the literature search, 12 met the selection criteria for inclusion in the systematic review. Housing disadvantage was measured by overcrowding, mortgage delinquency, housing mobility, housing tenure, subjective perceptions of inadequate housing, eviction, and physical housing conditions. Mental health was measured as depression, psychological impairment, anxiety, allostatic load, mental strain, and psychological health. Study s le sizes ranged from 205 to 16,234 people, and the follow-up period ranged from within 1 year to 34 years. Each study indicated a positive association between housing disadvantage and mental health for at least one housing disadvantage measure and mental health outcome. This systematic review confirms that prior exposure to housing disadvantage may impact mental health later in life.
Publisher: Wiley
Date: 06-09-2020
DOI: 10.1111/CDOE.12571
Publisher: Elsevier BV
Date: 12-2014
Publisher: Elsevier BV
Date: 11-2022
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1016/J.YPMED.2013.04.018
Abstract: 1. To assess clustering of oral health related behaviors among a s le of British adults. 2. To determine the variation in clustering of oral health related behaviors by socioeconomic position. We used secondary analysis of the Adult Dental Health Survey 2009 data. Health behaviors referred to smoking, tooth brushing frequency, dental visits and sugar consumption. Clustering was assessed by pairwise correlations, counts of clustering of health compromising behaviors and comparison of observed/expected ratios. Logistic regression was used to assess variation in clustering of oral health related behaviors by socioeconomic position crudely and adjusted for age, gender and self-rated oral health. There were weak correlations between four health behaviors. Very low prevalence of clustering was reported. Higher observed to expected ratio was observed for clustering patterns with lower prevalence. Multivariate logistic regression showed clear, strong and significant educational gradients in associations between different clustering patterns of health compromising behaviors and educational attainment. These educational gradients remained significant after adjusting for age, gender and self-reported oral health. Very clear and strong educational gradients were observed throughout patterns of clustering of oral health compromising behaviors, suggesting chances of having detrimental behavioral clustering are lower in more educated groups in population.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2020
DOI: 10.1186/S12889-020-09194-3
Abstract: Improving breastfeeding practice is important for reducing child health inequalities and achieving several Sustainable Development Goals. Indonesia has enacted legislation to promote optimal breastfeeding practices in recent years. We examined breastfeeding practices among Indonesian women from 2002 to 2017, comparing trends within and across sociodemographic subgroups. Data from four waves of the Indonesia Demographic and Health Surveys were used to estimate changes in breastfeeding practices among women from selected sociodemographic groups over time. We examined three breastfeeding outcomes: (1) early initiation of breastfeeding (2) exclusive breastfeeding and (3) continued breastfeeding at 1 year. Multivariate logistic regression was used to assess changes in time trends of each outcome across population groups. The proportion of women reporting early initiation of breastfeeding and exclusive breastfeeding increased significantly between 2002 to 2017 ( p 0.05), with larger increases among women who: were from higher wealth quintiles worked in professional sectors and lived in Java and Bali. However, 42.7% of women reported not undertaking early initiation of breastfeeding, and 48.9% of women reported not undertaking exclusive breastfeeding in 2017. Women who were employees had lower exclusive breastfeeding prevalence, compared to unemployed or self-employed women. Women in Java and Bali had higher increase in early initiation of breastfeeding and exclusive breastfeeding compared to women in Sumatra. We did not find statistically significant decline in continued breastfeeding at 1 year over time for the overall population, except among women who: were from the second poorest wealth quintile lived in rural areas did not have a health facility birth and lived in Kalimantan and Sulawesi ( p 0.05). There were considerable improvements in breastfeeding practices in Indonesia during a period of sustained policy reform to regulate breastfeeding and community support of breastfeeding, but these were not distributed uniformly across socioeconomic, occupation and geographic subgroups. Concerted efforts are needed to further reduce inequities in breastfeeding practice through both targeted and population-based strategies.
Publisher: Wiley
Date: 18-04-2022
DOI: 10.1111/CDOE.12646
Abstract: Income inequalities in children's oral health have been well described. It is plausible that the security of tenure reflected by the ownership status of children's housing dynamically interacts with household income to shape these inequalities. We examined whether housing tenure modifies the known association between household income and oral health. Data were analysed on 3344 10‐ to 11‐year‐old children from the Longitudinal Study of Australian Children. Multivariable regression models tested associations between household income and dental caries and tooth loss due to caries. Effect modification by home ownership (yes/no) was tested on the additive and multiplicative scales. Models were adjusted for sex, Indigenous status, main language spoken at home, area of residence, main carer education and family arrangement. Children in households in the low income group had worse oral health than children in the high group for caries and tooth loss. Models only weakly supported an additive interaction for tooth loss that is, the relative excess risk due to interaction (RERI) for low household income was −0.903 (−2.38 0.571) for tooth loss and −0.076 (−0.42 0.271) for dental decay, although we note that the low proportion of children from low‐income homeowning households (6%) reduces the power to detect interactions. Notably, our models suggest renters in both high‐ and low‐income categories had the highest risk of tooth loss compared to owners (PR for high‐income renters: 2.19 (95% CI: 1.25, 3.85) PR for low‐income renters: 2.11 (95% CI: 1.42, 3.16)). Our study confirms that children in low‐income households have poorer oral health outcomes than their high‐income counterparts. Our findings additionally suggest that children in rental households may fare the worst of all housing and income combinations considered. Improving the security of housing for families privately renting may have wider health benefits that currently acknowledged.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2015
Publisher: MDPI AG
Date: 26-10-2020
Abstract: The importance of health-promoting neighborhoods has long been recognized, and characteristics of local built environments are among the social determinants of health. People with disability are more likely than other population groups to experience geographic mobility and cost restrictions, and to be reliant on ‘opportunity structures’ available locally. We conducted an ecological analysis to explore associations between area-level disability prevalence for people aged 15–64 years and area-level built environment characteristics in Australia’s 21 largest cities. Overall, disability was more prevalent in areas with lower walkability and lower local availability of various neighborhood amenities such as public transport, healthier food options, public open space, physical activity and recreation destinations and health and mental health services. These patterns of lower liveability in areas of higher disability prevalence were observed in major cities but not in regional cities. Our findings suggest that geographically targeted interventions to improve access to health-enhancing neighborhood infrastructure could reduce disability-related inequalities in the social determinants of health.
Publisher: BMJ
Date: 21-06-2020
DOI: 10.1136/TOBACCOCONTROL-2018-054861
Abstract: To estimate health-adjusted life years (HALY) gained in the Solomon Islands for the 2016 population over the remainder of their lives, for three interventions: hypothetical eradication of cigarettes 25% annual tax increases to 2025 such that tax represents 70% of sales price of tobacco and a tobacco-free generation (TFG). We adapted an existing multistate life table model, using Global Burden of Disease (GBD) and other data inputs, including diseases contributing % of the GBD estimated disability-adjusted life years lost in the Solomon Islands in 2016. Tax effects used price increases and price elasticities to change cigarette smoking prevalence. The TFG was modelled by no uptake of smoking among those 20 years and under after 2016. Under business as usual (BAU) smoking prevalence decreased over time, and decreased faster under the tax intervention (especially for younger ages). For ex le, for 20-year-old males the best estimated prevalence in 2036 was 22.9% under BAU, reducing to 14.2% under increased tax. Eradicating tobacco in 2016 would achieve 1510 undiscounted HALYs per 1000 people alive in 2016, over the remainder of their lives. The tax intervention would achieve 370 HALYs per 1000 (24.5% of potential health gain), and the TFG 798 HALYs per 1000 people (52.5%). By time horizon, 10.5% of the HALY gains from tax and 8.0% from TFG occur from 2016 to 2036, and the remainder at least 20 years into the future. This study quantified the potential of two tobacco control policies over maximum health gains achievable through tobacco eradication in the Solomon Islands.
Publisher: Wiley
Date: 29-04-2016
DOI: 10.1111/OBR.12418
Abstract: This study conducted a systematic review to assess the bi-directional association between tooth loss/edentulism and obesity. Electronic searches were performed in four different databases. Observational studies that tested associations between tooth loss/edentulism and obesity as either exposures or outcomes were included. Additionally, meta-analyses, funnel plots and sensitivity analyses were conducted to synthesize the evidence. A total of 549 articles were identified in the electronic database search. Out of which, 16 studies were included within the meta-analyses: 75% considered tooth loss/edentulism as exposure and obesity as outcome, whereas 25% alternatively considered obesity as exposure and tooth loss/edentulism as outcome. Pooled estimates showed that obese in iduals had 1.49 (95%CI 1.20-1.86) and 1.25 (95%CI 1.10-1.42) times higher odds of having any tooth loss and edentulism, respectively. Alternatively, when tooth loss or edentulism were considered as exposures, in iduals with any tooth loss had 1.41 (95%CI 1.11-1.79) times higher odds for obesity, while edentates had even higher odds (OR 1.60 95%CI 1.29-2.00). The results indicate a bi-directional association between tooth loss and obesity. Considering that all selected studies were of cross-sectional study design limiting inferences on temporality, longitudinal prospective studies are required to test the causal relationship between tooth loss/edentulism and obesity or vice a versa. © 2016 World Obesity.
Publisher: Wiley
Date: 20-02-2018
DOI: 10.1111/CDOE.12369
Abstract: The high prevalence of oral diseases and the persistent nature of socioeconomic inequalities in oral health outcomes across societies presents a significant challenge for public health globally. A debate exists in epidemiology on the merits of investigating population variations in health and its determinants over studying in idual health and its in idual risk factors. The choice of analytical unit for health outcomes at the population level has policy implications and consequences for the causal understanding of population-level variations in health/disease. There is a lack of discussion in oral epidemiology on the relevance of studying population variations in oral health. Evidence on the role of societal factors in shaping variations in oral health at both the in idual level and the population level is also mounting. Multilevel studies are increasingly applied in social epidemiology to address hypotheses generated at different levels of social organization, but the opportunities offered by multilevel approaches are less applied for studying determinants of oral health at the societal level. Multilevel studies are complex as they aim to examine hypotheses generated at multiple levels of social organization and require attention to a range of theoretical and methodological aspects from the stage of design to analysis and interpretation. This discussion study aimed to highlight the value in studying population variations in oral health. It discusses the opportunities provided by multilevel approaches to study societal determinants of oral health. Finally, it reviews the key methodological aspects related to operationalizing multilevel studies of societal determinants of oral health.
Publisher: Wiley
Date: 24-11-2015
DOI: 10.1111/JPHD.12136
Abstract: Studies in high-income countries have reported associations between tooth loss and hypertension. There is however a lack of evidence on this association from South Asian countries especially India. The current study aimed to assess the association between self-reported tooth loss and hypertension in a primarily rural middle-aged and older Indian population. A secondary analysis of cross-sectional data from the Longitudinal Ageing Study of India - pilot survey was conducted on 1,486 adults aged 45 years and above from four states of India. The primary outcome was self-reported hypertension and the main explanatory variable was self-reported tooth loss. Multivariable logistic regression models estimated the association between hypertension and tooth loss after controlling for confounders including age, sex, marital status, area of residence, educational attainment, tobacco use, alcohol use, physical activity, and self-reported diabetes. Compared to those without any tooth loss, in iduals with partial tooth loss had 1.62 times (95% CI: 1.12-2.35) higher odds of being hypertensive after adjustment of confounders including age, sex, marital status, area of residence, educational attainment, tobacco use, alcohol use, physical activity, and self-reported diabetes. The crude significant association (OR: 2.54 95% CI: 1.50-4.29) between edentulousness and hypertension became nonsignificant and attenuated after adjustment of potential confounders (fully adjusted model OR: 1.33 95% CI: 0.72-2.44). Partial tooth loss was associated with a higher probability of hypertension among dentate middle-aged and older adults in four states of India.
Publisher: Wiley
Date: 29-01-2019
DOI: 10.1111/NEP.13225
Abstract: Chronic kidney disease (CKD) and kidney failure is increasing globally and evidence from observational studies suggest periodontal disease may contribute to kidney functional decline. Electronic searches of the PubMed, EMBASE, Web of Science, Scopus and Cochrane Library databases were conducted for the purposes of conducting a systematic review. Hand searching of reference lists was also performed. Meta-analysis of observational studies involving periodontal disease and chronic kidney disease in adults was performed. A total of 17 studies was selected from an initial 4055 abstracts. Pooled estimates indicated the odds of having CKD were 60% higher among patients with periodontitis: pooled OR 1.60 (95% CI 1.44-1.79, I Moderate evidence for a positive association between periodontitis and CKD exists. Evidence for the opposite direction is extremely weak based on significant heterogeneity between studies.
Publisher: FapUNIFESP (SciELO)
Date: 2015
DOI: 10.1590/S0034-8910.2015049005590
Abstract: OBJECTIVE To analyze if differences according to gender exists in the association between tooth loss and obesity among older adults. METHODS We analyzed data on 1,704 older adults (60 years and over) from the baseline of a prospective cohort study conducted in Florianopolis, SC, Southern Brazil. Multivariable logistic regression models were used to assess the association between tooth loss and general and central obesity after adjustment for confounders (age, gender, skin color, educational attainment, income, smoking, physical activity, use of dentures, hypertension, and diabetes). Linear regressions were also assessed with body mass index and waist circumference as continuous outcomes. Interaction between gender and tooth loss was further assessed. RESULTS Overall mean body mass index was 28.0 kg/m2. Mean waist circumference was 96.8 cm for males and 92.6 cm for females. Increasing tooth loss was positively associated with increased body mass index and waist circumference after adjustment for confounders. Edentates had 1.4 (95%CI 1.1 .9) times higher odds of being centrally obese than in iduals with a higher number of teeth however, the association lost significance after adjustment for confounders. In comparison with edentate males, edentate females presented a twofold higher adjusted prevalence of general and central obesity. In the joint effects model, edentate females had a 3.8 (95%CI 2.2 .6) times higher odds to be centrally obese in comparison with males with more than 10 teeth present in both the arches. Similarly, females with less than 10 teeth in at least one arch had a 2.7 (95%CI 1.6 .4) times higher odds ratio of having central obesity in comparison with males with more than 10 teeth present in both the arches. CONCLUSIONS Central obesity was more prevalent than general obesity among the older adults. We did not observe any association between general obesity and tooth loss. The association between central obesity and tooth loss depends on gender – females with tooth loss had greater probability of being obese.
Publisher: Wiley
Date: 21-02-2020
DOI: 10.1111/ODI.13303
Publisher: Ubiquity Press, Ltd.
Date: 03-2014
Publisher: SAGE Publications
Date: 10-01-2022
DOI: 10.1177/00220345211062475
Abstract: The multidisciplinary nature and long duration of birth cohort studies allow investigation of the relationship between general and oral health and indicate the most appropriate stages in life to intervene. To date, the worldwide distribution of oral health-related birth cohort studies (OHRBCSs) has not been mapped, and a synthesis of information on methodological characteristics and outcomes is not available. We mapped published literature on OHRBCSs, describing their oral health-related data and methodological aspects. A 3-step search strategy was adopted to identify published studies using PubMed, Embase, Web of Science, and OVID databases. Studies with baseline data collection during pregnancy or within the first year of life or linked future oral health data to exposures during either of these 2 life stages were included. Studies examining only mothers' oral health and specific populations were excluded. In total, 1,721 articles were suitable for initial screening of titles and abstracts, and 528 articles were included in the review, identifying 120 unique OHRBCSs from 34 countries in all continents. The review comprised literature from the mid-1940s to the 21st century. Fifty-four percent of the OHRBCSs started from 2000 onward, and 75% of the cohorts were from high-income and only 2 from low-income countries. The participation rate between the baseline and the last oral health follow-up varied between 7% and 93%. Ten cohorts that included interventions were mostly from 2000 and with fewer than 1,000 participants. Seven data-linkage cohorts focused mostly on upstream characteristics and biological aspects. The most frequent clinical assessment was dental caries, widely presented as decayed, missing, and filled teeth (DMFT/dmft). Periodontal conditions were primarily applied as isolated outcomes or as part of a classification system. Socioeconomic classification, ethnicity, and country- or language-specific assessment tools varied across countries. Harmonizing definitions will allow combining data from different studies, adding considerable strength to data analyses this will be facilitated by forming a global consortium.
Publisher: Oxford University Press (OUP)
Date: 11-2022
DOI: 10.1111/BJD.21771
Abstract: Eczema is a chronic inflammatory skin disease. Domestic water with high mineral content (hard water) is a risk factor for eczema in children, but this association has not been assessed in adults. To examine the association between domestic hard water supply and eczema prevalence and incidence in adults aged 40–69 years and the contextual effect in eczema outcomes by postcode in adults in the UK. We used data from the UK Biobank study collected in 2006–10 (baseline) and 2013–14 (follow-up). Eczema prevalence at baseline (2006–10) and at follow-up (2013–14) and incidence (new onset between baseline and follow-up) were determined from the touchscreen questionnaires and nurse-led interviews. Domestic hard water information was obtained in 2005 and 2013 from the local water supply companies in England, Wales and Scotland as CaCO3 concentrations. We fitted multilevel logistic regression models with random intercepts for postcode areas to examine the effect of domestic hard water on eczema outcomes, and we measured components of variance. In total, 306 531 participants with a mean age of 57 years nested across 7642 postcodes were included in the baseline analysis, and 31 036 participants nested across 3695 postcodes were included in the follow-up analysis. We observed an increase in the odds of eczema at baseline [odds ratio (OR) 1·02, 95% confidence interval (CI) 1·01–1·04] per 50 mg L−1 of CaCO3 increase. Furthermore, exposure to domestic hard water (& 200 mg L−1 of CaCO3) was associated with increased odds of prevalent eczema at baseline (OR 1·12, 95% CI 1·04–1·22). Moreover, there was a significant linear trend (P & 0·001) in which increasing levels of hard water increased eczema prevalence risk. No association was observed with incident eczema or eczema at follow-up. The intraclass correlation coefficient for postcode was 1·6% (95% CI 0·7–3·4), which remained unexplained by area-level socioeconomic measures. Increasing levels of domestic hard water, as measured by CaCO3 concentrations, were associated with an increased prevalence of eczema in adults but not increased incidence. Ongoing efforts to reduce hard water exposure may have a beneficial effect in reducing the burden of eczema in adults. Further research is needed to explore area-level factors that may lead to eczema. What is already known about this topic? Hard water is formed when minerals are dissolved in water from filtration through sedimentary rocks.Several studies have reported a higher prevalence of eczema in areas with hard water.However, all studies on this topic have assessed this in infants and school-aged children, while this association has not been explored in adults. What does this study add? Our findings suggest that exposure to higher concentrations of domestic hard water is associated with an increase in eczema prevalence in adults aged 40–69 years.Ongoing efforts to reduce hard water exposure may have a beneficial effect in reducing eczema prevalence in adults.
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 09-2013
Publisher: Oxford University Press (OUP)
Date: 25-08-2022
Abstract: It has been hypothesized that a mother’s diet during pregnancy may modulate her offspring’s immune system development and lead to development of allergic diseases among offspring. However, the evidence for this is unclear and inconclusive. This systematic review was undertaken to examine the weight of evidence for causality from cohort studies on the association between maternal free sugar intake during pregnancy and development of allergies in offspring. Using a systematic search strategy, PubMed, SCOPUS, and Web of Science databases were searched from inception to May 2020. For the reporting of this systematic review, the PRISMA guideline was followed. Studies examining maternal sugar consumption during pregnancy (using self-reported data) and the development of allergic diseases among offspring (infancy to 5 years) were included. The Newcastle–Ottawa Scale quality assessment tool was used to assess the study quality. Meta-analysis was conducted using a random-effects model to synthesize the findings. Of 159 publications identified from the search, 5 articles with 4 unique cohort studies were included in this systematic review. The limited meta-analysis showed that a mother’s increased free sugar intake during pregnancy was associated with an increased risk of developing asthma in offspring (odds ratio 1.07 [95% CI, 1.00 to 1.14 I2 = 0%]). High free sugar intake by the mother during pregnancy was also associated with increased odds of offspring (to age 7.7 years) developing other common allergies, including allergic rhinitis, atopy and eczema, wheeze, and food allergies . From the limited evidence, this review suggests that high free sugar consumption during pregnancy may be associated with the development of allergies in offspring. Clinical guidelines and public health policy recommendations for maternal diet in pregnancy should include advice about reducing free sugar intake due to a possible association with allergies in offspring. However, recommendations should be made with caution considering other maternal and fetal risk factors.
Publisher: MDPI AG
Date: 06-04-2020
Abstract: Good public transport accessibility is associated with active travel, but this is under-researched among adolescents. We tested associations between public transport accessibility and active travel among school-going adolescents (12–18 years n = 1329) from Melbourne, Australia analysing Victorian Integrated Survey of Travel and Activity data. Outcomes included main mode of transport to school and accumulating ≥20 min of active travel over the day. Low and high compared to no public transport accessibility around homes were associated with higher odds of public transport use (low (odds ratio (OR): 1.94 95% confidence interval (CI): 1.28, 2.94) high (OR: 2.86 95% CI: 1.80, 4.53)). Low and high public transport accessibility around homes were also associated with higher prevalence of achieving ≥20 min of active travel (low (prevalence ratio (PR): 1.14 95% CI: 0.97, 1.34) high (PR: 1.31 95% CI: 1.11, 1.54)) compared to none. Public transport accessibility around schools was associated with public transport use (low (OR: 2.13 95% CI: 1.40, 3.24) high (OR: 5.07 95% CI: 3.35, 7.67)) and achieving ≥20 min of active travel (low (PR: 1.18 95% CI: 1.00, 1.38) high (PR: 1.64 95% CI: 1.41, 1.90)). Positive associations were confirmed between public transport accessibility and both outcomes of active travel.
Publisher: Springer Science and Business Media LLC
Date: 10-2022
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-055264
Abstract: To document socioepidemiological theories used to explain the relationship between socioeconomic disadvantage and multimorbidity. Scoping review. A search strategy was developed and then applied to multiple electronic databases including Medline, Embase, PsychInfo, Web of Science, Scielo, Applied Social Sciences, ERIC, Humanities Index and Sociological Abstracts. After the selection of studies, data were extracted using a data charting plan. The last search was performed on the 28 September 2021. Extracted data included: study design, country, population subgroups, measures of socioeconomic inequality, assessment of multimorbidity and conclusion on the association between socioeconomic variables and multimorbidity. Included studies were further assessed on their use of theory, type of theories used and context of application. Finally, we conducted a meta-narrative synthesis to summarise the results. A total of 64 studies were included in the review. Of these, 33 papers included theories as explanations for the association between socioeconomic position and multimorbidity. Within this group, 16 explicitly stated those theories and five tested at least one theory. Behavioural theories (health behaviours) were the most frequently used, followed by materialist (access to health resources) and psychosocial (stress pathways) theories. Most studies used theories as post hoc explanations for their findings or for study rationale. Supportive evidence was found for the role of material, behavioural and life course theories in explaining the relationship between social inequalities and multimorbidity. Given the widely reported social inequalities in multimorbidity and its increasing public health burden, there is a critical gap in evidence on pathways from socioeconomic disadvantage to multimorbidity. Generating evidence of these pathways will guide the development of intervention and public policies to prevent multimorbidity among people living in social disadvantage. Material, behavioural and life course pathways can be targeted to reduce the negative effect of low socioeconomic position on multimorbidity.
Publisher: BMJ
Date: 25-06-2020
DOI: 10.1136/TOBACCOCONTROL-2019-055425
Abstract: To prioritise tobacco control interventions, simulating their health impacts is valuable. We undertook a systematic review of tobacco intervention simulation models to assess model structure and input variations that may render model outputs non-comparable. We applied a Medline search with keywords intersecting modelling and tobacco. Papers were limited to those modelling health outputs (eg, mortality, health-adjusted life years), and at least two of cancer, cardiovascular and respiratory diseases. Data were extracted for each simulation model with ≥3 arising papers, including: model type, untimed or with time steps and trends in business-as-usual (BAU) tobacco prevalence and epidemiology. Of 1911 papers, 186 met the inclusion criteria, including 13 eligible simulation models. The SimSmoke model had the largest number of publications (n=46), followed by Benefits of Smoking Cessation on Outcomes (n=12) and Tobacco Policy Model (n=10). Two of 13 models only estimated deaths averted, 1 had no time steps, 5 had no future trends in BAU tobacco prevalence, 9 had no future trends in BAU disease epidemiology and 7 had no time lags from quitting tobacco to reversal of health harm. Considerable heterogeneity exists in simulation models, making outputs substantively non-comparable between models. Ranking of interventions by one model may be valid. However, this may not be true if, for ex le, interventions that differentially affect age groups (eg, a tobacco-free generation policy vs increased cessation among adults) do not account for plausible future trends. Greater standardisation of model structures and outputs will allow comparison across models and countries, and for comparisons of the impact of tobacco control interventions with other preventive interventions.
Publisher: Wiley
Date: 29-12-2017
DOI: 10.1111/CDOE.12278
Abstract: Socioeconomic position (SEP) is a well-known risk indicator for chronic periodontitis. However, it is still unclear how SEP during the life course influences periodontal outcomes in adulthood. This study aimed to systematically review longitudinal studies investigating the influence of in idual-level SEP during the life course on subsequent periodontitis in adulthood. Inclusion criteria were epidemiological longitudinal observational studies, in which indicators of relative SEP were assessed prior to clinical assessment of periodontitis. Six electronic databases (PubMed, EMBASE, Web of Science, Scopus, Latin American and Caribbean Health Sciences Literature (LILACS) and ScieLO) were searched. The methodological quality of the studies was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). The search identified 1720 papers. After removal of duplicates (n=697), title and abstract screening (n=996), and full-text review (n=19), eight original manuscripts from seven studies were finally included. S le sizes ranged from 167 to 2806, and the follow-up time from exposure to outcome ranged from 2 to 28 years. Studies evaluated education, occupation or income as SEP indicators. Prevalence, extent and severity of periodontal attachment loss, probing pocket depth and alveolar bone loss were the studied outcomes. Based on NOS, studies presented low risk of bias. Six of eight papers reported that relatively low SEP earlier in life was associated with poorer periodontal health in adulthood. The available scientific evidence demonstrates potential longitudinal impact of earlier lower SEP on later periodontal health. The findings were consistent despite differences in study methods.
Publisher: SAGE Publications
Date: 15-05-2019
Abstract: In this critical review, we summarized the evidence on associations between in idual/household income and oral health, between income inequality and oral health, and income-related inequalities in oral health. Meta-analyses of mainly cross-sectional studies confirm that low in idual/household income is associated with oral cancer (odds ratio, 2.41 95% confidence interval [CI], 1.59–3.65), dental caries prevalence (prevalence ratio, 1.29 95% CI, 1.18–1.41), any caries experience (odds ratio, 1.40 95% CI, 1.19–1.65), tooth loss (odds ratio, 1.66 95% CI, 1.48–1.86), and traumatic dental injuries (odds ratio, 0.76 95% CI, 0.65–0.89). Reviews also confirm qualitatively that low income is associated with periodontal disease and poor oral health–related quality of life. Limited evidence from the United States shows that psychosocial and behavioral explanations only partially explain associations between low in idual/household income and oral health. Few country-level studies and a handful of subnational studies from the United States, Japan, and Brazil show associations between area-level income inequality and poor oral health. However, this evidence is conflicting given that the association between area-level income inequality and oral health outcomes varies considerably by contexts and by oral health outcomes. Evidence also shows cross-national variations in income-related inequalities in oral health outcomes of self-rated oral health, dental care, oral health–related quality of life, outcomes of dental caries, and outcomes of tooth loss. There is a lack of discussion in oral health literature about limitations of using income as a measure of social position. Future studies on the relationship between income and oral health can benefit substantially from recent theoretical and methodological advancements in social epidemiology that include application of an intersectionality framework, improvements in reporting of inequality, and causal modeling approaches. Theoretically well-informed studies that apply robust epidemiological methods are required to address knowledge gaps for designing relevant policy interventions to reduce income-related inequalities in oral health.
Publisher: Medknow
Date: 2020
Publisher: Elsevier BV
Date: 09-2023
Publisher: Elsevier BV
Date: 12-2016
Publisher: Medknow
Date: 2015
Publisher: Oxford University Press (OUP)
Date: 10-2020
DOI: 10.1093/IJE/DYAA132
Abstract: Burden of Disease studies—such as the Global Burden of Disease (GBD) Study—quantify health loss in disability-adjusted life-years. However, these studies stop short of quantifying the future impact of interventions that shift risk factor distributions, allowing for trends and time lags. This methodology paper explains how proportional multistate lifetable (PMSLT) modelling quantifies intervention impacts, using comparisons between three tobacco control case studies [eradication of tobacco, tobacco-free generation i.e. the age at which tobacco can be legally purchased is lifted by 1 year of age for each calendar year) and tobacco tax]. We also illustrate the importance of epidemiological specification of business-as-usual in the comparator arm that the intervention acts on, by demonstrating variations in simulated health gains when incorrectly: (i) assuming no decreasing trend in tobacco prevalence and (ii) not including time lags from quitting tobacco to changing disease incidence. In conjunction with increasing availability of baseline and forecast demographic and epidemiological data, PMSLT modelling is well suited to future multiple country comparisons to better inform national, regional and global prioritization of preventive interventions. To facilitate use of PMSLT, we introduce a Python-based modelling framework and associated tools that facilitate the construction, calibration and analysis of PMSLT models.
Publisher: Public Library of Science (PLoS)
Date: 28-05-2021
DOI: 10.1371/JOURNAL.PONE.0252382
Abstract: Cardiovascular diseases (CVDs) are major contributors to morbidity and mortality in lower-middle-income countries (LMICs). Features of the natural environment, such as greenness, are a potential, modifiable determinant of CVD, yet there is a lack of evidence, particularly in LMICs. Our study investigated associations between residential greenness, measured using the Normalized Difference Vegetation Index (NDVI), and self-reported heart disease in 5268 Sri Lankan men aged 34 to 55 years. Multivariable logistic regression models were fitted to examine associations between mean NDVI within 100 m, 400 m, 800 m, 1600 m, and 2000 m of the residential address, adjusting for age, marital status, income, education, alcohol consumption, smoking and road length. Fully adjusted models showed that a 0.1 increase in mean NDVI was associated with lower odds of heart disease when using the 400 m (OR: 0.80 95% CI: 0.64, 1.00), 800 m (OR: 0.85 95% CI: 0.63, 1.14), and 2000 m (OR: 0.74 95% CI: 0.48, 1.13) buffers. Further research in different contexts, and with improved outcome measures, is needed to confirm relationships between residential greenness and heart disease in rural areas and in LMICs.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.JADOHEALTH.2019.01.011
Abstract: There is evidence that traditional gender-role attitudes are associated with poor mental health outcomes in adults however, few studies have examined associations among adolescents. We sought to test associations between gender-role attitudes and mental health among Australian adolescents. Data were drawn from the Longitudinal Study of Australian Children, a nationally representative Australian study. Participants were 3,059 adolescents with complete data for Waves 5-6 (years 2012-2014, aged 12/13 and 14/15 years). Analyses were stratified by sex and controlled for parental education, household income, area socioeconomic position, ethnicity, religiousness, and household type. Multivariable linear regression analyses were conducted to test associations. Egalitarian gender-role attitudes were associated with fewer conduct problems for adolescent males (ß -.04, 95% confidence interval [CI] -.08 to .00 p = .048) and females (ß -.06, 95% CI -.11 to -.01 p = .014), and for females, less hyperactivity (ß -.15, 95% CI -.20 to -.09 p < .001), better prosocial behavior (ß .08, 95% CI .03 to .13 p = .003), and better overall mental health (ß -.27, 95% CI -.43 to -.11, p = .001). There were no associations for peer problems or emotional problems. Associations were more apparent for females than for males, and analyses using adolescent- and teacher-reported mental health supported the main findings. Egalitarian gender-role attitudes among adolescents are associated with better outcomes on some dimensions of adolescent mental health, suggesting that establishing egalitarian gender attitudes in adolescence could help impart mental health benefits among this population group.
Publisher: International Global Health Society
Date: 18-06-2022
Publisher: Nepal Journals Online (JOL)
Date: 2010
Abstract: Tongue-tie, or ankyloglossia, is poorly defined and involves a short, thick, fibrosed, or fixed lingual frenulum. Ankyloglossia has been reported to cause feeding difficulties, dysarthria, dyspnea, and social or mechanical problems. Ankyloglossia occurs in 1.7% of all neonates. As age advances, frenulum grows in length and normal function is established. Frenulectomy is recommended if it persists. We have also come across with the case of Tongue Tie in one of our patient. He is 19 years in age pursuing his graduation. He has got tongue tie which is persisting since birth. Keywords: Ankyloglossia frenulum frenulectomy. DOI: 10.3126/jcmsn.v6i3.4073Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.37-39
Publisher: Ubiquity Press, Ltd.
Date: 03-2014
Publisher: Wiley
Date: 03-06-2015
Publisher: Wiley
Date: 22-07-2019
DOI: 10.1111/OBR.12879
Abstract: We compared the healthiness of packaged foods and beverages between selected countries using the Health Star Rating (HSR) nutrient profiling system. Packaged food and beverage data collected 2013-2018 were obtained for Australia, Canada, Chile, China, India, Hong Kong, Mexico, New Zealand, Slovenia, South Africa, the UK, and USA. Each product was assigned to a food or beverage category and mean HSR was calculated overall by category and by country. Median energy density (kJ/100 g), saturated fat (g/100 g), total sugars (g/100 g) and sodium (mg/100 g) contents were calculated. Countries were ranked by mean HSR and median nutrient levels. Mean HSR for all products (n = 394,815) was 2.73 (SD 1.38) out of 5.0 (healthiest profile). The UK, USA, Australia and Canada ranked highest for overall nutrient profile (HSR 2.74-2.83) and India, Hong Kong, China and Chile ranked lowest (HSR 2.27-2.44). Countries with higher overall HSR generally ranked better with respect to nutrient levels. India ranked consistently in the least healthy third for all measures. There is considerable variability in the healthiness of packaged foods and beverages in different countries. The finding that packaged foods and beverages are less healthy in middle-income countries such as China and India suggests that nutrient profiling is an important tool to enable policymakers and industry actors to reformulate products available in the marketplace to reduce the risk of obesity and NCDs among populations.
Publisher: Public Library of Science (PLoS)
Date: 28-04-2020
Publisher: Wiley
Date: 02-12-2022
DOI: 10.1111/JPHD.12552
Abstract: The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health and to identify the theoretical frameworks applied to guide this literature. A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted. Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association. Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health.
Publisher: Elsevier BV
Date: 09-2013
Publisher: Springer Science and Business Media LLC
Date: 17-05-2022
DOI: 10.1186/S12940-022-00865-9
Abstract: Exposure to cold indoor temperature ( 18 degrees Celsius) increases cardiovascular disease (CVD) risk and has been identified by the WHO as a source of unhealthy housing. While warming homes has the potential to reduce CVD risk, the reduction in disease burden is not known. We simulated the population health gains from reduced CVD burden if the temperature in all Australian cold homes was permanently raised from their assumed average temperature of 16 degrees Celsius to 20 degrees Celsius. The health effect of eradicating cold housing through reductions in CVD was simulated using proportional multistate lifetable model. The model sourced CVD burden and epidemiological data from Australian and Global Burden of Disease studies. The prevalence of cold housing in Australia was estimated from the Australian Housing Conditions Survey. The effect of cold indoor temperature on blood pressure (and in turn stroke and coronary heart disease) was estimated from published research. Eradication of exposure to indoor cold could achieve a gain of undiscounted one and a half weeks of additional health life per person alive in 2016 (base-year) in cold housing through CVD alone. This equates to 0.447 (uncertainty interval: 0.064, 1.34 3% discount rate) HALYs per 1,000 persons over remainder of their lives through CVD reduction. Eight percent of the total health gains are achievable between 2016 and 2035. Although seemingly modest, the gains outperform currently recommended CVD interventions including persistent dietary advice for adults 5–9% 5 yr CVD risk (0.017 per 1000 people, UI: 0.01, 0.027) and persistent lifestyle program for adults 5–9% 5 yr CVD risk (0.024, UI: 0.01, 0.027). Cardiovascular health gains alone achievable through eradication of cold housing are comparable with real-life lifestyle and dietary interventions. The potential health gains are even greater given cold housing eradication will also improve respiratory and mental health in addition to cardiovascular disease.
Publisher: Springer Science and Business Media LLC
Date: 13-09-2019
DOI: 10.1007/S00127-019-01773-Z
Abstract: Unaffordable housing has a negative impact on mental health however, little is known about the causal pathways through which it transmits this effect. We examine the role of financial hardship and social support as mediators of this relationship. We identified households where housing costs changed from affordable to unaffordable across two waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2014-2015). The sequential causal mediation analysis was used to decompose the total effect of unaffordable housing on mental health into the portion attributable to financial hardship and social support [natural indirect effect (NIE)] and the portion not occurring through measured pathways [natural direct effect (NDE)]. Mental health was measured using the Mental Health Inventory (MHI) and Kessler psychological distress (KPD) scale. Baseline covariates included age, sex, household income, financial hardship, social support, marital status and employment status. Bootstrapping with 1000 replications was used to calculate 95% confidence intervals (CIs). Multiple imputations using chained equations were applied to account for missing data. Unaffordable housing led to a change in mean mental health score on the MHI scale (- 1.3, 95% CI: - 2.1, - 0.6) and KPDS scale (0.9, 95% CI: 0.4, 1.4). Financial hardship accounted for 54% of the total effect on MHI scale and 53% on KPD scale. Collectively, financial hardship and social support explained 68% of the total effect on MHI scale and 67% on KPD scale, respectively. In conclusion, the negative mental health effect of unaffordable housing is largely mediated through increased financial hardship.
Publisher: Oxford University Press (OUP)
Date: 16-03-2021
Abstract: Social disadvantage is a key determinant of multimorbidity. Pathways through which social disadvantage leads to multimorbidity are yet undefined. In this study, we first examined the causal effect of moving into financial hardship on multimorbidity among Australian adults, and then the role of social support as a mediator of the relationship between financial hardship and multimorbidity. Data were obtained from the Household, Income and Labour Dynamics in Australia (HILDA) Survey (2009–2013). We identified in iduals who moved into financial hardship between 2010 and 2011 (n = 5775). Inverse probability treatment weighting with regression adjustment was used to examine the relationship between financial hardship and multimorbidity. Causal mediation analysis was applied to decompose the total effect of financial hardship on multimorbidity into the proportion attributable to social support and the proportion not occurring through measured pathways. We accounted for baseline covariates including age, sex, marital status, educational attainment, employment status, income, country of birth, multimorbidity and social support. Bootstrapping with 1000 replications was used to calculate 95% confidence intervals (CIs). The risk of multimorbidity was higher in those with financial hardship by 19% [relative risk 1.19 (95% CI: 1.02–1.37) and absolute risk difference 0.036 (95% CI: 0.004–0.067)] than those without financial hardship. Social support accounted for 30% of the total effect of financial hardship on multimorbidity, risk difference 0.009 (95% CI: 0.003–0.018). Financial hardship leads to increased risk of multimorbidity. Interventions directed at increasing social support among those in financial hardship may reduce their risk of multimorbidity.
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-033178
Abstract: This study aims to quantify the extent to which people’s use of tobacco products varies by local areas (city ward and village) across India and the variation in this clustering by tobacco products. Cross-sectional study. Data on 73 954 adults across 2547 city wards and villages were available for analysis from 30 states and 2 union territories in India. We included as primary outcomes self-reported any tobacco use, current cigarette smoking, current bidi smoking, current smokeless tobacco use and a derived variable for dual use describing respondents who engaged in both smoking and smokeless tobacco use. The median risk of an in idual using tobacco was 1.64 times greater if a person hypothetically moved from an area of low to high risk of tobacco use (95% CI: 1.60 to 1.69). Area-level partitioning of variation differed by tobacco product used. Median ORs ranged from 1.77 for smokeless tobacco use to 2.53 for dual use. Tobacco use is highly clustered geographically in India. To be effective in India, policy interventions should be directed to influence specific local contextual factors on adult tobacco use. Where people live in India influences their use of tobacco, and this association may be greater than has been observed in other settings. Tailoring tobacco control policies for local areas in India may, therefore, provide substantial public health benefits.
Publisher: Springer Science and Business Media LLC
Date: 07-07-2022
DOI: 10.1007/S00127-022-02333-8
Abstract: This systematic review aims to assess and evaluate quantitative evidence on the association between informal caregiving and mental health in young people. This review was registered in PROSPERO (CRD42021251666). We conducted our search in the following four databases: Medline (PubMed and OVID), EMBASE, PsycInfo and Web of Science. The last search was performed on the 17th of March of 2021. Quantitative studies that focused on carers aged 25 years or less and compared the mental health status of carers and non-carers were eligible for inclusion. Two reviewers independently assessed articles for eligibility and performed the quality assessment using the Risk of Bias tool in Non-Randomised Studies of Exposures (ROBINS-E). We identified a total of ten eligible articles. Mental health outcomes included depression, anxiety and other mental or emotional problems. Nine out of the ten studies showed that being a young carer was consistently associated with poor mental health. However, the overall quality of evidence was low, and longitudinal data were limited to three articles. The primary sources of bias were confounding and outcome measurement. Young carers experience poorer mental health outcomes than their non-caring peers. However, we identified an overall lack of quantitative evidence of high methodological rigour. To establish if young caring leads to poor mental health, future research should focus on addressing the identified methodological limitations and understanding the mechanisms explaining these associations. Addressing these gaps can better inform the allocation of appropriate support and resources to optimise the mental health of young carers.
Publisher: Elsevier BV
Date: 09-2013
Publisher: Hindawi Limited
Date: 2015
DOI: 10.1155/2015/837804
Abstract: Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 ( n = 69 , 296 ) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier in iduals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.
Publisher: Wiley
Date: 21-07-2023
DOI: 10.1002/HEC.4739
Abstract: Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective). A cost‐effectiveness analysis according to quintiles of area‐level socioeconomic disadvantage was performed for the 2020 Australian population (0–100 years old) using a closed cohort Markov model. A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability‐adjusted life years (DALYs) averted. The 10‐year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles). The 10‐year scenario from a societal perspective yielded cost‐savings of AUD$63.5M, healthcare cost‐savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted. The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost‐savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost‐effectiveness for the 10‐year and lifetime scenarios, respectively. A three‐fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is cost‐effective and promotes health equity.
Publisher: SAGE Publications
Date: 27-07-2021
DOI: 10.1177/00048674211031488
Abstract: This study sought to assess the extent to which gender attitudes are associated with mental health among Australian men and women. This study used a s le of 26,188 in iduals drawn from five waves of the Household, Income and Labour Dynamics in Australia Survey. Gender attitudes were classified into three groups (traditional, moderate-egalitarian and egalitarian), and were constructed from six items. Mental health was measured using the Mental Health Inventory (MHI-5). We calculated the magnitude of associations between gender attitudes and mental health, stratified by gender, and adjusted for potential confounding. Compared to men with egalitarian attitudes, poorer mental health was observed among men with moderate-egalitarian (−1.16, 95% confidence interval = [−1.84, −0.49]) and traditional gender attitudes (−2.57, 95% confidence interval = [−3.33, −1.81]). Among women, poorer mental health was observed among those with moderate-egalitarian (−0.78, 95% confidence interval = [−1.34, −0.22]) and traditional attitudes (−1.91, 95% confidence interval = [−2.55, −1.26]) compared to those with egalitarian attitudes. For both men and women, egalitarian gender attitudes were associated with better mental health.
Publisher: Wiley
Date: 24-11-2022
DOI: 10.1111/CDOE.12816
Abstract: To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population‐based data. Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically erse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1–0.1 Severity: 1.0–0.1) or relative scale (ECC ratio: 1.3–1.3 Severity ratio: 1.6–1.1). Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub‐groups.
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2023
End Date: 12-2025
Amount: $431,476.00
Funder: Australian Research Council
View Funded ActivityStart Date: 12-2021
End Date: 11-2026
Amount: $1,115,069.00
Funder: Australian Research Council
View Funded Activity