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Summary
Objective: To examine the prevalence of major chronic diseases and their risk factors in different socioeconomic groups in the Australian population, in order to highlight the need for public policy initiatives to reduce socioeconomic inequalities in health. Methods: Data were provided by the Australian Bureau of Statistics (ABS) from the 2001 National Health Survey (NHS) for selected chronic diseases and associated risk factors. Conditions selected were those, which form the National Health Priority Area (NHPA) conditions (other than injury, which has not been included in this paper, with its focus on chronic disease); plus other 'serious' chronic conditions, in line with the classification developed by Mathers; and for which sufficient cases were available for analysis by socioeconomic status. Indirectly age-standardised prevalence rates were calculated by broad age group for Australia and for five groups of socioeconomic status; rate ratios were calculated to show variations in prevalence between these groups. Results: Significant socioeconomic inequalities were evident for many of the major chronic diseases; the largest was for diabetes mellitus (at ages 25 to 64 years); and for many diseases, there was also a strong, continuous socioeconomic gradient in the rates. Circulatory system diseases (in particular, hypertensive disease) and digestive system diseases also exhibited a strong differential in the 25 to 64 year age group. In the 65 years and over age group, the strongest inequalities were evident for mental and behavioural problems, diabetes (with a continuous socioeconomic gradient in rates) and respiratory system diseases. A number of risk factors for chronic diseases, namely self-reported smoking, alcohol misuse, physical inactivity and excess weight showed a striking association with socioeconomic status, in particular for people who were smokers and those who did not exercise. Conclusion: This analysis shows that the prevalence of chronic disease varies across the socioeconomic gradient for a number of specific diseases, as well as for important disease risk factors. Therefore, any policy interventions to address the impact of chronic disease, at a population level, need to take into account these socioeconomic inequalities. Authors: John D Glover, Diana MS Hetzel and Sarah K TennantPublished: Australia and New Zealand Health Policy 2004; 1: 8. Available free online |
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Journal article: Unpacking analyses relying on area-based data: are the assumptions supportable Summary Background: In the absence in the major Australian administrative health record collections of a direct measure of the socioeconomic status of the individual about whom the event is recorded, analysis of the association between the health status, use of health services and socioeconomic status of the population relies an area-based measure of socioeconomic status. This paper explores the reliability of the area of address (at the levels typically available in administrative data collections) as a proxy measure for socioeconomic disadvantage. The Western Australian Data Linkage System was used to show the extent to which hospital inpatient separation rates for residents of Perth vary by socioeconomic status of area of residence, when calculated at various levels of aggregation of area, from smallest (Census Collection District) to largest (postcode areas and Statistical Local Areas). Results are also provided of the reliability, over time, of the address as a measure of socioeconomic status. Results: There is a strong association between the socioeconomic status of the usual address of hospital inpatients at the smallest level in Perth, and weaker associations when the data are aggregated to larger areas. The analysis also shows that a higher proportion of people from the most disadvantaged areas are admitted to hospital than from the most well-off areas (13% more), and that these areas have more separations overall (47% more), as a result of larger numbers of multiple admissions. Of people admitted to hospital more than once in a five year period, four out of five had not moved address by the time of their second episode. Of those who moved, the most movement was within, or between, areas of similar socioeconomic status, with people from the most well off areas being the least likely to have moved. Conclusion: Postcode level and SLA level data provide a reliable, although understated, indication of socioeconomic disadvantage of area. The majority of Perth residents admitted to hospital in Western Australia had the same address when admitted again within five years. Of those who moved address, the majority had moved within, or between, areas of similar socioeconomic status. Access to data about individuals from the Western Australian Data Linkage System shows that more people from disadvantaged areas are admitted to a hospital, and that they have more episodes of hospitalisation. Were data to be available across Australia on a similar basis, it would be possible to undertake research of greater policy-relevance than is currently possible with the existing separations-based national database. Authors: John Glover, Diana Rosman, Sarah Tennant Published: International Journal of Health Geographics 2004; 3: 30. Available free online |
Geographic distribution of admissions to hospital with a mental health diagnosis and use of community mental health services, 2004This set of maps outlines the distribution of clients of mental health services in South Australia. This resource was produced for the Mental Health Directorate, Central Northern Adelaide Health Service and complements other health atlases including the Social Health Atlas of South Australia and the Social Health Atlas of the Central Northern Adelaide Health Service. Together, these provide important information for policy makers, planners, service providers and community members working towards the future health and wellbeing of South Australians. Authored by PHIDU Published: November 2006; Available free online; Printed copies: not available |
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Nationwide monitoring and surveillance concepts: Physical activity Working Paper No. 5This paper sets out the current situation in trends in the physical activity of Australians based on the most recent national surveys. It summarises the body of evidence and costings which set out the benefits of physical activity, identify physical inactivity as a major risk factor involved in preventable disease, disability and death, and estimated human and health system costs arising from these preventable events. Some of the current national multisectoral alliances and strategies to address the general goal of increasing levels of physical activity in the population are overviewed, together with the work being undertaken to underpin the strategies (such as work on measurements and standardisation of surveillance questions). It examines the identified characteristics of subgroups of the currently surveilled population and argues for an extension of surveillance to other subgroups (such as children, older people and indigenous populations) and to environmental factors. Possible national performance indicators are set out in long and short term frameworks, and related concepts are briefly discussed in terms of their inclusion in population surveillance and monitoring instruments. Important terms are set out in the glossary and appendices provide further information on some topics. Authored by PHIDU Published: 2003; Available free online; Printed copies: not available |
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Nationwide monitoring and surveillance data requirements for health: Physical activity Working Paper No. 4This paper sets out the current situation in trends in the physical activity of Australians based on the most recent national surveys. It summarises the body of evidence and costings which set out the benefits of physical activity, identify physical inactivity as a major risk factor involved in preventable disease, disability and death, and estimated human and health system costs arising from these preventable events. Some of the current national multisectoral alliances and strategies to address the general goal of increasing levels of physical activity in the population are overviewed, together with the work being undertaken to underpin the strategies (such as work on measurements and standardisation of surveillance questions). It examines the identified characteristics of subgroups of the currently surveilled population and argues for an extension of surveillance to other subgroups (such as children, older people and indigenous populations) and to environmental factors. Possible national performance indicators are set out in long and short term frameworks, and related concepts are briefly discussed in terms of their inclusion in population surveillance and monitoring instruments. Important terms are set out in the glossary and appendices provide further information on some topics. Authored by PHIDU Published: 2003; Available free online; Printed copies: not available |