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Shukla N, Pradhan B, Dikshit A, Chakraborty S, Alamri AM. A Review of Models Used for Investigating Barriers to Healthcare Access in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4087. [PMID: 32521710 PMCID: PMC7312585 DOI: 10.3390/ijerph17114087] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022]
Abstract
Understanding barriers to healthcare access is a multifaceted challenge, which is often highly diverse depending on location and the prevalent surroundings. The barriers can range from transport accessibility to socio-economic conditions, ethnicity and various patient characteristics. Australia has one of the best healthcare systems in the world; however, there are several concerns surrounding its accessibility, primarily due to the vast geographical area it encompasses. This review study is an attempt to understand the various modeling approaches used by researchers to analyze diverse barriers related to specific disease types and the various areal distributions in the country. In terms of barriers, the most affected people are those living in rural and remote parts, and the situation is even worse for indigenous people. These models have mostly focused on the use of statistical models and spatial modeling. The review reveals that most of the focus has been on cancer-related studies and understanding accessibility among the rural and urban population. Future work should focus on further categorizing the population based on indigeneity, migration status and the use of advanced computational models. This article should not be considered an exhaustive review of every aspect as each section deserves a separate review of its own. However, it highlights all the key points, covered under several facets which can be used by researchers and policymakers to understand the current limitations and the steps that need to be taken to improve health accessibility.
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Affiliation(s)
- Nagesh Shukla
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Biswajeet Pradhan
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
- Department of Energy and Mineral Resources Engineering, Sejong University, Choongmu-gwan, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Abhirup Dikshit
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Subrata Chakraborty
- Centre for Advanced Modelling and Geospatial Information Systems (CAMGIS), University of Technology Sydney, 2007 NSW, Australia; (N.S.); (A.D.); (S.C.)
| | - Abdullah M. Alamri
- Department of Geology & Geophysics, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia;
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Keramat SA, Alam K, Gow J, Biddle SJH. Impact of Disadvantaged Neighborhoods and Lifestyle Factors on Adult Obesity: Evidence From a 5-Year Cohort Study in Australia. Am J Health Promot 2020; 35:28-37. [PMID: 32458696 DOI: 10.1177/0890117120928790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study aims to investigate the impact of disadvantaged neighborhoods and lifestyle factors on obesity among Australian adults. DESIGN Quantitative, longitudinal research design. SETTING Cohort. SAMPLE Data for this study came from a cohort of 10 734 adults (21 468 observations) who participated in the Household, Income and Labour Dynamics in Australia survey. The participants were interviewed at baseline in 2013 and were followed up in 2017. MEASURES Generalized Estimating Equation model with logistic link function was employed to examine within-person changes in obesity due to disadvantaged neighborhoods and lifestyle factors at 2-time points over a 4-year follow-up period. RESULTS Adults living in the most disadvantaged area were 1.22 (odds ratio [OR]: 1.22, 95% CI: 1.08-1.38) and 1.30 (OR: 1.30, 95% CI: 1.20-1.42) times, respectively, more prone to be overweight and obese compared with peers living at least disadvantaged area. Study results also revealed that adults who consume fruits regularly and perform high levels of physical activity were 6% (OR: 0.94, 95% CI: 0.91-0.98) and 12% (OR: 0.88, 95% CI: 0.85-0.92) less likely to be obese, respectively, compared to their counterparts. Current alcohol drinkers were 1.07 (OR: 1.07, 95% CI: 1.01-1.13) times more likely to be obese compared to peers not consuming alcohol. Highly psychologically distressed adults were 1.08 times (OR: 1.08, 95% CI: 1.02-1.13) more likely to be obese than their peers. CONCLUSION This study contributes to the literature regarding disadvantaged neighborhoods and lifestyle factors, which have an influence on adult obesity rates and thus help health decision-makers to formulate effective obesity prevention strategies.
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Affiliation(s)
- Syed Afroz Keramat
- School of Commerce, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, Informatics and Economic Research, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
- Economics Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Khorshed Alam
- School of Commerce, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
- Centre for Health Research, Informatics and Economic Research, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Jeff Gow
- School of Commerce, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
- School of Accounting, Economics, and Finance, University of KwaZulu-Natal, Durban, South Africa
| | - Stuart J H Biddle
- Centre for Health Research, Informatics and Economic Research, 7932University of Southern Queensland, Toowoomba, Queensland, Australia
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Gallegos D, Do H, To QG, Vo B, Goris J, Alraman H. The effectiveness of living well multicultural-lifestyle management program among ethnic populations in Queensland, Australia. Health Promot J Austr 2020; 32:84-95. [PMID: 32053254 DOI: 10.1002/hpja.329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/13/2019] [Accepted: 02/09/2020] [Indexed: 12/11/2022] Open
Abstract
ISSUE Some migrant groups have higher risks of deaths and chronic diseases due to barriers associated with socioeconomic disadvantage, social isolation, racism, language, poor access to health services and low levels of health literacy. However, few culturally tailored interventions have targeted ethnic groups in Australia. This study evaluated the effectiveness of the Living Well Multicultural-Lifestyle Management Program (LWM-LMP) in Queensland, Australia. METHODS The LWM-LMP was originally co-designed with the targeted communities. Participants aged ≥18 years were eligible to participate without a fee. The evaluation was a quasi-experimental design without a control group, with data collected at baseline, the end of the programme and after-programme follow-up at week 14. The programme lasted 8 weeks with one group-based session of 120 minutes delivered each week in local community venues. Each session also included time to undertake physical activity (PA). Eating and PA behaviours were self-reported. Weight, height, waist circumference and blood pressure were measured using standard protocols. RESULTS Participants were more likely to consume ≥2 servings of fruit/day, five servings of vegetable/day, low-fat milk, processed meat, fast food, hot chips/fries, salty snacks, sweet snacks, sweet beverages less than once per week and meet the PA recommendation of ≥150 minutes/wk (P < .001) at week 8. Weight, BMI, waist circumference, waist-to-height ratio and blood pressure were also improved at week 8. Many of the changes were sustained at week 14. CONCLUSIONS The LWM-LMP was effective in improving participants' lifestyle behaviours and cardiometabolic indicators. SO WHAT Engaging targeted communities in designing interventions focussed on healthy personal behaviours helps with delivery and implementation. Behavioural interventions should be culturally tailored to increase their effectiveness.
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Affiliation(s)
- Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hong Do
- Chronic Disease Program, Ethnic Communities Council of Queensland, West End, QLD, Australia
| | - Quyen Gia To
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Brenda Vo
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Janny Goris
- Preventive Health Branch, Prevention Division, Queensland Department of Health, Herston, QLD, Australia
| | - Hana Alraman
- Chronic Disease Program, Ethnic Communities Council of Queensland, West End, QLD, Australia.,EACH, National Disability Insurance Scheme Partners in the Community Early Childhood Early Intervention, Ipswich, QLD, Australia
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Duncan EW, Cramb SM, Aitken JF, Mengersen KL, Baade PD. Development of the Australian Cancer Atlas: spatial modelling, visualisation, and reporting of estimates. Int J Health Geogr 2019; 18:21. [PMID: 31570101 PMCID: PMC6771109 DOI: 10.1186/s12942-019-0185-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well known that the burden caused by cancer can vary geographically, which may relate to differences in health, economics or lifestyle. However, to date, there was no comprehensive picture of how the cancer burden, measured by cancer incidence and survival, varied by small geographical area across Australia. METHODS The Atlas consists of 2148 Statistical Areas level 2 across Australia defined by the Australian Statistical Geography Standard which provide the best compromise between small population and small area. Cancer burden was estimated for males, females, and persons separately, with 50 unique sex-specific (males, females, all persons) cancer types analysed. Incidence and relative survival were modelled with Bayesian spatial models using the Leroux prior which was carefully selected to provide adequate spatial smoothing while reflecting genuine geographic variation. Markov Chain Monte Carlo estimation was used because it facilitates quantifying the uncertainty of the posterior estimates numerically and visually. RESULTS The results of the statistical model and visualisation development were published through the release of the Australian Cancer Atlas ( https://atlas.cancer.org.au ) in September, 2018. The Australian Cancer Atlas provides the first freely available, digital, interactive picture of cancer incidence and survival at the small geographical level across Australia with a focus on incorporating uncertainty, while also providing the tools necessary for accurate estimation and appropriate interpretation and decision making. CONCLUSIONS The success of the Atlas will be measured by how widely it is used by key stakeholders to guide research and inform decision making. It is hoped that the Atlas and the methodology behind it motivates new research opportunities that lead to improvements in our understanding of the geographical patterns of cancer burden, possible causes or risk factors, and the reasons for differences in variation between cancer types, both within Australia and globally. Future versions of the Atlas are planned to include new data sources to include indicators such as cancer screening and treatment, and extensions to the statistical methods to incorporate changes in geographical patterns over time.
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Affiliation(s)
- Earl W Duncan
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology (QUT), Brisbane, Australia.,School of Mathematics, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, Australia
| | - Susanna M Cramb
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology (QUT), Brisbane, Australia.,Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, QLD, 4004, Australia
| | - Joanne F Aitken
- Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, QLD, 4004, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,School of Public Health, The University of Queensland, Brisbane, Australia.,School of Research-Public Health, Queensland University of Technology, Brisbane, Australia.,Institute for Resilient Regions, University of Southern Queensland, Brisbane, Australia
| | - Kerrie L Mengersen
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology (QUT), Brisbane, Australia.,School of Mathematics, Science and Engineering Faculty, Queensland University of Technology (QUT), Brisbane, Australia
| | - Peter D Baade
- Cancer Council Queensland, PO Box 201, Spring Hill, Brisbane, QLD, 4004, Australia. .,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
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