National Health Priority Areas Research Articles

Developing a linked electronic health record derived data platform to support research into healthy ageing.

Digitalisation of Electronic Health Record (EHR) data has created unique opportunities for research. However, these data are routinely collected for operational purposes and so are not curated to the standard required for research. Harnessing such routine data at large scale allows efficient and long-term epidemiological and health services research. To describe the establishment a linked EHR derived data platform in the National Centre for Healthy Ageing, Melbourne, Australia, aimed at enabling research targeting national health priority areas in ageing. Our approach incorporated: data validation, curation and warehousing to ensure quality and completeness; end-user engagement and consensus on the platform content; implementation of an artificial intelligence (AI) pipeline for extraction of text-based data items; early consumer involvement; and implementation of routine collection of patient reported outcome measures, in a multisite public health service. Data for a cohort of >800,000 patients collected over a 10-year period have been curated within the platform's research data warehouse. So far 117 items have been identified as suitable for inclusion, from 11 research relevant datasets held within the health service EHR systems. Data access, extraction and release processes, guided by the Five Safes Framework, are being tested through project use-cases. A natural language processing (NLP) pipeline has been implemented and a framework for the routine collection and incorporation of patient reported outcome measures developed. We highlight the importance of establishing comprehensive processes for the foundations of a data platform utilising routine data not collected for research purposes. These robust foundations will facilitate future expansion through linkages to other datasets for the efficient and cost-effective study of health related to ageing at a large scale.

Exploring mental health clients' current medication knowledge, beliefs and experience with healthcare providers in the community in South Australia.

In Australia, mental illness has been recognised as a National Health Priority area, with the coronavirus pandemic adding a layer of urgency to the need to address the multiple health problems faced by clients with mental illnesses. Whilst much has been done in efforts to support these clients, little is known about their medication knowledge and experience with health professionals. The aim of the study was to explore the knowledge and beliefs of clients on the use of psychotropic medications and study their experiences with healthcare providers. Adult participants at a not-for-profit community-managed specialist mental health service provider in Adelaide, South Australia were recruited. Four focus group sessions were conducted between February 2020 and March 2021. All sessions were co-facilitated by a peer practitioner with lived experience. Sessions were audio recorded and transcribed verbatim. Participants (n= 27) reported that provision of medication education was inadequate and, in some cases, non-existent. There was an apparent lack of support for monitoring and managing common side effects, such as weight gain. Participants described not being involved in any decision-making processes and that establishing and maintaining a therapeutic relationship with their healthcare providers was challenging. Perceived stigma remains a barrier in accessing healthcare. Despite participants regularly interacting with a range of healthcare providers, findings highlight key gaps in care, particularly medication education and establishing a therapeutic relationship with their healthcare providers. Future mental health reforms should consider the provision of additional medication education in community settings, such as at not-for-profit organisations. Moreover, healthcare providers should take a proactive approach in establishing therapeutic relationships.

POS1442 THE PREVALENCE OF RHEUMATOID ARTHRITIS IN WESTERN AUSTRALIA EXTRAPOLATED FROM HOSPITALISATION AND BIOLOGICAL THERAPY USAGE DATA

BackgroundRheumatoid arthritis (RA) is a heterogeneous chronic autoimmune disease that affects the synovial joint lining and may result in permanent joint destruction, premature death, and socio-economic burden.1 Although RA is one of Australia’s national health priority areas and gathering information about the RA burden of disease was one of the national action plans2, no published epidemiological study adequately describes RA prevalence and risk factors for frequent hospitalisations in Western Australia (WA) to date. An accurate prevalence estimate of this disease offers a framework for predicting present and growing healthcare service requirements in the future.3ObjectivesWe estimated RA period prevalence and identified risk factors of frequent RA hospitalisations, using linked administrative health and state-specific Australian Pharmaceutical Benefits Scheme (PBS) datasets in WA from 1995–2014.MethodsRA prevalence was calculated per 1000 hospital separations and biological therapy users. RA patients were identified in the WA linked health dataset using ICD codes 714.0–714.9 and M05.00–M06.99. Dispensing data on biological therapy for RA were obtained from PBS records and converted to defined daily doses/1000 population/day. Multivariate logistic regression was used to analyse risk factors for frequent RA hospitalisations (>2/year), controlling for sex, age, and geographic locations.ResultsA total of 17,125 RA patients were admitted to WA hospitals between 1995–2014. The total number of RA hospital separations was 50,353, averaging three hospitalisations per patient over 20 years. The RA period prevalence was 3.4 per 1,000 separations (0.34%), while the RA period prevalence based on biological therapy use was 0.36%. The corrected RA prevalence based on biological therapy usage was 0.36% and 0.72% for the 2005–2009 and 2010–2014 periods, respectively (Table 1). Female gender, age 60–69 years, and living in rural areas were all risk factors for frequent RA hospitalisations.Table 1.Total number of Rheumatoid Arthritis patients in Western Australia taking a standard dose daily (DDD) of RA biological therapy from 1995 to 2014.YearTotal RA bDMARDs utilisation (DDD/1000 population/day)WA general populationPrevalence of RA bDMARDs use in WA population (%)Number of RA patients use standard dose daily of bDMARDs at WA20030.011,952,7410.001420040.081,979,5420.0115820050.162,011,2070.0232920060.232,050,5810.0247620070.312,106,1390.0364320080.502,171,7000.051,09420090.602,240,2500.061,33820100.592,290,8450.061,36120110.632,353,4090.061,47520120.772,425,5070.081,85920130.662,486,9440.071,64920141.002,517,6080.102,510Abbreviations: bDMARDs, biologic disease-modifying anti-rheumatic drugs included Abatacept, Adalimumab, Certolizumab, Etanercept, Golimumab, Infliximab, Rituximab, Tocilizumab; DDD, defined daily doses; RA, Rheumatoid arthritis; WA, Western Australia.ConclusionBased on hospital and biological therapy data, the minimal prevalence of RA in Western Australia is 0.34–0.36%, which falls within the literature range. Older female RA patients in rural areas were more likely to be hospitalised, suggesting unmet needs in primary care access.

How should we prepare pharmacy graduates for a world in which the only certainty is change?

Pharmacists contribute to patient care in an increasingly interconnected and interdependent healthcare landscape. Clinical decision making is growing more complex and more diverse, despite technology-enabled systems to assist with the vast amount of new knowledge. We find that as practice evolves, the profession is forced both to consider how we enhance generic graduate capabilities and how to recognise disciplinary expertise and perspectives. This demonstrates the scale of the challenge facing schools of pharmacy today; correspondingly, it suggests the need for the profession to look ahead collectively, something the Pharmacy Forecast Australia project has endeavoured to facilitate, with its key findings presented in this issue of the JPPR.1 Technological advances will continue to have far reaching consequences not only at an individual level but also for society more generally. Amid these changes, the future of health and health care must be person-centred and socially accountable, focused on maintaining well-being. It should be enabled by digital transformation, increased availability of data, and steered by higher public expectations for accessible healthcare. Increasingly, to address chronic health concerns, patients require more complex medicines taken over longer periods of time and these current and evolving trends offer workforce challenges and opportunities to deliver high quality care now and in the future. Because of this, pharmacists and the pharmacy profession more broadly have an important and increasing role in ensuring safety and quality of care. Appraising the evidence base and applying clinical reasoning and professional judgement which optimise outcomes and minimises risk for the person are core competencies for pharmacists. Any role, whether remunerated or not, in which the individual uses their skills and knowledge as a pharmacist in their profession. Practice is not restricted to the provision of direct clinical care. It also includes working in a direct, non-clinical relationship with clients; working in management, administration, education, research, advisory, regulatory or policy development roles; and other roles that impact on safe, effective delivery of services in the profession.2 The need for pharmacists working closely with patients, their carers, and other members of the healthcare team is also recognised in our National Medicines Policy, and in the inclusion of Medicine Safety as a National Health Priority Area. A look through the lens of future health care and the healthcare system identifies the broader societal need for interprofessional, collaborative healthcare teams where pharmacists play a prominent role in fostering patient-centred care. The future of health care demands interprofessional teams, which requires pharmacists to bring their expertise to the team to address the diverse and complex healthcare needs of our society. Successful interprofessional communication enables pharmacists to engage in collaborative practice sharing their skills and knowledge with other health professions and clinicians to influence clinical decisions and enhance outcomes from medicines. Further, leadership development is a critical component of programs of study leading to registration and included in the accreditation standards. Leadership is required across the system – including development of the technical pharmacy workforce – and necessarily involves management of financial and human resources, health economics, clinical governance, and health informatics. As for today’s leaders, collaborative efforts between universities and our professional and clinical stakeholders to prepare the profession for tomorrow – with Pharmacy Forecast Australia a key example – are our best chance at sustaining and improving our overall contribution to patient care in a world in which the only certainty is more change. The authors declare that they have no conflicts of interest.

Exercise as Medicine—Evidence for Prescribing Exercise for the National Health Priority Areas: An Umbrella Review

Exercise as Medicine—Evidence for Prescribing Exercise for the National Health Priority Areas: An Umbrella Review

THU-431-The burgeoning growth in cirrhosis-related hospitalization in Australia, 2008-2016

Background and aims:While chronic liver disease is a major global public health problem, it has not been recognized as a National Health Priority Area in Australia. A population-based study using hospital admission data for cirrhosis in the large state of Queensland, Australia during 2008-2016 was performed. Method:Hospital data on all patient admissions (public and private)and deaths during 2008-2016 in the state of Queensland were obtained. Queensland is a large state in the north-east of Australia with a population of 4.9 million. We identified all hospital admissions for cirrhosis for patients aged 20 years or older. We reported age-standardized hospitalization rates/10, 000 person-years by gender and per calendar year, in-hospital case fatality rate among these admissions (n = 30, 327) and examined the factors associated with hospital deaths. Results:Age-adjusted hospitalization rates increased by 32%between 2008 and 2016, from 8.50/10, 000 (95%CI 8.18-8.82) to11.21/10, 000 (95%CI 10.87-11.54). Admission rates peaked in men at34.03/10, 000 in 55-59 year-olds. The age-standardized admission rate for Indigenous Australians was 32.79/10, 000 (95%CI 31.28-34.31). Alcohol misuse was a contributing factor in over half (55.1%) of all admissions, and in 26.8% of admissions patients resided in most socio-economically disadvantaged areas. The overall in-hospital case fatality rate was 9.7% for males and 9.3% for females, and decreased significantly in males from 10.25% in 2008 to 8.32% in 2016 (p Conclusion:Our data highlights the increasing healthcare use by Australians with cirrhosis and this has major resource and economic implications. Greater awareness and emphasis on preventive care is needed to reduce the increasing prevalence of cirrhosis and the personal, social and economic burden of its complications.

Exercise as medicine – Evidence for prescribing exercise for Australia's nine national health priority areas: An umbrella review

Exercise as medicine – Evidence for prescribing exercise for Australia's nine national health priority areas: An umbrella review

Survival of the fittest

The case for exercise in preventive health is now comprehensively made: For all nine of the National Health Priority Areas (NHPAs) exercise therapy is shown to lower risk. However exercise can also be used effectively as both secondary prevention and treatment for these conditions, as well as a number of related conditions.

Medical Student Research during a Longitudinal Community-Based Placement Can Provide Opportunities for Learning about Public Health

While ‘public health medicine’ is a specialised field, most medical practitioners practice ‘public health’ to some extent, e.g., undertaking preventative screening tests or advising individuals about lifestyle interventions. While requirements to demonstrate capability in public health are common to medical education around the world, medical programs face a challenge to integrate public health education and promote health advocacy in an environment where the doctor: patient relationship is at the core of learning. Students who spend part of their medical education working within general practice or community settings have an opportunity to observe and identify issues of public health importance, and to see how they impact at both a personal and a population level. This paper aims to illustrate how a year-long research project can provide an opportunity for medical students to learn about public health issues and methods to investigate them. Analysis was undertaken of the research topics chosen by eight successive cohorts of medical students, representing 519 students, who successfully completed a research project. Over half of the student research projects (51.8%) directly related to Australian national health priority areas of dementia, obesity, arthritis and musculoskeletal conditions, asthma, diabetes, mental health, injury prevention and control, cardiovascular health and cancer control, and a further 28.5% of projects had a specific public health focus, within domains that include lifestyles and health, communicable disease, and healthy growth and development. Researching public health topics in the community setting represents a practical way to engage medical students in learning about public health, and can help to develop their potential to become ‘clinician researchers’, investigating and understanding issues relevant to their communities.

Associations between multimorbidity and additional burden for working-age adults with specific forms of musculoskeletal conditions: a cross-sectional study

BackgroundMultiple health conditions are increasingly a problem for adults with musculoskeletal conditions. However, multimorbidity research has focused primarily on the elderly and those with a limited subset of musculoskeletal disorders. We sought to determine whether associations between multimorbidity and additional burden differ with specific forms of musculoskeletal conditions among working-age adults.MethodsData were sourced from a nationally representative Australian survey. Specific musculoskeletal conditions examined were osteoarthritis; inflammatory arthritis; other forms of arthritis or arthropathies; musculoskeletal conditions not elsewhere specified; gout; back pain; soft tissue disorders; or osteoporosis. Multimorbidity was defined as the additional presence of one or more of the Australian National Health Priority Area conditions. Burden was assessed by self-reported measures of: (i) self-rated health (ii) musculoskeletal-related healthcare and medicines utilisation and, (iii) general healthcare utilisation. Associations between multimorbidity and additional health or healthcare utilisation burden among working-age adults (aged 18 – 64 years of age) with specific musculoskeletal conditions were estimated using logistic regression, adjusting for confounders. Interaction terms were fitted to identify whether there were specific musculoskeletal conditions where multimorbidity was more strongly associated with poorer health or greater healthcare utilisation than in the remaining musculoskeletal group.ResultsAmong working-age adults, for each of the specified musculoskeletal conditions, multimorbidity was associated with similar, increased likelihood of additional self-rated health burden and certain types of healthcare utilisation. While there were differences in the relationships between multimorbidity and burden for each of the specific musculoskeletal conditions, no one specific musculoskeletal condition appeared to be consistently associated with greater additional health burden in the presence of multimorbidity across the majority of self-rated health burden and healthcare use measures.ConclusionsFor working-age people with any musculoskeletal conditions examined here, multimorbidity increases self-reported health and healthcare utilisation burden. As no one musculoskeletal condition appears consistently worse off in the presence of multimorbidity, there is a need to better understand and identify strategies that acknowledge and address the additional burden of concomitant conditions for working-age adults with a range of musculoskeletal conditions.

Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use.

BackgroundThere is increasing evidence that complementary medicine (CM) services are being used by a substantial proportion of the Australian population and this topic has attracted keen interest from primary health care providers and policy makers. This article outlines the first summative critical review of the predictors of CM use in Australia as well as the characteristics and perceptions of Australian CM users over the last 14 years.MethodsA literature search was conducted to ascertain original research from 2000 to 2014 in the AMED; CINAHL; and PubMed databases. Selected articles were subject to a critical appraisal analysis to identify the quality of the article. The search was confined to peer reviewed original articles published in English which identified the nature of CM services use in Australia.ResultsThe findings indicate a correlation between CM users and gender, with reports of a higher rate of use from females compared to males. Female CM users are more likely to be middle-aged with a higher education and higher annual income in comparison to female non-CM users. An association between resident location and use of CM disciplines was also identified with reports of rural residents utilising manual therapies more frequently compared to urban residents. CM users are more likely to seek CM services for a range of chronic conditions including diseases identified as National Health Priority Areas by the Australian Government.ConclusionsThis article provides the first comprehensive review examining the nature of CM use in Australia. The review findings offer important insights into the characteristics and features of CM use in Australia and provide insights for national and regional primary health care initiatives and of interest to medical doctors, allied health professionals, CM practitioners, researchers and policy makers.

A decade of Rural Clinical School research: a PubMed review

One parameter of the operational framework of the Australian Rural Clinical Training & Support Program (RCTS) is rural health research, yet there are no published reports of the research outcomes generated by these hallmarks of Australian rural medical education. To assess the contribution of RCTS to rural health research, their MEDLINE-indexed research publications over the last decade was analysed, using a bibliometric method. MEDLINE-indexed RCTS publications from 2004 to 2013 were retrieved using validated PubMed queries. Two authors independently checked all retrieved RCTS publications for validity. Australian rural health (ARH) publications from RCTS were selectively enumerated and their proportion among all Australian rural health publications in each year was determined. ARH publications were defined as Australian publications that explore issues relevant to the health of the regional, rural or remote Australian population.RCTS publications related to medical education, Indigenous health, rural service areas, National Health Priority Areas (NHPA), and National Rural Health Alliance Priority Areas (NRHAPA) were analysed. Frequency of publication in different journals was also compared. A total of 280 RCTS publications were retrieved, increasing from 10 in 2004 to 49 in 2013. ARH topics dominated (177 articles; 67%). RCTS rural health publications increased as a proportion of all ARH publications from 3.4% in 2004 to 7.7% in 2013. Other RCTS publications increased from 2 (20% of total) in 2004 to 19 (39% of total) in 2013, and covered topics such as mental health, cancer, diabetes, obesity and asthma. RCTS medical education publications increased from 3 in 2004 to 14 in 2013. In total, 81 articles were retrieved comprising 28.9% of all RCTS publications. Indigenous health (18; 6%), rural populations (37; 13%) and rural health services (83; 29%) were the other important categories relevant to the RCTS funding parameters. RCTS publications also included NHPA (57; 20%) and NRHAPA (61; 22%). The main journals publishing RCTS research in this time period were Rural and Remote Health (16%), Australian Journal of Rural Health (13%) and Australian Family Physician (9%). This first study to report on the research efforts of RCTS researchers has shown that they are making a valuable contribution to rural health research and increasingly so within the research parameters indicated. These data represent a benchmark of research strengths and highlight research areas that should be strengthened with targeted research to best promote the health of rural Australians.

Australian clinical trial activity and burden of disease: an analysis of registered trials in National Health Priority Areas.

To assess whether Australian clinical trials activity in National Health Priority Areas (NHPAs) reflects the relative disease burden. Analysis of trials registered on the Australian New Zealand Clinical Trials Registry (ANZCTR) or ClinicalTrials.gov from January 2008 to December 2012 that planned recruitment in Australia and investigated interventions for NHPA conditions (cancer control, cardiovascular health, mental health, obesity, injury prevention/control, diabetes mellitus, arthritis and musculoskeletal conditions, dementia and asthma). Australian estimates of disability-adjusted life-years (DALYs) were used to quantify the burden of disease for each NHPA. For each NHPA, the total number of registered trials, planned recruitment, and the predicted numbers based on disability-adjusted life-years expressed as a proportion of the total burden of disease in Australia (%DALY). 5143 trials with Australian sites were registered in the 5-year study period with total planned recruitment of 2404609 participants. Of these, 3032 trials (59%) with planned recruitment of 1532064 participants (64%) investigated NHPA conditions. Trial numbers and planned recruitment were highest for cancer, cardiovascular and mental health - reflecting their higher disease burden. In contrast, planned recruitment into obesity and dementia trials was ≤50% of that predicted from total trial activity based on their relative disease burden. The number of registered trials for these conditions was also lower than predicted. Overall, of 3032 NHPA trials, 2335 (77%) used randomisation and 1520 (50%) planned to recruit >100 participants. Australian clinical trial activity for obesity and dementia interventions is lower that would be expected based on their relative disease burden. Trial registries provide a valuable public database to identify and monitor gaps in research activity.

Chronic wounds should be one of Australia's National Health Priority Areas.

Chronic wounds are a poorly recognised chronic disease that cause pain and suffering and cost the Australian healthcare system A $2.85 billion dollars per annum. Unlike the highly profiled and relatively well-funded chronic diseases that comprise the Australian National Health Priority Areas, chronic wounds remain a largely hidden and poorly supported problem in the Australian community. This perspective article proposes that one approach to generate action to reduce the burden of chronic wounds is to better articulate the relationship between chronic wounds and the Australian National Health Priority Areas, and to establish a profile of chronic wounds as a chronic disease of national significance in its own right. This approach has the potential to raise awareness of the significance of chronic wounds and garner support from the public, healthcare sector, research funders and policy makers to improve the outcomes for people who are living with or at risk of developing this condition and to potentially reduce expenditure in this area.

Obesity management by general practitioners: the unavoidable necessity.

Nearly 62% of primary care patients are overweight or obese, and obesity is now a National Health Priority Area. Weight management interventions in primary care currently generate little more than 1 kg of weight loss per patient over a 2-year period. Consequently, further strategies are required to improve the effectiveness of weight management in primary care. The National Health and Medical Research Council (NHMRC) have released updated guidelines for the management of overweight and obese patients in primary care. However, there is some disconnect between establishment of guidelines and their implementation in practice. Barriers to GPs using guidelines for the management of obesity include low self-efficacy, perceived insufficient time in consultations and the challenge of raising the topic of a patient's weight. Nonetheless, patients prefer to receive weight management support from GPs rather than other health professionals, suggesting that the demand on GPs to support patients in weight management will continue. GPs cannot afford to side-line obesity management, as obesity is likely to be the most prevalent modifiable risk factor associated with patients' long-term health. Without further strategies to support GPs in their management of patients' weight, obesity will continue to be an expensive and long-term public health issue.

Defining "elderly" in clinical practice guidelines for pharmacotherapy

To identify how 'elderly' patients are defined and considered within Australian clinical guidelines for the use of pharmacotherapy. Guidelines pertaining to the use of pharmacotherapy, focusing on conditions described in National Health Priority Areas, were identified using databases (Medline, Google Scholar) and organisation websites (Department of Health and Ageing, National Heart Foundation, National Health and Medical Research Council). Guidelines were reviewed and qualitatively analysed to identify any references or definitions of 'elderly' persons. Among the 20 guidelines reviewed, 3 defined 'elderly' by chronological age (i.e., years since birth) while the remaining 17 guidelines did not define 'elderly' in any way. All 20 guidelines used the term 'elderly', whilst some guidelines provided age (chronological)-based dosage recommendations suggesting an ageist or generalist approach in their representation of 'elderly', for which rationale was seldom provided. Thematic analysis of the statements revealed five key themes regarding how 'elderly' was considered within the guidelines, broadly describing 'elderly' persons as being frail and with altered pharmacology. Some guidelines also highlighted the limited evidence base to direct clinical decision-making. A continuum of perceptions of ageing also emerged out of the identified themes. Clinical practice guidelines currently do not adequately define 'elderly' persons and provide limited guidance on how to apply treatment recommendations to older persons. The representation of 'elderly' in guidelines needs to be less based on chronological age or generic definitions focusing more on establishing a direct link between an individual patient's characteristics and the pharmacology of their prescribed medication. Clinical guidelines that do not offer any practical descriptions of the features of ageing that are specifically related to the use of pharmacotherapy, or how to assess these in individual patients, render decision-making challenging.

Bibliometric analysis on Australian rural health publications from 2006 to 2012.

To review Australian rural health (ARH) publications in PubMed from 2006 to 2012 and address ARH issues raised by the 2013 Health and Medical Research report. Retrospective observational study. Internet-based bibliometric analysis using PubMed. MEDLINE-indexed ARH publications from 2006 to 2012 were retrieved using PubMed queries. ARH publications were defined as Australian publications that explore issues relevant to the health of the regional, rural or remote Australian population. Two authors independently reviewed a random sample of 5% of publications for validity. Analysis determined country of origin (Australia); publications relevant to the National Health Priority Areas, the 2013 National Rural Health Alliance priority areas and Rural Clinical Schools/University Departments of Rural Health; and journal frequencies and publication types. ARH publications increased from 286 in 2006 to 393 in 2012 and made up 1.4% of all Australian PubMed publications. Combined, the health priority areas were addressed in 52% of ARH publications. Rural Clinical Schools/University Departments of Rural Health articles made up 7% of ARH publications. An increase in cohort studies, systematic reviews and reviews indicated improved quality of articles. ARH articles were most commonly published in the Australian Journal of Rural Health (15.9%), Rural and Remote Health (13.4%) and the Medical Journal of Australia (6.3%). Striking a balance between broadening the queries (increasing sensitivity) and limiting the false positives by restricting the breadth of the queries (increasing specificity) was the main limitation. This reproducible analysis, repeated at given timelines, can track the progress of ARH publications and provide directions regarding future rural health research.

Trends in migrant mortality rates in Australia 1981–2007: a focus on the National Health Priority Areas other than cancer

Introduction. Migrants generally have more favourable mortality outcomes than the Australian-born population. The aim of this study is to update knowledge and inform future research in this field by examining mortality from musculoskeletal conditions, asthma, cardiovascular disease, diabetes mellitus, injuries and mental conditions between 1981 and 2007 among migrants in Australia.Methods. Average annual sex- and age-standardised mortality rates were calculated for each migrant group, period of death registration and cause of death.Results and Conclusions. Mortality rates decreased among most groups for asthma, cardiovascular disease and motor vehicle accidents, with rates diverging in the later time periods. The reverse was true for mental disorders, where Australian-born individuals experienced the greatest increase in mortality. Migrants generally displayed more favourable mortality outcomes than their Australian-born counterparts. Migrants from Southern Europe appeared to have the greatest advantage. However, some migrants appeared to be over-represented in the areas of diabetes, suicide and mental health.

General Practice and Medicare Locals, Best Placed to Curb Australia’s Chronic Disease Epidemic

Keeping in mind the burgeoning chronic disease problem of Australia, Australian governments have chosen to pay focused attention on certain diseases and conditions that contribute significantly to the burden of illness and injury in the Australian community and have called them, The National Health Priority Areas (NHPAs).

Policy scorecard for gender mainstreaming: gender equity in health policy

To examine whether gender mainstreaming for women's health is included in national and state health policies. A policy analysis tool (Policy Scorecard) was developed and then applied to Australia's National Health Priority Areas as well as policies of three Australian States. Despite Australia's leadership in women's health policy, its health policies are largely devoid of gender equity concerns at both national and state levels. Mainstreaming of gender equity outcomes has not yet occurred in Australia. Applying the Policy Scorecard for Gender Mainstreaming to local and country-specific policies is revealing of governments' commitment to women, and how well gender equity goals are embedded into policies and programs. Policy analysis using this gender-sensitive Policy Scorecard provides opportunities for advocacy to advance women's health and gender equity at any level of government, in any country.