Representative Sample Of Australian Women Research Articles

Health service and medication costs associated with common mental disorders and subthreshold symptoms in women: Findings from the Geelong Osteoporosis Study in Australia.

This analysis estimated 2013 annual healthcare costs associated with the common mental disorders of mood and anxiety disorders and psychological symptoms within a representative sample of Australian women. Data from the 15-year follow-up of women in the Geelong Osteoporosis Study were linked to 12-month Medicare Benefits Schedule and Pharmaceutical Benefits Scheme data. A Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Non-patient edition identified common mental disorders and the General Health Questionnaire 12 assessed psychological symptoms. Participants were categorised into mutually exclusive groups: (1) common mental disorder (past 12 months), (2) subthreshold (no common mental disorder and General Health Questionnaire 12 score ⩾4) or (3) no common mental disorder and General Health Questionnaire 12 score <4. Two-part and hurdle models estimated differences in service use, and adjusted generalised linear models estimated mean differences in costs between groups. Compared to no common mental disorder, women with common mental disorders utilised more Medicare Benefits Schedule services (mean 26.9 vs 20.0, p < 0.001), had higher total Medicare Benefits Schedule cost ($1889 vs $1305, p < 0.01), received more Pharmaceutical Benefits Scheme prescriptions (35.8 vs 20.6, p < 0.001), had higher total Pharmaceutical Benefits Scheme cost ($1226 vs $740, p < 0.05) and had significantly higher annual out-of-pocket costs for Pharmaceutical Benefits Scheme prescriptions ($249 vs $162, p < 0.001). Compared to no common mental disorder, subthreshold women were less likely to use any Medicare Benefits Schedule service (89.6% vs 97.0%, p < 0.01), but more likely to use mental health services (11.4% vs 2.9%, p < 0.01). The subthreshold group received more Pharmaceutical Benefits Scheme prescriptions (mean 43.3 vs 20.6, p < 0.001) and incurred higher total Pharmaceutical Benefits Scheme cost ($1268 vs $740, p < .05) compared to no common mental disorder. Common mental disorders and subthreshold psychological symptoms place a substantial economic burden on Australian healthcare services and consumers.

More to lose? Longitudinal evidence that women whose social support declines following childbirth are at increased risk of depression

ObjectiveWe examined the dynamic relationship between life changes (pregnancy and childbirth) and social support during the postpartum period. MethodsA large, nationally representative sample of Australian women (N=806) who completed the Household Income and Labour Dynamics in Australia Survey (HILDA) in the year immediately before and immediately after giving birth to a child reported on measures of perceived social support and mental health. ResultsAnalyses indicated a decrease in both social support and mental health after having a baby. Social support during the postpartum period – controlling for social support and mental health prior to the birth of a baby – predicted better mental health in women. However, for women who experienced a decline in social support, prenatal social support was a risk factor for a decline in mental wellbeing rather than a protective factor. ConclusionsWomen who have ‘more to lose’ are at increased risk of mental ill‐health if they cannot maintain existing sources of social support. Implications for public healthLoss of social support during pregnancy and the postpartum period should be considered as a significant risk factor for postpartum depression in its own right and one that warrants screening and intervention.

Women's engagement with diabetes prevention activities and the influence of contact by the Australian national gestational diabetes register

AbstractGestational diabetes increases a woman's risk of developing type 2 diabetes. In 2011, Australia started the first National Gestational Diabetes Register (NGDR). The register aims to improve risk awareness, promote diabetes prevention, and encourage regular diabetes screening. This study aimed to identify postnatal diabetes prevention activity and the association of NGDR awareness with that activity in a nationally representative sample of Australian women after a pregnancy with gestational diabetes.An anonymous, cross‐sectional, online survey of women previously diagnosed with gestational diabetes and aged 18 years or over was run from June to November 2014.Of 8860 women invited from a stratified NGDR sample, 966 participated (response rate 13%). Postnatal screening rate was 73%. Only 47% of respondents reported receiving NGDR information postnatally. Log‐binomial regression demonstrated an association with women reporting receiving NGDR information and being at intermediate risk of developing type 2 diabetes (relative ratio [RR] 1.307, 95% CI 1.030, 1.660) and at higher disadvantage (RR 1.501, 95% CI 1.080, 2.080). Postnatal screening rates, total diabetes risk perception and lifestyle risk factors were not significantly different between those recalling or not recalling receiving NGDR information.The reach and impact of NGDR information alone are limited. Women's engagement with the NGDR was not associated with better lifestyle, greater postnatal screening or higher risk perception. System‐level integration is needed for improved NGDR functioning and further improvements should yield enhanced diabetes prevention efforts when primary care ties are strengthened. Copyright © 2021 John Wiley &amp; Sons.

Australian women’s understanding of menopause and its consequences: a qualitative study

Background This study was undertaken to determine women’s knowledge of menopause and its consequences, and their menopause-related health-care experiences. Methods Participants were recruited to this cross-sectional qualitative study from a nationally, representative sample of Australian women. Recruitment was stratified by age to achieve groups of premenopausal (PRE), perimenopausal (PERI), early postmenopausal (E-POST), and late postmenopausal (L-POST) women. Results The 32 participants were aged 46–69 years: 10 PRE, three PERI, 11 E-POST and eight L-POST women. All understood that menopause meant the end of reproductive function and were aware of menopause-associated symptoms. Most PRE and E-POST women referred to lifestyle changes to optimize health, and self-help and complementary therapies to manage symptoms. E-POST and L-POST women were more likely to nominate seeing a doctor for overall health and symptom management. Menopausal hormone therapy (MHT) was viewed negatively, with shared perceptions of cancer risk and over-prescription. A strong theme was lack of knowledge of long-term menopause sequelae, with only four women nominating osteoporosis. Conclusions Our in-depth qualitative study would suggest that, while Australian midlife women have a good understanding of the immediate effects of menopause, their lack of knowledge of the long-term consequences is concerning. Despite the effectiveness and safety of MHT, the overall attitude to MHT remains negative.

Dietary Nitrate and Diet Quality: An Examination of Changing Dietary Intakes within a Representative Sample of Australian Women.

Dietary nitrate is increasingly linked to a variety of beneficial health outcomes. Our purpose was to estimate dietary nitrate consumption and identify key dietary changes which have occurred over time within a representative sample of Australian women. Women from the 1946–1951 cohort of the Australian Longitudinal Study on Women’s Health with complete food frequency questionnaire data for both 2001 and 2013 were included for analysis. Dietary nitrate intakes were calculated using key published nitrate databases. Diet quality scores including the Australian Recommended Food Score, the Mediterranean Diet Score and the Nutrient Rich Foods Index were calculated along with food group serves as per the Australian Dietary Guidelines. Wilcoxon matched pairs tests were used to test for change in dietary intakes and Spearman’s correlations were used to examine associations. In our sample of 8161 Australian women, dietary nitrate intakes were on average 65–70 mg/day, and we detected a significant increase in dietary nitrate consumption over time (+6.57 mg/day). Vegetables were the primary source of dietary nitrate (81–83%), in particular lettuce (26%), spinach (14–20%), beetroot (10–11%), and celery (7–8%) contributed primarily to vegetable nitrate intakes. Further, increased dietary nitrate intakes were associated with improved diet quality scores (r = 0.3, p < 0.0001). Although there is emerging evidence indicating that higher habitual dietary nitrate intakes are associated with reduced morbidity and mortality, future work in this area should consider how dietary nitrate within the context of overall diet quality can facilitate health to ensure consistent public health messages are conveyed.

Hypertension: What are the self-care and health-care-seeking behaviours in women over time?

The aim of this study was to estimate the prevalence and incidence of hypertension in women, and describe their self-care and health-seeking behaviours. This research was conducted as part of the Australian Longitudinal Study on Women's Health, a study comprising a nationally representative sample of Australian women in three age groups. The focus of this research is 14 099 women born in 1946-1951, who have been surveyed six times (1996-2010). Student t-tests were used to compare women who did or did not have hypertension by their health-care utilization. Longitudinal analyses were conducted using a Poisson generalized estimating equation model. The incidence of hypertension among this cohort during 1996 to 2010 ranged from 400 to 597 participants per survey, resulting in an increase in prevalence of hypertension from 20.9% in 1996 to 41.3% in 2010. For all survey periods, women with hypertension had a significantly higher average number of visits to doctors and allied health practitioners compared with women without hypertension (P<0.005). The use of complementary medicine (practitioners and self-prescribed treatments) by women with hypertension was significantly lower compared to women without hypertension (P<0.005). Over time, conventional health-care utilization was higher for women with hypertension compared with women without hypertension (adjusted RR=1.18; 95% CI: 1.14, 1.22; P<0.0001). Our findings show that women with hypertension are using a range of conventional and complementary and alternative medicine: with hypertensive women using more conventional medicine and less complementary and alternative medicine than non-hypertensive women. As such, health-care providers should communicate with their patients regarding their use of complementary and alternative medicine in their efforts to provide safe, effective and coordinate care.

How Do Previous Mental Health, Social Support, and Stressful Life Events Contribute to Postnatal Depression in a Representative Sample of Australian Women?

The purpose of this study was to examine the risk factors for postnatal depression (PND) using longitudinal data in a representative sample of Australian women. Mailed survey data collected from the youngest cohort of the Australian Longitudinal Study on Women's Health were analyzed. Of the women in this cohort, 2451 had a child in the 4 years preceding survey 4 in 2006, and those who reported being diagnosed or treated for PND at survey 4 (n = 252) were compared to those who had no report of PND at survey 4 (n = 2324) in order to identify risk factors for PND. Women with a history of depression (from survey 2 in 2000 and from survey 3 in 2003) were more likely to report postnatal depression (odds ratio [OR] 2.10; 95% confidence interval [CI], 1.39-3.18 and OR 2.15; 95% CI, 1.37-3.35, respectively). Contrary to previous research, demographic factors were not significantly related to PND. Women who rated their affectionate support and positive social interaction as being available some of the time were significantly more likely to experience PND (OR 2.37; 95% CI, 1.24-4.53) than those who rated this type of support as being available all of the time. While previous mental health problems and a history of stressful life events were found to be significant risk factors for PND, the results of this study show that women with PND are also lacking some aspects of social support around the time of the birth of their children. Implications for treatment and policy are discussed.

Lifetime Prevalence of Gender-Based Violence in Women and the Relationship With Mental Disorders and Psychosocial Function

Intimate partner physical violence, rape, sexual assault, and stalking are pervasive and co-occurring forms of gender-based violence (GBV). An association between these forms of abuse and lifetime mental disorder and psychosocial disability among women needs to be examined. To assess the association of GBV and mental disorder, its severity and comorbidity, and psychosocial functioning among women. A cross-sectional study based on the Australian National Mental Health and Well-being Survey in 2007, of 4451 women (65% response rate) aged 16 to 85 years. The Composite International Diagnostic Interview version 3.0 of the World Health Organization's World Mental Health Survey Initiative was used to assess lifetime prevalence of any mental disorder, anxiety, mood disorder, substance use disorder, and posttraumatic stress disorder (PTSD). Also included were indices of lifetime trauma exposure, including GBV, sociodemographic characteristics, economic status, family history of mental disorder, social supports, general mental and physical functioning, quality of life, and overall disability. A total of 1218 women (27.4%) reported experiencing at least 1 type of GBV. For women exposed to 3 or 4 types of GBV (n = 139), the rates of mental disorders were 77.3% (odds ratio [OR], 10.06; 95% confidence interval [CI], 5.85-17.30) for anxiety disorders, 52.5% (OR, 3.59; 95% CI, 2.31-5.60) for mood disorder, 47.1% (OR, 5.61; 95% CI, 3.46-9.10) for substance use disorder, 56.2% (OR, 15.90; 95% CI, 8.32-30.20) for PTSD, 89.4% (OR, 11.00; 95% CI, 5.46-22.17) for any mental disorder, and 34.7% (OR, 14.80; 95% CI, 6.89-31.60) for suicide attempts. Gender-based violence was associated with more severe current mental disorder (OR, 4.60; 95% CI, 2.93-7.22), higher rates of 3 or more lifetime disorders (OR, 7.79; 95% CI, 6.10-9.95), physical disability (OR, 4.00; 95% CI, 1.82-8.82), mental disability (OR, 7.14; 95% CI, 2.87-17.75), impaired quality of life (OR, 2.96; 95% CI, 1.60-5.47), an increase in disability days (OR, 3.14; 95% CI, 2.43-4.05), and overall disability (OR, 2.73; 95% CI, 1.99-3.75). Among a nationally representative sample of Australian women, GBV was significantly associated with mental health disorder, dysfunction, and disability.

Reducing Time to Diagnosis Does Not Improve Outcomes for Women With Symptomatic Ovarian Cancer: A Report From the Australian Ovarian Cancer Study Group

To determine if time to diagnosis is associated with stage of disease at diagnosis or survival among women with symptomatic ovarian cancer. A representative sample of Australian women (n = 1,463) with ovarian cancer diagnosed between 2002 and 2005 who participated in a population-based case-control study were interviewed regarding the events leading to their diagnosis and were observed for mortality for 5 years. Of the 1,318 women (90%) who presented to a medical practitioner with symptoms, 55% presented within 1 month, 70% in less than 2 months, and 92% within 6 months of symptom onset. There were no significant differences in the time from symptom onset to first medical practitioner consultation (P = .19) or symptom onset to diagnosis (P = .64) among women with borderline, early (International Federation of Gynecology and Obstetrics [FIGO] stages I to II) or late (FIGO stages III to IV) disease. There was also no association between time to diagnosis and survival; adjusted hazard ratio for long delay (> 12 months from symptom onset to diagnosis) versus short delay (≤ 1 month) was 0.94 (95% CI, 0.68 to 1.30). Women who had asymptomatic cancers diagnosed incidentally (n = 145) were younger and were more likely to have borderline or stage I disease compared with women who had symptomatic ovarian cancer. The results of this study suggest that, once ovarian cancer is symptomatic, reducing the time to diagnosis would not greatly alter stage of disease at diagnosis or survival.

Influences of Marriage, Motherhood, and Other Life Events on Australian Women’s Employment Aspirations

The study contributes to the understandings of how women negotiate work and family over the life course by investigating what factors impact young women’s aspirations for full time, part-time, and other forms of work. Using data from the Australian Longitudinal Study on Women’s Health (ALSWH) with its nationally representative sample of Australian women, the authors examine how women moving from their 20s to early 30s change their aspirations for employment (at the age of 35) after significant life events and changes, including the birth of a child. Multinomial logistic regression analyses across two transition periods ( N = 7,505 and N = 7,584) showed that changes in employment aspirations co-occurred with movement into marriage or stable relationships and with changes in aspirations for family size. As young women become mothers, or move into situations in which motherhood is likely, many adjusted their employment aspirations away from full-time employment and toward part-time work. The findings suggest a growing awareness of the practical difficulties of balancing paid work and family roles within the current context of work and family policy and practice in Australia. Women’s choices are not free of constraints; rather, younger generations of women negotiate work and family life by adjusting and changing their own aspirations within the context and circumstances of their lives.

Prevalence and Predictors of Alcohol Use in Pregnancy and Breastfeeding Among Australian Women

Previous research suggests that alcohol use during pregnancy and breastfeeding has a negative impact on birth and neonatal outcomes. No threshold for this effect has been determined. The aim of this study is to determine the prevalence and correlates of alcohol use in pregnancy and lactation in a large representative sample of Australian women. Data were used from a large representative sample of Australian women drawn from the 2007 National Drug Strategy Household Survey. A complex sampling framework was used to elicit prevalence estimates for alcohol use during pregnancy and lactation. A logistic regression analysis was used to determine the psychosocial characteristics associated with alcohol use during the perinatal period. Alcohol use was reported by 29 percent of women who were pregnant in the past 12 months. In addition, 43 percent of women who were breastfeeding in the past 12 months reported alcohol use, whereas 36 percent of women who were both pregnant and breastfeeding in the past 12 months reported alcohol use. Most women (95%) reported a reduction in the quantity of their alcohol use while pregnant or breastfeeding. Older age was significantly associated with alcohol use in pregnancy, and also with alcohol use while breastfeeding (after controlling for other psychosocial characteristics). Higher educational attainment, and breastfeeding for more weeks in the past 12 months were significantly associated with alcohol use while breastfeeding, after controlling for confounding psychosocial factors. More research is needed to ease uncertainty about "safe" levels of alcohol use during pregnancy and while breastfeeding. A high proportion of the sample reported alcohol use during pregnancy or lactation, despite uniform international government guidelines recommending that no alcohol should be consumed during the prenatal and postnatal periods. These results indicate that public health education campaigns about the risks of alcohol during these periods are needed.

Diet and pregnancy status in Australian women

To investigate and report the diet quality of young Australian women by pregnancy status. Pregnancy status was defined as pregnant (n 606), trying to conceive (n 454), had a baby in the last 12 months (n 829) and other (n 5597). The Dietary Questionnaire for Epidemiological Studies was used to calculate diet quality using the Australian Recommended Food Score (ARFS) methodology. Nutrient intakes were compared with the Nutrient Reference Values for Australia and New Zealand. A population-based cohort participating in the Australian Longitudinal Study on Women's Health (ALSWH). A nationally representative sample of Australian women, aged 25 to 30 years, who completed Survey 3 of the ALSWH. The 7486 women with biologically plausible energy intake estimates, defined as >4.5 but <20.0 MJ/d, were included in the analyses. Pregnancy status was not significantly predictive of diet quality, before or after adjusting for area of residence and socio-economic status. Pregnant women and those who had given birth in the previous 12 months had marginally higher ARFS (mean (se): 30.2 (0.4) and 30.2 (0.3), respectively) than 'other' women (29.1 (0.1)). No single food group accounted for this small difference. Across all pregnancy categories there were important nutrients that did not meet the current nationally recommended levels of intake, including dietary folate and fibre. Women do not appear to consume a wider variety of nutritious foods when planning to become pregnant or during pregnancy. Many young Australian women are failing to meet key nutrient targets as nationally recommended.

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Medical Journal of AustraliaVolume 190, Issue 1 p. 47-48 Letter Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women Jules S Black, Corresponding Author Jules S Black Obstetrician and Gynaecologist (semi-retired) julesblack@bigpond.com Brisbane, QLD.Correspondence: julesblack@bigpond.comSearch for more papers by this author Jules S Black, Corresponding Author Jules S Black Obstetrician and Gynaecologist (semi-retired) julesblack@bigpond.com Brisbane, QLD.Correspondence: julesblack@bigpond.comSearch for more papers by this author First published: 05 January 2009 https://doi.org/10.5694/j.1326-5377.2009.tb02268.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume190, Issue1January 2009Pages 47-48 RelatedInformation

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women

To identify the prevalence and correlates of three types of pelvic pain (dysmenorrhoea, dyspareunia, and other chronic pelvic pain [CPP]) in a nationally representative sample of Australian women. The CPP survey was part of a broader national study of health and relationships. Computer-assisted telephone interviews were administered to a random sample of 8656 Australian households; 4366 women aged between 16 and 64 years were interviewed in 2004 and 2005. Eighteen of the more than 200 potential survey questions related to pelvic pain. Self-reports of dysmenorrhoea, dyspareunia, and any other CPP not associated with sexual intercourse or menstruation. Data on 1983 women aged 16-49 years who were still menstruating and sexually active were analysed. Prevalences were 71.7% for dysmenorrhoea, 14.1% for dyspareunia and 21.5% for other CPP; 23.3% of women reported no pelvic pain of any kind. Severe pain was reported by 15.0% (95% CI, 13.0%-17.1%) of women with dysmenorrhoea, 7.8% (95% CI, 5.0%-11.9%) of women with dyspareunia and 20.0% (95% CI, 16.1%-24.6%) of women with other CPP. Just over a third (34.2%) of women who reported any pain had sought advice from a health professional. Women reporting CPP were also likely to report other health conditions, most notably depression and anxiety. There were clear associations between CPP and sexual difficulties, pregnancy and pregnancy outcomes. Rates of pelvic pain in Australian women are high. General practitioners need to be ready to discuss these issues with patients, particularly in relation to underlying anxiety and depression.

The 2003 Australian Breast Health Survey: survey design and preliminary results

BackgroundThe Breast Health Surveys, conducted by the National Breast Cancer Centre (NBCC) in 1996 and 2003, are designed to gain insight into the knowledge, attitudes and behaviours of a nationally representative sample of Australian women on issues relevant to breast cancer. In this article, we focus on major aspects of the design and present results on respondents' knowledge about mammographic screening.MethodsThe 2003 BHS surveyed English-speaking Australian women aged 30–69 without a history of breast cancer using computer-assisted telephone interviewing. Questions covered the following themes: knowledge and perceptions about incidence, mortality and risk; knowledge and behaviour regarding early detection, symptoms and diagnosis; mammographic screening; treatment; and accessibility and availability of information and services. Respondents were selected using a complex sample design involving stratification. Sample weights against Australian population benchmarks were used in all statistical analyses. Means and proportions for the entire population and by age group and area of residence were calculated. Statistical tests were conducted using a level of significance of 0.01.ResultsOf the 3,144 respondents who consented to being interviewed, 138 (4.4%) had a previous diagnosis of breast cancer and were excluded leaving 3,006 completed interviews eligible for analysis. A majority of respondents (61.1%) reported ever having had a mammogram and 29.1% identified mammography as being the best way of finding breast cancer. A majority of women (85.9%) had heard of the BreastScreen Australia (BSA) program, the national mammographic screening program providing free biennial screening mammograms, with 94.5% believing that BSA attendance was available regardless of the presence or absence of symptoms. There have been substantial gains in women's knowledge about mammographic screening over the seven years between the two surveys.ConclusionThe NBCC Breast Health Surveys provide a valuable picture of the knowledge of Australian women about a range of issues. The present analysis shows significant gains in knowledge and behaviours relating to mammographic screening, while identifying additional areas for targeted improvement, as in the need to better communicate with women about screening and diagnostic services. Further analysis of additional core topic areas (eg., incidence, mortality, risk and treatment) will provide equally noteworthy insight.

The Impact of Sexual Coercion on Psychological, Physical, and Sexual Well-Being in a Representative Sample of Australian Women

It is well established that, compared to other women, women who have been forced or frightened into unwanted sexual activity have poorer psychological, physical, and sexual health. However, it is not clear whether particular experiences of sexual coercion, such as younger age when coerced or number of times coerced, are more likely to lead to poorer health status. This study of a representative sample of Australian women aged 16-59 years was designed to examine such associations. Of the 9134 women recruited for the study, 885 (21%) had been sexually coerced, which was defined as being forced or frightened into unwanted sexual activity. This study showed that any experience of sexual coercion was associated with poorer psychological, physical, and sexual health. The data revealed no consistent associations between health status and particular characteristics of sexual coercion, such as the age when women were coerced, the number of times they had been coerced, or the time since being coerced. Two of the few significant findings were that women who had been coerced more than once reported significantly greater psychosocial distress, and that women first coerced when aged 13-16 reported poorer physical well-being than women first coerced at younger or older ages. There was no significant association between whether women had consulted a psychologist or other professional counselor and better health status. The absence of consistent associations between health status and particular characteristics of sexual coercion indicates a need for care and support services for all women who have been sexually coerced.