South Australians Research Articles

A 'plethora of services' but a lack of consistency: Aqualitative study of service providers' perspectives about transitioning from hospital to home for older South Australians.

We explored the perspectives of professionals working in health and aged care services in South Australia about factors that influenced successful transitions from hospital to home or residential aged care home for older people. We examined successful and recommended strategies that could support safe transitions following hospital discharge and reduce avoidable hospital admissions in South Australia. Nineteen professionals from acute, post-acute, primary, community and aged care settings in South Australia participated in semi-structured interviews. Qualitative content analysis was conducted. Participants reported that navigating service provision could be difficult, compounded by different funding arrangements for hospitals, community, primary care and aged care services. Some participants felt that there was an over-reliance on the hospital sector, leaving primary care and community-based services under-utilised to support hospital transitions. The importance of good communication between services and sectors was highlighted. Participants described different categories of services that supported safe transitions by supporting older people immediately post-discharge; services that provided support to stay at home in the weeks and months following discharge; and services that helped the person receive health care at locations other than hospitals or emergency departments when they were unwell. Participants noted that successful programs were not always maintained. Division of responsibility of aged and health-care services between state and national governance contributes to fragmentation of care in South Australia. Careful planning of transitions and coordination of services across sectors is required to ensure older people are supported in the months following discharge from hospital to reduce avoidable rehospitalisations.

Community-led vaccination programs: Getting the fundamentals right

In September 2021, South Sudanese Australians in Canberra, ACT, piloted a community-led COVID-19 vaccination program.

Association between self-reported periodontitis and high-risk oral human papillomavirus infection among Indigenous South Australians: A cross-sectional study.

IntroductionThe incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally, reflecting an increase in human papillomavirus (HPV)-related lesions. Indigenous populations are disproportionately affected by OPSCCs. Currently, testing for oral HPV is not recommended as a screening tool to permit early detection of OPSCCs due to the high population prevalence of HPV infection. Periodontitis may be a marker of oral HPV infection, but previous research evaluating this association has been inconclusive. Here we report a large population-based study examining the association between high-risk oral HPV infection and periodontitis among Indigenous South Australians.MethodsWe utilised a large convenience sample of Indigenous South Australians aged 18+ years recruited between February 2018 and February 2020. Of the original cohort (n = 1011), 748 (73.9%) participants participated in the 12 month follow-up. Detailed information on sociodemographic characteristics, health-related behaviours, and sexual history were collected at enrolment. Saliva samples were collected at 12 months and tested for the presence of oral HPV DNA using the optimized general primer (GP) + PCR system. The primary outcomes were the prevalence of any high-risk oral HPV DNA, and separately, HPV 16 and/or 18. Periodontitis was assessed at follow-up by using validated self-reported periodontitis screening questions. Logistic regression analyses were undertaken to assess the association between self-reported periodontitis and oral HPV infection with adjustment for potential sociodemographic and behavioural confounders, with estimates presented as odds ratios (OR) and 95% confidence interval (CI).ResultsData on 673 participants (89.9% of the follow-up cohort) were available. Participants ranged in age from 18 to 80 (mean age 42.2, SD 14.7) and 31.5% were male. Overall, 115 (17.1%) participants had self-reported periodontitis, 40 (5.9%) had any high-risk oral HPV and 14 (2.1%) had HPV 16 and/or 18. Any high-risk HPV was detected among seven (17.5%) participants and HPV 16 and/or 18 was detected in three (21.4%) who self-reported periodontitis. In the regression analyses no significant association was found between self-reported periodontitis and high-risk oral HPV (adjusted OR: 1.10; 95% CI: 0.45–2.70) or HPV 16 and/or 18 (adjusted OR: 1.27; 95% CI: 0.32–5.03).ConclusionThis study did not find any association between self-reported periodontitis and high-risk oral HPV among Indigenous South Australians. Further targeted studies with standardized clinical measures of periodontal disease are needed to clarify the link between high-risk oral HPV and periodontal disease. If confirmed this would add further weight to the importance of recommendations about the utility of periodontitis screening to identify individuals at risk of carrying high-risk oral HPV, who may benefit from more intensive screening and ongoing monitoring.

A vulnerable residential environment is associated with higher risk of mortality and early transition to permanent residential aged care for community dwelling older South Australians.

ObjectivesThis study examined the impact of the residential environment, measured by the Healthy Ageing/Vulnerable ENvironment (HAVEN) Index, on risk of mortality or entry into Permanent Residential Aged Care (PRAC).DesignA retrospective cohort study using data from the Registry of Senior Australians (ROSA) was conducted. HAVEN Index values were matched to the ROSA by residential postcode.Study setting and ParticipantsOlder individuals living in metropolitan Adelaide and receiving their first eligibility assessment for aged care services between 2014 and 2016 (N = 16,944).Main Outcome MeasureTime to death and entry into PRAC were the main outcomes.ResultsA higher HAVEN Index value, which represents a favourable residential environment, was associated with a lower risk of mortality and delayed entry to PRAC. For every 0.1 unit increase in HAVEN Index value, the risk of mortality is 3% lower (adjusted hazard ratio [HR], 95% confidence interval [CI] = 0.97, 0.96–0.99) and the risk of entry to PRAC is 5% lower (adjusted subdistribution HR, 95%CI = 0.95, 0.94–0.97) in the first 2 years following aged care assessment. After 2 years, the HAVEN Index was not associated with the risk of transition to PRAC.ConclusionPlace-based health inequalities were identified in Australians seeking aged care services, demonstrating that a better understanding of local neighbourhoods may provide insight into addressing ageing inequalities. Spatial indexes, such as the HAVEN Index, are useful tools to identify areas where populations are more vulnerable to adverse health outcomes, informing responses to prioritise local improvements and health interventions to enable healthy ageing.

COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia.

Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians' demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation. The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.

The Thermal Environment of Housing and Its Implications for the Health of Older People in South Australia: A Mixed-Methods Study

Older people are often over-represented in morbidity and mortality statistics associated with hot and cold weather, despite remaining mostly indoors. The study “Improving thermal environment of housing for older Australians” focused on assessing the relationships between the indoor environment, building characteristics, thermal comfort and perceived health/wellbeing of older South Australians over a study period that included the warmest summer on record. Our findings showed that indoor temperatures in some of the houses reached above 35 °C. With concerns about energy costs, occupants often use adaptive behaviours to achieve thermal comfort instead of using cooling (or heating), although feeling less satisfied with the thermal environment and perceiving health/wellbeing to worsen at above 28 °C (and below 15 °C). Symptoms experienced during hot weather included tiredness, shortness of breath, sleeplessness and dizziness, with coughs and colds, painful joints, shortness of breath and influenza experienced during cold weather. To express the influence of temperature and humidity on perceived health/wellbeing, a Temperature Humidity Health Index (THHI) was developed for this cohort. A health/wellbeing perception of “very good” is achieved between an 18.4 °C and 24.3 °C indoor operative temperature and a 55% relative humidity. The evidence from this research is used to inform guidelines about maintaining home environments to be conducive to the health/wellbeing of older people.

Searching for sanctuary during COVID-19: exploring regional South Australians’ nature-based tourism experiences

ABSTRACT This article draws upon the findings of an exploratory qualitative study of regional South Australian tourists' nature-based tourism experiences during COVID-19. Through the implementation of focus group interview sessions with participants across three age group categories, it was evident that many participants had visited nature-based settings in pursuit of health benefits. From the perspective of physical health, national parks and conservation areas were identified as “risk averse” backdrops that allowed exercise to be undertaken. From the perspective of mental health, nature-based tourism spaces acted as “mental sanctuaries” that supported wellbeing and enabled visitors to temporarily escape the stresses of COVID-19. Respondents aged under 30 reported a greater connectedness with nature and had positively re-evaluated the benefits of nature-based tourism. This article offers valuable insights into the role of nature-based tourism settings in supporting regional populations during the continuation of COVID-19 or other crises that present challenging times or hardship.

Road mapping recovery from the impacts of multiple crises: framing the role of domestic self-drive tourism in regional South Australia

ABSTRACT In regional South Australia, a combination of droughts, bushfires and the COVID-19 pandemic has presented dynamic challenges to tourism economies. As inbound international tourism remains unlikely to return to pre-COVID-19 levels for the foreseeable future, the importance of domestic tourism has become further pronounced, most notably in regions that have been affected by major declines in tourist flows. This exploratory qualitative study reports on regional South Australians’ participation in domestic tourism during the pandemic and the factors that have influenced how they travel. Our findings reveal that participants had predominantly engaged in self-drive tourism due to the feelings of safety it offered in contrast to other modes of transport, the opportunities it permitted in fostering reconnections and supporting wellbeing, and because of its ability to evoke positive feelings and emotions that were structured around adventure and discovery. Moreover, it was additionally observed that self-drive tourism offered practical opportunities to engage in altruistic pursuits to support crisis-affected regions across the state. Therefore, this paper offers timely insights into the behaviours of regional South Australians during the pandemic and how they utilised self-drive tourism to support both personal and community recovery from the impacts of multiple crises across the state.

Acute respiratory infection symptoms and COVID-19 testing behaviour: results based on South Australian health surveys

BackgroundEffective syndromic surveillance alongside COVID-19 testing behaviours in the population including in higher risk and hard to reach subgroups is vital to detect re-emergence of COVID-19 transmission in the community. The aim of this paper was to identify the prevalence of acute respiratory infection symptoms and coronavirus testing behaviour among South Australians using data from a population based survey.MethodsWe used cross-sectional data from the 2020 state-wide population level health survey on 6857 respondents aged 18 years and above. Descriptive statistics were used to explore the risk factors and multivariable logistic regression models were used to assess the factors associated with the acute respiratory infection symptoms and coronavirus testing behaviour after adjusting for gender, age, household size, household income, Aboriginal and/or Torres Strait Islander status, SEIFA, Country of birth, number of chronic diseases, wellbeing, psychological distress, and mental health.ResultsWe found that 19.3% of respondents reported having symptoms of acute respiratory infection and the most commonly reported symptoms were a runny nose (11.2%), coughing (9.9%) and sore throat (6.2%). Fever and cough were reported by 0.8% of participants. Of the symptomatic respondents, 32.6% reported seeking health advice from a nurse, doctor or healthcare provider. Around 18% (n = 130) of symptomatic respondents had sought testing and a further 4.3% (n = 31) reported they intended to get tested. The regression results suggest that older age, larger household size, a higher number of chronic disease, mental health condition, poor wellbeing, and psychological distress were associated with higher odds of ARI symptoms. Higher household income was associated with lower odds of being tested or intending to be tested for coronavirus after adjusting for other explanatory variables.ConclusionsThere were relatively high rates of self-reported acute respiratory infection during a period of very low COVID-19 prevalence and low rate of coronavirus testing among symptomatic respondents. Ongoing monitoring of testing uptake, including in higher-risk groups, and possible interventions to improve testing uptake is key to early detection of disease.

Gender differences in the lifecycle benefits of compulsory schooling policies

We estimate the lifecycle benefits of policies that raise the minimum school leaving age (MSLA). Using a difference-in-differences method, we estimate the causal impact of two adjacent Australian state reforms that extended the MSLA from 14 to 15 in mid 1960. Important gender and state differences emerge in how the reforms affected secondary and postsecondary education outcomes. The biggest winners were women in Victoria, for whom the reform increased postsecondary education, while the reform lifted only minimum schooling qualifications in South Australia. As a consequence, the Victorian reform improved the lifecycle capital accumulation process especially for women, while few benefits were observed for South Australians. Victorian women entered higher-skilled occupations, were more likely to own homes, to be still married and satisfied with family life in pre-retirement age. Victorian men also gained, but the gains were limited to better cognitive and non-cognitive skills, health, and satisfaction with (family) life. Yet, all groups benefitted from delayed and reduced fertility, and a happier family life. We conclude that raising education levels for individuals at the lower end of the education spectrum produces lifecycle benefits that exceed market-return considerations, but major benefits occur only if the reform impacts education outcomes beyond minimum schooling.

268An online survey of sexual health, knowledge and behaviour of young South Australians

Abstract Background Since 2010 rates of sexually transmitted infections (STIs-chlamydia, gonorrhoea and syphilis) have been increasing among young Australians. Most STIs are diagnosed in young people aged 16-29 and rates of diagnosis are higher among Aboriginal people than non-Aboriginal people. Little information exists to understand social and behavioural issues associated with increasing rate of STIs, especially in South Australia and among Aboriginal peoples. Methods We undertook an online cross-sectional survey of sexual health, knowledge and behaviour of young South Australians aged 16-29 years during a six-week period in 2019. Descriptive analysis, univariate and adjusted logistic regression models were used to compare Aboriginal and non-Aboriginal participants. Results In total 2,380 South Australians participated in the “Let’s Talk About It” (LTAI-2019); 52% were female, the median age was 20 years (IQR:17-24) and 10% of participants identified as Aboriginal. Regression analysis suggested among both Aboriginal and non-Aboriginal participants being female (aOR 2.41, CI:1.07-3.51, & 3.03, 2.17-4.23 respectively) and not using a condom during last sexual encounter (2.33, 1.03-5.29 & 1.62, 1.15-2.27) were associated with ever being tested for an STI and having two or more sexual partners in the past 12 months (1.37, 0.67-7.45 & 3.13, 1.31-7.45) was associated with testing positive for an STI. Conclusions LTAI-2019 is the first study to describe factors associated with STIs among young South Australians. It is evident that young people are engaged in behaviours which increase their risk of acquiring STIs. Public health action which considers these behaviours particularly those that target young Aboriginal people is required. Key messages LTAI 2019 is the first study to describe current sexual health, knowledge, behaviours and access to health services for STIs and related issues amongst young South Australians. It provides evidence that is useful for informing both public health practice and policy, and the development of STIs preventative health programs.

Using social networking sites to recruit participants: methods of an online survey of sexual health, knowledge and behaviour of young South Australians

ObjectiveTo describe the methods of recruitment and demographic results of an online sexual health survey using social networking sites (SNS) to recruit people aged 16–29 years in the state of South Australia (SA) during 2019. MethodsA crosssectional online survey titled ‘Let's Talk About It’ using SNS (Facebook and Instagram) was administered between July and August 2019, targeting Aboriginal and Torres Strait Islander and non‐Indigenous young people. The survey comprised questions on demographics information, sexual health knowledge, behaviours and healthcare access. ResultsDuring the data collection period, the study team closely monitored the demographics of participants and adjusted SNS messaging through paid advertising to increase the recruitment of under‐represented population groups, especially Aboriginal people, males and regional and remote residents of SA. A total of 2,724 people accessed the survey predominately via Facebook during a six‐week period between July and August 2019; 2,380 people were eligible and included in the analysis. Conclusions and implications for public healthEven though SNS have been used previously in recruitment for sexual health issues, small adjustments to the study during recruitment were specifically made to include under‐represented populations in the final study. Using SNS is an effective method for recruiting survey participants; during recruitment phases, additional strategies may be required to be inclusive of diverse and under‐represented populations.

Sociodemographic Predictors of Attitudes to Support Seeking From a Medical Doctor or Other Health Provider Among Rural Australians.

Rural Australians experience higher prevalence of several chronic diseases than metropolitan Australians and are less likely to access supportive health services. This study explored associations of sociodemographic factors and barriers to support seeking for health in a sample of rural South Australians. Participants (n=610) from three rural regions participated in a computer-assisted telephone interview (CATI), based on the Barriers to Help Seeking Scale. Each participant reported on barriers in one of three health contexts: 'general' physical health, skin cancer, and mental health. Sociodemographic factors included gender, age, highest education, region of residence, and presence of chronic conditions. Chi-squared Automatic Interaction Detection (CHAID) determined independent associations of sociodemographic factors and barrier categories (high, medium and low importance). Privacy was a high-importance barrier in the mental health context, particularly among participants of age <63 years. The tendency to minimise and normalise health issues was also a high-importance barrier in the mental health context. In the physical health context, those with a chronic condition were more likely to perceive normalisation as a barrier than those without a chronic condition. Need for control and self-reliance was a high-importance barrier in the mental health context and a low-importance barrier in the skin cancer context, particularly among participants <63 years. Structural factors and distrust of providers were high-importance barriers among those who did not complete secondary education, regardless of context. This study highlights the importance of a nuanced approach to promoting help-seeking in rural Australians, with message content and delivery tailored to specific health conditions and demographic circumstances.

The impact of interpersonal racism on oral health related quality of life among Indigenous South Australians: a cross-sectional study

BackgroundInterpersonal racism has had a profound impact on Indigenous populations globally, manifesting as negative experiences and discrimination at an individual, institutional and systemic level. Interpersonal racism has been shown to negatively influence a range of health outcomes but has received limited attention in the context of oral health. The aim of this paper was to examine the effects of experiences of interpersonal racism on oral health-related quality of life (OHRQoL) among Indigenous South Australians.MethodsData were sourced from a large convenience sample of Indigenous South Australian adults between February 2018 and January 2019. Questionnaires were used to collect data on sociodemographic characteristics, cultural values, utilization of dental services, and other related factors. OHRQoL was captured using the Oral Health Impact Profile (OHIP-14) questionnaire. We defined the dependent variable 'poor OHRQoL' as the presence of one or more OHIP-14 items rated as ‘very often’ or ‘fairly often'. Experiences of racism were recorded using the Measure of Indigenous Racism Experiences instrument. Interpersonal racism was classified into two categories (‘no racism’ vs ‘any racism in ≥ 1 setting’) and three categories ('no racism', 'low racism' (experienced in 1–3 settings), and 'high racism' (experienced in 4–9 settings)). Logistic regression was used to examine associations between interpersonal racism, covariates and OHRQoL, adjusting for potential confounding related to socioeconomic factors and access to dental services.ResultsData were available from 885 participants (88.7% of the total cohort). Overall, 52.1% reported experiencing any interpersonal racism in the previous 12 months, approximately one-third (31.6%) were classified as experiencing low racism, and one-fifth (20.5%) experienced high racism. Poor OHRQoL was reported by half the participants (50.2%). Relative to no experiences of racism in the previous 12 months, those who experienced any racism (≥ 1 setting) were significantly more likely to report poor OHRQoL (Odds Ratio (OR): 1.43; 95% Confidence Interval (CI): 1.08–1.92), after adjusting for age, education level, possession of an income-tested health care card, car ownership, self-reported oral health status, timing of and reason for last dental visit, not going to a dentist because of cost, and having no family support. This was particularly seen among females, where, relative to males, the odds of having poor OHRQoL among females experiencing racism were 1.74 times higher (95% CI: 1.07–2.81).ConclusionOur findings indicate that the experience of interpersonal racism has a negative impact on OHRQoL among Indigenous Australians. The association persisted after adjusting for potential confounding factors. Identifying this link adds weight to the importance of addressing OHRQoL among South Australian’s Indigenous population by implementing culturally-sensitive strategies to address interpersonal racism.

Impact of the COVID-19 pandemic on South Australia's emergency departments: evidence from two lockdowns.

Objective This study assessed the impact of the COVID-19 pandemic on emergency departments (EDs) in South Australia, measured by changes in the number and casemix of patients in the system over time. Methods Data from the South Australia Emergency Department Dashboard, updated every 30min, were analysed for the period 4 October-21 December 2020. The Dashboard reports live counts of the number and type of patients in each of the six adult metropolitan public EDs in Adelaide, South Australia. Results There was a significant difference in the mean daily average occupied ED capacity before and during two distinct increases in COVID-19 cases in South Australia. An increase in COVID-19 cases coincided with a decrease in patients in EDs (Pearson's r =-0.93 and -0.67; P Conclusions During the two periods of COVID-19 case growth in South Australia, there was a significant drop in the number of patients presenting to the major public EDs and a change in the casemix of patients over time. What is known about the topic? EDs in Australia often operate at or over capacity, with frequent reports of ambulance ramping, access block and long waiting times. There have been reports internationally of significant declines in ED presentations throughout the COVID-19 pandemic. What does this paper add? This paper uses a novel publicly available data source that is available in real time to contribute a new perspective from South Australia, which has experienced two distinct periods of strict restrictions and lockdown. The research showed that the number of mental health presentations remained consistently high, despite a significant overall decline in ED occupancy. What are the implications for practitioners? This study demonstrates that South Australians are accessing emergency medical treatment differently in response to the COVID-19 pandemic. In the context of an overall decline in presentation numbers, the number of mental health-related presentations has not changed significantly, suggesting that this trend should be closely monitored. The findings corroborate the national concern that unwell people have avoided accessing emergency medical care during the pandemic, leading to worse outcomes and increased need for healthcare resources at a later date. It will be important to monitor and quickly detect further changes in ED usage using real-time data as the pandemic evolves, as well as in any future significant health crises.

Optimizing Rural People's Access to Relevant Cancer Education and Support Using Peer-Led YouTube Films.

Rural cancer patients have inferior cancer outcomes and unique unmet information needs. This paper explores the value of rural people affected by cancer delivering cancer-related education and support to their peers via 3-5min online YouTube films. In part 1, 14 rural Australians affected by cancer (10 survivors, 4 carers), 50% (7/14) female, 55-79years, "storytellers", were purposively invited to be filmed sharing their cancer-related experience and advice for others facing similar challenges. They then reflected on their storytelling experience during semi-structured interviews with an independent researcher. In part 2, 11 rural South Australians affected by cancer (8 survivors, 3 carers), 82% (9/11) female, 32-75years, "viewers", who had watched at least three of the videos, were interviewed. When data saturation was reached, thematic analysis was employed. Storytellers were found to be highly satisfied with the film-making process and product. They valued rapport building prior to filming and the opportunity to help others. They also found storytelling cathartic and the films useful in communicating their cancer experience to family and friends. Rural viewers appreciated the honesty, authenticity, relatability and believability of the storytellers, the practical advice on rural-specific psychosocial issues, acknowledgment of the impact of isolation and the opportunity to understand others' cancer experiences. The film's short duration and professional film-making added appeal. Inclusion of younger storytellers and methods of delivery other than YouTube were suggested. This study highlights the value of this approach for storytellers and viewers. It may be particularly beneficial for isolated rural cancer survivors who feel that their unique challenges are not adequately addressed by mainstream cancer education resources However, further quantitative research to test acceptability and impact in representative rural samples is required.

Subjective and objective social status: associations with psychosocial predictors and oral health.

While social status and health have been investigated, there is less focus on the effects of objective and subjective social status and psychosocial factors. This study aimed to investigate oral health impacts by subjective social status (SSS) and psychosocial predictors stratified by subjective social status. A random cross-sectional sample of 45-54-year old South Australians was surveyed in 2004-05. Oral health impact was assessed using OHIP-14. Socio-economic status was determined using objective (income) and subjective (McArthur scale) measures. Psychosocial variables comprised social support, health self-efficacy, coping and affectivity. Responses were collected from 986 persons (response rate=44.4%). Lower SSS was more frequently observed in the low (70.2%) than high-income group (28.5%). Lower SSS was associated (p⟨0.05) with lower education, social support, health competence, and coping, but higher negative affect within income groups. The interaction of SSS and income showed OHIP was consistently lower at high SSS regardless of higher or lower income, but at low SSS, OHIP was higher (p⟨0.05) in the lower than higher income group. SSS was associated with income. Their interaction indicated low SSS in combination with low income was associated with higher oral health impacts.

South Sudanese perceptions of health and illness in South Australia

Purpose South Sudanese people form the largest number of resettled refugees in Australia between 2003 and 2004. This study aims to explore how this community understands and responds to health and illness. No study has specifically examined the concept of health and illness in the broader socio-cultural context of the South Sudanese people in Australia. Design/methodology/approach The design was a qualitative study using interviews and focus group discussions with 33 South Sudanese people in Adelaide, South Australia. Participants were asked to reflect on their understanding of health and illness and influences on their access and use of health and other services. Data were electronically audio-recorded, transcribed verbatim and analysed thematically. Findings Three main themes emerged from the analysis demonstrating complex and multifaceted views on health and illness. Participants described health as both a lack of disease and wider issues involving social belonging and participation, cultural well-being, living conditions and harmony in the society. They revealed that illnesses are predetermined by God or caused by a curse, breaking a cultural taboo, disharmony with the environment, community and ancestral spirits. Participants deeply tied their beliefs about illness causation and treatment to their historical, social and cultural lived realities, shaping their responses and health-care-seeking decisions. Originality/value The current study revealed a complex understanding of health and health-care-seeking practices amongst South Sudanese Australians. The multifaceted views of health and health-care-seeking practices underscore the importance of person-centred care for culturally and linguistically diverse people.

Trends in soft drink and sugar‐sweetened beverage consumption among South Australians, focusing on distribution of intake by subpopulation

ObjectiveThis study focused on describing local trends in sugar‐sweetened beverage (SSB) consumption, including variations between subgroups, to inform equitable health policy to curb soft drink consumption. MethodsWeighted data were obtained from the South Australian Monitoring and Surveillance System, a state‐based population health survey that monitors trends in health risk factors and chronic disease via computer‐assisted telephone interviewing. From 2008 onwards, participants provided an estimate of the average amount of soft drink they consumed per day. ResultsFrom 2008–2017, there were significant decreases in the proportion of adults who consumed any SSBs, but the mean consumption per consumer increased. High‐risk dietary and lifestyle behaviours are the strongest predictors for consumption of soft drink, but there is also a significant association with socioeconomic status. ConclusionsPopulation trends mask increasing inequity. There is a societal trend away from the consumption of SSBs across all subgroups, but at‐risk groups who engage in clusters of unhealthy behaviours remain high consumers. Implications for public healthThe identification of at‐risk populations allows research to focus more precisely on the structural barriers, beliefs, attitudes and facilitators of ongoing consumption of SSB in order to inform future health promotion efforts.

Telomere Length in Healthy Adults Is Positively Associated With Polyunsaturated Fatty Acids, Including Arachidonic Acid, and Negatively With Saturated Fatty Acids.

Lymphocyte telomere length (LTL) is a biomarker of aging that may be modified by dietary factors including fat. Red blood cell fatty acid status is a well-validated indicator of long-term dietary intake of fat from various sources. Recent findings from epidemiological studies of LTL in relation to fatty acids in red blood cells are not conclusive. The present study was carried out to investigate if red blood cell fatty acid status in 174 healthy older South Australians is associated with LTL. Lymphocyte telomere length was measured by real-time qPCR and fatty acid content in red blood cells was measured by gas chromatography. Our results indicate that the majority of saturated fatty acids and monounsaturated fatty acids are negatively associated with LTL, whereas polyunsaturated fatty acids are positively associated with LTL. Multiple regression analysis revealed that arachidonic acid (C20:4n-6) is significantly, independently, positively correlated with LTL (β = 0.262; p = .000). The significant association of fatty acids, particularly C20:4n-6, with telomere length warrants further research.