A geographical analysis of the role of water supply and sanitation in the risk of helminth infections of children in West Africa

Background We investigated the geographical variation of water supply and sanitation indicators (WS&S) and their role to the risk of schistosomiasis and hookworm infection in school age children in West Africa. The aim was to predict large-scale geographical variation in WS&S, quantify the attributable risk of S. haematobium, S. mansoni and hookworm infections due to WS&S and identify communities where sustainable transmission control could be targeted across the region. Methods National cross-sectional household-based demographic health surveys were conducted in 24,542 households in Burkina Faso, Ghana and Mali, in 2003–2006. We generated spatially-explicit predictions of areas without piped water, toilet facilities and finished floors in West Africa, adjusting for household covariates. Using recently published helminth prevalence data we developed Bayesian geostatistical models (MGB) of S. haematobium, S. mansoni and hookworm infection in West Africa including environmental and the mapped outputs for WS&S. Using these models we estimated the effect of WS&S on parasite risk, quantified their attributable fraction of infection, and mapped the risk of infection in West Africa. Findings Our maps show that most areas in West Africa are very poorly served by water supply except in major urban centers. There is a better geographical coverage for toilet availability and improved household flooring. We estimated smaller attributable risks for water supply in S. mansoni (47%) compared to S. haematobium (71%), and 5% of hookworm cases could be averted by improving sanitation. Greater levels of inadequate sanitation increased the risk of schistosomiasis, and increased levels of unsafe water supply increased the risk of hookworm. The role of floor type for S. haematobium infection (21%) was comparable to that of S. mansoni (16%), but was significantly higher for hookworm infection (86%). S. haematobium and hookworm maps accounting for WS&S show small clusters of maximal prevalence areas in areas bordering Burkina Faso and Mali smaller. The map of S. mansoni shows that this parasite is much more wide spread across the north of the Niger River basin than previously predicted. Interpretation Our maps identify areas where the Millennium Development Goal for water and sanitation is lagging behind. Our results show that WS&S are important contributors to the burden of major helminth infections of children in West Africa. Including information about WS&S as well as the “traditional” environmental risk factors in spatial models of helminth risk yielded a substantial gain both in model fit and at explaining the proportion of spatial variance in helminth risk. Mapping the distribution of infection risk adjusted for WS&S allowed the identification of communities in West Africa where integrative preventive chemotherapy and engineering interventions will yield the greatest public health benefits.

The subtropical row house charrette

Current urban development in South East Queensland (SEQ) is impacted by a number of factors: growth and sprawl eroding subtropical character and identity; changing demographics and housing needs; lack of developable land; rising transport costs; diminishing fresh water supply; high energy consumption; and generic building designs which ignore local climate, landscape and lifestyle conditions. The Subtropical Row House project sought to research ‘best practice’ planning and design for contemporary and future needs for urban development in SEQ, and stimulate higher-density housing responses that achieve sustainable, low-energy and low water outcomes and support subtropical character and identity by developing a workable new typology for homes that the local market can adopt. The methodology was that of charrette, an established methodology in architecture and design. Four leading Queensland architectural firms were invited to form multidisciplinary creative teams. During the two-day charrette, the teams visited a selected greenfield site, defined the problems and issues, developed ideas and solutions, and benchmarked performance of designs using the Australian Green Building Council’s Pilot Green Star Multi-Unit residential tool. Each of the four resulting designs simultaneously express a positive relationship with climate and place by demonstrating: suitability for the subtropical climate; flexibility for a diversity of households; integrated building/site/vegetation strategies; market appeal to occupants and developers; affordability in operation; constructability by ‘domestic’ builders; and reduced energy, water and wastage. The project was awarded a Regional Commendation by the Australian Institute of Architects.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Background: During December 2010 and January 2011, torrential rainfall in Queensland resulted in the worst flooding in over 50 years. We carried out a community-based survey to assess the health impacts of this flooding in the city of Brisbane. Methods: A community-based survey was conducted in 12 flood-affected electorates using postal questionnaires. A random sample of residents in these areas was drawn from electoral rolls. Questions examined sociodemographic information, the direct impact of flooding on the household, and perceived flood-related health impacts. Outcome variables included perceived flood-related effects on overall and respiratory health, along with mental health outcomes measured by psychosocial distress, reduced sleep quality and probable post-traumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and health outcome variables, adjusted for current health status and socioeconomic factors. Results: 3000 residents were invited to participate in this survey, with 960 responses (32%). People whose households were directly impacted by flooding had a decrease in perceived overall health (OR 5.3, 95% CI: 2.8–10.2), along with increases in psychological distress (OR 1.9, 1.1–3.5), decreased sleep quality (OR 2.3, 1.2–4.4), and probable PTSD (OR 2.3, 1.2–4.5). Residents were also more likely to increase usage of both tobacco (OR 6.3, 2.4–16.8) and alcohol (OR 7.0, 2.2–22.3) after flooding. Conclusions: There were significant impacts of flood events on residents’ health, in particular psychosocial health. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood‐related health impacts.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Background: During December 2010 and January 2011, torrential rainfall in Queensland resulted in the worst flooding in over 50 years. We carried out a community-based survey to assess the health impacts of this flooding in the city of Brisbane. Methods: A community-based survey was conducted in 12 flood-affected electorates using postal questionnaires. A random sample of residents in these areas was drawn from electoral rolls. Questions examined sociodemographic information, the direct impact of flooding on the household, and perceived flood-related health impacts. Outcome variables included perceived flood-related effects on overall and respiratory health, along with mental health outcomes measured by psychosocial distress, reduced sleep quality and probable post-traumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and health outcome variables, adjusted for current health status and socioeconomic factors. Results: 3000 residents were invited to participate in this survey, with 960 responses (32%). People whose households were directly impacted by flooding had a decrease in perceived overall health (OR 5.3, 95% CI: 2.8–10.2), along with increases in psychological distress (OR 1.9, 1.1–3.5), decreased sleep quality (OR 2.3, 1.2–4.4), and probable PTSD (OR 2.3, 1.2–4.5). Residents were also more likely to increase usage of both tobacco (OR 6.3, 2.4–16.8) and alcohol (OR 7.0, 2.2–22.3) after flooding. Conclusions: There were significant impacts of flood events on residents’ health, in particular psychosocial health. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts.

Food insecurity among Australian children : potential determinants, health and developmental consequences

Children in food-insecure households may be at risk of poor health, developmental or behavioural problems. This study investigated the associations between food insecurity, potential determinants and health and developmental outcomes among children. Data on household food security, socio-demographic characteristics and children’s weight, health and behaviour were collected from households with children aged 3–17 years in socioeconomically disadvantaged suburbs by mail survey using proxy-parental reports (185 households). Data were analysed using logistic regression. Approximately one-in-three households (34%) were food insecure. Low household income was associated with an increased risk of food insecurity [odds ratio (OR), 16.20; 95% confidence interval (CI), 3.52–74.47]. Children with a parent born outside of Australia were less likely to experience food insecurity (OR, 0.42; 95% CI, 0.19–0.93). Children in food-insecure households were more likely to miss days from school or activities (OR, 3.52; 95% CI, 1.46–8.54) and were more likely to have borderline or atypical emotional symptoms (OR, 2.44; 95% CI, 1.11–5.38) or behavioural difficulties (OR, 2.35; 95% CI, 1.04–5.33). Food insecurity may be prevalent among socioeconomically disadvantaged households with children. The potential developmental consequences of food insecurity during childhood may result in serious adverse health and social implications.

Gender gap in household investment : a study on Bhutan

Differing parental considerations for girls and boys in households are perceived as one of the primary causes of the gender gap in school enrolment and educational attainment in developing countries, particularly in the countries in Sub-Saharan Africa and South Asia. While there are a number of studies on the gender gap focusing on education and health provision in the countries in South Asia, little is known about Bhutan. This thesis aims to explore the gender gap in the intra-household allocation of resources on schooling and health provision for children in Bhutan. This thesis investigates whether boys are shown preference by their parents in terms of educational opportunities, including enrolment and spending on schooling as well as health. To conduct examination, this study makes use of household data from the Bhutan Living Standard Survey of 2007. Using cross-sectional as well as household fixed and random effect approaches, this study attempts to analyse the gender gap in allocation of resources across households as well as within households. The analysis includes characteristics of children and households such as gender and age of children, family wealth, education and gender of household head, number of dependents and the area of residence. The findings reveal a significant gender gap in schooling of children aged six to sixteen in Bhutan. However, no robust evidence of a gender gap has been found in the allocation of health expenditure on children aged less than sixteen. Policy recommendations to alleviate the gender bias in educational opportunities of females are proposed.

A comparison of security of tenure in Queensland and in Western Europe

Queensland residential tenancies are usually granted for up to 12 months with no guarantee of renewal. On expiration of the term, the landlord, without need to provide an explanation, can require the tenant to leave. Europeans find this unusual. As Hammar observes, to ‘never be sure whether ... you will be allowed to stay for another year ... is ok for a student, or for someone working ... but not for households’. This article informs Queensland policy makers and industry about European practices and concludes by proposing legislative amendments to realise the tenant’s security of tenure.

Assessment of the health impacts of the 2011 summer floods in Brisbane

Objective To assess the effects of the 2011 floods in Brisbane, Australia, on residents’ physical and mental health. Methods Residents who had been affected by the floods completed a community-based survey that examined the direct impact of flooding on households and their perceived physical and mental health. Outcome variables included overall and respiratory health and mental health outcomes related to psychological distress, sleep quality, and posttraumatic stress disorder (PTSD). Multivariable logistic regression was used to examine the association between flooding and perceived health outcome variables, adjusted for current health status and sociodemographic factors. Results Residents whose households were directly affected by flooding were more likely to report poor overall (Odds Ratio [OR] 5.3; 95% CI, 2.8-10.1) and respiratory (OR 2.3; 95% CI, 1.1-4.6) health, psychological distress (OR 1.9; 95% CI, 1.1-3.5), poor sleep quality (OR 2.3; 95% CI, 1.2-4.4), and probable PTSD (OR 2.3; 95% CI, 1.2-4.5). Conclusions The 2011 Brisbane floods had significant impact on the physical and psychosocial health of residents. Improved support strategies may need to be integrated into existing disaster management programs to reduce flood-related health impacts, particularly those related to mental health.

Young people whose parents are separated or divorced: A case for researching their experiences at the intersection of home and school

Background: Young people whose parents are separated or divorced form a significant and increasing proportion of young people who attend school. To date, empirical research with young people whose parents are separated or divorced has tended to focus on either their household context, or their school context, rather than on both contexts together. This paper redresses this singular focus by examining the intersection of the experiences of young people at both home and school. Purpose: The paper seeks to map the empirical evidence of young people's home and school experiences as they move between households and schools. Sources of evidence: The paper provides a narrative review of the literature from the 1990s to the present, locating Australian research within an international context. The review is framed by four main questions. What is the impact upon young people of the family transitions that occur when parents separate or divorce? What is the everyday impact upon young people of moving between one household and another? What does the research reveal regarding educational, social and emotional outcomes for this group? What does the research reveal regarding their school experiences? Main argument: The review reveals a paucity of Australian research at the intersection of home and school. It shows that, while young people from these contexts form a growing proportion of the school population, there is little empirical evidence of what is actually occurring in their everyday lives. The review reveals the importance of researching from the perspectives of the young people themselves. Conclusions: Evidence provided in the paper shows that many young people whose parents separate or divorce are affected socially, emotionally and educationally. Such evidence points to the need for research into the everyday experiences of the young people at school, in order to identify, from their perspective, how schools can better cater for these young people and their families.

Assessing efficiency of a transit oriented development (TOD) by comparative analysis

Transit oriented developments (TODs) are master planned communities constructed to reduce the dependence on the private car and promote the modes of transport such as public transport, walking and cycling, which are presumed by many transport professionals to be more sustainable. This paper tests this assumption that TOD is a more sustainable form of development than traditional development, with respect to travel demand, by conducting travel surveys for a case study TOD and comparing the travel characteristics of TOD residents with the travel characteristics of residents of Brisbane, Australia who live in non TOD suburbs. The results of a household comparison showed that the Kelvin Grove Urban Village (KGUV) households had slightly smaller household size, lower vehicle and bicycle ownership compared to Brisbane Statistical Division (BSD), Brisbane’s inner north and inner south suburbs. The comparison of average trip characteristics showed that on an average KGUV residents undertook fewer trips on the given travel day (2.6 trips/person) compared to BSD (3.1 trips/person), Brisbane Inner North Suburbs (BINS) (3.6 trips/person) and Brisbane Inner South Suburbs (BISS) (3.5 trips/person) residents. The mode share comparison indicated that KGUV residents used more public transport and made more walk-only trips in comparison to BSD, BINS and BISS residents. Overall, 72.4 percent of KGUV residents used a sustainable mode of transport for their travel on a typical weekday. On the other hand, only 17.4 percent, 22.2 percent and 24.4 percent residents of BSD, BINS and BISS used sustainable modes of transport for this travel. The results of trip length comparison showed that overall KGUV residents have smaller average trip lengths as compared to its counterparts. KGUV & BINS residents used car for travelling farther and used public transport for accessing destinations located closer to their homes. On the contrary, BSD and BISS residents exhibited an opposite trend. These results support the transportation claims of many transport professionals that TODs are more transport efficient and therefore more sustainable in this respect.

Colour coding the fridge to reduce food waste

This paper introduces the first iteration of a study aimed at grouping similar food types together in a refrigerator to increase the awareness of available foods for consumers in a domestic environment. The goals of the project are twofold: i) Raise the awareness of available foods for all members of a household; ii) Reduce the amount of expired food waste in the household. The project implemented a paper-based colour scheme in refrigerators in households, assigning colours to particular food types (e.g. green to fruit and vegetables, red to meat, etc.). The findings show that the colour coding raised participants’ awareness of available food items in the fridge, particularly for those participants who were not directly involved in the shopping and initial storage of each food item. The findings also indicate that such awareness led to a reduction in expiration of food and thus general food waste in the household. These preliminary findings suggest that raising awareness of food availability through categorisation and efficient communication of this information may lead to a reduction in food waste in domestic environments.

Food insecurity among adults residing in disadvantaged urban areas : potential health and dietary consequences

Objective: Food insecurity is the limited or uncertain availability or access to nutritionally-adequate, culturally-appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of this study was to investigate associations between food insecurity, socio-demographic and health factors and dietary intakes among adults residing in disadvantaged urban areas. Design: Data were collected by mail survey (n= 505, 53% response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, take-away and meat consumption, general health, depression and chronic disease. Setting: Disadvantaged suburbs of Brisbane city, Australia, 2009. Subjects: Individuals aged ≥ 20 years. Results: Approximately one-in-four households (25%) were food insecure. Food insecurity was associated with lower household income, poorer general health, increased healthcare utilisation and depression. These associations remained after adjustment for age, gender and household income. Conclusion: Food insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socioeconomically-disadvantaged suburbs.

Associations between socioeconomic position, food insecurity and BMI

Introduction: Food insecurity is a social determinant of health and is defined as limited ability to access sufficient amounts of nutritionally adequate or safe food for a healthy and active life. Food insecurity is associated with poor health status and the exacerbation of other health inequalities. This study examined whether an association existed between 1) socioeconomic position (SEP) and food insecurity and 2) food insecurity and weight status. Methods: Data from the 1995 National Nutrition Survey was analysed. A random sample of households (n = 13 858) were asked about dietary habits and food choices. Information about gender, age, BMI, waist circumference, household income and whether the household had run out of money to purchase food in the previous 12 months was obtained and analysed using chi-square and logistic regression. Results: Income was significantly associated with food insecurity; households with lower income were at higher risk of food insecurity. Lower income males were nine times more likely to experience food insecurity and lower income females were three times more likely to experience food insecurity than their higher income counterparts. Food insecurity was significantly associated with body mass index (BMI) among women but not men. Women experiencing food insecurity were at higher risk of overweight/obesity according to BMI and waist circumference measures. Conclusion: Evidence suggests that low income households are at higher risk of food insecurity and women who are food insecure are at higher risk of being overweight or obese. Food insecurity may mediate the association between SEP and BMI.

Does food insecurity contribute to socioeconomic inequalities in BMI?

Introduction: Food insecurity is a social determinant of health and is defined as limited ability to access sufficient amounts of nutritionally adequate or safe food for a healthy and active life. Food insecurity is associated with poor health status and the exacerbation of other health inequalities. This study examined whether an association existed between 1) socioeconomic position (SEP) and food insecurity and 2) food insecurity and weight status. Methods: Data from the 1995 National Nutrition Survey was analysed. A random sample of households (n = 13 858) were asked about dietary habits and food choices. Information about gender, age, BMI, waist circumference, household income and whether the household had run out of money to purchase food in the previous 12 months was obtained and analysed using chi-square and logistic regression. Results: Income was significantly associated with food insecurity; households with lower income were at higher risk of food insecurity. Lower income males were nine times more likely to experience food insecurity and lower income females were three times more likely to experience food insecurity than their higher income counterparts. Food insecurity was significantly associated with body mass index (BMI) among women but not men. Women experiencing food insecurity were at higher risk of overweight/obesity according to BMI and waist circumference measures. Conclusion: Evidence suggests that low income households are at higher risk of food insecurity and women who are food insecure are at higher risk of being overweight or obese. Food insecurity may mediate the association between SEP and BMI.