Living with osteoarthritis: Patient expenditures, health status, and social impact

Objective. To determine out-of-pocket expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

Socioeconomic disadvantage and changes in health risk behaviours in Australia: 1989-90 to 2001

Objective. Lower socioeconomic status (SES) is associated in industrialized countries with unhealthy lifestyle characteristics, such as smoking, physical inactivity and being overweight or obese. This paper examines changes over time in the association between SES and smoking status, physical activity and being overweight or obese in Australia. Methods. Data were taken from three successive national health surveys in Australia carried out in 1989-90 (n = 54 576), 1995 (n = 53 828) and 2001 (n = 26 863). Participants in these surveys were selected using a national probability sampling strategy, and aggregated data for geographical areas are used to determine the changing association between SES and lifestyle over time. Findings. Overall, men had less healthy lifestyles, In 2001 inverse SES trends for both men and women showed that those living in lower SES areas were more likely to smoke and to be sedentary and obese, There were some important socioeconomic changes over the period 1989-90 to 2001. The least socioeconomically disadvantaged areas had the largest decrease in the percentage of people smoking tobacco (24% decrease for men and 12% for women) and the largest decrease in the percentage of people reporting sedentary activity levels (25% decrease for men and 22% for women). While there has been a general increase in the percentage over time of those who are overweight or obese, there is a modest trend for being overweight to have increased (by about 16% only among females) among those living in areas of higher SES. Conclusion. Socioeconomic inequalities have been increasing for several key risk behaviours related to health; this suggests that T specific population-based prevention strategies intended to reduce health inequalities are needed.

Sexual partner preferences: evolutionary imperative, emotional attachment or hedonism?

Data are taken from a representative sample of the Australian population to determine the qualities that are desired in a sexual partner. These qualities are considered in three categories: those reflecting the perceived reproductive value of the partner (evolutionary imperative), the emotional attachment to a partner and the pure pleasure associated with having sex. Subjects completed a telephone-based survey 876 males; 908 females; aged 18-59). The qualities respondents report they most desire in a sexual partner are that the person is someone who cares about them, and whom they love. They also rank highly the criterion that their partner should enjoy sex, and much less highly that they themselves should enjoy the sex. Evolutionary imperatives are ranked fairly low as criteria sought in a sexual partner. Males and females generally expressed similar preferences in a sexual partner, as do persons in different age groups, and persons in different marital status categories. Heterosexual males appear to place a higher emphasis on the physical appearance of a partner when compared with non-heterosexuals. [PUBLICATION ABSTRACT]

Conceptual Frameworks for SIA Revisited: a cumulative effects study on lead contamination and economic change

This article trials three conceptual frameworks on an Australian case study of a small remote city suffering lead contamination, with cumulative effects from concurrent economic change due to downsizing in the mining industry. It interprets the usefulness of these frameworks, and explores two questions: can they apply to circumstances other than project assessment, and what are their relative merits as guides to SIA? All the frameworks reviewed can be used in non-project and cumulative SIA, although, if they had been used to predict the impacts in our case study, we may easily have been misled as to the resilience of the community. Choosing among these frameworks becomes a matter personal preference: each has different merits.