Socioeconomic status and quality of life in population-based Australian men: data from the Geelong Osteoporosis Study

Objective : To investigate the relationship between socioeconomic status (SES) and reported perceptions of quality of life (QOL) in a cross-sectional population-based analysis of a representative sample of Australian men.

Severely obese people with diabetes experience impaired emotional well-being associated with socioeconomic disadvantage: results from diabetes MILES – Australia

Aim
To examine the emotional well-being of severely obese Australians with type 2 diabetes, along with markers of social and economic disadvantage, using the Diabetes MILES – Australia dataset.
Methods
Diabetes MILES – Australia was a national survey of 3338 adults with diabetes that focused on psychosocial issues; 1795 had type 2 diabetes and reported BMI. We extracted data regarding depression (PHQ-9), anxiety (GAD-7), obesity- and diabetes- related comorbidities, and demographics. The severely obese group (SOG) (BMI ≥ 35; median BMI = 41.6) constituted 530 (30%) of the type 2 diabetes respondents and was matched with 530 controls (CG) (BMI < 35; median BMI = 28.2). Within- and between- group trends were examined.
Results
The SOG had higher depression scores (median (IQR) 6.0 (3–12)) than CG (5.0 (2–10)); p < 0.001, and were more likely to report moderate-severe depressive symptoms (37% versus 27%; p < 0.001). The groups did not differ on anxiety. The SOG, compared with the CG, were more likely to live alone (21% versus 17%), receive a disability pension (21% versus 15%), earn ≤$40.000/year (51% versus 41%; all p < 0.05), and were less likely to be employed (46% versus 53%), university or higher educated (17% versus 26%), or have health insurance (50% versus 60%; all p ≤ 0.01). Moderate-severe depression was positively associated with cumulative stressors of severe obesity, socioeconomic disadvantage, and obesity- and diabetes- related comorbidity.
Conclusions
Severely obese people living with type 2 diabetes have cumulative stressors related to health, disability, demographic and socioeconomic factors, and impaired emotional well-being.

Does the shortage of diabetes specialists in regional and rural Australia matter? Results from Diabetes MILES – Australia.

Aim: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas.

Methods: Diabetes MILES—Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%).

Results: Respondents from rural/regional (n=1574, 48%) and metropolitan areas were represented equally (n=1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83–0.97) and T2DM (RR 0.69, 95% CI 0.59–0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community/practice nurse for diabetes care (RR 2.22, 95% CI 1.25–3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07–1.36) or dietician (RR 1.17, 95% CI 1.07–1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators.

Conclusions: Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.

Performance indicators and the deeper foundations of performance

Critics of Key Performance Indicators (KPIs) argue that KPIs culture rewards the immediate production of tangible outcomes sometimes at the expense of social engagement and cooperative behaviour. The need to gain immediate outcomes in the current KPIs performance culture focuses many individuals onto forms of productivity that gain high KPIs but at what cost? What effect does this single minded focus have on developing organisational loyalties and commitments? Some scholars have suggested that a singular focus on performance indicator success may crowd out other positive social capital in institutions.

Urban growth in arid environments : developing water sustainability indicators for Abu Dhabi (UAE)

The United Arab Emirates (UAE) face a serious water problem. It has a very dry climate, high evaporation rate, combined with large water consumption from fast growing population, economic activities and uncontrolled uses of water for irrigation. Currently, UAE has one of the largest water footprints in the world. Groundwater is overexploited. Waste water is increasingly being treated to supply non-drinking water, but it still cover a small proportion of the demand. Desalination of sea water is the main source of potable water in UAE, but the high economic cost of desalination, its intensive energy demand and the adverse effects of its effluents on the marine life are a major concern. Other factors contributing to the problem are the focus of water management policies on keep supplying the growing demand for water, the increase of the per capita water consumption, and the free water charge for most of population. This research goal is to develop a water sustainability set of indicators for the challenging context of UAE. This paper presents the first stage of the research. Based on a review of the literature, the proposed framework involves 19 indicators, divided into four categories: water availability; water quality; water use efficiency; and policy and governance. Using an integrated cause-effect approach (DSR - Driving force, State, Response), the indicators were related in terms of their interdependencies, with a holistic view of the city water cycle. A preliminary test of the indicators to Abu Dhabi as a case study allowed an evaluation of the main 'Driving force' on the system, such as the scarcity of water due to natural constraints of the region, and increasing water consumption patterns of modern society; an assessment of the current 'state', which is under serious water stress. Also it indicated some potential 'responses', such as implementing policies for increasing efficient use.

Indicators of the impact of climate change on migratory species

The Bonn Convention on the Conservation of Migratory Species of Wild Animals adopted a Resolution in 2005 recognising the impacts of climate change on migratory species. It called on Contracting Parties to undertake more research to improve our understanding of these impacts and to implement adaptation measures to reduce foreseeable adverse effects. Given the large diversity of taxa and species affected by climate change, it is impossible to monitor all species and effects thereof. However, it is likely that many of the key ecological and physical processes through which climate change may impact wildlife could be monitored using a suite of indicators, each comprising parameters of species/populations or groups of species as proxies for wider assemblages, habitats and ecosystems. Herein, we identify a suite of 17 indicators whose attributes could reveal negative impacts of climate change on the global status of migratory species: 4 for birds, 4 for marine mammals, 2 for sea turtles, 1 for fish, 3 for land mammals and 3 for bats. A few of these indicators would be relatively straightforward to develop, but most would require additional data collation, and in many cases methodological development. Choosing and developing indicators of the impacts of climate change on migratory species is a challenge, particularly with endangered species, which are subject to many other pressures. To identify and implement conservation measures for these species, indicators must account for the full ensemble of pressures, and link to a system of alerts and triggers for action.

Patterns and correlates of self-reported racial discrimination among Australian Aboriginal and Torres Strait Islander adults, 2008–09: analysis of national survey data

Background
There is now considerable evidence that racism is a pernicious and enduring social problem with a wide range of detrimental outcomes for individuals, communities and societies. Although indigenous people worldwide are subjected to high levels of racism, there is a paucity of population-based, quantitative data about the factors associated with their reporting of racial discrimination, about the settings in which such discrimination takes place, and about the frequency with which it is experienced. Such information is essential in efforts to reduce both exposure to racism among indigenous people and the harms associated with such exposure.

Methods
Weighted data on self-reported racial discrimination from over 7,000 Indigenous Australian adults participating in the 2008–09 National Aboriginal and Torres Strait Islander Survey, a nationally representative survey conducted by the Australian Bureau of Statistics, were analysed by socioeconomic, demographic and cultural factors.

Results
More than one in four respondents (27%) reported experiencing racial discrimination in the past year. Racial discrimination was most commonly reported in public (41% of those reporting any racial discrimination), legal (40%) and work (30%) settings. Among those reporting any racial discrimination, about 40% experienced this discrimination most or all of the time (as opposed to a little or some of the time) in at least one setting. Reporting of racial discrimination peaked in the 35–44 year age group and then declined. Higher reporting of racial discrimination was associated with removal from family, low trust, unemployment, having a university degree, and indicators of cultural identity and participation. Lower reporting of racial discrimination was associated with home ownership, remote residence and having relatively few Indigenous friends.

Conclusions
These data indicate that racial discrimination is commonly experienced across a wide variety of settings, with public, legal and work settings identified as particularly salient. The observed relationships, while not necessarily causal, help to build a detailed picture of self-reported racial discrimination experienced by Indigenous people in contemporary Australia, providing important evidence to inform anti-racism policy.

Socioeconomic status, neighborhood characteristics, and walking within the neighborhood among older Hong Kong Chinese

Objective: 

FRAX provides robust fracture prediction regardless of socioeconomic status

The authors investigated the fracture risk assessment tool (FRAX) Canada calibration and discrimination according to income quintile in 51,327 Canadian women, with and without a competing mortality framework. The data shows that, under a competing mortality framework, FRAX provides robust fracture prediction and calibration regardless of socioeconomic status (SES).

Objectively assessed recess physical activity in girls and boys from high and low socioeconomic backgrounds

Background
The school environment influences children’s opportunities for physical activity participation. The aim of the present study was to assess objectively measured school recess physical activity in children from high and low socioeconomic backgrounds.

Methods
Four hundred and seven children (6–11 years old) from 4 primary schools located in high socioeconomic status (high-SES) and low socioeconomic status (low-SES) areas participated in the study. Children’s physical activity was measured using accelerometry during morning and afternoon recess during a 4-day school week. The percentage of time spent in light, moderate, vigorous, very high and in moderate- to very high-intensity physical activity were calculated using age-dependent cut-points. Sedentary time was defined as 100 counts per minute.

Results
Boys were significantly (p < 0.001) more active than girls. No difference in sedentary time between socioeconomic backgrounds was observed. The low-SES group spent significantly more time in light (p < 0.001) and very high (p < 0.05) intensity physical activity compared to the high-SES group. High-SES boys and girls spent significantly more time in moderate (p < 0.001 and p < 0.05, respectively) and vigorous (p < 0.001) physical activity than low-SES boys.

Conclusions
Differences were observed in recess physical activity levels according to socioeconomic background and sex. These results indicate that recess interventions should target children in low-SES schools.