Attaching unit costs to Australia`s national survey of mental health and wellbeing

Background: In mental health, policy-makers and planners are increasingly being asked to set priorities. This means that health economists, health services researchers and clinical investigators are being called upon to work together to define and measure costs. Typically, these researchers take available service utilisation data and convert them to costs, using a range of assumptions. There are inefficiencies, as individual groups of researchers frequently repeat essentially similar exercises in achieving this end. There are clearly areas where shared or common investment in the development of statistical software syntax, analytical frameworks and other resources could maximise the use of data.

Aims of the Study: This paper reports on an Australian project in which we calculated unit costs for mental health admissions and community encounters. In reporting on these calculations, our purpose is to make the data and the resources associated with them publicly available to researchers interested in conducting economic analyses, and allow them to copy, distribute and modify them, providing that all copies and modifications are available under the same terms and conditions (i.e., in accordance with the `Copyleft' principle). Within this context, the objectives of the paper are to: (i) introduce the `Copyleft' principle; (ii) provide an overview of the methodology we employed to derive the unit costs; (iii) present the unit costs themselves; and (iv) examine the total and mean costs for a range of single and comorbid conditions, as an example of the kind of question that the unit cost data can be used to address.

Method: We took relevant data from the Australian National Survey of Mental Health and Wellbeing (NSMHWB), and developed a set of unit costs for inpatient and community encounters. We then examined total and mean costs for a range of single and comorbid conditions.

Results: We present the unit costs for mental health admissions and mental health community contacts. Our example, which explored the association between comorbidity and total and mean costs, suggested that comorbidly occurring conditions cost more than conditions which occur on their own.

Discussion: Our unit costs, and the materials associated with them, have been published in a freely available form governed by a provision termed `Copyleft'. They provide a valuable resource for researchers wanting to explore economic questions in mental health.

Implications for Health Policies: Our unit costs provide an important resource to inform economic debate in mental health in Australia, particularly in the area of priority-setting. In the past, such debate has largely been based on opinion. Our unit costs provide the underpinning to strengthen the evidence-base of this debate.

Implications for Further Research: We would encourage other Australian researchers to make use of our unit costs in order to foster comparability across studies. We would also encourage Australian and international researchers to adopt the `Copyleft' principle in equivalent circumstances. Furthermore, we suggest that the provision of `Copyleft'-contingent funding to support the development of enabling resources for researchers should be considered in the planning of future large-scale collaborative survey work, both in Australia and overseas.

Domestic drinking water in rural areas : are water tanks on farms a health hazard?

The aim of the research was to gain a better understanding of the relationship between drinking water quality, householders' knowledge and maintenance practices of private water supplies and drinking water-related public health risk on farms. Samples of drinking water were taken from 100 farming households. The Colilert-18 method was used for the detection of total coliforms and Escherichia coli (E. coli) as indicators of water quality. Each household completed a questionnaire about their knowledge and practices relating to a safe water supply. Coliforms were present in 52 water samples and E. coli was present in 38. Seven households reported minor illnesses in the previous three months and two households reported gastroenteritis. Some tank maintenance occurred in 86 households, but tank maintenance activities varied considerably. Four of the households had published guidelines on water quality. None of the participating households had their drinking water tested regularly. There was no obvious relationship between drinking water quality, householder knowledge, maintenance practices and drinking water-related health risk on farms.

Does parkland influence walking? The relationship between area of parkland and walking trips in Melbourne, Australia

Background : Using two different measures of park area, at three buffer distances, we sought to investigate the ways in which park area and proximity to parks, are related to the frequency of walking (for all purposes) in Australian adults. Little previous research has been conducted in this area, and results of existing research have been mixed.

Methods : Residents of 50 urban areas in metropolitan Melbourne, Australia completed a physical activity survey (n = 2305). Respondents reported how often they walked for >=10 minutes in the previous month. Walking frequency was dichotomised to 'less than weekly' (less than 1/week) and 'at least weekly' (1/week or more). Using Geographic Information Systems, Euclidean buffers were created around each respondent's home at three distances: 400metres (m), 800 m and 1200 m. Total area of parkland in each person's buffer was calculated for the three buffers. Additionally, total area of 'larger parks', (park space >= park with Australian Rules Football oval (17,862 m2)), was calculated for each set of buffers. Area of park was categorised into tertiles for area of all parks, and area of larger parks (the lowest tertile was used as the reference category). Multilevel logistic regression, with individuals nested within areas, was used to estimate the effect of area of parkland on walking frequency.

Results : No statistically significant associations were found between walking frequency and park area (total and large parks) within 400 m of respondent's homes. For total park area within 800 m, the odds of walking at least weekly were lower for those in the mid (OR 0.65, 95% CI 0.46-0.91) and highest (OR 0.65, 95% CI 0.44-0.95) tertile of park area compared to those living in areas with the least amount of park area. Similar results were observed for total park area in the 1200 m buffers. When only larger parks were investigated, again more frequent walking was less likely when respondents had access to a greater amount of park area.

Conclusions : In this study we found that more park area in residential environments reduced the odds of walking more frequently. Other area characteristics such as street connectivity and destinations may underlay these associations by negatively correlating with park area.

Area-level unemployment and perceived job insecurity: evidence from a longitudinal survey conducted in the Australian working-age population

Research significance: Job insecurity, the subjective individual anticipation of involuntary job loss, negatively affects employees’ health and their engagement. Although the relationship between job insecurity and health has been extensively studied, job insecurity as an ‘exposure’ has received far less attention, with little known about the upstream determinants of job insecurity in particular. This research sought to identify the relationship between self-rated job insecurity and area-level unemployment using a longitudinal, nationally representative study of Australian households. Methods: Mixed-effect multi-level regression models were used to assess the relationship between area-based unemployment rates and self-reported job insecurity using data from a longitudinal, nationally representative survey running since 2001. Interaction terms were included to test the hypotheses that the relationship between area-level unemployment and job insecurity differed between occupational skill-level groups and by employment arrangement. Marginal effects were computed to visually depict differences in job insecurity across areas with different levels of unemployment. Results: Results indicated that areas with the lowest unemployment rates had significantly lower job insecurity (predicted value 2.74; 95% confidence interval (CI) 2.71–2.78, P < 0.001) than areas with higher unemployment (predicted value 2.81; 95% CI 2.79–2.84, P < 0.001). There was a stronger relationship between area-level unemployment and job insecurity among precariously and fixed-term employed workers than permanent workers. Conclusion: These findings demonstrate the independent influences of prevailing economic conditions, individual- and job-level factors on job insecurity. Persons working on a casual basis or on a fixed-term contract in areas with higher levels of unemployment are more susceptible to feelings of job insecurity than those working permanently.

Gen green 4 Australia: a national study of demand for and supply of skills for sustainability

In this research, skills for sustainability are broadly conceived as including skills for social, economic and environmental sustainability – a triple bottom-line approach. Since 2009 Australian governments have been implementing an agreement that embeds skills for sustainability into vocational education and training, despite scant information about the actual levels of demand for, and supply of these skills. This study provides evidence on the actual depth and breadth of the take-up of these skills within Australian training organisations and workplaces. The demand studied in this research is that expressed by the primary consumers of Australian Vocational Education and Training (VET) services, students who engage in VET studies, this is known in the literature as social demand for education. VET students and teachers responded to two survey instruments that explored the sustainability values, behaviours, learning and teaching of Australian apprentices, trainees and their teachers. The results of this study show ‘a social demand’ for skills for sustainability. In summary, the results show that: •Apprentices, trainees and their teachers cared a great deal about social, economic and environmental sustainability; •Supply was closely aligned to social demand for skills for sustainability so that demand for skills for sustainability from VET students was almost entirely met; •There are important differences in the teaching, learning and utilisation of skills for sustainability that are related to gender and age; and •In-class learning of environmental skills has increased over time and now slightly outweighs learning of these skills at work, however community learning of these skills outweighs both. The findings suggest that: •Further action is required to embed green skills into the VET system, especially in the areas of energy efficiency and supply chains; •The VET system plays an important role in supporting community cohesion and economic literacy, especially for women; •It is important that social sustainability is properly considered in analysis informing VET policy; and •Gender differences in values and behaviours and gender and age differences in learning skills for sustainability have important implications for the design of future skills for sustainability programs. VET students and their teachers have unique insights into the supply of and demand for skills for sustainability, and this viewpoint can contribute, now and in the future, to the further development of skills for sustainability in Australia.

Studying and working : a national study of student finances and student engagement

A key determinant of the new relationship between students and universities in Australia is the changing nature of higher education funding arrangements and the shift towards “user-pays”. In 2007, the Centre for the Study of Higher Education (CSHE) completed a commissioned national study, Australian University Student Finances 2006: Final Report of a National Survey of Students in Public Universities. Drawing on the project report, this article discusses selected findings relating to student expectations and engagement to present a worrying picture of financial duress and involvement in paid work and examines the possible effects on the quality of higher education.

Heating effects on water repellency in Australian eucalypt forest soils and their value in estimating wildfire soil temperatures

Wildfires can induce or enhance soil water repellency under a range of vegetation communities. According to mainly USA-based laboratory studies, repellency is eliminated at a maximum soil temperature (T) of 280–400°C. Knowledge of T reached during a wildfire is important in evaluating post-fire soil physical properties, fertility and seedbed status. T is, however, notoriously difficult to ascertain retrospectively and often based on indicative observations with a large potential error. Soils under fire-prone Australian eucalypt forests tend to be water repellent when dry or moderately moist even if long unburnt. This study aims to quantify the temperature of water repellency destruction for Australian topsoil material sampled under three sites with contrasting eucalypt cover (Eucalyptus sieberi, E. ovata and E. baxteri). Soil water repellency was present prior to heating in all samples, increased during heating, but was abruptly eliminated at a specific T between 260 and 340°C. Elimination temperature varied somewhat between samples, but was found to be dependent on heating duration, with longest duration resulting in lowest elimination temperature. Results suggest that post-fire water repellency may be used as an aid in hindcasting soil temperature reached during the passage of a fire within repellency-prone environments.