An ecological study of the relationship between social and environmental determinants of obesity

There is growing concern with the increasing prevalence of obesity in industrialised countries, a trend that is more apparent in the poor than in the rich. In an ecological study, the relationship between an area measure of socioeconomic status (SES) and the density of fast-food outlets was examined as one possible explanation for the phenomenon. It was found that there was a dose-response between SES and the density of fast-food outlets, with people living in areas from the poorest SES category having 2.5 times the exposure to outlets than people in the wealthiest category. The findings are discussed.

Duration of unemployment and suicide in Australia over the period 1985–2006: an ecological investigation by sex and age during rising versus declining national unemployment rates

Background The relationship between unemployment and suicide may be sensitive to demographic factors, national unemployment rates, and length of time without employment. This study investigated these factors in relation to suicide in Australia for the period 1985–2006, in an ecological study. Methods The outcome variable was annual suicide rate by age group, sex and the eight states and territories over 22 years of observation (total observations=1760). The main predictor variable was the average duration of unemployment in the population, categorised into three time periods (<2 weeks, 2–4 weeks, >4 weeks). Poisson regression models were used to investigate the relationship between duration of unemployment and suicide over the years 1985–2006 in a series of cross-sectional analyses. Interaction analyses indicated significant differences during periods of declining or increasing labour market opportunity and by age group. Results During periods of declining unemployment rates in the country, longer durations of unemployment were associated with higher male suicide rates. During periods of increasing unemployment in the country, longer unemployment duration was associated with lower male suicide rates. Effect modification was also apparent by age-group, with stronger associations between unemployment duration and male suicide evident in those aged 25–34 and 55–64, and weaker associations in those aged 15–24 and 44–54 years. Longer length of unemployment was not associated with an increase in female suicide rates. Conclusions The labour market opportunities in Australia modified the effect of duration of unemployment on suicide, and the effect was more prominent in men and older age groups. This may reflect social norms and acceptability about unemployment, as well as life-stage influences associated with transitions into and out of the labour market.

Ageing, chronic disease and injury: a study in western Victoria (Australia)

Background : An increasing burden of chronic disease and associated health service delivery is expected due to the ageing Australian population. Injuries also affect health and wellbeing and have a long-term impact on health service utilisation. There is a lack of comprehensive data on disease and injury in rural and regional areas of Australia. The aim of the Ageing, Chronic Disease and Injury study is to compile data from various sources to better describe the patterns of chronic disease and injury across western Victoria.

Design : Ecological study.

Methods : Information on demographics, socioeconomic indicators and lifestyle factors are obtained from health surveys and government departments. Data concerning chronic diseases and injuries will be sourced from various registers, health and emergency services, local community health centres and administrative databases and compiled to generate profiles for the study region and for sub-populations within the region.

Expected impact for public health: This information is vital to establish current and projected population needs to inform policy and improve targeted health services delivery, care transition needs and infrastructure development. This study provides a model that can be replicated in other geographical settings.

Tuberculosis associated with household crowding in a developed country

Background: Tuberculosis (TB) remains an important infectious disease in New Zealand (NZ) and globally, but risk factors for transmission are still poorly understood. This research aimed to identify whether household crowding contributes to TB transmission in NZ.

Methods: This ecological study used TB surveillance and census data to calculate TB incidence rates by census area unit (CAU). Census data were used to determine CAU characteristics including proportion of household crowding (a bedroom deficit of one or more), proportion of population who are migrants born in high-TB-incidence countries, median household income, and deprivation level. A negative binomial regression model was used to estimate the association between TB incidence and household crowding.

Results: The analysis included 1898 notified TB cases for the 2000–4 period. Univariate analysis showed TB incidence at the CAU level was associated with household crowding, for the total population and for all ethnic and age groups. After adjusting for the covariates of household income, existing TB burden, and proportion of migrants from high-TB-incidence countries, multivariate analysis showed statistically significant associations between TB incidence and household crowding. The incidence rate ratio (IRR) was 1.05 (95% CI 1.02 to 1.08) in the total population and 1.08 (95% CI 1.04 to 1.12) for NZ-born people <40 years.

Conclusion: At the CAU level, TB incidence in NZ is associated with household crowding. An individual-based study (e.g. case–control) in recently infected cases (detected by molecular epidemiology techniques) is suggested to complement these findings. Reducing or eliminating household crowding could decrease TB incidence in NZ and globally.

Changes in intravenous fluid use patterns in Australia and New Zealand: evidence of research translating into practice

OBJECTIVES: To describe changes in the use of intravenous (IV) fluid by quantity and type in different regions of Australia and New Zealand. DESIGN, SETTING AND PARTICIPANTS: We conducted a retrospective ecological study examining regional and temporal trends in IV fluid consumption across Australia and New Zealand over the periods 2012-2013 and 2013- 2014, using national proprietary sales data as a surrogate for consumption, and demographic data from the public domain. RESULTS: More than 13.3 million litres of IV fluid were consumed in Australia and New Zealand in 2012-2013, and more than 13.9 million litres in 2013-2014, with colloid solutions accounting for < 2%. There was marked regional variation in consumption of fluids, by volumes and proportions used, when standardised to overall Australian and New Zealand values. There was no significant change in the overall volume of crystalloid solutions consumed but there was a significant decrease (9%; P = 0.02) in the ratio of unbalanced to balanced crystalloid solutions consumed. Consumption of all forms of colloid solutions decreased, with a 12% reduction overall (P = 0.02), primarily driven by a 67% reduction in the consumption of hydroxyethyl starch (HES) solutions. CONCLUSIONS: The amount and type of IV fluid use, as determined by fluid sales, is highly variable across Australia and New Zealand. However, overall use of balanced crystalloid solutions is increasing and the use of HES has decreased dramatically.

What are the policy priorities for sustaining ecological processes? A case study from Victoria, Australia

Developments in ecological theory indicate that ecological processes have major implications for sustaining biodiversity and the provision of ecosystem services. Consequently, conservation actions that focus solely on particular species, vegetation communities, habitats or sites ('assets') are unlikely to be effective over the long term unless the ecological processes that support them continue to function. Efforts to sustain biodiversity must embrace both 'assets' and 'process-oriented' approaches. Existing knowledge about ecological processes, incomplete though it is, has not been adequately considered in government decision making. It is, therefore, necessary to consider how to build consideration of ecological processes into legislative and institutional frameworks, policy and planning processes, and on-ground environmental management. Drawing on insights from interviews, a facilitated workshop, and a literature review, this paper identifies a suite of policy priorities and associated reforms which should assist in ensuring that ecological processes are given more attention in policy-making processes. It is concluded that a multi-pronged approach is required, because there are no 'silver bullets' for sustaining ecological processes.

From ecological creativity to an ecology of well-being: 'flows & catchments' as a case study of NVivo

This paper’s research question concerns how the ecological creativity of the Volcanic Plains region of Western Victoria may be transformed into an ecology of well-being of benefit to the local community. Drawing on the philosophies of Spinoza and Gilles Deleuze, we argue that community well-being results from the richness of connections and relationships made within a place. The case study for our investigation is ‘Flows & Catchments’, which is an ongoing, collaborative, creative-arts research project auspiced by Deakin University. Its modus operandi is Practice-Based Research (PBR), and its aim is to promote community well-being in Western Victoria. However, while the whole metier of the creative arts is to make the novel connections and relationships that should bring about community wellbeing, the various artists of ‘Flows & Catchments’ have proved slightly reluctant to make connections outside of their individual or small-group sub-projects. In this way, ecological creativity has not reached its full potential as an ecology of well-being because the rich connections and relationships essential to this well-being have not yet been fully realised. This paper explores the potential of using the NVivo qualitative analysis software package to bring together the creative-arts sub-projects of ‘Flows & Catchments’, as a way of fostering an ecology of well-being out of a currently dispersed ecological creativity.

'Ecological embeddedness' and its public health implications: findings from an exploratory study

Western culture over the last two centuries has become significantly ecologically 'dis-embedded', with nature increasingly reduced to resources for human use. The consequence is global environmental degradation, including accelerating climate change. Much recent research supports associations between nature contact and human health and well-being, and between feelings of nature-connectedness and pro-environmental attitudes and behaviours. The oft-cited Ottawa Charter for Health Promotion (WHO, Ottawa Charter for Health Promotion, 1986) emphasises human-environment inextricability; however public health discourse and response has not fully engaged with this recognition. This qualitative study explored the attitudes, motivations, and experiences-including formative influences-of six individuals whose behaviour was congruent with recognition of human-nature interconnectedness; such individuals may be understood as ecologically embedded. Key aspects of participants' experience, identified through grounded theory thematic analysis, were (i) connecting with nature (especially in childhood); (ii) seeing the threat and taking it personally; (iii) the nature of reality; (iv) dedicated beyond the ego-oriented self; and (v) sustaining the eco-centric self. The findings highlight the necessity for cross-sectoral advocacy at all levels of government policy development focused on recognition of human-environment connectedness, especially bridging health, planning and education policies affecting children. Only thus will both population health and ecological health on which population health depends be possible.

Land use, water quality and ecological responses in Lake Colac – trends from Australia

Purpose - Recently, Colac Otway Shire in Australia released its management plan for Lake Colac, claiming over-enrichment of the lake with nutrients and degraded water quality. This paper aims to investigate these claims by establishing a correlation between key water and ecological indicators and land uses.

Design/methodology/approach - Examines the correlation between impairment and stressors in Lake Colac. This was achieved by identifying the likely sources of pollutants into Lake Colac; identifying any existing monitoring program; and characterizing the water and sediment inputs. The likely impacts of increased nutrients and sediment levels on indigenous flora and fauna were also examined. The use of meiofauna (very small benthic metazoan animals) was investigated as an indicator of degraded sites. Plankton diversity as a measure of water health was also assessed.

Findings - Water quality in Lake Colac was found to vary both temporally and spatially, and exhibited low attainment against acceptable trigger values/objectives. At current levels the lake can be classified as poorly degraded. Likely sources of pollution were identified to be related to land uses in the catchments. The biota of the lake, investigated at four study sites, yielded a sparse, benthic macrofaunal assemblage that was dominated by oligochaetes. In contrast, an abundant and taxonomically diverse meiofaunal assemblage was noted. Future meiofaunal analyses are likely to resolve suitable biotic indicator species of free-living nematodes in response to land use and waterway threats specified in the study. Originality value - This work will provide a better understanding of integrated environmental systems to enable development of best management practices, thus transforming the way the land and water are used in the future. Following the present work, other key water and ecological indicators (increased dispersion and dominance of biological species) at five additional sites were studied. Alternative management options for the effluent generated at Colac Sewage Treatment Plant and possible ecological effects of each option were also evaluated. More recently, a sediment characterization study was also carried out at sensitive sites representative of locations where build up of sediments and algae outbreaks are reported. This will enable classification of sediment and evaluation of dredging options.

Where do children usually play? A qualitative study of parents' perceptions of influences on children's active free-play

This study explored the perceptions of 78 parents from low, mid and high socio-economic areas in Melbourne, Australia to increase understanding of where children play and why. Using an ecological model interviews with parents revealed that safety and social factors emerged as key social themes, facilities at parks and playgrounds, and urban design factors emerged as important physical environment themes. The children's level of independence and attitudes to active free-play were considered to be important individual level influences on active free-play. The study findings have important implications for future urban planning and children's opportunities for active free-play.

How can socio-economic differences in physical activity among women be explained? A qualitative study

This qualitative study investigated why women of low socio-economic status (SES) are less physically active than women of higher-SES. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low-SES women. A social-ecological framework, taking into account intrapersonal, social and environmental level influences, was adopted to guide the development of interview questions and interpretation of data. Thematic analysis identified a number of key influences on physical activity that varied by SES. These included negative early life/family physical activity experiences (a consistent theme among those of low-/mid-SES); participation in a wider range of physical activities in leisure time (high-SES); greater priority given to television viewing (low-SES); lack of time due to work commitments (low-SES); lack of time due to family commitments (high-SES); and neighbourhood-level barriers (low-SES). Financial costs were not perceived as a key barrier by women in any SES group. Public health strategies aimed at reducing SES