Variation in cervical cancer screening by region, socio-economic, migrant and Indigenous status in women in New South Wales

The purpose of this study was to estimate the extent of association of cervical screening in NSW women with socio-economic status (SES), rurality, and proportions of non-English speaking background (NESB) and Indigenous status. Data on women who had at least one Pap test over two years (January 1998-December 1999) were obtained from the NSW Pap test Register. Each local government area (LGA) was allocated to categories of population proportions of NESB and Indigenous status, a rurality classification based on population density and remoteness, and to an SES quintile. The odds ratios (OR) of having a Pap test were estimated and confounding adjusted by multiple logistic regression analysis. Implied Pap test rates in urban NESB and in rural Indigenous women were estimated from the modelled estimates. The adjusted OR for a Pap test in large rural centres (1.14) was significantly higher than those for metropolitan or capital city residents (0.9 and 1.0 respectively). Adjusted OR for a Pap test in other rural centres (0.73) and other remote areas (0.64) were significantly lower than those for metropolitan or capital city residents. In urban populations the lowest OR were in areas with both low SES and high proportion of NESB. The lowest OR for Pap screening in rural populations occurred in the most remote areas with the highest proportion of Indigenous women. For urban NESB women the biennial Pap test rate was estimated as 50%, and for rural Indigenous women 29%, compared with the NSW average of 59%.

Mental health and socio-economic variations in Australian suicide

This paper investigates the relationship between suicide rates and prevalence of mental disorder and suicide attempts, across socio-economic status (SES) groups based on area of residence. Australian suicide data (1996-1998) were analysed in conjunction with area-based prevalences of mental disorder derived from the National Survey of Mental Health and Well-Being (1997). Poisson regression models of suicide risk included age, quintile of area-based SES, urban-rural residence, and country of birth (COB), with males and females analysed separately. Analysis focussed on the association between suicide and prevalences of (ICD-10) affective disorders, anxiety disorders, substance use disorders and suicide attempts by SES group. Prevalences of other psychiatric symptomatology, substance use problems, health service utilisation, stressful life-events and personality were also investigated. Significant increasing gradients were evident from high to low SES groups for prevalences of affective disorders, anxiety disorders (females only), and substance use disorders (males only); sub-threshold drug and alcohol problems and depression; and suicide attempts and suicide (males only). Prevalences of mental disorder, other sub-threshold mental health items and suicide attempts were significantly associated with suicide, but in most cases associations were reduced in magnitude and became statistically non-significant after adjustment for COB, urban-rural residence, and SES. For male suicide the relative risk (RR) in the lowest SES group compared to the highest was 1.40 (95% CI 1.29-1.52, p < 0.001) for all ages, and 1.46 (95% CI 1.27-1.67, p < 0.001) for male youth (20-34 years). This relationship was not substantially modified in males when regression models included prevalences of affective disorders, and other selected mental health variables and demographic factors. From a population perspective, SES remained significantly associated with suicide after controlling for the prevalence of mental disorders and other psychiatric symptomatology. Mental conditions and previous suicidal behaviour may play an intermediary role between SES and suicide, but this study suggests that an independent relationship between suicide and SES also exists. (c) 2005 Elsevier Ltd. All rights reserved.

Conservation and economic benefits of wildlife-based marine tourism: Sea turtles and whales as case studies

Tourism development can have positive and/or negative impacts on wildlife. However, if tourism is developed in accordance with the basic tenets of wildlife tourism such an activity can be sustainable and can aid the conservation of species. Based on two case studies in Queensland, Australia, this article outlines the various economic and conservation benefits arising from wildlife-based tourism. Some of the benefits are direct, such as tangible economic benefits, others are less tangible, such as increased visitors’ willingness to pay in principle for the conservation of species. Wildlife-based tourism is shown to foster political support for the conservation of species utilized for such tourism by various mechanisms. Non-consumptive uses of wildlife are not only sustainable, but may provide a viable alternative to consumptive uses.

Major demographic changes in Bangladesh and their socio-economic correlates: Analysis of trends

Catalogues the demographic changes in Bangladesh during the period 1975-2000 and examines how they relate to key socio-economic attributes. Trends are examined in population growth, growth of the working age population, women’s workforce participation, age-dependency ratio, female-male ratio, longevity, fertility, mortality and mean age at first marriage. Bangladesh has made significant breakthroughs in all these areas, a feat not matched by most other South Asian countries, but comparable with the South-East Asia region as whole. The study isolates factors contributing to the changes in each attribute. It assesses the correlation between Bangladesh’s demographic changes and selected socio-economic indicators namely, its per capita GDP, female labour force participation, per capita public health expenditure and educational achievements by both men and women. All five socio-economic variables display statistically significant correlation, in varying degrees, with measures of the demographic changes. Per capita GDP is probably the most significant determinant of demographic changes in Bangladesh. The study observes that men’s education reinforces women’s education and with increased workforce participation contributed to reduced fertility. The study suggests that the role of family planning programs in curbing population growth in Bangladesh maybe overestimated.