Community languages, linguistic isolation and social exclusion in the Australian context

The detrimental impacts of social exclusion to health and well-being are well-known and are of increasing concern around the world. For many of the population sub-groups who are most at risk of social exclusion, linguistic isolation—the inability to use and understand the majority language—is a major barrier to full participation in the life of the community as well as to full integration into the society in which its members live. This paper, using data obtained from community-based research in Melbourne, Australia, will discuss the problem of linguistic isolation in the context of Australian multicultural policy and use of languages other than English among members of culturally and linguistically diverse (CALD) communities. The experience of members of two specific CALD communities, speakers of Arabic and speakers of Indonesian, will be discussed to illustrate the impacts of linguistic isolation on health and well-being and to elucidate the relationship between CALD status and social exclusion in these communities.

Risk, resistance and the neoliberal agenda: young people, health and well-being in the UK, Canada and Australia

In this article we describe how concepts of risk are both generated by and used to reinforce a neoliberal agenda in relation to the health and well-being of young people. We examine how risk may be used as a tool to advance ideals such as rational choice and individual responsibility, and how this can further disadvantage young people living within the contexts of structural disadvantage (such as geographic areas of long-term unemployment; communities that experience racial discrimination). We also identify the ways in which risk is applied in uneven ways within structurally disadvantaged contexts. To suggest a way forward, we articulate a set of principles and strategies that offer up a means of resisting neoliberal imperatives and suggest how these might play out at the micro-, meso- and macro-levels. To do this, we discuss examples from the UK, Canadian and Australian contexts to illustrate how young people resist being labelled as risky, and how it is possible to engage in health equity-enhancing actions, despite seemingly deterministic forces. The cases we describe reveal some of the vulnerabilities (and hence opportunities) within the seemingly impenetrable world view and powers of neoliberals, and point towards the potential to formulate an agenda of resistance and new directions for young people's health promotion.

Using internet enabled mobile devices and social networking technologies to promote exercise as an intervention for young first episode psychosis patients

Young people with first episode psychosis are at an increased risk for a range of poor health outcomes. In contrast to the growing body of evidence that suggests that exercise therapy may benefit the physical and mental health of people diagnosed with schizophrenia, there are no studies to date that have sought to extend the use of exercise therapy among patients with first episode psychosis. The aim of the study is to test the feasibility and acceptability of an exercise program that will be delivered via internet enabled mobile devices and social networking technologies among young people with first episode psychosis.

Dynamic and diverse ways of knowing in mental health occupational therapy

This study focused on evidence based practice in mental health occupational therapy. It investigated the theoretical, evidentiary and practical knowledge that occupational therapists use to support consumers and understand the relationship between occupation and health.

Personal, musical and social benefits of singing in a community ensemble: three case studies in Melbourne (Australia)

Australia has a diverse, multilayered society that reflects its rich musical life. There are many community choirs formed by various cultural and linguistically diverse groups. This article is part of an ongoing project, Well-being and ageing: community, diversity and the arts (since 2008), undertaken by Deakin University and Monash University, that explores the cultural diversity within Australian society and how active music engagement fosters well-being. The singing groups selected for this discussion are the Skylarkers, the Bosnian Behar Choir, and the Coro Furlan. The Skylarkers and the Bosnian Behar Choir are mixed groups who respectively perform popular music from their generation and celebrate their culture through music. The Coro Furlan is an Italian male choir who understand themselves as custodians of their heritage. In these interpretative, qualitative case studies semi-structured interviews were undertaken and analyzed using Interpretative Phenomenological Analysis. In this approach there is an exploration of participants’ understanding of their lived experiences. The analysis of the combined data identified musical and social benefits that contribute to participants’ sense of individual well-being. Musical benefits occurred through sharing, learning and singing together. Social benefits included opportunities to build friendships, overcome isolation and gain a sense of validation. Many found that singing enhanced their health and happiness. Active music making in community choirs and music ensembles continues to be an effective way to support individuals, build community, and share culture and heritage.

Self-reported racism and experience of toothache among pregnant Aboriginal Australians: the role of perceived stress, sense of control, and social support

Objectives We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship. Methods Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator. Results Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (β coefficient-=-0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator. Conclusions The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache.

Is alcohol and community sport a good mix? Alcohol management, consumption and social capital in community sports clubs

Objective: Community sports clubs provide an important contribution to the health and wellbeing of individuals and the community; however, they have also been associated with risky alcohol consumption. This study assessed whether a club's alcohol management strategies were related to risky alcohol consumption by members and levels of social capital, as measured in terms of participation in and perceived safety of the club. Method: A total of 723 sports club members from 33 community football clubs in New South Wales, Australia, completed a computer assisted telephone interview (CATI) and a management representative from each club also completed a CATI. The club representative reported on the club's implementation of 11 alcohol management practices, while club members reported their alcohol consumption and perceived levels of safety at the club and participation in the club. Results: A structural equation model identified having the bar open for more than four hours; having alcohol promotions; and serving intoxicated patrons were associated with increased risky alcohol consumption while at the club; which in turn was associated with lower levels of perceived club safety and member participation. Conclusion and implications: The positive contribution of community sports clubs to the community may be diminished by specific inadequate alcohol management practices. Changing alcohol management practices can reduce alcohol consumption, and possibly increase perceived aspects of social capital, such as safety and participation.

International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators

Dairy farm operators-farmers, workers, and family members-are faced with many demands and stressors in their daily work and these appear to be shared across countries and cultures. Dairy operators experience high psychosocial demands with respect to a hard work and production ethos, economic influences, and social and environmental responsibility. Furthermore, both traditional and industrial farms are highly dependent on external conditions, such as weather, fluctuating markets, and regulations from government authorities. Possible external stressors include disease outbreaks, taxes related to dairy production, and recent negative societal attitudes to farming in general. Dairy farm operators may have very few or no opportunities to influence and control these external conditions, demands, and expectations. High work demands and expectations coupled with low control and lack of social support can lead to a poor psychosocial work environment, with increased stress levels, ill mental health, depression, and, in the worst cases, suicide. Internationally, farmers with ill mental health have different health service options depending on their location. Regardless of location, it is initially the responsibility of the individual farmer and farm family to handle mental health and stress, which can be of short- or long-term duration. This paper reviews the literature on the topics of psychosocial working conditions, mental health, stress, depression, and suicide among dairy farm operators, farm workers, and farm family members in an international perspective.

Out & online; effectiveness of a tailored online multi-symptom mental health and wellbeing program for same-sex attracted young adults: study protocol for a randomised controlled trial

Same-sex attracted young adults have been found to experience higher rates of mental health problems and greater difficulties in accessing specialist mental health care services compared to their heterosexual peers. Internet-based mental health interventions have the potential to be more engaging and accessible to young adults compared to those delivered face-to-face. However, they are rarely inclusive of lesbian women and gay men. Thus, the current study aims to evaluate the effectiveness of an online mental health and wellbeing program, Out & Online (http://www.outandonline.org.au), in comparison to a wait-list control group, for reducing anxiety and depressive symptoms in same-sex attracted young adults aged between 18 and 25 years.

Optimizing health literacy: improving health and reducing health inequities: a selection of information sheets from the health literacy toolkit for low- and middle-income countries

This series of information sheets introduces health literacy, its relevance to public policy, and the ways it can be used to inform the promotion of good health, the prevention and management of communicable and noncommunicable diseases, and the reduction of health inequities. It provides information and links to further resources to assist organizations and governments to incorporate health literaacy responses into practice, service delivery systems, and policy.

The health and economic benefits of reducing intimate partner violence: an Australian example.

BACKGROUND: Intimate partner violence (IPV) has important impacts on the health of women in society. Our aim was to estimate the health and economic benefits of reducing the prevalence of IPV in the 2008 Australian female adult population. METHODS: Simulation models were developed to show the effect of a 5 percentage point absolute feasible reduction target in the prevalence of IPV from current Australian levels (27%). IPV is not measured in national surveys. Levels of psychological distress were used as a proxy for exposure to IPV since psychological conditions represent three-quarters of the disease burden from IPV. Lifetime cohort health benefits for females were estimated as fewer incident cases of violence-related disease and injury; deaths; and Disability Adjusted Life Years (DALYs). Opportunity cost savings were estimated for the health sector, paid and unpaid production and leisure from reduced incidence of IPV-related disease and deaths. Workforce production gains were estimated by comparing surveyed participation and absenteeism rates of females with moderate psychological distress (lifetime IPV exposure) against high or very high distress (current IPV exposure), and valued using the friction cost approach (FCA). The impact of improved health status on unpaid household production and leisure time were modelled from time use survey data. Potential costs associated with interventions to reduce IPV were not considered. Multivariable uncertainty analyses and univariable sensitivity analyses were undertaken. RESULTS: A 5 percentage point absolute reduction in the lifetime prevalence of IPV in the 2008 Australian female population was estimated to produce 6000 fewer incident cases of disease/injury, 74 fewer deaths, 5000 fewer DALYs lost and provide gains of 926,000 working days, 371,000 days of home-based production and 428,000 leisure days. Overall, AUD371 million in opportunity cost savings could be achievable. The greatest economic savings would be home-based production (AUD147 million), followed by leisure time (AUD98 million), workforce production (AUD94 million) and reduced health sector costs (AUD38 million). CONCLUSIONS: This study contributes new knowledge about the economic impact of IPV in females. The findings provide evidence of large potential opportunity cost savings from reducing the prevalence of IPV and reinforce the need to reduce IPV in Australia, and elsewhere.

Associations between dehydroepiandrosterone (DHEA) levels, pituitary volume, and social anxiety in children

 Early timing of adrenarche, associated with relatively high levels of dehydroepiandrosterone (DHEA) and its sulphate (DHEA-S) in children, has been linked with mental health problems, particularly anxiety. However, little is known about possible neurobiological mechanisms underlying this association. The pituitary gland is a key component of the hypothalamic–pituitary–adrenal (HPA) axis, the activation of which triggers the onset of adrenarche. The purpose of this study was to examine the extent to which pituitary gland volume mediated the relationship between levels of DHEA/DHEA-S relative to age (i.e., adrenarcheal timing) and symptoms of anxiety in 95 children (50 female, M age 9.50 years, SD 0.34 years). Relatively high DHEA and DHEA-S (DHEA/S) levels were found to be associated with larger pituitary gland volumes. There was no significant direct effect of relative DHEA/S levels on overall symptoms of anxiety. However, results supported an indirect link between relatively high DHEA/S levels and symptoms of social anxiety, mediated by pituitary gland volume. No sex differences were observed for any relationship. Our findings suggest that neurobiological mechanisms may be partly responsible for the link between relatively early adrenarche and anxiety symptoms in children. One possible mechanism for this finding is that an enlarged pituitary gland in children experiencing relatively advanced adrenarche might be associated with hyper-activity/reactivity of the HPA axis. Further research is needed to understand the role of stress in the link between adrenarcheal timing and HPA-axis function, especially in relation to the development of anxiety symptoms in children and adolescents.

Associations between Australian early childhood educators’ mental health and working conditions: A cross-sectional study

© 2015, Early Childhood Australia Inc. All rights reserved. EARLY CHILDHOOD EDUCATION and care quality relies on educator capacity; however, working conditions may compromise educators’ mental health. This study examines associations between family day care (FDC) educators’ mental health and working conditions to inform workplace mental health promotion. Three hundred and sixty-six FDC educators completed an online or written survey. In addition to this, regression analyses were used to examine relationships between educator mental health and working conditions. Although many FDC educators had low psychological distress and moderate mental wellbeing, 41.7 per cent reported psychological distress. Most educators’ ‘efforts’ and ‘rewards’ were unbalanced (effort–reward imbalance [ERI] ratio) and showed high ‘overcommitment’ to work. Effort and overcommitment were significantly related to increased odds of psychological distress, whereas social support was associated with higher mental wellbeing. The ERI ratio had the strongest associations with educator psychological distress and mental wellbeing. As many working conditions associated with educator mental health are modifiable, this study highlights opportunities for workplace mental health promotion in FDC.