Investigators: Prof Julie Byles, Ms Nicole Mealing (CI).

This project aim was to explore the factors that enhance the likelihood that older people will “age in place”, and stay living independently for as long as possible. These factors being financial resources; good relationships with family and friends; supportive home and neighbourhood environments; physical and mental health status; availability of informal support; and access to support services. The project involved linking data from the 45 and Up Study baseline questionnaire with records from the NSW Home and Community Care Program Minimum Dataset (HACC MDS) and NSW Admitted Patient Data Collection (APDC). Analyses explored who uses HACC services in NSW and why, and the relationships between use of HACC and hospital inpatient services.

Investigators: Prof Julie Byles, A/Prof Lynette Mackenzie, A/Prof Lynne Parkinson, Prof Sally Redman, Dr Anna Williamson.

This study examined the home and neighbourhood environments of a sample of community dwelling older people, to determine the extent to which these environments can be considered to be “supportive” according to internationally accepted measures; identified those people who are least likely to be currently living in supportive environments; and then contrast these findings against people’s expectations of their increasing needs as they age and of how these needs are to be met.

Outcomes resulting from this research:

Byles J, Gallienne L, Blyth F, Banks E. Relationship of age and gender to the prevalence and correlates of psychological distress in later life. Int Psychogeriatr 2012 Jun;24(6):1009–18. doi: 10.1017/S1041610211002602

Byles J, Mackenzie L, Parkinson L, Leigh L, Redman S, Curryer C. Supporting housing and neighbourhoods for healthy ageing: Findings from the Housing and Independent Living Study (HAIL). Australasian Journal on Ageing [Internet] 2012 Oct 25. doi:10.1111/j.1741-6612.2012.00646.x

Byles JE, Leigh L, Vo K, Forder P, Curryer C. Life space and mental health: a study of older community-dwelling persons in Australia. Aging & Mental Health [Internet] 2014:1-9. doi: 10.1080/13607863.2014.917607

Mackenzie L, Curryer C, Byles JE. Narratives of home and place: findings from the Housing and Independent Living Study. Ageing and Society [Internet] 2014:1-29. doi: 10.1017/s0144686x14000476

Investigators: A/Prof Barbara Griffin, Prof Mike Jones, Dr Kerry Sherman.

Typically large groups of people are studied by dividing them into subgroups based on demographic variables such as age, race, gender and income. This segmentation neglects the rich diversity of psychosocial factors that are known to underlie health-related intentions and behaviours. This study, by segmenting the 45 and Up baseline data, investigated whether people can be grouped by the health-related behaviours in which they engage and whether there are differential outcomes for members of different subgroups.

Outcomes resulting from this research:

Griffin B, Sherman KA, Jones M, Bayl-Smith P. The clustering of health behaviours in older Australians and its association with physical and psychological status, and sociodemographic indicators. Ann Behav Med [Internet] 2014;48(2). doi: 10.1007/s12160-014-9589-8

Investigators: Prof Amanda Baker, Dr Billie Bonevski (CI), Mrs Ashleigh Guillaumier, A/Prof Patrick McElduff, A/Prof Chris Paul, Ms Laura Twyman.

A substantial body of research has shown that smoking rates are significantly higher in disadvantaged groups compared with the general population, for example, compared with a population prevalence of 15% in Australia, smoking rates are 62-91.9% among individuals with a mental illness, and 25.9% among individuals in the lowest quintile of disadvantage.

The aim of this project was to explore the relationships between smoking, alcohol use, socioeconomic status and mental health (depression and anxiety in particular) in the 45 and Up Study population to help model the associations between these factors, and guide the development of tailored smoking cessation interventions in low socioeconomic status group with mental health issues.

Outcomes resulting from this research:

Bonevski B, Regan T, Paul C, Baker AL, Bisquera A. Associations between alcohol, smoking, socioeconomic status and comorbidities: Evidence from the 45 and Up Study. Drug Alcohol Rev [Internet] 2013. doi:10.1111/dar.12104

Investigators: Dr Billie Bonevski (CI), Ms Anne Jones, A/Prof Patrick McElduff, A/Prof Chris Paul, Dr Allison Salmon.

Numerous complaints from residents in multi-unit housing about their exposure to second-hand tobacco smoke from neighbours are reported to Action on Smoking on Health (ASH) and Cancer Council NSW. Complaints are often from people who feel trapped because they have to keep doors and windows closed to stop tobacco smoke from infiltrating their homes.

There has been very little Australian data regarding the extent of second-hand smoke in various housing types and the link between second-hand smoke and socioeconomic status. A substantial amount of research evidence has drawn direct links between exposure to second-hand smoke and harm to health for both adults and children. Given smoking rates are much higher among groups of lower economic status who are more likely to be from areas of high-density living, the research project’s aim was to examine the relationships between these factors.

Outcomes resulting from this research:

Findings have been utilised by ASH Australia for advocacy to achieve health policy and legislative change in smoke-free policies for multi-unit housing. This has contributed to changes in NSW legislation with a by-law being introduced restricting smoking in common areas of multi-unit housing.

Bonevski B, Paul C, Jones A, Bisquera A, Regan T. Smoky homes: Gender, socioeconomic and housing disparities in second hand tobacco smoke (SHS) exposure in a large population-based Australian cohort. Prev Med [Internet] 2013 doi:10.1016/j.ypmed.2013.12.024

Investigators: Prof Adrian Bauman, Prof Dorothy Broome, Dr Anne Grunseit, Prof Don Nutbeam, Dr Philayrath Phongsavan (CI), Prof Sally Redman.

Social networks are considered an important factor in healthy ageing. It is argued that positive connections to people can sustain well-being and quality of life and contribute to independent living. This study, in conducting a follow-up survey of 100,000 participants, will profile the distributions of social interactions by demographic characteristics and examine its relationship with health practices and health status.

Investigators: Prof Adrian Bauman, A/Prof Jack Chen (CI), Prof Bin Jalaludin, Dr Lixin Ou.

In past health studies socioeconomic status is often based on three measures — education, prestige of occupation and family income. However these three measures have been criticised as inadequate. This project will test whether further indicators — such as home ownership and family wealth — should be routinely included additional measures. Investigators will compare the predictive and constructive validity of the conventional Principle Component method of deriving approximate Socioeconomic Status with a Social Economic Position score (SEP based on one-factor confirmatory factor analysis) and a Socioeconomic Status class membership (based on latent class analysis). Using the results gleaned from these investigations, either a SEP score or SES class membership will be derived for each respondent in the 45 and up baseline data. Investigators hope that such a score or SES class membership can be used in both baseline and follow-up analyses.

Investigators: Ms Sandra Bailey, Dr Hilary Bambrick, Prof Emily Banks, Prof Adrian Bauman (CI), Dr John Beard, Prof Dorothy Broom, Prof Julie Byles, Prof Judith Clark, Prof Mark Harris, Prof Bin Jalaludin, Prof Louisa Jorm, Prof Tony McMichael, Prof Don Nutbeam, Prof Sally Redman, Dr Bryan Rodgers, Prof Deborah Schofield.

As the Australian population ages, there is an urgent need to understand how people can remain healthy and independent for as long as possible.

This research will examine the ways in which social, economic and environmental factors contribute to the health of Australians in mid to later life. The participants will be selected as a 100,000 person sub-sample of the 45 and Up Study, allowing an in-depth investigation into the ways in which these factors affect each other and their importance in different sub-groups within the population. Information gained from this project will outline the most necessary areas in which programs and policies should be directed to aid in improving the health of disadvantaged Australians.

Exploring the social, economic and environmental determinants of health among Aboriginal and Torres Strait Islander participants and non-Aboriginal participants of the ‘45 and Up’ and ‘SEEF-A’ Study

Project ID: 06001H
Study type: Baseline, linkage

Investigators: Prof Emily Banks, Prof Adrian Bauman, Prof Sandra Eades (CI), Dr Lina Gubhaju, Ms Rona Macniven, Dr Bridgette McNamara.

2013

This project investigates the socio-demographic characteristics, environmental factors, lifestyle behaviours and the physical and mental well-being of middle-aged and older Aboriginal and Torres Strait Islander people from New South Wales.

Investigators: Dr Caroline Jackson (CI), Prof Gita Mishra, Prof Cathie Sudlow.

There are important gaps in our understanding of how depression and socioeconomic status (SES) affect stroke risk. Preliminary studies suggest that age and gender differences may exist, but the evidence is limited. It is also unclear whether depression is simply a risk marker for disease, rather than an independent risk factor for stroke. Furthermore, the mechanisms by which SES and depression might influence stroke risk remains unclear and under-investigated.

This project aims to determine the association between depression, SES and stroke, investigate whether the effect of depression and SES differs by age and gender, and the extent to which conventional stroke risk factors mediate associations with stroke.

Investigators: A/Prof Sharon Friel (CI), Dr Rosemary Korda, Ms Isabel Latz, Dr Vasoontara Yiengprugsawan.

Existing research has shown that an individuals’ position in society and the associated differences in access to resources such as employment, education and housing is associated with the social distribution in health outcomes. Various demographic and socio-economic factors have been studied in the context of health status, with results generally indicating poorer health outcomes with lower social status.

The overall aim of this project is to provide new evidence on the associations between material, socio-cultural, psychosocial and behavioural factors and a number of major physical and mental health outcomes in a large Australian cohort of middle-aged and older citizens. The results of this project will provide new insight into the relative influence of social and health inequalities, highlighting key entry points for public policy.