The health and wellbeing of Australian lesbian, gay and bisexual people: a systematic assessment

Australian and New Zealand Journal of Public Health, I04 June 2019

https://doi.org/10.1111/1753-6405.12855

Abstract

Objective: This study revisits disparities in health and wellbeing by sexual identity in Australia, identifying which domains demand priority policy intervention, documenting differences between gay/lesbian vs. bisexual populations, and examining change over time in the relative health and wellbeing of sexual minorities.

Method: I fitted multivariable ordinary least squares and random‐effect panel regression models on 20 outcomes to compare the health and wellbeing of heterosexual, gay/lesbian and bisexual people, using 2012/2016 data from a national probability sample – the Household, Income and Labour Dynamics in Australia (HILDA) Survey.

Results: I found strong associations between sexual minority identities and most health and wellbeing outcomes. These were comparatively larger for: role‐emotional health, mental health and general health; bisexual compared to gay/lesbian people; and minority women compared to minority men. I found no change over time in the relative health and wellbeing outcomes of gay/lesbian people, but evidence of worsening circumstances among bisexual people.

Conclusion: There are important disparities in the health and wellbeing profiles of different sexual minority populations in Australia, based on sex (male vs. female), sexual identity (gay/lesbian vs. bisexual), and observation time (2012 vs. 2016).

Implications for public health: Sexual identity remains an important marker of risk for health and wellbeing outcomes within Australia, underscoring the importance of fully integrating sexual identity in health policy and practice.

Disrupting gender norms in health systems: making the case for change

The Lancet, Gender Equality, Norms, and Health Steering Committee, Published May 30, 2019

Summary

Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health.
In this Series paper, we explore how to address all three through recognition and then with disruptive solutions.
We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research.
We found that health systems reinforce patients’ traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused.
With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women’s empowerment collectives can increase health-care access and provider responsiveness.
We see promise from social movements in supporting women’s reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.

Liver cancer death rate rising: study

SBS News, 9/4/19

The rate of liver cancer deaths and diagnoses has increased substantially in the past three decades, yet researchers say little has been done to help Australians most at risk.

While it is considered a relatively rare type of cancer – nearly 2000 people were diagnosed in 2014 – the high mortality rate and increasing incidence of diagnosis has been concerning, researcher Barbara de Graaff says.

Rates were highest in the Northern Territory, mostly due to a higher prevalence of hepatitis B and C.

Advertising (in)equality: the impacts of sexist advertising on women’s health and wellbeing

Women’s Health Victoria, Issues Paper No. 14, December 2018

 

The aim of this issues paper is to provide an overview of significant literature

currently published on the nature of gender portrayals in advertising, and the

impacts of these representations on women’s health and wellbeing, gender

inequality and attitudes and behaviours that support violence against women.

 

This issues paper found that the continued use of gender stereotypes

and increasing reliance on images that sexualise and objectify women in

advertisements undermines efforts to promote gender equality in Australia.

Gender-stereotyped portrayals limit the aspirations, expectations, interests and

participation of women and men in our society. These portrayals are associated

with a range of negative health and wellbeing outcomes and are highly

problematic for the prevention of family violence and other forms of violence

against women.

 

The studies cited in this paper demonstrate that there is a clear business

case for change. Brands, businesses and creative agencies can benefit from

portraying both women and men proportionately, respectfully and realistically.

 

Factors associated with testing for HIV in people aged ≥50 years

BMC Public Health 2018 18:1204

https://doi.org/10.1186/s12889-018-6118-x

Published: 26 October 2018

Factors associated with testing for HIV in people aged ≥50 years: a qualitative study

Abstract

Background

Despite a decline in the number of new HIV infections in the UK overall, the number and proportion of new HIV diagnoses in people aged ≥50 years continues to increase. People aged ≥50 years are disproportionately affected by late diagnosis, which is associated with poorer health outcomes, increased treatment complexity and increased healthcare costs. Late HIV diagnosis also has significant public health implications in terms of onward HIV transmission. It is not fully understood what factors affect the decision of an older person to test for HIV. The aim of this study was to identify factors associated with testing for HIV in people aged ≥50 years who tested late for HIV.

Methods

We interviewed 20 people aged ≥50 years diagnosed late with HIV to identify factors associated with HIV testing. Interviews were audio recorded, transcribed verbatim and thematically analysed.

Results

Seven themes associated with HIV testing in people aged ≥50 years were identified: experience of early HIV/AIDS campaigns, HIV knowledge, presence of symptoms and symptom attribution, risk and risk perception, generational approaches to health and sexual health, stigma, and type of testing and testing venue.

Conclusion

Some factors associated with testing identified in this study were unique to older individuals. People aged ≥50 years often do not perceive themselves to be at risk of HIV. Further, stigma and a lack of knowledge of how to access HIV testing suggest a need for health promotion and suggest current sexual health services may need to adapt to better meet their needs.

Translation and implementation of the Australian-led PCOS guideline

Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Med J Aust 2018; 209 (7 Suppl): S3-S8. || doi: 10.5694/mja18.00656
Published online: 2018-10-01

Abstract

Introduction: We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian-led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will diagnoenable practice benchmarking and feedback to further inform evidence-based practice. We propose that this methodology could be used in developing and implementing guidelines for other women’s health conditions and beyond.

Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non-fertility indications; and assessment and treatment of infertility.

Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow-up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple metapregnancies compared with clomiphene citrate.