https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)00516-4.pdf

The World report on ageing and health: a policy framework for healthy ageing.

Background: The suboptimal compliance to vaccinations continues to be a major public health problem.

Factors associated with

Background:Prolonged sitting is considered detrimental to health, but evidence regarding the independent relationship of total sitting time with all-cause mortality is limited. This study aimed to determine the independent relationship of sitting time with all-cause mortality. Methods:Welinkedprospectivequestionnairedatafrom 222497 individuals 45 years or older from the 45 and Up Study to mortality data from the New South Wales RegistryofBirths,Deaths,andMarriages(Australia)from February1,2006,throughDecember31,2010.Coxproportional hazards models examined all-cause mortality in relation to sitting time, adjusting for potential confounders that included sex, age, education, urban/rural residence, physical activity, body mass index, smoking status, self-rated health, and disability. Results:During621695person-yearsoffollow-up(mean follow-up, 2.8 years), 5405 deaths were registered. Allcause mortality hazard ratios were 1.02 (95% CI, 0.951.09),1.15(1.06-1.25),and1.40(1.27-1.55)for4toless than 8, 8 to less than 11, and 11 or more h/d of sitting, respectively,comparedwithlessthan4h/d,adjustingfor physicalactivityandotherconfounders.Thepopulationattributable fraction for sitting was 6.9%. The associationbetweensittingandall-causemortalityappearedconsistent across the sexes, age groups, body mass index categories,andphysicalactivitylevelsandacrosshealthy participants compared with participants with preexisting cardiovascular disease or diabetes mellitus. Conclusions: Prolonged sitting is a risk factor for allcause mortality, independent of physical activity. Publichealthprogramsshouldfocusonreducingsittingtime in addition to increasing physical activity levels.

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Sitting Time and All-Cause Mortality Risk in 222 497 Australian Adults

major aspects of women’s health and well-being and health service use. The surveys cover major diagnosed diseases, symptoms, health behaviours, use of health services and medications, and a range of factors relating to psychological well-being, social roles, and life events. The study began with the objective of exploring five key themes: health service use; health-related behaviours (e.g. diet and exercise); time use (paid work, unpaid work, and leisure); life stages and key events (e.g. childbirth, divorce, and widowhood); and violence against women. 4 Changes in Australian government policy priorities and enhanced understanding of women’s needs resulting from earlier phases of the study have led to some modifications to the original emphases. Currently we identify four major research topics: chronic disease; health services and systems; social factors in health and well-being; and methodology for longitudinal studies. Continuing cross-cutting themes include rural and remote women’s health; intergenerational issues; tobacco, alcohol, and other drugs; weight, nutrition, and physical activity; and mental health.

Cohort Profile: The Australian Longitudinal Study on Women's Health

Objective: To investigate the use of and expenditure on 17 of the most popular forms of complementary and alternative medicine (CAM) by adult Australians, sociodemographic characteristics of CAM users, and communication between CAM users and their doctors. Methods: In May–June 2005, a sample of 1067 adults, 18 years and older, from all Australian states and territories, was recruited by random-digit telephone dialing and interviewed about their CAM use in the previous 12 months. Results: In the 12-month period, 68.9% (95% CI: 66.1%–71.7%) of those interviewed used at least one of the 17 forms of CAM and 44.1% (95% confidence interval: 41.1%–47.1%) visited a CAM practitioner. The estimated number of visits to CAM practitioners by adult Australians in the 12-month period (69.2 million) was almost identical to the estimated number of visits to medical practitioners (69.3 million). The annual “out of pocket” expenditure on CAM, nationally, was estimated as 4.13 billion Australian dollars (US $3.12 billion). L...

Complementary and Alternative Medicine Use in Australia: A National Population-Based Survey

OBJECTIVES: To compare the characteristics of complementary and alternative medicine (CAM) users and non-users among Australian women. DESIGN: Cross-sectional postal questionnaire conducted during 1996, forming the baseline survey of the Australian Longitudinal Study on Women's Health. PARTICIPANTS: Women aged 18-23 years (n = 14 779), 45-50 years (n = 14 099) and 70-75 years (n = 12 939), randomly selected from the Health Insurance Commission database, with over-sampling of women from rural and remote areas of Australia. MAIN OUTCOME MEASURES: Consultation with an alternative health practitioner in the 12 months before the survey. RESULTS: Women in the mid-age cohort were more likely to have consulted an alternative health practitioner in the previous year (28%) than women in the younger cohort (19%) or older cohort (15%). In all age groups, CAM users were more likely than CAM non-users to reside in non-urban areas, to report poorer health, have more symptoms and illness, and be higher users of conventional health services. CONCLUSIONS: Women in non-urban Australia are more likely to use CAM but do so in in parallel with conventional health services.

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The profile of women who consult alternative health practitioners in Australia.

Is there an association between the use of oral contraception and depressive symptoms in young Australian women

Complementary and Alternative Medicine (CAM) has become increasingly popular amongst healthcare consumers world-wide. As such, CAM is now an important public health issue with taking non-prescription medications. This paper constitutes an exploratory investigation into CAM use over time. As such, there is need for further research to provide in-depth examination of the adoption and relinquishment of CAM use over a longer time period. serious implications for healthcare organization and delivery. While previous studies have provided a profile of CAM users, there remains very limited analysis of CAM consumption over time. The purpose of this paper is to describe the changing use of CAM practitioners over time by 11,454 mid-age women in the Australian Longitudinal Study on Women's Health. Over the study period (1996-1998), 10% of women adopted the use of CAM and 9% relinquished CAM. The predominant factor found to be predictive of CAM adoption was changes in health status. Specifically, those women experiencing more illness over time are more likely to adopt CAM than those experiencing no change or better health. CAM relinquishment was associated with use of non-prescription medications, where women were more likely to relinquish CAM if they never used non-prescription medications or if they stopped.

A longitudinal analysis of mid-age women's use of Complementary and Alternative Medicine (CAM) in Australia, 1996-1998

Objective: To describe the changes in bulk-billing and out-of-pocket costs for Australian general practice consultations over the period 1995-2001. Design: Retrospective analysis of 1996-2001 survey data from the Australian Longitudinal Study on Women's Health (ALSWH), linked with Medicare and Department of Veterans' Affairs (DVA) data on general practice consultations from 1995 to 2001. Participants: 22 633 women who gave consent to linkage of their ALSWH data with Medicare/DVA records. In 1996, women in the "young" cohort (n = 6219) were aged 18-23 years, those in the "mid-age" cohort (n = 8883) were aged 45-50 years, and those in the "older" cohort (n = 7531) were aged 70-75 years. Outcome measures: Out-of-pocket costs paid by patients for general practice consultations, by calendar year, urban/rural area of residence, age, frequency of attendance, self-rated health, and education level. Results: For each age group and year studied, the use of bulk-billing was lower in rural areas than in urban areas. For example, in 2000, the percentage of women in rural and urban areas, respectively, who had all their general practice consultations bulk-billed was 31% v 52% (young women), 24% v 45% (mid-age women) and 58% v 79% (older women). There has been a steady decline in bulk-billing for general practice consultations in rural areas since 1995. The average out-of-pocket cost per consultation for women in rural areas was higher than the cost for women living in urban areas. After adjusting for age, health and socioeconomic factors, women living in urban areas were more than twice as likely to have all their consultations bulk-billed as women living in rural areas: odds ratio (OR), 2.4 (95% Cl, 2.1-2.7) (young women); OR, 2.5 (95% Cl, 2.3-2.8) (mid-age women); OR, 2.6 (95% Cl, 2.3-2.9) (older women). Conclusions: In Australia, the geographic differential in the cost of general practice consultations is widening. Policy changes are required to enable women in rural and remote areas to have access to affordable healthcare services.

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Anne F. Young

Papers

Cohort Profile: The Australian Longitudinal Study on Women's Health

The profile of women who consult alternative health practitioners in Australia.

Is there an association between the use of oral contraception and depressive symptoms in young Australian women

A longitudinal analysis of mid-age women's use of Complementary and Alternative Medicine (CAM) in Australia, 1996-1998

The decline in bulk-billing and increase in out-of-pocket costs for general practice consultations in rural areas of Australia, 1995-2001.