Dataset Information

Social determinants of maternal self-rated health in South Western Sydney, Australia.

ABSTRACT:

Background

From 2000 a routine survey of mothers with newborn infants was commenced in South Western Sydney. The aim of this study is to examine the relationship of maternal self-rated health, as a measure of well-being, to various socio-demographic factors including measures of social capital, country of birth, financial status and employment.

Results

The sample consisted of 23,534 mothers who delivered in South Western Sydney between 2004 and 2006. The data were collected as part of a routine post-partum assessment at 2-4 weeks postpartum. We examined the relationship of self-rated health with socio-demographic variables using binary logistic regression. Worse self-rated health was reported in 4% of women. Variables which were found to be significantly associated with worse self-rated health were: poor financial situation, public housing accommodation, fathers employment, no car access, unplanned pregnancy, maternal smoking, poor emotional and social support, and motherhood being more difficult than expected.

Conclusion

We confirmed the importance of social disadvantage and social isolation as independent risk factors for poor self-reported health. The findings reported here provide further justification for public health interventions which increase support for socially excluded mothers and strengthen their connection to their community.

SUBMITTER: Morgan KJ

PROVIDER: S-EPMC3899616 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Publications

Social determinants of maternal self-rated health in South Western Sydney, Australia.

Morgan Katie J KJ Eastwood John G JG

BMC research notes 20140121

<h4>Background</h4>From 2000 a routine survey of mothers with newborn infants was commenced in South Western Sydney. The aim of this study is to examine the relationship of maternal self-rated health, as a measure of well-being, to various socio-demographic factors including measures of social capital, country of birth, financial status and employment.<h4>Results</h4>The sample consisted of 23,534 mothers who delivered in South Western Sydney between 2004 and 2006. The data were collected as par ...[more]

PMID: 24447371

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Project description:BackgroundThere is increasing interest in the role played by maternal depression in mediating the effects of adversity during pregnancy and poor infant outcomes. There is also increasing evidence from multilevel regression studies for an association of area-level economic deprivation and poor individual mental health. The purpose of the study reported here is to explore the spatial distribution of postnatal depressive symptoms in South Western Sydney, Australia, and to identify covariate associations that could inform subsequent multilevel studies.MethodsMothers (n?=?15,389) delivering in 2002 and 2003 were assessed at 2-3 weeks after delivery for risk factors for depressive symptoms. The individual-level binary outcome variables were Edinburgh Depression Scale (EDS) >9 and >12. The association between social, demographic and ecological factors and aggregated outcome variables were investigated using exploratory factor analysis and multivariate hierarchical Bayesian spatial regression. Relative risks from the final EDS?>12 regression model were mapped to visualise the contribution from explanatory covariates and residual components.ResultsThe exploratory factor analysis identified six factors: neighbourhood adversity, social cohesion, health behaviours, housing quality, social services, and support networks. Variables associated with neighbourhood adversity, social cohesion, social networks, and ethnic diversity were consistently associated with aggregated depressive symptoms. Measures of social disadvantage, lack of social cohesion and lack of social capital were associated with increased depressive symptoms. The association with social disadvantage was not significant when controlling for ethnic diversity and social capital.ConclusionsThe findings support the theoretical proposition that neighbourhood adversity causes maternal psychological distress and depression within the context of social buffers including social networks, social cohesion, and social services. The finding have implications for the distribution of health services including early nurse home visiting which has recently been confirmed to be effective in preventing postnatal depression.

Project description:ObjectivesRecommendations of the recent mental health reforms provided an opportunity to implement regional approaches to service provision through Primary Health Networks. This study is designed to identify the determinants of sociodemographic, diagnostic and referral-level factors and first treatment session non-attendance among those referred to primary mental health care (PMHC) services in Western Sydney, Australia.DesignThis study used routinely collected retrospective PMHC data between July 2016 and December 2018.SettingThe study was based on a geographical catchment that covers four local government areas of Blacktown, Parramatta, Cumberland and Hills Shire in Western Sydney, Australia.ParticipantsAll individuals 5 years of age or older referred to PMHC services.Primary outcome measureFirst treatment session non-attendance, following a referral to receive psychological treatments.ResultsThere were 9158 referrals received for 8031 clients, with 1769 (19.32%) referrals resulting in non-attendance to the first treatment session. Those with younger age (ORs ranging from 1.63 to 1.92), substance use (OR=1.55, 95% CI 1.17 to 2.06), poor English proficiency (OR=1.64, 95% CI 1.23 to 2.20), lower socioeconomic status (OR=1.57, 95% CI 1.34 to 1.83), psychotropic medication use (OR=1.20, 95% CI 1.06 to 1.36), and a referral by a social worker (OR=2.04, 95% CI 1.36 to 3.05), allied health (OR=1.49, 95% CI 1.03 to 2.16) or other professional (OR=1.72, 95% CI 1.30 to 2.29) were associated with a higher likelihood of first treatment session non-attendance. Those with a risk of suicide, who mainly speak a language other than English, and a previous use of PMHC services were more likely to attend their first treatment session.ConclusionYouth-specific treatment approaches, behavioural engagement strategies, facilitation of transport services for those live in deprived regions and improvements in capacity for mental health training among allied health professionals are areas of focus for primary care service and policy responses.

Project description:ObjectivesAdverse childhood experiences (ACE) are associated with poor short, medium and long-term health outcomes. South Western Sydney (SWS) has a large culturally diverse population, including many disadvantaged population groups. Our aims were to determine the burden of ACE in children attending community paediatric (CP) clinics using a purposefully developed ACE checklist, and explore any association with developmental health of children.MethodsWe trialled the ACE checklist in all CP clinics including child development (CD) and vulnerable child (VC) clinics between February 2017 and August 2017. Data were collated from completed ACE checklists and relevant clinical information from CP clinics. Statistical analysis was performed using SPSS and MedCalc software.ResultsOf 279 children seen in CP clinics with checklists completed for the period, 167 (60%) attended CD clinics and 112 (40%) attended VC clinics. Seventy-eight (28%) had ACE ≥4 and 178 (64%) had ACE ≥1. Of those attending CD clinics, 8 (5%) had ACE ≥4 compared with 70 (63%) attending VC clinics (p<0.001). Of all age groups, children ≥10 years of age had the highest proportion of children with ACE ≥4 (65%); significant association between age group and ACE ≥4 (p<0.001). There was a significant association between cultural background and ACE ≥4 (p<0.001); indigenous children had the highest proportion of ACE ≥4 (n=21; 64%), followed by Anglo-Australian children (55%). On logistic regression analysis, only attending VC clinics was significantly associated with ACE ≥4. There was no significant association between ACE ≥4 and developmental health.ConclusionAmong children attending CP clinics in SWS, more than a quarter had a significant burden of ACE; those attending specialised clinics for vulnerable children, those from particular ethnic groups and from older age groups, had the highest burden of ACE. Our findings support the need for specialised pathways for paediatric assessment for vulnerable, at-risk children.

Dataset Information

Social determinants of maternal self-rated health in South Western Sydney, Australia.

Background

Results

Conclusion

Publications

Social determinants of maternal self-rated health in South Western Sydney, Australia.

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