The Sax Institute Wiser Decisions for a Healthier Australia
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1 The Sax Institute Wiser Decisions for a Healthier Australia Melanie Andersen, PhD Student AHURI Housing & Health Workshop Sydney, 22 nd July 2010
2 Today The Sax Institute 45 and Up Study The SEARCH Program
3 The Sax Institute Vision: Evidence from health research is considered fundamental to policy to improve the health of the community Mission: To improve health, health services and programs by increasing the use of research in policy making.
4 About the Sax Institute Independent not for profit company limited by guarantee Membership from public health and health services research groups in NSW Formed in 2002 to act as a bridge or broker between health researchers and health policy makers Core funding from NSW Health Governance Board chaired by Irene Moss (AO, Previously ICAC chair and NSW Ombudsman)
5 The Sax Institute Helps policy makers access existing research findings Knowledge Transfer Program Facilitates policy relevant research.. By building infrastructure to answer important policy questions
6 Today The Sax Institute 45 and Up Study The SEARCH Program
7 45 and Up Study 250,000 men and women aged 45 and over from NSW Participants selected at random from the Medicare Australia enrolment database and mailed a baseline questionnaire Those aged over 80 and from rural areas oversampled Follow-up questionnaire will be mailed every five years
8 45 and Up Study Participants provide self-reported information about background, lifestyle, health and health service use at baseline and then every five years Consent obtained to link to medical records including NSW Admitted Patient Data Collection, Medical and Pharmaceutical Benefits Schedule (MBS and PBS) datasets, NSW Central Cancer Registry and Australian Bureau of Statistics (ABS) mortality data Consent to be approached about sub-studies e.g. HAIL (Housing and Independent Living) Study, Julie Byles
9 Today The Sax Institute 45 and Up Study The SEARCH Program
10 Study of Environment on Aboriginal Resilience and Child Health
11 Why is SEARCH important? 60% of the Indigenous health gap is attributable to the health of Indigenous people living in non-remote areas of Australia (Burden of Disease and Injury in Australia Report,1993 ) 53% of Aboriginal people live in cities and large regional centres Only 10% of research focuses on the needs of urban Aboriginal people 20 papers about urban Aboriginal children in the last five years (SEARCH Investigators, MJA in press) We cannot identify early opportunities for intervention that might have the potential to improve health, well being, educational and employment outcomes among urban Aboriginal children
12 What is SEARCH? A cohort study of the health of urban Aboriginal children aged 0-17 years recruited through Aboriginal Community Controlled Health Services across NSW A a collaboration between Aboriginal Health and Medical Research Council of NSW, the Sax Institute, University of Sydney and four Aboriginal Community Controlled Health Services Initiated through CRIAH by Aboriginal communities - extensive input and review by these communities Involves a number of leading researchers from different disciplinary backgrounds
13 What is SEARCH? The first large-scale long-term cohort study of the health of urban Aboriginal children aged 0-17 yrs with: Sufficient numbers of children to examine complex interrelationships Self report, clinical and other data to examine the impact of social, cultural, environmental, birth outcomes, parental health and well being in a holistic The capacity to study the children s trajectories over time and to examine prospectively the factors that influence them (follow up contact trial had >95% recontact rate) The capacity to embed intervention programs and validation studies within a sustainable context
14 The present and the future More costly and time consuming than anticipated Building trust and being respectful of processes at each unique site More children aged 7 and under requiring speech assessment Ear health and speech and language assessment more involved and uncovering more issues Aiming to recruit 2000 children Currently >1200 children recruited
15 The present and the future Funding of $2.1 million over 5 years received from NHMRC Healthy Start to Life Grant to establish the cohort, ends 2010 Additional funding from Rio Tinto, DEEWR and others Recently submitted a project grant application to NHMRC for 2011 onwards to maintain the cohort, continue recruitment and to follow up the children at 2 and 4 years
16 SEARCH implementation 4 participating ACCHSs to date: Western Sydney (Mt Druitt) Tharawal (Campbelltown) Awabakal (Newcastle/Hunter) Riverina (Wagga Wagga) Parents of children attending the ACCHS are invited to participate by an Aboriginal research officer
17 Priorities determined by Community Speech and language development Resilience Mental health and emotional wellbeing Ear health Housing, neighbourhood and environment Obesity, exercise and green space
18 SEARCH participants Provide self-report information via a baseline questionnaire about the quality and safety of their housing, health service use, caregiver health, history of forced separation, injury, illness and infections, emotional health, resilience and more Have clinical measures taken, including weight, height, waist circumference and blood pressure Receive age appropriate audiology and speech and language development assessments Consent to have their questionnaire data linked to data from a range of health services Agree to have their health followed over time
19 SEARCH at July 2010 Over 1200 children have been recruited > 800 children aged 0 to 17 seen by SEARCH audiologists > 400 children aged 1 to 7 years received speech and language assessment Recruitment continuing at existing sites First 12-month follow-up underway at two sites Interest from other ACCHs to expand to new sites
20 Housing sub-study Focus groups at Western Sydney AMS SEARCH housing and neighbourhood data Description of housing from self-report surveys Associations with a range of health outcomes Direct audits of a sub-sample using a standardised tool Validation of self-report against audit observation data Potentially an evaluation of Housing for Health in 50 houses in Western Sydney - Steve Corbett
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