Health service utilisation associated with chronic breathlessness: random population sample.

BACKGROUND: Most health service utilisation studies are of people with specific diagnoses or demographic characteristics, and rarely of specific chronic symptoms. The aim of this study was to establish whether population-level health service utilisation increases in people with chronic breathlessness. METHODS: A cross-sectional analysis was carried out of the South Australian Health Omnibus Survey 2017, a multi-stage, clustered area, systematic sampling survey of adults where questions are administered face-to-face in respondents' homes. Self-report of health service utilisation in the previous 3 months (medical consultations, emergency department, hospital admission), chronic breathlessness (severity, duration, modified Medical Research Council (mMRC) breathlessness scale) and demographic data were used to predict self-reported health service utilisation. RESULTS: A total of 2898 people were included (49.0% male; median age 48.0 years (IQR 32.0-63.0); 64.1% educated beyond school; 55.4% in work; 73.5% had outpatient contact; 6.3% had a hospital admission in the previous 3 months). Chronic breathlessness (mMRC ≥1) was reported by 8.8% of respondents. In bivariable analyses, people with greater contact with health services were older, and a higher proportion were overweight/obese and had more severe chronic breathlessness. In multivariable analyses, chronic breathlessness and older age were positively associated with outpatient care and inpatient care, and people with chronic breathlessness were hospitalised for longer (incidence rate ratio 2.5; 95% CI 1.4-4.5). CONCLUSION: There is a significant association between worse chronic breathlessness and increased health service utilisation. There is a need for greater understanding of factors that initiate contact with health services.

Is YouTube promoting the exotic pet trade? Analysis of the global public perception of popular YouTube videos featuring threatened exotic animals.

The exploitation of threatened exotic species via social media challenges efforts to regulate the exotic pet trade and consequently threatens species conservation. To investigate how such content is perceived by the global community, mixed model sentiment analysis techniques were employed to explore variations in attitudes expressed through text and emoji usage in public comments associated with 346 popular YouTube® videos starring exotic wild cats or primates in 'free handling' situations. Negative interactions between wild cats and primates with other species were found to be associated with both text and emoji median sentiment reduction, however were still accompanied by a median emoji sentiment above zero. Additionally, although a negative trend in median text sentiment was observed in 2015 for primates, an otherwise consistent positive median text and emoji sentiment score through time across all IUCN Red List categories was revealed in response to both exotic wild cat and primate videos, further implying the societal normalisation and acceptance of exotic pets. These findings highlight the urgency for effective YouTube® policy changes and content management to promote public education and conservation awareness, whilst extinguishing false legitimisation and demand for the exotic pet trade.

Regulatory Compliance in Online Dog Advertisements in Australia.

In Australia, each state and territory authority implements and enforces regulations regarding dog management-including the breeding and sale of dogs online-which is increasingly becoming the most popular method of obtaining pets. The aims for this study included: 1. Benchmarking regulatory compliance in online dog advertisements in Australia, and, 2. Understanding factors associated with regulatory compliance in online advertisements. We collected advertisements for dogs and puppies from Gumtree-one of Australia's most popular online trading platforms - on two separate days, two weeks apart (25 March and 8 April 2019). A total of 1735 unique advertisements were included in the dataset. Chi-squared tests and multivariable logistic regression models were used to identify risk factors for microchipping, desexing and breeder identification number, and compliance levels. State laws requiring animals to be microchipped prior to sale and the inclusion of chip numbers in advertisements were found to be the biggest factor in increasing likelihood of microchipped animals in Gumtree advertisements, while desexing was more common in microchipped and older animals. The online ad was more likely to include a breeder ID if the dog was young, vaccinated, and advertised by a breeder rather than an owner. The findings from this study will assist regulators to make evidence-based decisions on managing online advertisements for companion animals. In the future, the benchmarking this study has presented will allow future analysis of the effectiveness of regulation changes.

Endangered Exotic Pets on Social Media in the Middle East: Presence and Impact.

The popularization of exotic pets on celebrity social media in the Middle East has led to questionable impacts on exotic pet demand and threats to species conservation. The objective of this study was to identify exotic animal species featured on Middle Eastern celebrity social media account posts, the public perception of those posts, and their potential impacts on exotic pet demand and conservation (for global-scale extrapolation). Public social media accounts of highly influential persons from oil-rich Middle Eastern regions were manually investigated to evaluate subject demographics, species features, and post information (likes, comments) between January 2017 and August 2018. Twenty-five subjects possessed active social media accounts, from which 418 social media posts were extracted based on their inclusion of a privately owned exotic animal. SPSS Version 25 was used for frequency and descriptive analyses of these posts, in addition to comment analyses to evaluate quantitative (emojis) and qualitative (text) audience perceptions from a total of 10 social media posts of CITES Appendix I- or II-listed species. A greater frequency of positive than negative comments was observed (n = 8017), demonstrating the higher likelihood of social media promotion rather than negation of the exotic pet trade. Public education on wildlife conservation and exotic animal trade risks is imperative for successful conservation and welfare protection.

Clusters of alcohol abstainers and drinkers incorporating motives against drinking: a random survey of 18 to 30 year olds in four cities in four different continents.

OBJECTIVE: The aim of this analysis was to identify alcohol consumption clusters for adolescents and early adults according to attitudes to drinking, motivations against drinking and perceptions associated with alcohol. METHOD: Interviews were undertaken with people aged 18-34 years old living in four cities in different regions of the world. Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward and back translated into relevant languages and face-to-face interviewing undertaken. The data were weighted to the population of each city. In total 6235 structured interviews were undertaken (1391 in Ilorin, 1600 in Montevideo, 1604 in Moscow and 1640 in Wuhan). Questions regarding motivation against alcohol consumption (14 items), assessing perceptions (3 items) and attitudes to drinking in certain situations (8 items) were asked of all respondents including abstainers. Factor analysis was initially undertaken to identify highly related correlated variables. RESULTS: Cluster analysis provided a variety of clusters (Ilorin (3 clusters), Montevideo (5), Moscow (4) and Wuhan (4)). At least one cluster in each city was dominated by abstainers and another by heavy episodic drinkers. Variations by city and alcohol consumption patterns existed in regards to variables included. CONCLUSION: This analysis detailed the city specific motivations against drinking alcohol, and the attitudes towards alcohol consumption. Differences highlight the influence of country/city specific culture, customs, laws, societal norms and traditions.

Assessing Heavy Episodic Drinking: A Random Survey of 18 to 34-Year-Olds in Four Cities in Four Different Continents.

BACKGROUND: Heavy episodic drinking (HED) can have health and social consequences. This study assesses the associations between HED and demographic, socioeconomic, motivation and effects indicators for people aged 18⁻34 years old living in four cities in different regions of the world. METHOD: Multistage random sampling was consistent across the four cities (Ilorin (Nigeria), Wuhan (China), Montevideo (Uruguay) and Moscow (Russia)). The questionnaire was forward/back translated and face-to-face interviewing was undertaken. A total of 6235 interviews were undertaken in 2014. Separate univariable and multivariable modelling was undertaken to determine the best predictors of HED. RESULTS: HED prevalence was 9.0%. The best predictors differed for each city. The higher probability of HED in the final models included beliefs that they have reached adulthood, feeling relaxed as an effect of drinking alcohol, and forgetting problems as an effect of drinking alcohol. Lower probability of HED was associated with not being interested in alcohol as a reason for limiting alcohol, and the belief that drinking alcohol is too expensive or a waste of money. CONCLUSION: Although some indicators were common across the four cities, the variables included in the final models predominantly differed from city to city. The need for country-specific prevention and early intervention programs are warranted.

Increasing gaps in health inequalities related to non-communicable diseases in South Australia; implications towards behavioural risk factor surveillance systems to provide evidence for action.

BACKGROUND: Although Australia is a country cited as having generally low health inequalities among different socioeconomic groups, inequalities have persisted. The aim of this analysis was to highlight how inequalities have evolved over a 13 years period in South Australia (SA). METHODS: Since 2002, over 600 interviews per month have been undertaken with SA residents through a computer assisted telephone survey method (total 77,000+). Major risk factors and chronic diseases have been analyzed providing trends by two socio-economic variables: education and a proxy of income (ability to save). RESULTS: While income and educational gaps are reducing over time in SA, those that remain in the lower socio-economic groups have a generally higher prevalence of risk factors and chronic diseases. The health disparity gap is still relevant, although at a different extent, for all the variables considered in our study, with most appearing to be stable if not increasing over time. CONCLUSIONS: Surveillance can be a good source of information both to show the evolution of problems and to evaluate possible future interventions. Extensive effort is still required to "close the gap" of health inequalities in SA. More precisely targeted and properly implemented interventions are needed.

Burden and trend of diet-related non-communicable diseases in Australia and comparison with 34 OECD countries, 1990-2015: findings from the Global Burden of Disease Study 2015.

BACKGROUND: Diet is a major determining factor for many non-communicable chronic diseases (NCDs). However, evidence on diet-related NCD burden remains limited. We assessed the trends in diet-related NCDs in Australia from 1990 to 2015 and compared the results with other countries of the Organization for Economic Co-operation and Development (OECD). METHODS: We used data and methods from the Global Burden of Disease (GBD) 2015 study to estimate the NCD mortality and disability-adjusted life years (DALYs) attributable to 14 dietary risk factors in Australia and 34 OECD nations. Countries were further ranked from the lowest (first) to highest (35th) burden using an age-standardized population attributable fraction (PAF). RESULTS: In 2015, the estimated number of deaths attributable to dietary risks was 29,414 deaths [95% uncertainty interval (UI) 24,697 - 34,058 or 19.7% of NCD deaths] and 443,385 DALYs (95% UI 377,680-511,388 or 9.5% of NCD DALYs) in Australia. Young (25-49 years) and middle-age (50-69 years) male adults had a higher PAF of diet-related NCD deaths and DALYs than their female counterparts. Diets low in fruits, vegetables, nuts and seeds and whole grains, but high in sodium, were the major contributors to both NCD deaths and DALYs. Overall, 42.3% of cardiovascular deaths were attributable to dietary risk factors. The age-standardized PAF of diet-related NCD mortality and DALYs decreased over the study period by 28.2% (from 27.0% in 1990 to 19.4% in 2015) and 41.0% (from 14.3% in 1990 to 8.4% in 2015), respectively. In 2015, Australia ranked 12th of 35 examined countries in diet-related mortality. A small improvement of rank was recorded compared to the previous 25 years. CONCLUSIONS: Despite a reduction in diet-related NCD burden over 25 years, dietary risks are still the major contributors to a high burden of NCDs in Australia. Interventions targeting NCDs should focus on dietary behaviours of individuals and population groups.

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study.

BACKGROUND: Gout has an increasing global prevalence. Underutilization of urate-lowering therapy (ULT) is thought to be common, via both suboptimal dosing and poor medication adherence. The aims of this study were to determine the prevalence of self-reported gout and the key predictors of ULT use in those with gout in a representative population survey in South Australia. METHODS: Data were obtained from the Spring 2015 South Australian Health Omnibus Survey, a multilevel, systematic, survey in a representative population sample involving face-to-face interviews (n = 3005). This study analyzed responses from respondents aged ≥ 25 years (n = 2531) about self-reported gout, ULT use, sociodemographic factors, lifestyle factors, and comorbidities, using survey weighting. Univariate and subsequent adjusted logistic regression analyses on self-reported gout were performed. ULT use was divided into three categories (never use, prior use, and current use) and these data were analyzed using a multinomial logistic regression model. RESULTS: Self-reported gout prevalence was 6.8% (95% CI 5.8, 7.9). The mean age of respondents with gout was 64 years (standard deviation 16) and 82% were male. As expected, older age, male gender, lower socioeconomic status (SES), and higher body mass index (BMI) were associated with gout, as were high alcohol consumption, current smoking, other forms of arthritis, and hypertension or hypercholesterolemia medication, after adjustment for sociodemographic variables. Two thirds of respondents with gout reported ULT use (36% current; 29% previous) with only 55% continuing treatment. Predictors of ULT use included male gender, low SES, and concomitant cholesterol-lowering therapy. Respondents with gout with a higher BMI were more likely to remain on ULT. CONCLUSIONS: Despite gout being a common, potentially disabling joint disease, only 55% of respondents with gout in this study adhered to ULT. Identification of key predictors of ULT use will provide guidance on prescribing strategy in clinical practice and on the quality of gout care in the community.

Frailty and usage of health care systems: Results from the South Australian Monitoring and Surveillance System (SAMSS).

OBJECTIVES: Little is known about frailty and its impact on health-care systems. Using large-scale population health surveillance data, this study determined the prevalence of frailty, its associated factors, and the impact it places on health care services. STUDY DESIGN: A cross-sectional snapshot of the 2013-2015 South Australian Monitoring and Surveillance System (SAMSS) database was used, focusing on individuals aged ≥65years. Frailty was assessed by the Frailty Index (FI), and classified as robust (scores≤0.1), pre-frail (>0.1 to ≤0.25), and frail (>0.25). RESULTS: 7207 people (53.7% female) were included; mean (SD) age was 74.8 (7.17) years. The mean (SD) FI score was 0.23 (0.11), with a 99% upper limit of 0.53. Over a third (36.3% (95% CI 34.8-37.9)) were classified as frail and over half (53.6% (95% CI 52.0-55.1)) as pre-frail. Frailty was less common in rural areas, and was associated with age, lower education level, and higher socioeconomic disadvantage. After adjustment for confounders, multivariable analyses showed a gradient effect by frailty classification with regard to both hospital- and non-hospital-based services. Frail older adults were more likely to present to hospital Emergency Departments (EDs) than their pre-frail or robust counterparts, yet visited the GP at the same rate as older adults with pre-frailty. CONCLUSION: Frail older adults were higher users of health care services, with the exception of GPs. Knowledge of the health service usage patterns of frail older adults can be used to direct public health policy and plan future GP provision.

Lower educational level and unemployment increase the impact of cardiometabolic conditions on the quality of life: results of a population-based study in South Australia.

PURPOSE: To investigate if sociodemographic characteristics increase the adverse effects of cardiovascular diseases (CVD) and cardiometabolic risk factors (CMRF) on health-related quality of life (HRQoL). METHODS: Cross-sectional, face-to-face survey investigating 2379 adults living in South Australia in 2015 (57.1 ± 14 years; 51.7% females). Questions included diagnosis of CMRF (obesity, diabetes, hypertension, dyslipidaemia) and CVD. Physical and mental HRQoL were assessed using the SF-12v1 questionnaire. Multiple linear regression models including confounders (sociodemographic, lifestyle, use of preventive medication) and interaction terms between sociodemographic variables and cardiometabolic conditions were used in adjusted analysis. RESULTS: The prevalence of CMRF (one or more) was 54.6% and CVD was 13.0%. The physical HRQoL reduced from 50.8 (95%CI 50.2-51.4) in healthy individuals to 45.1 (95%CI 44.4-45.9) and 39.1 (95%CI 37.7-40.5) among those with CMRF and CVD, respectively. Adjustment for sociodemographic variables reduced these differences in 33%, remaining stable after controlling for lifestyle and use of preventive medications (p < 0.001). Differences in physical HRQoL according to cardiometabolic conditions were twice as high among those with lower educational level, or if they were not working. Among unemployed, having a CMRF or a CVD had the same impact on the physical HRQoL (9.7 lower score than healthy individuals). The inverse association between cardiometabolic conditions and mental HRQoL was subtle (p = 0.030), with no evidence of disparities due to sociodemographic variables. CONCLUSIONS: A lower educational level and unemployment increase the adverse effects of cardiometabolic conditions on the physical HRQoL. Targeted interventions for reducing CMRF and/or CVD in these groups are necessary to improve HRQoL.

Public attitudes to government intervention to regulate food advertising, especially to children.

The World Health Organization has called on governments to implement recommendations on the marketing of foods and beverages to children. This study describes high public support for government intervention in marketing of unhealthy food to children and suggests more effort is needed to harness public opinion to influence policy development.

Two colliding epidemics - obesity is independently associated with chronic pain interfering with activities of daily living in adults 18 years and over; a cross-sectional, population-based study.

BACKGROUND: Chronic pain interfering with activities of daily living is highly prevalent in the community. More than 600 million people worldwide are obese. The aim of this paper is to assess if such chronic pain is associated independently with obesity across the adult population, having controlled for other key factors. METHODS: The South Australian Health Omnibus is an annual, population-based, cross-sectional study. Data on 2616 participants were analysed for episodes of daily pain for three of the preceding six months. Obesity was derived from self-reported height and weight. Multivariable logistic regression analysed the associations between chronic pain interfering with activities of daily living, body mass index (BMI) and key socio-demographic factors. RESULTS: Chronic pain interfering with activities of daily living peaks in people ≥75 years of age while obesity peaks in the 45-54 age group. Pain and obesity together peak in the 55-74 year age group. In the adjusted multinominal logistic regression model, compared to those with no pain, there was a strong association between obesity and pain that interfered moderately or extremely with day-to-day activities (OR 2.25; 95 % CI 1.57-3.23; p < 0.001) having controlled for respondents' age, gender, rurality, country of birth and highest educational attainment. People over 65 years of age and those with lower educational levels were more likely to experience such chronic pain related to obesity. CONCLUSION: This study demonstrates a strong association between chronic pain and obesity/morbid obesity in the South Australian population. Prospective, longitudinal data are needed to understand the dynamic interaction between these two prevalent conditions.

Bias of health estimates obtained from chronic disease and risk factor surveillance systems using telephone population surveys in Australia: results from a representative face-to-face survey in Australia from 2010 to 2013.

BACKGROUND: Emerging communication technologies have had an impact on population-based telephone surveys worldwide. Our objective was to examine the potential biases of health estimates in South Australia, a state of Australia, obtained via current landline telephone survey methodologies and to report on the impact of mobile-only household on household surveys. METHODS: Data from an annual multi-stage, systematic, clustered area, face-to-face population survey, Health Omnibus Survey (approximately 3000 interviews annually), included questions about telephone ownership to assess the population that were non-contactable by current telephone sampling methods (2006 to 2013). Univariable analyses (2010 to 2013) and trend analyses were conducted for sociodemographic and health indicator variables in relation to telephone status. Relative coverage biases (RCB) of two hypothetical telephone samples was undertaken by examining the prevalence estimates of health status and health risk behaviours (2010 to 2013): directory-listed numbers, consisting mainly of landline telephone numbers and a small proportion of mobile telephone numbers; and a random digit dialling (RDD) sample of landline telephone numbers which excludes mobile-only households. RESULTS: Telephone (landline and mobile) coverage in South Australia is very high (97%). Mobile telephone ownership increased slightly (7.4%), rising from 89.7% in 2006 to 96.3% in 2013; mobile-only households increased by 431% over the eight year period from 5.2% in 2006 to 27.6% in 2013. Only half of the households have either a mobile or landline number listed in the telephone directory. There were small differences in the prevalence estimates for current asthma, arthritis, diabetes and obesity between the hypothetical telephone samples and the overall sample. However, prevalence estimate for diabetes was slightly underestimated (RCB value of -0.077) in 2013. Mixed RCB results were found for having a mental health condition for both telephone samples. Current smoking prevalence was lower for both hypothetical telephone samples in absolute differences and RCB values: -0.136 to -0.191 for RDD landline samples and -0.129 to -0.313 for directory-listed samples. CONCLUSION: These findings suggest landline-based sampling frames used in Australia, when appropriately weighted, produce reliable representative estimates for some health indicators but not for all. Researchers need to be aware of their limitations and potential biased estimates.

Pre-Survey Text Messages (SMS) Improve Participation Rate in an Australian Mobile Telephone Survey: An Experimental Study.

Mobile telephone numbers are increasingly being included in household surveys samples. As approach letters cannot be sent because many do not have address details, alternatives approaches have been considered. This study assesses the effectiveness of sending a short message service (SMS) to a random sample of mobile telephone numbers to increase response rates. A simple random sample of 9000 Australian mobile telephone numbers: 4500 were randomly assigned to be sent a pre-notification SMS, and the remaining 4500 did not have a SMS sent. Adults aged 18 years and over, and currently in paid employment, were eligible to participate. American Association for Public Opinion Research formulas were used to calculated response cooperation and refusal rates. Response and cooperation rate were higher for the SMS groups (12.4% and 28.6% respectively) than the group with no SMS (7.7% and 16.0%). Refusal rates were lower for the SMS group (27.3%) than the group with no SMS (35.9%). When asked, 85.8% of the pre-notification group indicated they remembered receiving a SMS about the study. Sending a pre-notification SMS is effective in improving participation in population-based surveys. Response rates were increased by 60% and cooperation rates by 79%.

Parent-reported Mental Health Problems and Mental Health Services Use in South Australian School-aged Children.

BACKGROUND: Monitoring and reporting childhood mental health problems and mental health services utilization over time provide important information to identify mental health related issues and to guide early intervention. This paper aims to describe the recent prevalence of parent-reported mental health problems among South Australian (SA) children; to identify mental health problems associated characteristics; and to describe mental health services utilization and its related characteristics among this population. METHODS: Parent-reported mental health problems were assessed against the first item of the Strength and Difficulties Questionnaire. School-aged children were randomly sampled monthly and data were collected using a surveillance system between 2005 and 2015. Associations between mental health problems and various factors were analysed using univariable analysis and multivariable logistic regression modelling. RESULTS: Prevalence of parent-reported mental health problems among children was 9.1% and 9.3% for children aged 5 to 11 years and children aged 12 to 15 years, respectively. No change in prevalence was observed during the past decade. Mental health problems were associated with male sex, long-term illness or pain, negative school experiences, not living with biological parents, and living in a rental dwelling. Less than half (48.7%) of the children with mental health problems received professional help. An increasing trend was found in mental health services utilisation among children aged 5 to 15 years. Utilization of mental health services was associated with male sex, older age, long-term illness or pain, and feeling unhappy at school. CONCLUSION: This study reports the prevalence of parent-reported mental and mental health services utilisation among SA school-aged children. Identified characteristics associated with mental health problems and mental health services utilisation provide useful information for the planning of catered population initiatives.

The Relationship between Alcohol Consumption and other Risk Factors Assessed Using An Ongoing Population-based Surveillance System.

The aim of this study was to determine the relationship of alcohol consumption (reported in four different ways) with other specific disease-related risk factors (that is, smoking, high body mass index, low physical activity and insufficient fruit and vegetables). Data were collected from 2003 to 2015 in South Australia using an on-going monthly chronic disease and risk factor telephone survey of randomly selected persons (18+ years). The proportion of alcohol drinkers and, for those who drank alcohol, the proportion drinking more than one day per week, the proportion drinking on six or more days per week, and the mean alcohol drinks per day were assessed. Logistic regression and linear regression modelling were used on age and sex adjusted data. In total, over 71,000 respondents aged 18 years and older were interviewed (48.8% male). Overall prevalence of alcohol consumption was 81.3%. Trends in the direction promoted by current policies and preventative authorities were apparent with appropriate changes for all four measures for overall and for those underweight, undertaking sufficient activity, consuming <2 serves of fruit per day, consuming <5 serves of vegetables per day and with 3+ total risk factors. This research has provided evidence on the trends in alcohol consumption in relation to a range of other specific modifiable disease-related risk factors. The trends analysis has shown different patterns for each risk factor, and highlights the interplay between the respective modifiable or preventive risk factors.

Health Estimates Using Survey Raked-Weighting Techniques in an Australian Population Health Surveillance System.

A challenge for population health surveillance systems using telephone methodologies is to maintain representative estimates as response rates decrease. Raked weighting, rather than conventional poststratification methodologies, has been developed to improve representativeness of estimates produced from telephone-based surveillance systems by incorporating a wider range of sociodemographic variables using an iterative proportional fitting process. This study examines this alternative weighting methodology with the monthly South Australian population health surveillance system report of randomly selected people of all ages in 2013 (n = 7,193) using computer-assisted telephone interviewing. Poststratification weighting used age groups, sex, and area of residence. Raked weights included an additional 6 variables: dwelling status, number of people in household, country of birth, marital status, educational level, and highest employment status. Most prevalence estimates (e.g., diabetes and asthma) did not change when raked weights were applied. Estimates that changed by at least 2 percentage points (e.g., tobacco smoking and mental health conditions) were associated with socioeconomic circumstances, such as dwelling status, which were included in the raked-weighting methodology. Raking methodology has overcome, to some extent, nonresponse bias associated with the sampling methodology by incorporating lower socioeconomic groups and those who are routinely not participating in population surveys into the weighting formula.

Effect of social mobility in family financial situation and housing tenure on mental health conditions among South Australian adults: results from a population health surveillance system, 2009 to 2011.

BACKGROUND: To assess the association of socioeconomic position (SEP), measured by family financial situation and housing tenure in childhood and adulthood, with mental health conditions in adulthood. METHODS: Representative cross-sectional population data were collected using a risk factor surveillance system in South Australia, Australia. Each month, a random sample were selected from the Electronic White Pages. Participants aged 25 years and above (n = 10429) were asked about doctor diagnosed anxiety, stress or depression, suicidal ideation, psychological distress, demographic and socioeconomic factors using Computer Assisted Telephone Interviewing (CATI). Social mobility measures were derived from housing status and perceived financial situation during adulthood and at 10 years of age. RESULTS: The prevalence of psychological distress was 8.1 %, current diagnosed mental health condition was 14.8 % and suicidal ideation was 4.3 %. Upward mobility in family financial situation and housing tenure was experienced by 28.6 % and 19.3 %, of respondents respectively. Downward mobility was experienced by 9.4 % for housing tenure and 11.3 % for family financial situation. In the multivariable analysis, after adjusting for age, sex, childhood family structure and adult education, downward social mobility and stable low SEP (both childhood and adulthood), in terms of both housing tenure and financial situation, were positively associated with all three mental health conditions. CONCLUSION: People with low SEP in adulthood had poor mental health outcomes regardless of their socioeconomic circumstances in childhood. Policies to improve SEP have the potential to reduce mental health conditions in the population.