Occurrence of Stenurus globicephalae (Nematoda: Pseudaliidae) in the blowhole of Globicephala macrorhynchus (Cetacea: Delphinidae) in Tasmania, Australia.

Information about parasites of cetaceans in Australia is scarce and mostly opportunistic. The morphology of specimens of the metastrongyloid Stenurus globicephalae Baylis & Daubney, 1925 (Nematoda: Pseudaliidae), collected from the blowhole of a pilot whale Globicephala macrorhynchus Gray, 1846 (Cetacea: Delphinidae) off northern Tasmania, Australia, were studied. Light and scanning electron microscopical examinations enabled a detailed redescription of this nematode species, including corrections of some inaccuracies in previous species descriptions, particularly those concerning cephalic and caudal structures. The presence of numerous ventrolateral oblique muscle bands, characteristic of the males of S. globicephalae, is reported for the first time. This is the second finding of this nematode parasite, in a different host species, in Tasmania.

Health System and Individual Barriers to Supporting Healthy Gestational Weight Gain and Nutrition: A Qualitative Study of the Experiences of Midwives and Obstetricians in Publicly Funded Antenatal Care in Tasmania, Australia.

Individual and health system barriers can impede clinicians from supporting weight-related behaviour change for pregnant women, particularly in publicly funded antenatal care accessed by women from diverse socioeconomic backgrounds. The aim was to understand clinicians' experiences of supporting healthy gestational weight gain for pregnant women in a publicly funded antenatal setting. The work was undertaken to guide the implementation of systems changes, resource development, and workforce capacity building related to nutrition, physical activity, and gestational weight gain in the service. The qualitative descriptive study used purposive sampling and semi-structured interviews conducted between October 2019 and February 2020. Nine midwives and five obstetricians from a publicly funded hospital antenatal service in Tasmania, Australia participated. Interview transcripts were analysed using inductive thematic analysis. The three dominant themes were prioritising immediate needs, continuity of care support weight-related conversations, and limited service capacity for weight- and nutrition-related support. The subthemes were different practices for women according to weight and the need for appropriately tailored resources. Improving access to continuity of care and clinician training, and providing resources that appropriately consider women's socioeconomic circumstances and health literacy would enhance the ability and opportunities for clinicians to better support all women.

Negative and positive mental health characteristics of affected family members: Findings from a cross-sectional Australian general population gambling study.

Despite the impact of problem gambling on affected family members (AFMs), there are limited large-scale population level studies identifying the negative mental health (NMH) and positive mental health (PMH) characteristics of AFMs. Furthermore, no study has explored whether PMH characteristics are protective in the relationships between AFM status and NMH characteristics. This study involved secondary data analysis from the Third Social and Economic Impact Study of Gambling in Tasmania. Using a subsample of 1,869 adults (48.30 % male; meanage = 48.48; 4.67 % AFMs), this study aimed to explore whether: (1) AFM status is associated with NMH (depression, anxiety, panic, post-traumatic stress disorder, social anxiety, binge drinking, tobacco use, and drug use symptoms) and PMH (quality of life [QOL], personal growth/autonomy, interpersonal/social skills, coping skills) characteristics after separately controlling for sociodemographic, problem gambling severity, and other NMH characteristics; (2) PMH characteristics moderate (buffer) the relationships between AFM status and NMH characteristics; and (3) gender influences these relationships. AFM status, defined as exposure to family member gambling problems, significantly positively predicted NMH characteristics (depression, anxiety, panic, PTSD, and tobacco use symptoms) and negatively predicted QOL (physical, social) and planning coping. The strength of these relationships generally attenuated after controlling for various covariates. Gender did not moderate these relationships. Religious coping exacerbated the relationship between AFM status and panic disorder symptoms. These findings can inform the development of intervention initiatives for family members exposed to gambling problems. Future population-representative research is required using a range of affected other types, longitudinal study designs, and more comprehensive measures.

Impact of Traditional and New Media on Smoking Intentions and Behaviors: Secondary Analysis of Tasmania's Tobacco Control Mass Media Campaign Program, 2019-2021.

BACKGROUND: Tasmania, the smallest state by population in Australia, has a comprehensive tobacco control mass media campaign program that includes traditional (eg, television) and "new" channels (eg, social media), run by Quit Tasmania. The campaign targets adult smokers, in particular men aged 18-44 years, and people from low socioeconomic areas. OBJECTIVE: This study assesses the impact of the 2019-2021 campaign program on smokers' awareness of the campaign program, use of Quitline, and smoking-related intentions and behaviors. METHODS: We used a tracking survey (conducted 8 times per year, immediately following a burst of campaign activity) to assess campaign recall and recognition, intentions to quit, and behavioral actions taken in response to the campaigns. The sample size was approximately 125 participants at each survey wave, giving a total sample size of 2000 participants over the 2 years. We merged these data with metrics including television target audience rating points, digital and Facebook (Meta) analytics, and Quitline activity data, and conducted regression and time-series modeling. RESULTS: Over the evaluation period, unprompted recall of any Quit Tasmania campaign was 18%, while prompted recognition of the most recent campaign was 50%. Over half (52%) of those who recognized a Quit Tasmania campaign reported that they had performed or considered a quitting-related behavioral action in response to the campaign. In the regression analyses, we found having different creatives within a single campaign burst was associated with higher campaign recall and recognition and an increase in the strength of behavioral actions taken. Higher target audience rating points were associated with higher campaign recall (but not recognition) and an increase in quit intentions, but not an increase in behavioral actions taken. Higher Facebook advertisement reach was associated with lower recall among survey participants, but recognition was higher when digital channels were used. The time-series analyses showed no systematic trends in Quitline activity over the evaluation period, but Quitline activity was higher when Facebook reach and advertisement spending were higher. CONCLUSIONS: Our evaluation suggests that a variety of creatives should be used simultaneously and supports the continued use of traditional broadcast channels, including television. However, the impact of television on awareness and behavior may be weakening. Future campaign evaluations should closely monitor the effectiveness of television as a result. We are also one of the first studies to explicitly examine the impact of digital and social media, finding some evidence that they influence quitting-related outcomes. While this evidence is promising for campaign implementation, future evaluations should consider adopting rigorous methods to further investigate this relationship.

Creating an interactive map visualising the geographic variations of the burden of diabetes to inform policymaking: An example from a cohort study in Tasmania, Australia.

OBJECTIVES: To visualise the geographic variations of diabetes burden and identify areas where targeted interventions are needed. METHODS: Using diagnostic criteria supported by hospital codes, 51,324 people with diabetes were identified from a population-based dataset during 2004-2017 in Tasmania, Australia. An interactive map visualising geographic distribution of diabetes prevalence, mortality rates, and healthcare costs in people with diabetes was generated. The cluster and outlier analysis was performed based on statistical area level 2 (SA2) to identify areas with high (hot spot) and low (cold spot) diabetes burden. RESULTS: There were geographic variations in diabetes burden across Tasmania, with highest age-adjusted prevalence (6.1%), excess cost ($2627), and annual costs per person ($5982) in the West and Northwest. Among 98 SA2 areas, 16 hot spots and 25 cold spots for annual costs, and 10 hot spots and 10 cold spots for diabetes prevalence were identified (p<0.05). 15/16 (94%) and 6/10 (60%) hot spots identified were in the West and Northwest. CONCLUSIONS: We have developed a method to graphically display important diabetes outcomes for different geographical areas. IMPLICATIONS FOR PUBLIC HEALTH: The method presented in our study could be applied to any other diseases, regions, and countries where appropriate data are available to identify areas where interventions are needed to improve diabetes outcomes.

Mapping community-based youth mental health services in Tasmania, Australia.

BACKGROUND: Tasmania has the most rurally and remotely dispersed population of young people in Australia with high rates of youth experiencing mental ill health and socioeconomic disadvantage. Standard descriptions of mental healthcare provision are necessary for evidence-informed mental healthcare policy, planning and implementation. This systematic scoping study aimed to: (1) map and describe the characteristics of community-based youth mental health services (including substance-use) for young people in Tasmania, Australia and (2) identify gaps in service accessibility and provision. METHODS: A list of eligible services was developed through a systematic search and consultation with key stakeholders. Data were collected from a representative from each eligible service via an interview or online survey. A standardised framework was used to classify, describe and map services. Thematic analysis was used to analyse service providers' perceived gaps to service access and provision. RESULTS: Twenty-eight community-based mental health services for youth were identified, predominantly located in the major city of Tasmania's three service regions. Service gaps include the 'missing middle', lack of integrated supports and limited service capacity. CONCLUSIONS: The findings highlight the limited availability, accessibility and capacity of youth mental health services across Tasmania. Recommendations focus on increasing accessibility of rural/regional supports, provision of assertive outreach, psychosocial support, integrated care and strengthening the rural mental health workforce. These findings may inform the (re)design/(re)development of community-based youth mental health services in Tasmania. The findings may also guide evidence-informed mental health service planning, decision-making, development and implementation of integrated models of youth mental health care across Australia.

Acceptability of a peer-led self-management program for people living with chronic obstructive pulmonary disease in regional Southern Tasmania in Australia: A qualitative study.

OBJECTIVES: People living with chronic obstructive pulmonary disease (COPD) in regional communities experience a higher disease burden and have poorer access to support services. This study sought to investigate the acceptability of a peer-led self-management program (SMP) in regional Tasmania, Australia. METHODS: This descriptive qualitative study, underpinned by interpretivism used semi-structured one-to-one interviews to gather data to explore COPD patients' views of peer-led SMPs. Purposeful sampling recruited a sample of 8 women and 2 men. Data was analysed using a thematic approach. RESULTS: The three final themes, 'Normality and Living with the disease', a 'Platform for sharing' and 'Communication mismatch' suggest that peer-led SMPs could offer an opportunity to share experiences. The themes also suggest that COPD often manifested as a deviation from 'normal life'. Communication was often felt to be ambiguous leading to tension between the health experts and people living with the condition. DISCUSSION: Peer-led SMP has the potential to provide the much-needed support for people living with COPD in regional communities. This will ensure that they are empowered to live with the condition with dignity and respect. Benefits of exchanging ideas and socialisation should not be ignored and may enhance sustainability of SMPs.

An exploration of the determinants of overweight and obesity and the capacity to intervene in North-West Tasmania: A stakeholder consultation.

ISSUE ADDRESSED: The capacity of communities to develop effective obesity prevention initiatives varies and should be a focus for obesity prevention intervention planning and investment. This research aimed at engaging and consulting local community stakeholders to identify determinants, needs, strategic priorities and capacity to act on overweight and obesity prevention in North-West (NW) Tasmania. METHODS: A series of semi-structured interviews and thematic analyses was implemented to explore the knowledge, insights, experiences and attitudes of stakeholders. RESULTS: Mental health and obesity were identified as major concerns and were often reported to share similar determinants. This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). CONCLUSIONS: This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). SO WHAT?: Broad upstream socio-economic, cultural and environmental determinants underpin the conditions by which the local community develops overweight/obesity and/or health and wellbeing outcomes. Including stakeholder consultations as a significant technique within a comprehensive plan of action aimed at achieving a sustainable, long-term strategy for obesity prevention and/or health promotion, should be considered in future programs.

Exploring the experiences and perspectives of women on oral health during pregnancy: A qualitative study in Tasmania, Australia.

OBJECTIVE: To explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy. METHODS: A qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation sampling. Semi-structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach. RESULTS: Fifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy; barriers to oral health care during and after pregnancy; and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health. CONCLUSION: This study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy-level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.

The impact of COVID-19 on community mental health: lessons learned from Tasmania, Australia.

BACKGROUND: The COVID-19 pandemic had a significant impact on community mental health globally and widened pre-existing health and social inequities. Tasmania, Australia has one of the highest rates of mental ill health and socioeconomic disadvantage in the country. Whilst Tasmania experienced a delayed and reduced physical presence of COVID-19 compared to other states and territories, mental health impacts remain. It is necessary to understand such impacts to inform policy, practice, and recommendations to enhance the mental health service sector and prevent future mental health burden. This qualitative study aimed to explore expert mental health stakeholders' perspectives of the impact of COVID-19 on: (1) the mental health of people living in Tasmania, and (2) mental health services. METHOD: Semi-structured interviews with 12 expert mental health stakeholders across Tasmania were conducted. This sample was well-positioned to comment on the impact of COVID-19 on community mental health and provide recommendations to enhance the sector. Interviews were thematically analysed. RESULTS: Three subthemes exploring the COVID-19 impact on mental health were included: (1) anxiety, distress, and isolation; (2) varying presentations across age groups; and (3) increased complexity. Four key themes capturing the COVID-19 impact on mental health services were identified: (1) transition to telehealth; (2) increased service demand; (3) spotlight on service gaps; and (4) local workforce shortages. CONCLUSIONS: The pandemic has highlighted existing gaps across the community mental health service sector, and exacerbated existing psychosocial/structural stressors resulting in increased presentations and complexity of mental illness among the community, particularly for youth. Existing treatment gaps and inequities in service access, engagement, and mental health outcomes will persist if not addressed. Recommendations have been provided to inform community mental health service planning, policy, design, access, and provision, and improve wellbeing.

Tasmaniomyxa umbilicata, a new genus and new species of myxomycete from Tasmania.

A new genus and species of myxomycete, Tasmaniomyxa umbilicata, is described based on numerous observations in Tasmania and additional records from southeastern Australia and New Zealand. The new taxon is characterized by an unusual combination of characters from two families: Lamprodermataceae and Didymiaceae. With Lamprodermataceae the species shares limeless sporocarps, a shining membranous peridium, an epihypothallic stalk, and a cylindrical columella. Like Didymiaceae, it has a soft, flaccid, sparsely branched capillitium, with rough tubular threads that contain fusiform nodes and are firmly connected to the peridium. Other characters of T. umbilicata that also occur in many Didymiaceae are the peridium dehiscing into petaloid lobes, the yellow, motile plasmodium, and the spores ornamented with larger, grouped and smaller, scattered warts. The transitional position of the new taxon is reflected by a three-gene phylogeny, which places T. umbilicata at the base of the branch of all lime-containing Physarales, thus justifying its description as a monotypic genus.

Selection despite low genetic diversity and high gene flow in a rapid island invasion of the bumblebee, Bombus terrestris.

Invasive species are predicted to adjust their morphological, physiological and life-history traits to adapt to their non-native environments. Although a loss of genetic variation during invasion may restrict local adaptation, introduced species often thrive in novel environments. Despite being founded by just a few individuals, Bombus terrestris (Hymenoptera: Apidae) has in less than 30 years successfully spread across the island of Tasmania (Australia), becoming abundant and competitive with native pollinators. We use RADseq to investigate what neutral and adaptive genetic processes associated with environmental and morphological variation allow B. terrestris to thrive as an invasive species in Tasmania. Given the widespread abundance of B. terrestris, we expected little genetic structure across Tasmania and weak signatures of environmental and morphological selection. We found high gene flow with low genetic diversity, although with significant isolation-by-distance and spatial variation in effective migration rates. Restricted migration was evident across the mid-central region of Tasmania, corresponding to higher elevations, pastural land, low wind speeds and low precipitation seasonality. Tajima's D indicated a recent population expansion extending from the south to the north of the island. Selection signatures were found for loci in relation to precipitation, wind speed and wing loading. Candidate loci were annotated to genes with functions related to cuticle water retention and insect flight muscle stability. Understanding how a genetically impoverished invasive bumblebee has rapidly adapted to a novel island environment provides further understanding about the evolutionary processes that determine successful insect invasions, and the potential for invasive hymenopteran pollinators to spread globally.

A new species of Mycomya Rondani, 1856 (Diptera: Mycetophilidae) common to southeast Australia, Tasmania, and New Zealand.

Mycomya quadrimaculata sp. nov. is described from specimens collected in southeast Australia, Tasmania, and New Zealand. A key and type photographs of known Australian and New Zealand Mycomya species are provided. The relative abundance, observed distribution, and morphological affinities of the new species suggests that it is adventive and a recent introduction to New Zealand. Wing characters indicate that the new species is most closely aligned with a subgroup of the Australian Mycomya fauna.

'Growing your own' a case study of a collaborative training program in medical radiation science.

INTRODUCTION: Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. METHODS: A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. RESULTS: 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). CONCLUSIONS: Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.

Research output of radiologists in Australia and New Zealand: Strengths, weaknesses and future directions.

INTRODUCTION: Clinical radiology is a popular career. However, academic radiology in Australia and New Zealand (ANZ) has not traditionally been a strength of the specialty which has a focus on clinical medicine and has been influenced by corporatisation of the specialty. The aim of this study was to review the source(s) of radiologist-led research in Australia and New Zealand, to identify areas of relative deficiency and propose plans to improve research output. METHODS: A manual search was performed of all manuscripts in seven popular ANZ journals, where the corresponding or senior author was a radiologist. Publications between January 2017 and April 2022 were included. RESULTS: There were 285 manuscripts from ANZ radiologists during the study period. This equates to 10.7 manuscripts per 100 radiologists based on RANZCR census data. Radiologists in Northern Territory, Victoria, Western Australia, South Australia and the Australian Capital Territory all produced manuscripts above the corrected mean incidence rate of 10.7 manuscripts per 100 radiologists. However, locations including Tasmania, New South Wales, New Zealand and Queensland were below the mean. The majority of manuscripts arose from public teaching hospitals with accredited trainees (86%), and there were a higher proportion of manuscripts published by female radiologists (11.5 compared to 10.4 per 100 radiologists). CONCLUSION: Radiologists in ANZ are academically active; however, interventions aimed at increasing output could be targeted at certain locations and/or areas within a busy private sector. Time, culture, infrastructure and research support are vital, but personal motivation is also extremely important.

Trends and associations between maternal characteristics and infant birthweight among Indigenous and non-Indigenous people in Tasmania, Australia: a population-based study.

OBJECTIVE: This study aimed to investigate the trends and associations of maternal characteristics and birthweight among Indigenous and non-Indigenous infants. STUDY DESIGN: This was a retrospective population-based study. METHODS: Fourteen years (2005-2018) of birthweight and perinatal health data of live-born singletons and their mothers obtained from the Tasmanian Data Linkage Unit were used to assess the trends and associations between maternal characteristics and infant birthweight using regression modelling. RESULTS: Compared with non-Indigenous mothers (n = 76,750), Indigenous mothers (n = 3805) had a significantly higher prevalence of risk factors during the 14-year period. Although the prevalence of prepregnancy obesity and gestational diabetes mellitus (GDM) markedly increased in both groups, the rate of increase was higher (P < 0.001) for Indigenous than non-Indigenous mothers. Smoking, alcohol consumption and illegal drug use during pregnancy reduced over the years, and there was no significant difference in the rate of reduction between the groups. Large-for-gestational-age (LGA) births increased while small-for-gestational-age (SGA) births decreased in both groups over time. In addition, high birthweight (HBW) births decreased while low birthweight (LBW) births increased. The rates of increase in LGA and LBW births and the rates of decrease in SGA and HBW births were significantly higher in Indigenous mothers compared with non-Indigenous mothers (P < 0.001 for all). The association between Indigenous ethnicity and LBW and SGA births weakened after adjusting for other confounding maternal and perinatal variables. LBW and SGA were positively associated with Indigenous ethnicity, age <18 years, smoking, alcohol consumption and illegal drug use, pre-eclampsia, underweight prepregnancy body mass index and low socio-economic status. Women with higher parity, pre-existing diabetes and prepregnancy overweight or obesity were more likely to give birth to an infant with HBW or LGA. CONCLUSIONS: The prevalence of risk factors for abnormal birthweight is higher among Tasmanian Indigenous mothers, contributing to a gap in birthweight outcomes between Indigenous and non-Indigenous infants. The dramatic increase in prepregnancy obesity and GDM in both groups highlight the importance of screening and management of GDM during pregnancy. Comprehensive programmes co-designed and co-managed in consultation with Indigenous people are needed to support healthy lifestyle choices among Indigenous women to address the barriers to individuals adopting behaviour change and to help close the health outcomes-related gap between Indigenous and non-Indigenous mothers and infants.

Determining best practice for technical assessment of hookah surface supply diving equipment during diving fatality investigation.

INTRODUCTION: This study aimed to develop a standard process and checklist for technical investigation of hookah diving equipment and apply it to Tasmanian hookah fatality investigations from the last 25 years. METHODS: A literature search was undertaken to identify technical reports and equipment investigations associated with diving accidents. The information was assimilated to create a process and checklist for specifically assessing the hookah apparatus. The checklist was then applied in a gap analysis of Tasmanian hookah diving fatality technical reports from 1995 to 2019. RESULTS: As no papers specifically describing technical evaluation of hookah equipment were identified, references evaluating scuba equipment were used to create a hookah technical assessment process incorporating unique features of the hookah. Features included: owner responsibility for air quality; maintenance, function; exhaust proximity to air intake; reservoir volume; output non-return valves; line pressure; sufficiency of supply; entanglement; hose severance risk; gas supply failure and hosing attachment to the diver. Seven hookah diving deaths occurred in Tasmania (1995-2019) of which three had documented technical assessment. Gap analysis identified inconsistent structure between reports with variability in the case descriptors. Missing technical data included: overview of the hookah systems; accessories; weights; how the apparatus was worn by the diver; compressor suitability; assessment of hookah function; breathing gas output and exhaust position relative to air intake. CONCLUSIONS: The study demonstrated a need to standardise technical reporting of hookah equipment after diving accidents. The checklist generated may serve as a resource for future hookah assessments and inform strategies for preventing future hookah accidents.

Keratinocyte carcinomas, area-level socioeconomic status and geographic remoteness in Tasmania: cross-sectional associations and temporal trends.

OBJECTIVE: This article aims to examine cross-sectional associations and assess temporal trends in keratinocyte carcinoma (KC) incidence by area-level socioeconomic status (SES) and geographic remoteness in Tasmania, Australia. METHODS: KCs-basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC)-registered by the Tasmanian Cancer Registry were assigned to area-level SES and remoteness area. Incidence rate ratios (2014-2018) were estimated using Poisson regression. Average annual percentage changes (2001-2018) were estimated using the Joinpoint Regression Program. RESULTS: BCC incidence increased with increasing area-level advantage (p value for trend <0.001), but no trend was found for SCC. SCC incidence was higher in rural than urban areas (p value <0.001), and BCC incidence was slightly lower in rural than urban areas for males (p value = 0.026), but not for females (p value = 0.381). BCC and SCC incidence increased between 2001 and the mid-2010s, when it peaked across most areas. CONCLUSIONS: Associations were found between BCC and higher area-level SES, and between SCC and geographic remoteness. The findings suggest differences in sun exposure behaviours, skin cancer awareness and access to services, or ascertainment bias. IMPLICATIONS FOR PUBLIC HEALTH: Efforts to control and deliver KC services in Tasmania should consider targeting populations with specific area-level characteristics.