Are There Ethnic Disparities in Exposure to Workplace Hazards Among New Zealand Migrants to Australia?

Disparities in exposure to workplace hazards exist between Maori and non-Maori workers in New Zealand, with Maori workers generally incurring poorer conditions. This study aimed to determine if these ethnic disparities are similar after migration to Australia. A national cross-sectional telephone survey asked participants what tasks they undertook in their job to assess exposure to carcinogens as well as whether they experienced ethnic discrimination, bullying, job precariousness, or job strain. A total of 389 New Zealand Caucasians and 152 Maori/Pasifika workers were recruited. After adjustment, 79% of Maori/Pasifika compared with 67% of New Zealand Caucasian workers were assessed as being exposed to at least one carcinogen at work. Maori/Pasifika workers were also more likely to report ethnic discrimination and fair or poor current health than New Zealand Caucasians. Some ethnic disparities in exposure to workplace hazards in New Zealand are apparent after migration to Australia.

Does exposure to workplace hazards cluster by occupational or sociodemographic characteristics? An analysis of foreign-born workers in Australia.

BACKGROUND: Disparities in exposure to occupational hazards may be linked to social position as well as the type of job a person holds. This study aimed to describe the prevalence of exposure to workplace hazards among three migrant worker groups and to assess whether social disparities in exposure for these groups remain after adjusting for occupational characteristics. METHODS: Data were collected in 2017/2018 from 1630 Australian workers born in New Zealand, India, and the Philippines. Weighted estimated prevalence of exposure to 10 carcinogens and four psychosocial hazards (discrimination, job strain, vulnerability, and insecurity) was calculated for sociodemographics and occupation. Regression estimated the likelihood of exposure by sociodemographics after adjustment for occupational characteristics. RESULTS: Exposure to workplace hazards ranged from 11.7% (discrimination) to 61.2% (exposed to at least one carcinogen). Compared with workers born in India, New Zealand born workers were over twice as likely to be exposed to diesel engine exhaust (adjusted odds ratio [aOR] = 2.60) and 60% more likely to be exposed to at least one carcinogen (aOR = 1.60) but less likely to be exposed to any psychosocial hazard. Social disparities by country of birth, sex, age, education, and number of years in Australia, as well as company size, employment type, and hours, worked remained associated with greater likelihood of reporting one or more workplace hazards after adjusting for occupational characteristics. CONCLUSION: Examining sociodemographic as well as occupational characteristics helps to clarify groups most likely to be exposed to workplace hazards who can be hidden when examining occupational characteristics alone.

Using Cross-Sectional Data to Identify and Quantify the Relative Importance of Factors Associated with and Leading to Food Insecurity.

Australian governments routinely monitor population household food insecurity (FI) using a single measure-'running out of food at least once in the previous year'. To better inform public health planning, a synthesis of the determinants and how they influence and modify each other in relation to FI was conducted. The analysis used data from the Health & Wellbeing Surveillance System cross-sectional dataset. Weighted means and multivariable weighted logistic regression described and modelled factors involved in FI. The analysis showed the direction and strength of the factors and a path diagram was constructed to illustrate these. The results showed that perceived income, independent of actual income was a strong mediator on the path to FI as were obesity, smoking and other indicators of health status. Eating out three or more times a week and eating no vegetables more strongly followed FI than preceded it. The analysis identified a range of factors and demonstrated the complex and interactive nature of them. Further analysis using propensity score weighted methods to control for covariates identified hypothetical causal links for investigation. These results can be used as a proof of concept to assist public health planning.

Benefits, barriers and enablers of breastfeeding: factor analysis of population perceptions in Western Australia.

OBJECTIVE: The objective of this study was to investigate knowledge and community perceptions of breastfeeding in Western Australia using a factor analysis approach. METHODS: Data were pooled from five Nutrition Monitoring Survey Series which included information on breastfeeding from 4,802 Western Australian adults aged 18-64 years. Tetrachoric factor analysis was conducted for data reduction and significant associations identified using logistic, ordinal and poisson regression analyses. RESULTS: Four factors were derived for benefits (it's natural, good nutrition, good for the baby, and convenience), barriers (breastfeeding problems, poor community acceptability, having to go back to work, and inconvenience) and for enablers (breastfeeding education, community support, family support and not having to work). As assessed by standardized odds ratios the most important covariates across benefit factors were: importance of breastfeeding (ORs range from 1.22-1.44), female gender (ORs range from 0.80 to 1.46), being able to give a time for how long a baby should be breastfed (ORs range from 0.96 to 1.27) and education (less than high school to university completion) (ORs range from 0.95 to 1.23); the most important covariate across barrier factors was being able to give a time for how long a baby should be breastfed (ORs range from 0.89 to 1.93); and the most important covariates across all enabling factors were education (ORs range from 1.14 to 1.32) and being able to give a time for how long a baby should be breastfed (ORs range from 1.17 to 1.42). CONCLUSIONS: Being female, rating breastfeeding as important, believing that babies should be breastfed for a period of time and education accounted for most of the statistically significant associations. The differences between male and female perceptions require investigation particularly in relation to returning to work.

Public say food regulatory policies to improve health in Western Australia are important: population survey results.

OBJECTIVE: To investigate the level of support among Western Australian adults for food control policies to improve diet, reduce obesity and protect the environment. METHODS: Attitudes towards government food control policies on food labelling, food advertising, and the supply of environmentally friendly food data were pooled from two Nutrition Monitoring Survey Series telephone surveys of 2,147 adults aged 18-64 years collected in 2009 and 2012. Descriptive and logistic regression analyses were conducted using survey module of STATA 12. RESULTS: The majority of adults believe it is important that government regulates food policy options under consideration: nutrition information on food labels (97% versus 2% who think it is not important); health rating on food labels (95% versus 3%); food advertising (83% versus 11%); and the supply of environmentally friendly food (86% versus 9%). CONCLUSIONS: Community perception is that government control or regulation of food labelling, food advertising and the supply of environmentally friendly food is important. IMPLICATIONS: Curbing excess weight gain and related disease burden is a public health priority. Australian governments are considering food regulatory interventions to assist the public to improve their dietary intake. These findings should provide reassurance to government officials considering these regulatory measures.

Community attitudes toward breastfeeding in public places among Western Australia Adults, 1995-2009.

BACKGROUND: Community attitudes toward breastfeeding in public influence how comfortable women feel about continuing breastfeeding. Knowledge of the social context helps target breastfeeding-promoting interventions. OBJECTIVE: To examine trends in Western Australian adult attitudes toward breastfeeding in public places. METHODS: As part of 5 cross-sectional surveys from the Western Australian Nutrition Monitor Survey Series conducted between 1995 and 2009, 5496 adults aged 18 to 64 years were asked whether it was acceptable for mothers to breastfeed their babies in public places, including shopping centers, workplaces, and restaurants, and on public transport. Descriptive statistics and multinomial regressions were used to describe factors associated with attitudes toward publicly breastfeeding. RESULTS: There was no change in the acceptance of breastfeeding in shopping centers, restaurants, and workplaces and on public transport over time, but in 2009, significantly fewer people said that it was unacceptable to breastfeed in public compared with 1995. Women, people older than 44 years, those born outside Australia, and the less educated were those most likely to say that breastfeeding in public was unacceptable. In the years that the question was asked, more than 97% of respondents said that breastfeeding was acceptable if a separate room was provided. CONCLUSIONS: Making breastfeeding acceptable and pleasant for mothers in public spaces is a key policy recommendation. Women, people older than 44 years, and those born outside Australia were most likely to respond that breastfeeding in public was unacceptable unless a room was provided. Given that, on average, 70% of the population said that breastfeeding in public was acceptable, investigation into why some women do not think so is warranted.

Marketing paediatric influenza vaccination: results of a major metropolitan trial.

OBJECTIVES: After a cluster of rapidly fulminant influenza related toddler deaths in a Western Australian metropolis, children aged six to 59 months were offered influenza vaccination in subsequent winters. Some parental resistance was expected and previous poor uptake of paediatric influenza vaccination overseas was noted. A marketing campaign addressing barriers to immunization was developed to maximise uptake. DESIGN: Advertising occurred in major statewide newspapers, via public poster displays and static 'eye-lite' displays, via press releases, via a series of rolling radio advertisements, via direct marketing to child care centres, and via a linked series of web-sites. Parents were subsequently surveyed to assess reasons for vaccination. MAIN OUTCOME RESULTS: The campaign produced influenza vaccination coverage above that previously described elsewhere and led to a proportionate reduction in influenza notifications in this age group compared to previous seasons. CONCLUSIONS: Influenza in children comes with significant morbidity and some mortality. Paediatric influenza vaccination is safe, well tolerated and effective if two doses are given. A targeted media campaign can increase vaccine uptake if it reinforces the seriousness of influenza and addresses community 'myths' about influenza and influenza vaccine. The lessons learned enabling enhancements of similar programs elsewhere.

Consumer perceptions of fruit and vegetables serving sizes.

OBJECTIVE: To assess consumer understanding of fruit and vegetable serving sizes. DESIGN: The Western Australian Health Department launched the Go for 2&5(R) campaign to promote fruit and vegetables in March 2002. The Health & Wellbeing Surveillance System surveyed 1108 adults, aged 16 years and over, between September and November 2002 about what constituted a serving of fruit and of vegetables, their usual daily fruit and vegetables intake, and their recall of the campaign. SETTING: The study was undertaken as a part of a public health intervention - social marketing campaign in Western Australia, which had a population of 1 927 000 in 2002. RESULTS: Forty-two per cent of respondents knew that the fruit serving size was one piece and only 14.5 % reported the (1/2) cup vegetable serving size. The mean fruit intake was 1.8 (95 % CI 1.7, 1.8) servings/d and the mean vegetable intake was 2.8 (95 % CI 2.7, 3.0) servings/d. Vegetable intake was associated with being female (P = 0.006), increasing age (P < 0.0001), awareness of the campaign (P = 0.031) and knowledge of standard serving size (P = 0.006). Fruit consumption was associated with being female (P = 0.007). Fruit and vegetable intakes were not associated with educational attainment or household income. CONCLUSIONS: The Go for 2&5(R) campaign uses a prescriptive message to promote increased consumption of fruit and vegetables. Respondent's knowledge of the standard of serving sizes for fruit and vegetables suggests there is value in separating fruit and vegetable recommendations in messages to encourage increased consumption.

Increasing fruit and vegetable consumption: success of the Western Australian Go for 2&5 campaign.

OBJECTIVE: The Western Australian Health Department's Go for 2&5 campaign aimed to increase adults' awareness of the need to eat more fruit and vegetables and encourage increased consumption of one serving over five years. DESIGN: The multi-strategy fruit and vegetable social marketing campaign, conducted from 2002 to 2005, included mass media advertising (television, radio, press and point-of-sale), public relations events, publications, a website (www.gofor2and5.com), and school and community activities. Campaign development and the evaluation framework were designed using health promotion theory, and assessed values, beliefs, knowledge and behaviour. Two independent telephone surveys evaluated the campaign: the Campaign Tracking Survey interviewed 5032 adults monitoring fruit and vegetable attitudes, beliefs and consumption prior to, during and 12 months after the campaign; and the Health & Wellbeing Surveillance System surveyed 17,993 adults between 2001 and 2006, continuously monitoring consumption. SETTING: Population public health intervention-social marketing campaign in Western Australia, population of 2,010,113 in 2005. SUBJECTS: Adults in the Perth metropolitan area. RESULTS: The campaign reached the target audience, increasing awareness of the recommended servings of fruit and vegetables. There was a population net increase of 0.8 in the mean number of servings of fruit and vegetables per day over three years (0.2 for fruit (1.6 in 2002 to 1.8 in 2005) and 0.6 for vegetables (2.6 in 2002 to 3.2 in 2005), significant at P < 0.05). CONCLUSION: Sustained, well-executed social marketing is effective in improving nutrition knowledge, attitudes and consumption behaviour. The Go for 2&5 campaign provides guidance to future nutrition promotion through social marketing.