Prevention, health services, wellbeing

The economic impact of multiple sclerosis in Australia

In 2017, Prime Minister Scott Morrison launched our ‘Health economic impact of multiple sclerosis’ (MS) report. It revealed several important findings. In the previous 7 years, the number of Australians living with MS grew by over 4,000 to top 25,000. We calculated their quality of life to be two-thirds that of the average Australian. Costs to the health system from MS also rose by $0.5 billion during those 7 years, to $1.75 billion.

Our findings have been used in policy translation documents, including MS Australia’s submissions to the Pharmaceutical Benefits Advisory Committee and in its document ‘A roadmap to defeat multiple sclerosis in Australia’. This was presented to government officials, ministers and shadow ministers. It sets out what is needed over the next 10 years to ensure that MS prevalence can be limited and ultimately defeated, and to ensure everyone with MS receives effective, appropriate and timely interventions.

Active living in rural Tasmania

Our local environments influence our physical activity, health and wellbeing. This has been well studied in large cities but not in rural areas, where people are less physically active and poor health is more common.

Local citizens are helping us map features that make it easier or harder to be active and walk around 10 Tasmanian towns. To do this, they use our online tool, take photos, and discuss the findings at community workshops. Common barriers to walkability are a lack of footpaths, a highway bisecting the town, traffic speed, and inadequate signage.

We are finding local people prioritise linking up existing trails and town features, rather than large infrastructure projects, as doing so improves both physical and social connections. In our project’s early stage, Huon Valley Council tabled our report on the southern town of Dover, where it is being used by groups to advocate for improvements that will help link areas of the town to each other.

Building evidence for obesity surgery policy

One of the effective options for the clinical management of severe obesity is bariatric surgery. While most surgery occurs in the private sector, there have been large numbers of patients on the waiting list for publicly funded surgery and increasing pressure on the system due to public hospital admissions for surgical revisions. In partnership with the

Tasmanian Department of Health, this research demonstrated a large disparity between supply and demand for surgery and identified some key policy gaps and unmet patient needs. Bariatric surgery was found to be cost-effective and to improve quality of life for public patients.

Recommendations arising from the research highlighted the importance of patient pathways and system integration, clear criteria for patient eligibility and prioritisation, choice of surgical procedure, separation of waiting lists for primary and revisional procedures, and patient and GP support before and after surgery.

Mental health in the workplace

The prevalence and impact of mental illness is a globally significant social, health and economic challenge. Workplace mental health and wellbeing strategies are our focus and a vital aspect of healthy, safe workplaces.

In a major project, we have worked with an Australian Public Sector taskforce to design, pilot and evaluate a framework for protecting, promoting and supporting the mental health of all APS employees.

The outcome, the proposed APS Mental Health Capability Framework is a systems-based approach to building mental health capability. The task force developed a suite of resources to help agencies operationalise the framework, including a maturity assessment tool to assess their maturity of practice, and action plan templates. An important recommendation and outcome from the task force’s final report was the creation of an APS Mental Health and Suicide Prevention Unit.

Childhood Determinants of Adult Health Study (CDAH)

The CDAH study is a cohort study with follow-up of 8,498 children who participated in the 1985 Australian Schools Health and Fitness Survey (ASHFS) when aged 7 to 15 years. Using data from repeated measures of demographic, lifestyle, and physical characteristics collected since childhood, the study's main aim is to determine the contribution of childhood factors to the risk of developing cardiovascular disease (CVD) and type 2 diabetes in later life. The study’s rich data has also allowed researchers to address questions about a broad range of other health conditions including mental, reproductive, bone and kidney health, and cognition.

Find out more about CDAH

Girls in Action Sports Project (GASP)

GASP was designed to better understand the enablers and barriers to girls engaging in male dominated action sports (mountain biking, skateboarding and surfing) with a view to providing more opportunities for girls to be physically active.

Capturing perspectives of young people, parents and adult stakeholders (e.g. board/committee members, CEOs, coaches, officials), along with a policy review and collation of membership data, GASP has provided novel and rich information to help more girls get involved in these and possibly other sports.

Find out more about GASP

Turning to turmeric for osteoarthritis knee pain

In our rigorous pilot trial, Curcuma longa extract, commonly known as turmeric, was found to be more effective than a placebo for reducing knee pain.

This study provided promising evidence for taking turmeric for knee osteoarthritis.

However, it was a small study with a short follow-up duration, which means that further research is needed. Multi-centre trials with larger sample sizes and longer follow-up time will help us confirm whether our findings are clinically significant.

Ruling out vitamin D for osteoarthritis treatment

It has long been thought that using vitamin D supplements may protect against developing knee pain and cartilage loss.

Thanks to our large, multi-centre, randomised placebo-controlled trial, we were able to provide definitive evidence that vitamin D supplementation does not improve knee pain or slow disease progression in knee osteoarthritis patients. GPs can now advise their patients not to waste money on vitamin D pills for this purpose.

Physical activity for better bones, muscles and balance

Through our research, we have identified that maintaining and improving bone strength, muscle strength and balance in midlife is important for preventing osteoporosis, falls and fractures.

Our study presents the first report on a link between objectively measured (not self-reported) physical and sedentary activities and musculoskeletal health in middle-aged women.

Importantly, while greater total physical activity is important for middle-aged women, increasing time spent in moderate to vigorous activity may be more important than decreasing sitting time or increasing light activity. These findings provide an evidence base for developing interventions to improve habitual physical activities in middle-aged women that aim to improve bone strength, muscle strength and balance.

Preventing fractures by treating pain

Musculoskeletal pain is common and often occurs at multiple sites across the body.

We conducted a study that found the number of painful sites is associated with both one-off and multiple fractures over time. This suggests that widespread pain is an independent risk factor for fractures. By treating and managing pain, there is the potential to prevent and reduce fracture risk, and therefore reduce fracture-related mortality.

Childhood obesity leads to adult knee pain

Obesity is a major public health problem among adults and, more recently, among children. It is also associated with musculoskeletal conditions, especially osteoarthritis.

Our study, conducted over 25 years, found that being overweight during childhood increased the risk of having knee pain, stiffness and joint dysfunction in adulthood, especially among men. Most importantly, adults were at risk of knee pain whether they were overweight as a child, as an adult, or both. Those overweight in both childhood and adulthood were most at risk.