I was playing with some numbers yesterday that came across my desk and fed into the Department of Health and Human Services State of Public Health 2008 report and was surprised by a little quirk that I really hadn’t thought about.
Now, we probably are all intrinsically aware of the clear divergence in health status between the most disadvantaged and most advantaged groups in our society. Statistically, lower socioeconomic status (SES) is associated with higher disability levels and higher premature death rates. Low SES – whichever way you choose to measure it: income, educational attainment or occupation – means poorer health, a higher incidence of chronic conditions and higher levels of health care utilisation. Moreover, health inequalities do not just indicate disadvantage, they tend to drive further disadvantage.
Now for those who do not know, Tasmania – for a lot of historical, geographical, economic and sociological reasons – trails the rest of the country (bar the Northern Territory) on many indicators: lower employment levels; lower incomes; lower educational retention rates; an aging workforce and so on.
So in this manner, I went into looking at smoking and drinking amongst Tasmanians. Unsurprisingly, Tasmania had the highest proportion of smokers of all states and territories (bar NT), with 25.4% of Tasmanians 18 years and over smoking. More directly related to the above point, smoking rates are connected with household income. The prevalence of smoking declines with rising household income levels, from 32.1% in the lowest income quintile to 15.6% in the highest income quintile.
This did not really come as much of a surprise to me, even factoring in the expensiveness of cigarettes these days. High risk alcohol consumption is more prevalent among higher rather than lower income groups. Of all Tasmanians in the top household income quintile, 17% consume alcohol at risky or high risk levels, compared to 9.4% of Tasmanians in the lowest income quintile.
I am not too sure why that reverse is true. I suspect that it may be influenced by the larger proportion of older people in that lower group, but don’t have the numbers and don’t know if it would leave that big a dent. Any ideas?
The other troubling stat that really troubled me is that of smoking during pregnancy, which remains a huge public health problem in Tasmania. A total of 35.7% of all public patients who were pregnant in 2005 reported that they smoked. In contrast, 8.3% of private patients who were pregnant in 2005 reported that they smoked. This reflects pregnant women accessing public hospital services are likely to be younger and of lower socio-economic status than those accessing private hospital services. With all that we know of the harms that can occur in utero, it troubles me that we haven’t really knocked this one on the head yet.
Now, we probably are all intrinsically aware of the clear divergence in health status between the most disadvantaged and most advantaged groups in our society. Statistically, lower socioeconomic status (SES) is associated with higher disability levels and higher premature death rates. Low SES – whichever way you choose to measure it: income, educational attainment or occupation – means poorer health, a higher incidence of chronic conditions and higher levels of health care utilisation. Moreover, health inequalities do not just indicate disadvantage, they tend to drive further disadvantage.
Now for those who do not know, Tasmania – for a lot of historical, geographical, economic and sociological reasons – trails the rest of the country (bar the Northern Territory) on many indicators: lower employment levels; lower incomes; lower educational retention rates; an aging workforce and so on.
So in this manner, I went into looking at smoking and drinking amongst Tasmanians. Unsurprisingly, Tasmania had the highest proportion of smokers of all states and territories (bar NT), with 25.4% of Tasmanians 18 years and over smoking. More directly related to the above point, smoking rates are connected with household income. The prevalence of smoking declines with rising household income levels, from 32.1% in the lowest income quintile to 15.6% in the highest income quintile.
This did not really come as much of a surprise to me, even factoring in the expensiveness of cigarettes these days. High risk alcohol consumption is more prevalent among higher rather than lower income groups. Of all Tasmanians in the top household income quintile, 17% consume alcohol at risky or high risk levels, compared to 9.4% of Tasmanians in the lowest income quintile.
I am not too sure why that reverse is true. I suspect that it may be influenced by the larger proportion of older people in that lower group, but don’t have the numbers and don’t know if it would leave that big a dent. Any ideas?
The other troubling stat that really troubled me is that of smoking during pregnancy, which remains a huge public health problem in Tasmania. A total of 35.7% of all public patients who were pregnant in 2005 reported that they smoked. In contrast, 8.3% of private patients who were pregnant in 2005 reported that they smoked. This reflects pregnant women accessing public hospital services are likely to be younger and of lower socio-economic status than those accessing private hospital services. With all that we know of the harms that can occur in utero, it troubles me that we haven’t really knocked this one on the head yet.
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