Social determinants of health, Australians’ health situation, chronic diseases, food insecurity, dietary guidelines, social connectedness, person-centred practice, engaging men
This page has three sections:
Background Material that provides the context for the topic
A suggested Practice Approach
A list of Supporting Material / References
Health is ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (WHO 1946).
Research over many years has uncovered the aspects of life that underlie healthy living and ageing, called the social determinants of health. They are responsible for the differences in health status between individuals and between countries; they are the “conditions into which people are born, grow, live, work and age”. Determinants are organised in a hierarchy—upstream to downstream. Individuals may have little control over upstream determinants (e.g. government policies, culture and societal values, and the natural and built environments) but have more control of downstream determinants (e.g. smoking, diet, and physical activity).
Socioeconomic characteristics (intermediate determinants) are located between, and influence, upstream and downstream determinants: education (including health literacy), employment, income, social class, gender, ethnicity, access to services, social cohesion, housing, and food security. Socioeconomic characteristics are related and can be cyclical in nature, e.g. the level of education can determine employment and income. Income can determine quality of housing, one’s social class and access to services. Social class and income can then impact on the importance and level of education helping to reinforce this relationship and maintaining the cycle. People have some control, but not total control over these intermediate, socioeconomic determinants and most control over downstream determinants.
Downstream determinants include people’s material circumstances, behaviours, biological factors and psychosocial factors: tobacco use, alcohol consumption, physical activity, dietary behaviour, use of illicit drugs, sexual practices, vaccination, stress, torture, risk taking, blood pressure, blood cholesterol, body weight, and immune status. Again, people’s ability to either avoid or adopt healthy practices can be determined by the higher determinants, e.g. health literacy, employment, and social class may determine whether healthy behaviours take precedence over unhealthy behaviours. In general, those in the lower social gradients have the poorer health.
Research indicates that five of the most influential and most challenging determinants of health are (i) class and social gradient, (ii) early childhood development, (iii) poverty, deprivation and social exclusion, (iv) health literacy, and (v) gender
From Australia’s Health 2018
Over the past 10 years there have been improvements in the following health areas:
The incidence of heart attacks
Incidence of bowel cancer
Severe or profound core activity limitation
Adults who are daily smokers
Adults at risk of long-term harm from alcohol
Immunisation rates for children aged 1 and 5 years
Over the past 10 years there have been declines in the following health areas:
Hospitalisation for injury and poisoning
People who are overweight and obese
Waiting time for elective surgery
Over the past 10 years there has been no change in the following health areas:
Incidence of end-stage kidney disease
Incidence of lung cancer
Immunisation rates for children aged 2 years
Potentially preventable hospitalisations
Waiting time for emergency department care
Leading causes of death in Australia include the following, described in more detail later in this summary:
1. Coronary heart disease
3. Cerebrovascular disease (predominantly stroke)
4. Lung cancer
5. Chronic obstructive pulmonary disease
Half of Australians have a chronic condition. Chronic conditions are generally long lasting, require ongoing management and have a substantial effect on individuals, their families and carers, and the health system.
One in 2 (50%) Australians are estimated to have at least 1 of 8 selected common chronic conditions: cancer, cardiovascular disease, mental health conditions, arthritis, back pain and problems, chronic obstructive pulmonary disease, asthma and diabetes.
Nearly 1 in 4 (23%) Australians are estimated to have two or more of these conditions. The three chronic conditions that contribute most to the disease burden in Australia are cancer, coronary heart disease and mental illness.
People with chronic conditions are generally less likely than other Australians to be employed, and are generally more likely to have disability and experience psychological distress, body pain and poor health.
Cancer is the leading cause of disease burden. Breast cancer is the most commonly diagnosed cancer for females, and prostate cancer for males. However, lung cancer is the leading cause of cancer death for males and females.
Coronary heart disease (CHD) and stroke death rates have fallen. Many of the risk factors for CHD and stroke can be modified through lifestyle changes and there are also treatment options available for these conditions.
Nearly half of Australians will experience a mental illness in their life—most commonly anxiety, substance use disorders (especially alcohol use) and mood disorders (especially depression).
More Australian teens are saying ‘no’ to smoking, alcohol and illicit drugs.
10% of mothers reported smoking at some point during their pregnancy in 2015, down from 15% in 2009
56% of mothers abstained from drinking alcohol during pregnancy in 2016, up from 40% in 2007.
Almost two-thirds (63%) of Australians aged 18 and over, and more than one-quarter (28%) of children aged 5–17 are overweight or obese. Overweight and obesity are risk factors for a number of chronic conditions. Overweight or obese adults report higher rates of arthritis, back pain and problems, diabetes and cardiovascular diseases than adults in the normal weight range. Being overweight or obese is associated with low physical activity, frequent medication use, poor diet, smoking, drinking alcohol and lower life satisfaction (Swami, et al., 2020).
Australians are not eating a healthy diet or doing enough exercise. More than 99% of all children and 96% of adults do not eat the recommended amount of vegetables. Additionally, more than two-thirds of children and almost half of adults do not follow the recommendation to limit their consumption of free sugars to less than 10% of total energy intake. Australians are not doing the recommended amount of exercise for their age each week. This is most pronounced among adolescents (aged 13–17), where 92% do not get the recommended amount of exercise.
Just over 1 in 3 (6 million) Australian adults have high blood pressure.
Differences between Indigenous and non-Indigenous Australians in three key areas help explain the well-documented health gap:
Social determinants: Indigenous Australians, on average, have lower levels of education, employment, income, and poorer quality housing than non-Indigenous Australians
Health risk factors: Indigenous Australians, on average, have higher rates of smoking and risky alcohol consumption, exercise less, and have a greater risk of high blood pressure than non-Indigenous Australians
Access to appropriate health services: Indigenous Australians are more likely to report difficulty in accessing affordable health services that are nearby than non-Indigenous Australians.
Social determinants are estimated to be responsible for more than one-third (34%) of the health gap between Indigenous and non-Indigenous Australians, and health risk factors such as smoking and obesity are estimated to account for about one-fifth (19%) of the health gap.
Generally, the higher a person’s socioeconomic position, the better their health. Compared with people in the highest socioeconomic group, people in the lowest group are:
2.7 times as likely to smoke
2.6 times as likely to have diabetes
2.4 times as likely to state cost as a barrier to seeing a dental professional
2.3 times as likely to state cost as a barrier to filling a prescription
2.1 times as likely to die of potentially avoidable causes
Health in major cities, inner regional and outer regional/remote areas:
Diseases causing the most burden in 65-85+ age groups
Source - Health Direct: https://www.healthdirect.gov.au/
Coronary heart disease
There are two forms: heart attack and angina. It is caused by lifestyle habits and other conditions: smoking, high cholesterol, high blood pressure (hypertension), and diabetes. Both types can be treated by various medications. To reduce risk and aid recovery, take your medicines as prescribed, be smoke-free, enjoy healthy eating, be physically active, control your blood pressure and cholesterol, achieve and maintain a healthy body weight, and maintain your psychological and social health.
Dementia is not a normal part of ageing - most older people do not have dementia. Over a period of months or years, most people with dementia gradually:
lose their memory – at first for recent events, and later for events further back in their lives
have a personality change
lose interest in life
withdraw from their usual activities
lose their ability to care for themselves and for others around them.
Chronic obstructive pulmonary disease (COPD)
Many people with COPD have a combination of emphysema, chronic bronchitis and asthma. Symptoms include
Getting out of breath more easily than others your age when doing things like climbing stairs, walking up a hill or even having a shower.
A new, persistent or changed cough.
A build-up in the lungs of a sticky substance called phlegm, which you swallow or cough-up.
Treatment includes (i) stop smoking, (ii) seek help from health professionals, (iii) exercise, (iv) have annual flu injections and act quickly if symptoms worsen, (v) join a support group
Symptoms of lung cancer include: coughing, unexplained weight loss, shortness of breath, and chest pain. Lung cancer is usually treated with a combination of chemotherapy, radiotherapy and surgery.
There are two types of stroke: ischaemic (85%)—a clot forms in one of the blood vessels supplying the brain)—and haemorrhagic (15%)—a rupture of one of the arteries in the brain. Stroke commonly presents with loss of sensory and/or motor function on one side of the body (85% of ischemic stroke patients have hemiparesis), change in vision, gait (walking), or ability to speak or understand or sudden, severe headache. Risk factors include hypertension, diabetes, smoking, excess alcohol consumption, obesity and lack of exercise.
Diabetes is the name given to a group of different conditions in which the body cannot maintain healthy levels of glucose (a type of sugar) in the blood. The main symptoms are: feeling very thirsty, urinating frequently, particularly at night, feeling very tired, and weight loss and loss of muscle bulk. People with type 1 diabetes cannot produce insulin and require lifelong insulin replacement for survival. Type 2 diabetes is associated with hereditary factors and lifestyle risk factors including poor diet, insufficient physical activity and being overweight or obese. It can be controlled by lifestyle changes or insulin replacement. Gestational diabetes occurs during pregnancy and usually disappears once the baby is born.
Arthritis including osteoarthritis and rheumatoid arthritis
Symptoms of arthritis include pain, swelling, redness and heat, and stiffness or reduced movement. Treatment may include medication or pain management techniques such as meditation. Management includes the following: maintain a healthy weight, eat a well-balanced diet, exercise regularly, learn ways to manage your pain, and seek support when you need it.
Three key characteristics of osteoarthritis are:
mild inflammation of the tissues in and around the joints
damage to cartilage, the strong, smooth surface that lines the bones and allows joints to move easily and without friction
bony growths that develop around the edge of the joints.
Risk factors include excess weight or obesity, joint injury, repetitive kneeling or squatting and repetitive heavy lifting.
Rheumatoid arthritis (RA) is an autoimmune disease that causes pain and swelling in the joints. This happens because the immune system attacks the lining of the joints causing inflammation and joint damage. RA usually affects the smaller joints, such as those in the hands, feet and wrists, although larger joints such as the hips and knees can also be affected.
Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and more likely to break (fracture). These fractures most commonly occur in the spine, wrist and hips, but can affect other bones such as the arm or pelvis. There are often no warning signs. Treatment for osteoporosis is based on treating and preventing fractures and using medication to strengthen your bones.
Prostate Cancer (From Sax Institute, 2021)
Older Australians with prostate cancer are twice as likely to receive surgery over radiotherapy, despite similar survival rates, according to new research from the 45 and Up Study. Both treatments have similar survival rates, but distinctly different side effects and costs, with surgery linked to higher rates of urinary incontinence and sexual dysfunction, and generally higher out-of-pocket costs. Radiotherapy is a much less invasive intervention but still has potential side effects, such as rectal bleeding. Education programs about treatment options are needed to better inform patients, caregivers and their physicians.
Source: CFCA Paper 55 and Practice Guide
Estimates in Australia suggest that between 4% and 13% of the general population are food insecure; and 22% to 32% of the Indigenous population, depending on location. Australians who are more vulnerable to food insecurity are low-income earners, people who are socially or geographically isolated, Aboriginal and Torres Strait Islander peoples, CALD groups, single-parent households, older people and people experiencing homelessness. The primary reason for food insecurity is material hardship and inadequate financial resources. For children, food insecurity can have negative short- and long-term effects academically, socially, emotionally, physically and developmentally.
Screening for food insecurity can be part of a BPSS. The strategies required to address food insecurity for all Australians are many and varied. These include policy interventions; local level collaborations; emergency food relief initiatives; school-based programs and education.
Women affected by domestic and family violence are particularly vulnerable to food security issues. These women may face controlled finances (e.g. withholding money), the restriction of money for food, and financial hardship after leaving an abusive partner. Food insecurity also leads powerlessness exhibiting in restricted decision making by women, e.g. the ability to leave an abusive relationship (Paterson & Farrugia, 2020).
Frailty (and Depression, Deit and Gender)
New results from the Framingham Heart Study (Lowry, 2021) reveal middle-aged and older adults with depressive symptoms who reported consuming a pro-inflammatory diet were 28% more likely to go on to develop frailty as their peers who did not have depression, but who also consumed a pro-inflammatory diet.
Frailty is most often defined as an aging-related syndrome of physiological decline, characterized by marked vulnerability to adverse health outcomes. Frail older patients often present with an increased burden of symptoms including weakness and fatigue, medical complexity, and reduced tolerance to medical and surgical interventions.
A pro-inflammatory diet includes red meat, refined carbohydrates, and sweetened beverages like colas. It has previously been associated with increased depression risk and increased frailty.
Prior to this study, it wasn’t clear if depressive symptoms exacerbate the effect of a proinflammatory diet on frailty onset.
The study included 1712 adults (mean age, 58 years; 45% male). Depressive symptoms and diet assessment were measured in 1998-2001 and again in 2011-2014. Over the 16-year study period, 227 participants became frail. Participants who became frail scored much higher on the pro-inflammatory diet scale (0.08) than the full study group and the non-frail individuals (–0.17 and –0.20 respectively). Participants who became frail also scored significantly higher on the depression instrument.
The study's finding suggest dietary modification may be a useful strategy for frailty prevention, especially in those with depressive symptoms.
Recent research around frailty in middle-aged and older people also highlighted its link to diet and gender. An Australian study (Xu, Inglis and Parker, 2021) using data from the 45 and Up Study found links between diet, gender and frailty. Using data stretching back to 2006 Xu et al. were able to track the dietary changes of both men and women over the long term. They found that men were more likely to have better diets as they aged, while women’s eating habits got worse. These changes in diet affect the odds of frailty, with results showing that females were more likely to suffer from frailty than men – particularly women over the age of 80 who were widowed, with low education levels and from low socioeconomic areas. Conversely, men and women who had diets rich in fruits, grains, or ate a variety of foods, had a low risk of frailty. Furthermore, women who added lean meat and poultry to their diet, were less frail. These results support previous research that shows eating a variety of healthy foods is one key to preventing frailty. Xu et al. suggest that developing dietary advice tailored to each gender could go some way towards preventing frailty.
Source: Australian Dietary Guidelines, 2013.
Enjoy a wide variety of nutritious foods from these five groups every day:
Plenty of vegetables, including different types and colours and legumes/beans
Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat milks are not suitable for children under the age of 2 years)
And drink plenty of water.
Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks.
Replace high fat foods which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods which contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.
low fat diets are not suitable for children under the age of 2 years.
Limit intake of foods and drinks containing added salt.
Read labels to choose lower sodium options among similar foods.
Do not add salt to foods in cooking or at the table.
Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.
If you choose to drink alcohol, limit intake. For women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.
At least one-third of people aged 65 years and older fall once or more each year. Exercise prevents falls among older adults living in the community by 21% (Sherrington, et al. 2017; Tiedemann et al., 2021). The most effective programs include a high level of challenge for balance and a high dose of exercise, i.e. 3 hours per week (Sherrington, et al., 2017). As health and exercise professionals are well placed to prescribe fall prevention exercise in their daily practice, it is crucial that health and exercise professionals have the knowledge and skills to prescribe appropriate fall prevention exercise (Tiedemann et al., 2021). Sherrington et al. (2017) recommend the following for fall prevention practice in community-dwelling older people:
Exercise programmes should aim to provide a high challenge to balance. Choose exercises that involve safely:
reducing the base of support (e.g., standing with two legs close together, standing with one foot directly in front of the other, standing on one leg);
moving the centre of gravity and controlling body position while standing (e.g., reaching, transferring body weight from one leg to another, stepping up onto a higher surface); and
standing without using the arms for support, or if this is not possible then aim to reduce reliance on the upper limbs (e.g., hold onto a surface with one hand rather than two, or one finger instead of the whole hand).
At least 3 hours of exercise should be undertaken each week.
Ongoing participation in exercise is necessary or benefits will be lost.
Fall prevention exercise should be targeted at the general community as well as community-dwellers with an increased risk of falls.
Fall prevention exercise may be undertaken in a group or home-based setting.
Walking training may be included in addition to balance training, but high-risk individuals should not be prescribed brisk walking programmes.
Strength training may be included in addition to balance training.
Exercise providers should make referrals for other risk factors to be addressed.
Exercise as a single intervention may prevent falls in people with Parkinson’s disease or cognitive impairment. There is currently no evidence that exercise as a single intervention prevents falls in stroke survivors or people recently discharged from hospital. Exercise should be delivered to these groups by providers with expertise in the areas in question.
Brown, Moorhead and Marshall (2005) provide a physical activity guide for older Australians. Likewise, the Australian Government, Department of Health (2014) provides tips and ideas for older Australians that addresses balance, strength and activity in general.
Person-centred practice is about partnering with consumers / patients / clients / service users. It is based on self-management where social workers have to work with people’s beliefs, knowledge and aims, emotions and motivations and do so within their, not the social worker’s social framework.
Work with people to motivate them to help themselves, i.e. engage in self-management. There are seven components to this:
Beliefs – correct faults and health beliefs that lead to unhelpful actions
Coping actions – check for unhelpful self-management, e.g. fear, avoidance
Motivation – increase motivation, find out the patient’s agenda using motivational interviewing methods to avoid confrontation
Confidence (self-efficacy) – increase confidence by building up goals in small steps
Control – increase perceived control over the illness
Anxiety & depression – relaxation and breathing, self-help or referral
Self-management skills – show proper use of medications, increase activity, how to lose weight, etc.
Food Insecurity (From CFCA Practice Guide)
Screening for food insecurity can be part of a BPSS assessment, e.g. ‘The next two questions are about your food situation. We know that going without food happens to lots of Australian families now and again. These questions will let us know about your food situation and help us understand what support you might need to get through these times. For each question, can you tell me whether this is often true, sometimes true, or never true for your household in the last 12 months:
Have you ever worried that food will run out before you are able to buy more?
Have you run out of food and not had enough money to buy more?’
Best-practice strategies to support food insecure households include:
Emergency food relief initiatives: pantry-style services; food trucks; pop-up and mobile markets; community meals; soup kitchens; emergency relief hampers; and meals at homeless shelters or women’s refuges
School breakfast club programs
Café/restaurant meal voucher programs
Nutrition education programs to assist with identifying healthy foods: getting value for money, balancing food groups, budgeting, storage and preparation skills
Older men are less likely than older women to seek help for mental and physical health issues until their condition worsens. Poor adherence to pharmacological therapies is fundamentally a behavioural problem for men. It may be advantageous to capitalize on men’s desires for independence, anxiety-reduction, and control by highlighting and clearly explaining how they can be proactive in their own treatment, especially with regard to behavioral and self-management strategies. Evidence shows that if men are given some power to negotiate on specific aspects of lifestyle change, it can result in at least partial adherence.
Potential social network interventions to engage men “where they live” include the following.
Include spouse or family members in clinic visits to engage, educate, and empower as agents in man’s health management
Create ‘resource maps’ of men’s social networks (family, friends, religious, community) with delineated roles and contact information; distribute to network members
Invite healthy male patient or spouse of chronically ill male patient to co-deliver talk about lifestyle change or health management at senior centers, community centers or churches
Social Connectedness Among Australian Males (Quinn et al., 2021)
Social connectedness comprises three domains:
Self-perceived social support – availability of tangible social interactions, companionship and support systems
Attachment relationships – number and quality of relationships with family, friends, and colleagues
Community integration – employment status, participation in community-based sport, hobby, volunteering, religion and other activities
These three domains are important for optimal health and overall wellbeing and longevity. Conversely, having limited social connectedness is associated with a variety of poorer mental health outcomes and risk behaviours including depression, substance use, suicidality and personality disorders. It is also associated with adverse physical health outcomes, e.g. obesity, sleep problems and cardiovascular disease.
A significant minority of adult males experience limited social connectedness. Being unemployed, being single and living alone are significantly associated with less social support and relationship satisfaction after adjusting for other factors. Older age is also independently associated with lower perceived social support and relationship satisfaction, as is greater conformity to masculine norms.
There is evidence of a bidirectional association between depression and self-support, i.e. the experience of depressive symptoms may cause reduced social support and vice versa.
Adult males who experience functional difficulty in 2015/16 are typically less socially connected than those without difficulty; they are older, live alone, are less likely to be employed, and are more likely to have no close friends or relatives. Functional difficulty domains include the visual, auditory, mobility, cognition, self-care and communication areas
Men who engage in certain community-based activities report significantly greater average levels of perceived social support compared to those who do not take part. Furthermore, involvement in community-based activities is shown to directly improve personal wellbeing, while also enhancing perceived social support, which further indirectly and positively affects wellbeing.
Cancer (Schiena et al., 2019)
Parents diagnosed with cancer have unique needs including concern about the impact on their children and families. Social workers should be proactive in identifying patient needs and ensuring services and supports are provided in a timely way. The challenges faced by parents with a diagnosis of cancer include:
Emotional impact on the patient The emotional impact on the patient was reported in the context of guilt arising from complex negotiations between the need to self-care and attending to the needs of children, partners, extended family, and others.
Accessing professional supports Access to professional support was deemed crucial in dealing with the numerous aspects of parental cancer.
Children’s understanding Explaining the illness to children and ensuring continued support were parents’ primary concerns.
Meeting children’s needs An important and urgent concern was ensuring children’s ongoing needs were met.
(available on request)
Australian Government, Department of Health. (2014). Physical activity and sedentary behaviour guidelines – older Australians (65 years and over) – tips and ideas for being active. Retrieved from https://www.health.gov.au/resources/publications/physical-activity-and-sedentary-behaviour-guidelines-older-australians-65-years-and-over-tips-and-ideas-for-being-active
Australia’s Health 2016, AIHW. Retrieved from https://www.aihw.gov.au/reports/australias-health/australias-health-2016/contents/chapter-4-determinants-of-health
Australia’s Health 2018 in brief
Australia’s Health 2018.
Brown, W.J., Moorhead, G. E., & Marshall, A. L. (2005). Choose health: Be active. A physical activity guide for older Australians. Canberra: Commonwealth of Australia and the Repatriation Commission. Retrieved from https://www.health.gov.au/sites/default/files/documents/2021/03/choose-health-be-active-a-physical-guide-for-older-australians.pdf
Understanding Food Security in Australia. CFCA Paper 55 (Child Family Community Australia), 2020.
Identifying and Responding to Food Insecurity in Australia. CFCA Practice Guide, 2020.
Australian Dietary Guidelines, 2013.Retrieved from https://www.eatforhealth.gov.au/sites/default/files/content/n55_australian_dietary_guidelines.pdf
Lowry, F. (2021).Depressive symptoms plus inflammatory diet add up to higher frailty risk.Medscape, March 31, 2021.Retrieved from https://www.medscape.com/viewarticle/948404?src=WNL_dne_210331_mscpedit&uac=410643FT&impID=3281866&faf=1#vp_1
Paterson, N., & Farrugia, C. (2020). Experiences of food insecurity for Australian women and children affected by domestic and family violence. Child Family Community Australia. Retrieved from https://aifs.gov.au/cfca/2020/12/02/experiences-food-insecurity-australian-women-and-children-affected-domestic-and-family
Quinn, B., Prattley, J., Rowland, B. (Eds.). (2021). Social connectedness among Australian males. Melbourne: Australian Institute of Family Studies. Retrieved from https://tentomen.org.au/research-findings/social-connectedness-among-australian-males
Sax Institute. (2021). Prostate cancer: Are men making informed choices about their treatment? Retrieved from https://www.saxinstitute.org.au/our-work/45-up-study/ (search for “prostate cancer”)
Schiena, E., Hocking, A., Joubert, L., Wiseman, F., & Blaschke, S. (2019) An Exploratory Needs Analysis of Parents Diagnosed with Cancer, Australian Social Work, 72(3), 325-335, doi: 10.1080/0312407X.2019.1577472
Sherrington C, Michaleff ZA, … Herbert, R. D., & Lord, S. R. (2017). Exercise to prevent falls in older adults: an updated systematic review and meta- analysis. British Journal of Sports Medicine, 51, 1750-58. 2017;51:1750–58. http://dx.doi.org/10.1136/ bjsports-2016-096547
Swami, N., Quinn, B., Terhaag, S., & Daraganova, G. (2020). Overweight and obesity among Australian males. Ten to Men: The Australian Longitudinal Study on Male Health. Retrieved from https://tentomen.org.au/sites/default/files/publication-documents/2020_ttm_insights_report_chapter_3.pdf
Tiedemann A, Sturnieks DL, Hill A-M, Lovitt L, Clemson L, Lord SR, Sherrington C. (2021). Impact of a fall prevention program for health and exercise professionals: a randomised controlled trial. Public Health Research and Practice, 31(3):e30342013. https://doi.org/10.17061/ phrp30342013
Xu, X., Inglis, S. C., & Parker, D. Sex differences in dietary consumption and its association with frailty among middle-aged and older Australians: A 10-year longitudinal survey. BMC Geriatrics, 21, 217-229. https://doi.org/10.1186/s12877-021-02165-2