Factors Influencing Health For

The Older GLBTI Person :

A SEEF Perspective

Professor Julie Byles University of Newcastle

Research Collaborators

• Professor Julie Byles (University of Newcastle; SEEF Liaison)

• Peta Forder (University of Newcastle)

• Professor Andrew Grulich (The Kirby Institute, UNSW)

• A.Professor Garrett Prestage (The Kirby Institute, UNSW)

• Alan Brotherton (ACON)

• Diana Bernard (ACON)

• Adrian Bauman & the SEEF Investigators

0y 5y 10y

ROUTINE DATA

OTHER DATA LINKAGE

NESTED STUDIES

resurvey of selected individuals

recruitment 267,153 people follow-up follow-up

N=267,153 participants across NSW, Australia

courtesy of Professor Emily Banks

The SEEF substudy

• SEEF : the Social, Economic and Environmental Factors that influence the health of Australians in mid-later life – Information from this project will outline the most necessary

areas in which programs and policies should be directed to aid in improving the health of disadvantaged Australians

• A substudy of the 45 & Up Study – The first 100,000 people recruited to the 45 & Up Study were

invited to participate in the SEEF study – SEEF sample size n=60,404 participants (60.4% response)

• Questionnaire included a question on sexual orientation …

Sexual orientation – will people answer this?

Sexual orientation – comparison groups

Sexual orientation

Sex Age Heterosexual Homosexual Other

Men <65 11,851 (94.5%) 262 (2.1%) 433 (3.5%)

65+ 13,468 (94.8%) 137 (1.0%) 608 (4.3%)

Women <65 17,319 (95.9%) 237 (1.3%) 504 (2.8%)

65+ 11,859 (96.2%) 61 (0.5%) 413 (3.4%)

‘Other’ includes : bisexual; mainly heterosexual; and ‘I don’t know’

Proportion without a spouse/partner

%

0

10

20

30

40

50

60

70

<65 years 65+ years <65 years 65+ years

Men Men Women Women

Heterosexual Homosexual

Current Housing

0% 20% 40% 60% 80% 100%

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

<6

5 y

ears

65

+ ye

ars

<6

5 y

ears

65

+ ye

ars

Me

nW

om

en

House Flat/unit/apartment Other

Household income

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

<6

5 y

ears

65

+ ye

ars

<6

5 y

ears

65

+ ye

ars

Me

nW

om

en

<$20K $20-$49K $50-$79K $80-$119K $120-$149K $150K+

Smoking status

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

<6

5 y

ears

65

+ ye

ars

<6

5 y

ears

65

+ ye

ars

Me

nW

om

en

Non-smoker Former smoker Current smoker

Proportion exceeding alcohol consumption guidelines (>2 drinks/day, on average)

%

NOTE : Exceeding guidelines is defined as >2 drinks/day over a week

0

10

20

30

40

50

<65 years 65+ years <65 years 65+ years

Men Men Women Women

Heterosexual Homosexual

Body Mass Index

0% 20% 40% 60% 80% 100%

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

Heterosexual

Homosexual

<6

5 y

ears

65

+ ye

ars

<6

5 y

ears

65

+ ye

ars

Me

nW

om

en

Underweight Healthy Overweight Obese

General health

• Similar in terms of – Self-rated health (overall, quality of life, vision,

hearing & memory) – Requiring assistance with daily tasks (due to illness

or disability, self-care activities, physical movement, or communication activities)

– Falls in the past 12 months – Fractures in the past 12 months – Physical functioning (SF36-PF subscale) – Pain in the last 4 weeks

Health – chronic conditions

• Similar for some conditions – high blood pressure, – skin cancer, – melanoma – diabetes, – thrombosis, – Parkinson’s disease

• HIV or AIDS (text search in “other chronic conditions”)

– Heterosexual 2 cases (0.0%) – Homosexual 23 cases (3.3%)

Cancer

Cancer

Men, <65 Men, 65+ Women, <65 Women, 65+

Heterosexual

(n=11851)

Homosexual

(n=262)

Heterosexual

(n=13468)

Homosexual

(n=137)

Heterosexual

(n=17319)

Homosexual

(n=237)

Heterosexual

(n=11859)

Homosexual

(n=61)

Breast 0.2 0.0 0.3 0.0 4.9 5.1 8.7 16.4

Prostate 3.1 1.5 13.6 11.0 - - - -

Lung 0.2 0.0 0.5 0.0 0.1 0.4 0.4 0.0

Bowel 0.9 0.8 3.7 5.1 0.6 2.1 2.7 3.3

Anal 0.0 0.8 0.0 0.7 0.0 0.0 0.0 0.0

Cervical - - - - 1.2 2.1 0.7 1.6

NOTE : Anal cancer – only 9 cases reported (5 heterosexual women, 1 heterosexual man, 3 homosexual men) Cervical cancer – 296 cases heterosexual women, 6 cases homosexual women

Depression, anxiety & K10 score

Men, <65 Men, 65+ Women, <65 Women, 65+

Heterosexual

(n=11851)

Homosexual

(n=262)

Heterosexual

(n=13468)

Homosexual

(n=137)

Heterosexual

(n=17319)

Homosexual

(n=237)

Heterosexual

(n=11859)

Homosexual

(n=61)

Depression

Diagnosed 14.6 26.7 8.8 16.1 19.7 31.7 13.6 16.4

Treated 6.1 11.8 3.9 9.5 8.6 12.7 6.5 3.3

Anxiety

Diagnosed 9.4 17.6 6.0 11.0 14.2 17.3 11.1 9.8

Treated 3.8 6.9 2.5 6.6 5.8 6.3 4.8 3.3

K-10 score

High (22+) 6.5 10.3 4.7 8.3 7.3 7.3 5.2 1.7

Health checks and screening

Men, <65 Men, 65+ Women, <65 Women, 65+

Heterosexual

(n=11851)

Homosexual

(n=262)

Heterosexual

(n=13468)

Homosexual

(n=137)

Heterosexual

(n=17319)

Homosexual

(n=237)

Heterosexual

(n=11859)

Homosexual

(n=61)

Health checks

Blood pressure 90.3 90.4 97.3 98.5 89.2 87.3 96.5 93.4

Cholesterol 76.9 83.5 87.3 88.2 69.6 68.5 81.3 80.3

Skin cancer 52.7 56.2 66.7 65.4 48.6 43.6 59.6 51.7

Sugar levels 73.8 74.3 84.0 86.4 65.2 61.6 77.3 73.8

Bowel cancer 66.3 67.4 71.2 71.8 59.8 57.7 66.8 73.8

Advice

Exercise more 25.1 24.5 21.4 29.7 21.7 25.0 18.4 10.0

Quit smoking (current smokers only)

71.0 67.9 70.8 83.3 66.6 69.2 68.2 100.0

Conclusion

• Different patterns, according to age & gender

• Demographics and SES – more likely to be single, live in a flat/unit/apartment, with differences in average household incomes

• Different health risks regarding smoking, alcohol consumption and BMI

• For the most part, there are similar general health patterns, including general health checks and screening

• Some differences in selected cancers, HIV, depression and anxiety

Research Collaborators

• Professor Julie Byles (University of Newcastle; SEEF Liaison)

• Peta Forder (University of Newcastle)

• Professor Andrew Grulich (The Kirby Institute, UNSW)

• A.Professor Garrett Prestage (The Kirby Institute, UNSW)

• Alan Brotherton (ACON)

• Diana Bernard (ACON)

• Adrian Bauman & the SEEF Investigators