Health & place
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This article reports on research undertaken with members of three Indigenous groups in Victoria, Australia, to explore the health and wellbeing implications of caring for Country (defined as having knowledge, sense of responsibility and inherent right to be involved in the management of traditional lands). The research findings provide a better understanding of this key determinant of the health and wellbeing of Indigenous people in the context of public health where there are few existing published studies assessing this relationship. ⋯ This qualitative study involving semi-structured interviews identified that caring for Country offers great benefits, including building self-esteem, fostering self-identity, maintaining cultural connection and enabling relaxation and enjoyment through contact with the natural environment. Results generated indicate that caring for Country may offer a means of improving the current poor health status of Indigenous Australian peoples.
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The incidence of suicide exhibits marked geographic variability; however, documentation of features in its spatial distribution, or the magnitude of differences, is limited. Standardised mortality ratios, commonly presented in maps, are calculated in each area independently and incorporate no information about heterogeneity or clustering. Bayesian hierarchical models with random effects for between-area and local variability in neighbouring areas were used to map age- and sex-specific estimates of rate ratios of suicide across wards in England and Wales. ⋯ Although the geography of suicide differed across age/sex groups, some common patterns emerged e.g. high rates in (a) central parts of cities and (b) remote and coastal areas. Some features were common to all, while others appeared male specific or specific to the younger age group. Suicide prevention strategies can be informed by an understanding and addressing the geography of suicide.
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Since their establishment in 1992, Australian Immigration Detention Centres have been the focus of increasing concern due to allegations of their serious impact on the mental health of asylum seekers. Informed by Foucault's treatise on surveillance and the phenomenological work of Casey, this paper extends the current clinical data by examining the architecture and location of detention centres, and the complex relationships between space, place and mental health. ⋯ In particular, it is the embodied effects of surveillance and suspended liminality that impact on mental health. An approach which locates the embodiment of place and space as central to the poor mental health of asylum seekers adds an important dimension to our understandings of (dis)placement and mental health in the lives of the exiled.
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Drug addiction, violence and anti-social behaviour are characteristics of street prostitution. An alternative approach to zero tolerance is establishing a managed zone where sex workers operate according to regulations and can access health services. Using a consultation with sex workers (n=50), businesses (n=51), residents (n=179) and the public (n=789) we examined where a zone might be established in a UK city (Liverpool) and characteristics of the zone required by these stakeholders. ⋯ Sex workers (96%) agreed to work in a zone. Location criteria from all groups were used to identify two potential business areas to host a zone but businesses in or near these areas rejected plans through fear for staff safety and reduced business. We discuss the consultation process, difficulties in locating services for marginalised groups in cities and the implications for health and judicial policy relating to prostitution.
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Despite the growing international interest in place of death and its relationship to healthcare policy, virtually nothing is known about where people die in Australia. To address this gap our study employs a longitudinal, population-based retrospective cohort study of people who died in Western Australia over a 30-month period. Mortality, morbidity and palliative care service data sets from the Western Australian Data Linkage System were examined to provide demographic and disease-specific characteristics and healthcare service use in the last year of life for the 26882 people who died during this time. ⋯ People who accessed community-based specialist palliative care had a seven times higher chance of dying in their usual place of residence. Importantly, this information is provided, not just for cancer deaths, as has been the practice to date, but for a range of other painful and life-limiting conditions considered amenable to palliative care. The unique population data on palliative care service use, made possible by the data linkage system, provides a basis for planning health services and policies.