Use of Longitudinal and Linked Population Data in Health Research
Program Leader: Professor Julie Byles
Population data are important for understanding not only patterns of use of health services, but also the impact of health care use on the health of the community. Such data may be derived from routine data sets (such as hospital separations data) or may be collected through population surveys. Longitudinal population surveys are particularly useful for determining the trends in health service use within and across different population groups and communities, factors associated with health care use, and those patterns of use that are associated with better physical and mental health over time. These studies are of increasing interest and importance as the average age of the population increases and the demands on health care expand.
This strand of our research activities builds on the group's experience in dealing with population data from routine data sources and from population surveys, and our investment into the development of longitudinal studies to explore issues of healthy ageing.
Three studies will provide the infrastructure on which to build this capacity:
- The Australian Longitudinal Study on Women's Health (ALSWH) involves over 40,000 women in three age groups (Age at baseline in 1996: 18-23, 45-50, 70-75) who have now been surveyed repeatedly since 1996. Women in rural areas were deliberately over-sampled to provide a valuable source of information on rural issues. Survey data are linked to data from Medicare Australia and Pharmaceutical Benefits Scheme (PBS), hospital seperations data for NSW and plans are underway to also link with Home and Community Care (HACC) data, Aged Care data and other health service data sets and disease registries.
- The 45 and up study involves 266,000 people. Survey data are to be linked to Medicare Australia, PBS, NSW Hospital data, NSW HACC data, NSW Cancer registry. There is an intention to collect biological data from participants at some future time.
- The Hunter Community Study (HCS) expects to recruit up to 10,000 individuals. Participants have provided consent for linkage to Medicare Australia, PBS, NSW Hospital data, NSW Cancer registry, the Hunter Heart and Stoke register, other local registers. The Hunter Community Study is based within NIPH-HMRI. Clinical and biological data are also collected, and biological samples are stored for later analysis.
In addition investigators in the Centre are also closely involved in two large NHMRC grants to combine data from longitudinal studies:
- Dynamic Processes of Ageing (DYNOPTA) combines data from nine longitudinal studies of ageing.
- Men, Women and Ageing combines data from the ALSWH and the Perth Men's study, allowing gendered analyses of changes associated with age.
These sets of studies provide enormous infrastructure for understanding the interplay between health and health care utilization for people across the adult lifespan. Our research program involves powerful and robust analyses regarding a number of important research questions, including:
- Factors associated with maintenance of independence and mobility at later ages.
- Incidence, natural history and prevention of chronic conditions, including cognitive impairment, chronic airflow limitation, cardiovascular disease, diabetes, obesity, and cancer.
- Prevention of falls and fractures through behavioural and environmental factors.
- Impact of chronic conditions (eg. arthritis, asthma, diabetes, cardiovascular disease) and medication for these conditions on health and health services use.
- Adequacy of treatment of depression and other mental health needs.
- Chronic disease self management and rehabilitation.
- The role of informal carers in providing services for frail aged and disabled persons.
- Differential need for and access to health services across urban, rural and remote areas, and across socio-economic determinants of health.
The information provided will be critical in understanding the health needs of the community, those factors within individuals, communities, and health care systems that are most effective in averting or meeting health needs, and how individuals and communities can better manage their health.