Research that’s helping realise optimal health for all women

Well-known and respected researcher Professor Deb Loxton is a passionate advocator for women’s health. Through her work, she’s not only assisting understanding but also informing and positively impacting policy for equality.

Deb is interested in the things that help women lead the lives they want to live.

Working in the field of women’s health research and surveying women across Australia, she’s attempting to identify the factors that lead to wellbeing in women—and those that damage it over the course of a lifetime.

“I have a passion for understanding how different events, especially trauma, impact women’s wellbeing and am especially intent on detecting those elements of life that can mitigate those adverse impacts”, Deb explains.

In line with this, her research over the years has had a strong focus on the impact of violence on women’s health and wellbeing, as well as the wellness of women having children. It’s work she feels privileged to be involved in.

Researchhubs and policy impact

Deb is the Director of the Centre for Women’s Health Research (CWHR) at the University of Newcastle, driven by the vision of optimal health for all women. This vision continues to guide her work when shaping the Centre’s strategic goals.

Deb’s commitment to this vision also informs her role in the Hunter Medical Research Institute’s (HMRI) Women’s Health Program, Australia’s largest regional medical research institute.

Her main approach to translating research is through influencing policy. This involves authoring policy briefs, preparing reports and presenting her findings to government departments.

Throughout her career, Deb has published over 260 peer-reviewed articles and 41 government reports, securing more than $50 million in grant funding from both competitive and direct sources. Her research has significantly contributed to policy development, including the National Women’s Health Strategy (2020-2030).

ALSWH: a leading longitudinal study

A significant area of Deb’s research work is as director of the globally substantial Australian Longitudinal Study on Women’s Health (ALSWH)—the largest and longest-running survey of its kind in the country.

This population-based survey that began in 1996 is housed within the CWHR, funded by the Australian Government Department of Health and Aged Care and jointly managed with the University of Queensland. It tracks four generations of more than 57,000 women, exploring a range of health and wellbeing outcomes across the lifespan.

The study was the first to investigate the health impacts of domestic violence over such a long period—an issue that has really come into focus in recent years, thanks to advocacy campaigns, media coverage and the apparent COVID surge.

“Violence is a big term and incorporates emotional abuse, financial abuse, physical abuse, sexual abuse and harassment”, says Deb.

“If you think about any four women in your life, the statistics suggest at least one of them has lived with a violent partner, or will, at some point in their lifetime. And it doesn't just happen to people who live a certain sort of life. It happens across the board.”

Overcoming the enduring impact of DV

Deb’s research reveals that the impact of domestic violence on physical and mental health can last for decades—and potentially for a lifetime.

“We have data showing women 15 years post-violence with the same deficit in physical and mental health they had when they were in the relationship.”

Deb explains that violence can lead to an array of complex health problems, including depression, anxiety and even chronic pain and diseases such as cervical cancer.

She’s particularly interested in the cumulative impact of different experiences of abuse, such as abuse in childhood followed by violence in later life. Her goal is to identify factors that facilitate recovery so solutions can follow.

What she’s shown is that ending violence is not sufficient to improve women’s health. There needs to be a focus on recovery from violence, and a life course perspective should be adopted when addressing violence against women.

These factors have all been considered in the most recent National Plan to End Violence Policy against Women and Children 2022-2030. The goal is to end gender-based violence within a generation.

Following on from this, she’s now working at the community level with the Primary Healthcare Network to develop evidence-based recommendations to facilitate recovery from violence.

She’s also leading an investigation into the elements of trauma-informed care to understand better the ways in which people successfully and mindfully work with women who have experienced trauma.

Maternal mortality and morbidity

Alongside domestic violence, Deb is also involved in collaborative global research (also through CWHR) into maternal and infant mortality and morbidity.

Despite progress towards reducing maternal and infant mortality rates, the situation remains dire for millions of mums and babies worldwide, she says.

“The 2015 Millennium Development Goals to reduce these rates was not achieved in many low-middle income countries. In Australia, some adverse birth outcomes and maternal mental health remain serious issues.”

To address this, Deb developed the Worldwide Wellness of Mothers and Babies (WWOMB) program, which aims to eliminate preventable maternal and infant mortality and morbidity globally .

“The program generates new knowledge about health services for maternal and infant wellbeing and investigates health behaviour during pregnancy, such as alcohol use and the use of mental health services.”

Thanks to the hard work of Deb and her team, they’ve seen results translated into policies in two countries and hope to do more in this area.

Uncovering healthcare gender bias

A strong advocate for women in the healthcare space, another string to Deb’s bow is being a member of the National Women’s Health Advisory Council.

The Council provides the Australian Government with strategic advice on improving our health system for women and girls. It aims to provide a better, more targeted healthcare system for our women and girls and ensure it’s culturally safe and appropriate.

To this end, they’ve been examining how women experience healthcare and the often adverse outcomes of patriarchal approaches.

They recently conducted a landmark research survey, which resulted in the #EndGenderBias survey report, which describes how Australian women have experienced barriers and bias in the health system.

“We discovered that two-thirds of women report having experienced healthcare-related gender bias or discrimination themselves”, shares Deb.

They found that sexual and reproductive health and chronic pain were the top areas where women experienced gender bias. More than 70 per cent of women experienced bias in the diagnosis and treatment of health conditions. And more than 70 per cent of women reported they experienced bias in GP visits.

“The report also showed that Australian women commonly felt unheard and not taken seriously by their medical practitioner.”

The systemic and structural disadvantage of gender bias in health care has far-reaching implications for the health and outcomes of Australian women. The findings of the report clearly demonstrate the need to listen to the experiences of Australian women and find solutions to address women’s health.

Goals going forward

Deb shares that her high-level goals going forward are three-fold:

Firstly, to continue to provide the information necessary to design policies and practices that mitigate the adverse impact of violence on women’s health. Secondly, to continue working towards the elimination of violence against women. And thirdly, to continue to work towards a maternal mortality rate of zero.