Social Inclusion
Determinants of HealthThe Social Inclusion research stream in Determinants of Health works collaboratively with communities, organisations and governments to promote social inclusion, and looks at ways to improve health and wellbeing, especially among individuals and groups who may be experiencing exclusion.
The Social Inclusion research stream focuses on improving health and wellbeing for individuals and groups, particularly those who may be marginalised due to social adversity, cultural diversity, gender identity, physical disabilities or geographic remoteness. We specialise in employing multidisciplinary approaches to tackle causes of exclusion in practical ways.
Our research profile is characterised by an acknowledgment of the multiple forms of exclusion and diversity of communities:
- promotion of individual creativity, agency and autonomy
- remaining optimistic that policies and practices that promote inclusion can be developed
- tackling causes of exclusion in practical ways
Our work is underpinned by:
- the development of mixed methodologies
- multidisciplinary approaches and the application of systems thinking
- the systematic review and synthesis of the research literature
- the importance of knowledge transfer and practice development
Our Social Inclusion stream leader is Professor Sharon Brennan Olsen. Email: sharon.brennanolsen@deakin.edu.au
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Health inequities and social policy
The health and wellbeing of individuals and communities is impacted by the broader social policy environment. This research work focuses on exploring the inequities experienced by particular social groups who are reliant on social and institutional policies. This includes a specific focus on women’s health and wellbeing and how reproductive decisions are impacted by policy, and low income families’ engagement with the welfare system. This stream is led by Dr Hayley McKenzie.
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Community engagement and citizen science
This body of research is based on the acknowledgement of community as an underutilised resource in research with a wealth of knowledge and skills to share. Our research encompasses a variety of projects, ranging from local to national, and encompassing international expertise. Projects are all based on the underlying foundations of co-design principles, participatory action, citizen science training, and, most importantly, meaningful collaboration with community and community-based stakeholders.
Various topics are currently being investigated: social isolation, loneliness, ageism, sense of purpose, self-esteem, deteriorating mental health and emotional wellbeing, and exclusion from society at the micro (immediate family), meso (social relationships) and macro levels (social and environmental structures and policies).
Current projects:
- Building a Community Legacy Together (BCLT) during a pandemic: Australian arm
- Giving it a Go: co-designing a support program for recipients of the Disability Support Pension to enhance re-engagement with work and society
- Indigenous co-designed model of knowledge sharing
Current/previous funding:
- Institute for Health Transformation: Building a Community Legacy Together (BCLT) during a pandemic: the Australian arm of an intergenerational knowledge sharing program
- Federal Government Department of Social Services: Giving it a Go – co-designing a support program for recipients of the Disability Support Pension to enhance re-engagement with work and society
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Social determinants of musculoskeletal health
There exists much evidence that poorer health outcomes in general are associated with social adversity at the micro (immediate), meso (surrounding environment) and macro (social structures and policy). It’s imperative to understand such relationships understand to inform future health policy and disease prevention and targeted treatment, where warranted. There’s also a growing body of evidence to suggest that the associations between social disadvantage and poorer health outcomes may be, in part, related to lower health literacy. This large body of work spans more than a decade, and encompasses osteoporosis, fracture, arthritis diseases, and sarcopenia, along with risk factors that are associated with musculoskeletal health outcomes such as vitamin D exposure, diagnosis methods, physical activity, chronic conditions and comorbidities, health service utilisation, and diagnosis and treatments that may inadvertently exclude marginalised populations.
Current projects:
- Multidisciplinary investigations of social equity in osteoporosis
- Sarcopenia: Environmental and Biological risk factors for older Adults (SEBA)
- Post-fracture care pathways that promote the return to pre-fracture quality of life and function
- Development of screening tool using self-reported measures to determine vitamin D deficiency
- Development of reference range standards for sarcopenia in community-based older adults
Recent publications:
- Brennan-Olsen SL, Vogrin S, Balogun S, Wu F, Scott D, Jones G, Hayes A, Phu S, Duque G, Talevski J, Naureen G, Winzenberg TM. Education, occupation and operational measures of sarcopenia: Data spanning six years from the Tasmanian Older Adult Cohort. Aust J Ageing, 24 September, 2020
- Miszkiewicz JJ, Brennan-Olsen SL, Riancho J (Editors). Bone health: A reflection of the social mosaic. Springer Nature, 2019. ISBN 978-981-13-7256-8 [Book].
Current/previous funding:
- NHMRC: Multidisciplinary translational research to address social disparities in osteoporosis: Understanding the social context of biological mechanisms
- Amgen: Study of Indigenous Bone and Muscle Ageing
- Hologic: Reference standards for body composition measures using Hologic DXA in Australian adults
- Sanofi: Vitamin D Screening Tool
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Social equity in healthcare
A key challenge for health systems is to ensure equity in the delivery of health care. Given this, a key element of health strategies should be aimed at improving equity of access to services for those experiencing social adversity and those marginalised or excluded from society.
Current projects:
- Equity of healthcare resource use in osteoporotic fracture patients: The Australian arm of the International Costs and Utilities Related to Osteoporosis Study
- Relevance of COVID-19 health messaging to Indigenous populations
Recent publications:
- Brennan-Olsen SL, Vogrin S, Graves S, Holloway-Kew KL, Page RS, Sajjad MA, Kotowicz MA, Livingston PM, Khasraw M, Hakkennes S, Dunning TL, Brumby S, Sutherland AG, Talevski J, Green D, Kelly T-L, Williams LJ, Pasco JA. Revision joint replacement surgeries of the hip and knee across geographic region and socioeconomic status in the western region of Victoria. BMC Musculoskeletal Disorders, 2019;20:300
- Brennan SL, Tallieu TL, Turner S, Bolton J, Quirk SE, Gomez F, Duckham R, Hosking SM, Duque G, Green D, Afifi TO. Arthritis in adults, socioeconomic factors, and the moderating role of childhood maltreatment: Cross-sectional data from the National Epidemiological Survey on Alcohol and Related Conditions. Osteoporosis International, 2019;30(2):363-373
- Talevski J, Sanders KM, Connaughton C, Duque G, Beauchamp A, Green D, Millar L, Brennan-Olsen SL. Effect of clinical care pathways on health-related quality of life and physical function following fragility fracture: a systematic review and meta-analysis. JAMDA, 2019;20(7):926.e1-926.e11
- Hyde NK, Brennan-Olsen SL, Wark JD, Hosking SM, Pasco JA. Maternal vitamin D in pregnancy and offspring bone measures in childhood: The Vitamin D in Pregnancy study. Bone, 2019;124:124-131
Current/previous funding:
- NHMRC: Multidisciplinary translational research to address social disparities in osteoporosis: Understanding the social context of biological mechanisms
- Sanofi: Vitamin D Screening Tool
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First Nations health
There is a four-to seven-fold increase in the prevalence of current mood, anxiety, substance use and any mental disorders in Indigenous adults compared with non-Indigenous Australians. The burden of disease attributable to mental health disparities account for as much as 16% in Indigenous Australians, which is likely a major underestimation given accurate data on the prevalence of mental disorders in Indigenous Australians have not been available. Musculoskeletal health is also much poorer in Indigenous compared to non-Indigenous populations. For instance, a higher risk of fracture, and a much-lower likelihood of being tested or treated for fracture-risk exists: a paradigm observed in many First Nations populations across the world. This body of research focuses on community consultation, co-designed research with Community, and a focus on developing, implementing and evaluating culturally appropriate treatment models for First Nations.
Current projects:
- Study of Indigenous Bone and Muscle Ageing (led by Monash University)
- Indigenous Model of Mental Health Care (IMMHC): RCT based on trans-diagnostic CBT program co-designed with Community (led by University of Queensland)
Recent publications:
- Nasir B, Brennan-Olsen SL, Toombs M. Implications of COVID-19 on a clinical trial of an Indigenous Model of Mental Health Care. MJA Insights. 2020, in press
- Brown KA, Toombs M, Nasir B, Kisely S, Ranmuthugala G, Brennan-Olsen SL, Nicholson GC, Gill NS, Hayman NS, Kondalsamy-Chennakesavan S, Hides L. How can mobile applications support suicide prevention gatekeepers in Australian Indigenous communities? Social Science Medicine, 2020, Online First, doi.org/10.1016/j.socscimed.2020.113015
- Brennan-Olsen SL, Vogrin S, Leslie WD, Kinsella R, Toombs M, Duque G, Hosking SM, Holloway KL, Doolan BJ, Williams LJ, Page RS, Pasco JA, Quirk SE. Fractures in Indigenous compared to non-Indigenous populations: A systematic review of rates and aetiology. Bone Reports, 2017;6:145-158, doi.org/10.1016/j.bonr.2017.04.003
Current/previous funding:
- Amgen: Study of Indigenous Bone and Muscle Ageing
- NHMRC Global Alliance for Chronic Diseases: IMMHC: RCT based on trans-diagnostic CBT program co-designed with Community
- Dyason Fellowship: Bone health in Canadian First Nations
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Influence of work-related and psychosocial exposures on health in lower and middle income countries
In higher income countries, work-related stressors are well-documented as influencing poorer health outcomes. In contrast, very little is known about psychosocial and physical work-related stressors on health outcomes in lower and middle income countries. This is despite an inextricable link existing between occupation and education in higher income countries, which may plausibly exist in lower and middle income countries with clear consequences for health outcomes. This body of research encompasses data from many lower and middle income countries, including Ghana, India, China, Mexico, Russian Federation and South Africa, and is founded on a continuing relationship with the World Health Organization’s Department of Health Statistics and Information Systems.
Current projects:
World Health Organisation’s Study on global AGEing and adult health (SAGE) – The role of work-related exposures, and psychosocial and sociodemographic influences on musculoskeletal health
Recent publications:
- Brennan-Olsen SL, Bowe SJ, Kowal P, Naidoo N, Snodgrass JJ, Quashie NT, Agrawal S, Eick G, D’Este C. Functional measures of sarcopenia: prevalence, and associations with physical disability in 10,461 adults aged 65 years and over from six lower- and middle-income countries. Calcified Tissue International, 2019;105(6):609-618
- Green D, Williams LJ, Pasco JA, Brennan-Olsen SL. Cancer and body composition: An association of global relevance. Women’s Health Bulletin, 2019,6(3):e65315
- Brennan-Olsen SL, Solovieva S, Viikari-Juntura E, Ackerman IN, Bowe SJ, Kowal P, Naidoo N, Chatterji S, Wluka AE, Leech M, Page RS, Sanders KM, Gomez JF, Green D, Duque G, Mohebbi M. Arthritis diagnosis and symptoms are positively associated with specific physical job exposures in lower- and middle-income countries: Cross-sectional results from the World Health Organization’s Study on global AGEing and adult health (SAGE). BMC Public Health, 2018;18(1):719.
Current/previous funding:
- NHMRC: Multidisciplinary translational research to address social disparities in osteoporosis: Understanding the social context of biological mechanisms
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Our staff
Professor of Social Inclusion:
Professor Sharon Brennan-Olsen
Researchers:
Students:
Ghazala Naureen, PhD candidate
Mizghan Fatima, PhD candidate (co-supervised)
Erika de Regina Chambriard, PhD candidate (co-supervised)
Honoraries: