Previous studies found an association between depression and osteoporosis and/or fracture in adults; however, the relationship is under-researched in Australia. This longitudinal study examined osteoporosis and fracture risk among middle-aged Australian women with depression.

We analysed survey and linked Pharmaceutical Benefits Scheme (PBS) data of 11,226 women from the Australian Longitudinal Study on Women’s Health (ALSWH) who were born from 1946 to 1951 and followed up from 2001 to 2019. Depression was defined by affirmative answers to the survey question- “In past three years, have you been diagnosed or treated for: Depression?” Osteoporosis was defined by the first prescription date of any antiosteoporosis medications from PBS. Fracture was defined by the affirmative answers to the survey question- “In the last 12 months, have you: Broken or fractured any bone/s?” Fine-Gray competing risk regression model was used with death as a competing risk to examine osteoporosis and fracture risk among women with depression. Directed Acyclic Graphs were used to select potentially confounding variables
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1,263 (11.4%) women reported depression at the baseline survey. Women reporting a diagnosis or treatment of osteoporosis before baseline were excluded from the analyses. Both unadjusted (SHR: 1.09; 95% CI: 1.04-1.15; p= 0.001) and adjusted (SHR: 1.08; 95% CI: 1.02-1.14; p= 0.012) models showed increased events of osteoporosis among women with depression than women without depression. Both unadjusted (SHR: 1.44; 95% CI: 1.36-1.52; p= <0.001) and adjusted (SHR: 1.34; 95% CI: 1.26-1.43; p= <0.001) models also showed increased fracture events among women with depression than women without depression.

We concluded that among the middle-aged women of the ALSWH 1946-1951 birth cohort, depression increased the risk of osteoporosis and fracture in eighteen years. The results highlight the importance of regular bone health screening among adult women living with depression to prevent fracture-related morbidity and mortality in the community.

Objectives: As temperatures rise, there is an increase in the transmission and incidence of enteric infections such as Salmonella and Campylobacter. Our study aimed to estimate the current and future burden attributed to increasing temperature in Australia.
Methods: We obtained data on disability-adjusted life years (DALYs) related to Salmonella and Campylobacter infections from the Australian Institute of Health and Welfare (AIHW) Burden of Disease database for the years 2003 to 2018. To determine how temperature affects these enteric infections, we conducted a meta-analysis of previous studies. This allowed us to calculate the relative risks per 1°C temperature increase based on the Köppen-Geiger climate zone sub group. Using the comparative risk assessment (CRA) framework, we determined the threshold or theoretical minimum risk exposure distribution (TMRED) for each climate zone. This information enabled us to assess the burden of Salmonella and Campylobacter infections attributed to temperature at different climate zone and Jurisdiction level. during the baseline period (2003–2018) and project future burdens for the 2030s and 2050s. We considered two greenhouse gas emission scenarios (Representative Concentration Pathways, RCP 4.5 and RCP 8.5), two adaptation scenarios, and different population growth series.

Results: During the baseline period (2003-2018), mean temperatures contributed 8.7% of the total burden or 28.4 DAYLs (95%CI:26.5-30.3) of the observed Campylobacter burden and 75.7 DAYLs (95%CI:74.4-80.5) or 18.3% of the observed Salmonella burden in Australia. The mean temperature-attributable burden for both enteric infections varied across climate zones and jurisdictions. Under both RCP scenarios, the projected burden of enteric infections is estimated to increase in the future, despite adaptation scenarios. The burden is projected to be the highest at tropical climate zones and at state level, it will be in Queensland. By the 2050s, without adaptation, the burden of Salmonella infection could reach 97.5 DAYLs under RCP4.5 and 110.5 DAYLs under RCP8.5. Meanwhile, the burden of Campylobacter infection could reach 36.7 DAYLs under RCP4.5 and 41.6 DAYLs under RCP8.5. Implementing a 10% adaptation strategy under RCP8.5 could reduce the burden of Salmonella and Campylobacter to 37.9 and 100.1 DAYLs in 2050, respectively. However, it should be noted that these values would still be higher than the baseline period.

Conclusion: These findings offer valuable insights that can inform policy decisions and guide the allocation of resources in order to mitigate the future burden of both enteric infections. The findings highlight the importance of developing adaptation strategies that are tailored to specific locations, with a focus on controlling and preventing climate-sensitive diseases.

Keywords: Salmonella; Campylobacter; Burden of disease; Climate change; Attributable burden; Adaptation

Background: Gestational diabetes mellitus (GDM) is a major pregnancy complication of global public health concern. Few studies suggest that climate-related exposures may contribute to the GDM risk. We investigated the association between biothermal stress (Universal Thermal Climate Index, UTCI) and GDM risk to identify potential critical susceptible windows, vulnerable populations, and interaction effects of fine particulate air pollution.
Methods: We linked 413,579 singleton pregnancies with 5% cases of GDM between 1 January 2000 and 31 December 2015 in Western Australia to daily space-time varying UTCI from three months preconception to the date of GDM diagnosis or birth delivery. Novel distributed lag nonlinear logistic regressions were performed to estimate weekly and cumulative adjusted odds ratios, interaction effects, and stratified analyses.
Results: The mean (standard deviation) UTCI was 14.5 ℃ (2.5). Relative to the median exposure (14.2 ℃), lower (1st-10th centiles) and higher (90th-99th centiles) UTCI exposures were associated with increased odds of GDM, showing a slightly inverted U-shape with observable critical windows in gestational weeks 6-34. The most elevated exposure-time-response association was 1.06 (95% CI 1.05, 1.07) in gestational weeks 18-20 at the 99th or 1st exposure centiles relative to the median. Preconception exposure showed essentially no association. Extreme biothermal stresses and high fine particulate air pollution exposures interactively increased the odds of GDM. For both lower and higher biothermal exposures, the odds of GDM were consistently more elevated in female births, and pregnancies by women who were non-Caucasians, < 35 years old, nulliparous, and resided in low or moderate socioeconomic areas. Pregnant women with and without pre-pregnancy medical conditions were at higher risk for higher and lower exposures, respectively.
Conclusion: Both low and high biothermal exposures were associated with increased odds of GDM with identified critical periods. Targeted climate-related health interventions may contribute to minimising the GDM risk, especially among vulnerable populations.

Australia’s first National Health and Climate Strategy (the Strategy) was launched in December 2023, and includes ‘research and innovation’ as a key enabler for achieving its vision of ‘healthy, climate-resilient communities and a sustainable, resilient, high-quality, net zero health system.’ To inform the prioritisation of future research funding and support development of the Australian climate and health evidence base, the Australian Government has commissioned a systematic mapping review of current and past Australian research activities on health and climate change. This presentation will share insights from the review, which sought to map and thematically understand the existing research on policies and interventions related to health and climate change adaptation and mitigation in Australia, and identify any evidence gaps that could be addressed by future research in this area.

This presentation will include a summary of results from the review; a discussion of the need for solutions-focused research on climate and health policies and interventions; and reflections on ways of working that led to the successful collaboration between the public sector and academia to deliver this project. The presentation will also include an overview of the Strategy and its implementation.