The economics of child and adolescent health in Australia

PhD by Publication


Ahmad, Kabir. 2022. The economics of child and adolescent health in Australia. PhD by Publication Doctor of Philosophy. University of Southern Queensland. https://doi.org/10.26192/y841v
Title

The economics of child and adolescent health in Australia

TypePhD by Publication
AuthorsAhmad, Kabir
Supervisor
1. FirstProf Rasheda Khanam
2. SecondDr Enamul Kabir
3. ThirdHendrik Jurges
Institution of OriginUniversity of Southern Queensland
Qualification NameDoctor of Philosophy
Number of Pages292
Year2022
PublisherUniversity of Southern Queensland
Place of PublicationAustralia
Digital Object Identifier (DOI)https://doi.org/10.26192/y841v
Abstract

Long-term medical conditions or disabilities, such as respiratory and allergic diseases, and obesity are the leading chronic conditions that affect children worldwide. This thesis examines the associations between maternal health and different childhood health outcomes, including wheezing, asthma, eczema and long-term medical conditions or disabilities. This thesis also identifies vulnerable clusters based on childhood wheezing, asthma or eczema morbidities and on the lifestyles and health behaviours of adolescents that contribute to obesity. Finally, this thesis examines the excess healthcare costs that are associated with children’s asthma and any medical condition or disability that lasts six months or more. To accomplish the research objectives and make new contributions to the literature, this ‘PhD by publication’ thesis presents an accumulation of eight studies that use data from the Longitudinal Study of Australian Children (LSAC). The adapted developmental origins framework and the bio-ecological model of child development underpin this thesis, and the research relies on the applied quantitative approach for the empirical analyses. The spectrum of the study was enhanced by establishing data linkages between the Health CheckPoint survey, the Pharmaceutical Benefits Scheme and the Medicare Benefits Schedule data with the LSAC databases. The thesis follows a typical format: the eight research articles are bookended by rudimentary introduction and conclusion chapters. The research contents of this thesis are divided into the following four main parts:

i) prevalence and risk factor analyses of children’s health
a. in general
b. based on leading chronic diseases – wheezing, asthma and eczema (Papers 1 and 2)
ii) survival analyses and risk factor assessments for long-term medical conditions or disabilities (Papers 3 and 4)
iii) identification of clusters of vulnerable children in relation to respiratory and allergic diseases and health-related behaviour or lifestyle characteristics (Papers 5 and 6)
iv) cost studies that assess the excess healthcare cost of children that are associated with asthma and long-term health conditions or disabilities (Papers 7 and 8)

Paper 1 utilised a cross-section analysis of infants’ and adolescents’ health status through the lens of the foetal origins hypothesis and analyses data from Wave 1 and Wave 7 of the LSAC surveys. The study found evidence that poor maternal physical health status and health-related behaviours during pregnancy or up to 15 months from childbirth adversely affected their children’s health during infancy and adolescence in all three of the health dimensions examined; the poor general health, the chronic health conditions and lower physical health scores. Maternal psychological distress during pregnancy also increased the odds that their offspring would develop chronic health conditions and have lower physical health scores. Focusing again on the foetal origins framework and further strengthened by using longitudinal data from eight waves, Paper 2 reveals that maternal asthma, obesity, and smoking during pregnancy are strongly associated with an increased risk of offspring’s wheezing and asthma. This study also reveals that the risk of contracting childhood eczema is mainly associated with maternal asthma during pregnancy. Paper 3 deployed a panel data survival analysis method to estimate the prevalence of long-term medical conditions or disabilities in Australian children. This study also examined the association of maternal healthrelated risk factors with chronic health conditions. Through an application of the same technique (survival analysis), Paper 4 reveals that low birth weight, receiving emergency hospital services just after birth, being male and being obese during childhood up to the age of 15 years are associated with an increased risk of having a long-term medical condition or disability. Both Papers 3 and 4 deployed a ‘developmental origins’ framework in forming the study questions and interpreting the findings. iii This thesis implemented an unsupervised machine learning method known as latent class clustering to identify the vulnerable clusters of children who experience wheezing, asthma or eczema and vulnerable children with problematic lifestyles and health behaviours who are prone to be obese and have a lower quality of life (Paper 5 and 6, respectively). Finally, Papers 7 and 8 were conducted using a health economic approach to assess the direct costs of healthcare services. Paper 7 utilised an assessment of the national-level excess healthcare costs for Australian children that are associated with the burden of asthma morbidity. The estimated increased costs to the Australian healthcare system due to childhood asthma are A$190.6 million per year among children ages 2-3– to-18-19, based on the 2018 population data. Paper 8 reveals that at the population level, the estimated total excess Medicare costs associated with a medical condition or disability among children ages 0-1-to–16-17 is, on average, A$170.0 million per year. The evidence from this thesis should help health policymakers find ways to reduce and control asthma, obesity and long-term health conditions or disabilities and gain further insight into the associated excess healthcare costs of asthma and any childhood medical condition or disability.

KeywordsChildhood asthma; Childhood obesity; Long-term medical condition/disability; Latent class analysis; Survival analysis; Healthcare costs
Related Output
Has partMaternal health and health-related behaviours and their associations with child health: evidence from an Australian birth cohort
Has partAre wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort
Has partAssociation of infant and child health characteristics with the hazard of any medical condition or disability in Australian children
Has partClustering of asthma and related comorbidities and their association with maternal health during pregnancy: evidence from an Australian birth cohort
ANZSRC Field of Research 2020380108. Health economics
420699. Public health not elsewhere classified
Public Notes

This article is part of a UniSQ Thesis by publication. See Related Output

Byline AffiliationsSchool of Mathematics, Physics and Computing
Permalink -

https://research.usq.edu.au/item/y841v/the-economics-of-child-and-adolescent-health-in-australia

Download files


Published Version
Kabir Ahmad - Thesis.pdf
License: CC BY 4.0
File access level: Anyone

  • 74
    total views
  • 31
    total downloads
  • 6
    views this month
  • 2
    downloads this month

Export as

Related outputs

The impact of gender and age on bullying role, self-harm and suicide: Evidence from a cohort study of Australian children
Ahmad, Kabir, Beatson, Amanda, Campbell, Marilyn, Hashmi, Rubayyat, Keating, Byron W., Mulcahy, Rory, Riedel, Aimee and Wang, Shasha. 2023. "The impact of gender and age on bullying role, self-harm and suicide: Evidence from a cohort study of Australian children." PLoS One. 18. https://doi.org/10.1371/journal.pone.0278446
Association of maternal physical and mental health characteristics with the hazard of having any medical condition or disability in Australian children: A 15-year birth cohort study
Ahmad, Kabir, Ormsby, Gail M., Kabir, Enamul and Khanam, Rasheda. 2023. "Association of maternal physical and mental health characteristics with the hazard of having any medical condition or disability in Australian children: A 15-year birth cohort study ." SSM - Population Health. 22. https://doi.org/10.1016/j.ssmph.2023.101385
The Healthcare Cost Burden of Asthma in Children: A Longitudinal Population-Based Study
Ahmad, Kabir, Khanam, Rasheda, Kabir, Enamul and Jurges, Hendrik. 2023. "The Healthcare Cost Burden of Asthma in Children: A Longitudinal Population-Based Study ." Value in Health. 26 (8), pp. 1201-1209. https://doi.org/10.1016/j.jval.2023.04.003
Clustering of lifestyle and health behaviours in Australian adolescents and associations with obesity, self-rated health and quality of life
Ahmad, Kabir, Keramat, Syed Afroz, Ormsby, Gail M., Kabir, Enamul and Khanam, Rasheda. 2023. "Clustering of lifestyle and health behaviours in Australian adolescents and associations with obesity, self-rated health and quality of life ." BMC Public Health. 23. https://doi.org/10.1186/s12889-023-15724-6
Association of infant and child health characteristics with the hazard of any medical condition or disability in Australian children
Ahmad, Kabir, Keramat, Syed Afroz, Sathi, Nusrat Jahan, Kabir, Enamul and Khanam, Rasheda. 2022. "Association of infant and child health characteristics with the hazard of any medical condition or disability in Australian children." Archives of Public Health. 80, pp. 1-11. https://doi.org/10.1186/s13690-022-00913-3
Nexus between maternal underweight and child anthropometric status in South and South-East Asian countries
Haque, Rezwanul, Alam, Khorshed, Rahman, Syed Mahbubur, Mustafa, Maimun Ur Rashid, Ahammed, Benojir, Ahmad, Kabir, Hashmi, Rubayyat, Wubishet, Befikadu Legesse and Keramat, Syed Afroz. 2022. "Nexus between maternal underweight and child anthropometric status in South and South-East Asian countries." Nutrition. 98, pp. 1-8. https://doi.org/10.1016/j.nut.2022.111628
Disability, physical activity, and health-related quality of life in Australian adults: An investigation using 19 waves of a longitudinal cohort
Keramat, Syed Afroz, Ahammed, Benojir, Mohammed, Aliu, Seidu, Abdul-Aziz, Farjana, Fariha, Hashmi, Rubayyat, Ahmad, Kabir, Haque, Rezwanul, Ahmed, Sazia, Ali, Mohammad Afshar and Ahinkorah, Bright Opoku. 2022. "Disability, physical activity, and health-related quality of life in Australian adults: An investigation using 19 waves of a longitudinal cohort ." PLoS One. 17 (5 May), pp. 1-17. https://doi.org/10.1371/journal.pone.0268304
Clustering of asthma and related comorbidities and their association with maternal health during pregnancy: evidence from an Australian birth cohort
Ahmad, Kabir, Kabir, Enamul, Ormsby, Gail M. and Khanam, Rasheda. 2021. "Clustering of asthma and related comorbidities and their association with maternal health during pregnancy: evidence from an Australian birth cohort." BMC Public Health. 21 (1), pp. 1-13. https://doi.org/10.1186/s12889-021-11997-x
Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort
Ahmad, Kabir, Kabir, Enamul, Ormsby, Gail M. and Khanam, Rasheda. 2021. "Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort." Archives of Public Health. 79 (1), pp. 1-18. https://doi.org/10.1186/s13690-021-00718-w
Maternal health and health-related behaviours and their associations with child health: evidence from an Australian birth cohort
Ahmad, Kabir, Kabir, Enamul, Keramat, Sayed Afroz and Khanam, Rasheda. 2021. "Maternal health and health-related behaviours and their associations with child health: evidence from an Australian birth cohort." PLoS One. 16 (9), pp. 1-18. https://doi.org/10.1371/journal.pone.0257188
Interaction between the place of residence and wealth on the risk of overweight and obesity in Bangladeshi women
Ahmad, Kabir, Khanam, Taslima, Keramat, Sayed Afroz, Islam, Md. Irteja, Kabir, Enamul and Khanam, Rasheda. 2020. "Interaction between the place of residence and wealth on the risk of overweight and obesity in Bangladeshi women." PLoS One. 15 (12), pp. 1-15. https://doi.org/10.1371/journal.pone.0243349