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COVID-19 responses have cast a spotlight on the uneven impacts of public health policy with particular populations or sites targeted for intervention. Perhaps the starkest example in Australia was the 'hard' lockdown of nine public housing complexes in inner-city Melbourne from 4 to 18 July 2020, where residents were fully confined to their homes. These complexes are home to diverse migrant communities and the lockdown drew public criticism for unfairly stigmatising ethnic minorities. This article draws on media articles published during the lockdown and the Victorian Ombudsman's subsequent investigation to explore the implications of broad, top-down public health measures for culturally and linguistically diverse (CALD) communities. Drawing on Lea's (2020) conceptualisation of policy ecology, we analyse the lockdown measures and community responses to explore the normative assumptions underpinning health policy mechanisms, constituting 'target populations' in narrow, exclusionary terms. We argue that the lockdown measures and use of police as compliance officers positioned tower residents as risky subjects in risky places. Tracing how such subject positions are produced, and resisted at the grassroots level, we highlight how policy instruments are not neutral interventions, but rather instantiate classed and racialised patterns of exclusion, reinforcing pervasive social inequalities in the name of public health. [ABSTRACT FROM AUTHOR]

Households play a major role in secondary transmission of pandemic influenza. Modeling estimates that household transmission has accounted for 25%-40% of all pandemic (H1N1) 2009 cases (1,2). Although understanding the [...]

Objective: To review Australian legislation about privacy, focusing on provisions within the regulations to conduct health research using identified data and lobby for regulatory change in the ACT. Method: A systematic review of Commonwealth and jurisdiction health privacy regulation. Results: Australia has a number of regulations for the protection of privacy of health information. In addition to Commonwealth privacy laws, there are jurisdictional regulations concerning protection of health information. These range from no specific legislation in Western Australia, to a code of practice in South Australia, and Commonwealth legislation that deals with use and disclosure of identified health information to conduct health research (Sections 95 and 95A of the Privacy Act 1988). At the time of this review, all but one jurisdiction, the Australian Capital Territory (ACT), had provisions for disclosing identified health information for health research. Conclusion: The ACT's Health Records (Privacy and Access) Act was inconsistent with the other Australian regulation concerning the use of identified health data in health research. Implications: The information from the review was used to inform the ACT Government that the health privacy regulations in place were inconsistent with the rest of Australia and resulted in regulatory change in the ACT. ACT legislation was amended to include provisions for the disclosure of identified health information for health research under controlled circumstances. The amendments were passed in December 2005, facilitating future health research involving data linkage in the ACT. Keywords: Medical Records Linkage, Privacy, Indigenous identifier, Indigenous health.

Objective: Between May and June 2002 an outbreak of chickenpox (CP) occurred at a child care centre in Perth, Western Australia. An epidemiological study was undertaken in order to determine the characteristics of the outbreak, assess vaccine effectiveness, and to define the direct and indirect costs associated with (CP) infections in young children. Methods: A cohort study of the outbreak utilising attendance records and a telephone survey of parents was conducted. Results: Of the 211 children attending the child care centre at the time of the outbreak, 44 contracted CP (attack rate 25.7%). In addition, two staff members, five secondary household contacts (secondary attack rate 38.5%) and four secondary non-household associated contacts were infected. There were no severe complications or any hospitalisations recorded in infected persons. Two cases had been vaccinated previously. Vaccine effectiveness for CP of any severity was 78.0% (95% (CI 15.4-94.3%) while vaccine effectiveness against severe CP was 100%. Direct costs during this outbreak were estimated to be $54 per case and the total costs, including cost of parental time off work or study, were estimated to be $525.73 per case. Conclusions and Implications: Although morbidity associated with CP in young children is not great, infection in childhood is almost universal. This study found that the average costs associated with each CP case were considerable. Since varicella vaccine affords good protection against CP, the recent inclusion of this vaccine in the Australian childhood vaccination schedule should save the community a considerable amount in direct and indirect costs if high coverage rates can be achieved. Key words: Chickenpox, outbreak, child care centre, costs, vaccination.

Objective: Asthmatic reactions to foods and drinks are a significant health problem in the community, however, the true extent of this problem is unclear. In this study, a new food allergy questionnaire (FAQ) was designed to specifically investigate the prevalence and characteristics of asthmatic reactions triggered by alcoholic drinks, as well as other foods and chemicals. The questionnaire's validity and reliability were assessed by comparing respondents' answers with data from clinical interview and repeat application. Methods: Twenty consecutive outpatients attending a Hospital Asthma Clinic completed the FAQ and subsequently were interviewed independently by their respiratory physician. The FAQ's ability to classify the asthma severity and atopic status of respondents, and to identify those asthmatics sensitive to alcoholic drinks, sulphite-containing foods and aspirin was assessed by comparison with clinical interview. The questionnaire's reliability was assessed in a separate and diverse community group of 20 asthmatic volunteers using the test-retest method. Results: Responses to the FAQ were found to correlate highly with assessment by clinical interview for all of the parameters assessed. Specifically, the FAQ identified reactions to alcoholic drinks with a coefficient of agreement of 88.9%, a sensitivity of 100%, and a specificity of 83.3%. Responses to the FAQ were also found to be reproducible for all of the parameters assessed. Conclusion and implications: The FAQ is a useful and reliable tool for assessing the sensitivity of asthmatics to alcoholic drinks and various foods and chemicals, and provides a means to collect data relating to the prevalence and characteristics of these responses in community-based populations.

Abstract Background Less healthy diets are common in high income countries, although proportionally higher in those of low socio-economic status. Food subsidy programs are one strategy to promote healthy nutrition and to reduce socio-economic inequalities in health. This review summarises the evidence for the health and nutritional impacts of food subsidy programs among disadvantaged families from high income countries. Methods Relevant studies reporting dietary intake or health outcomes were identified through systematic searching of electronic databases. Cochrane Public Health Group guidelines informed study selection and interpretation. A narrative synthesis was undertaken due to the limited number of studies and heterogeneity of study design and outcomes. Results Fourteen studies were included, with most reporting on the Special Supplemental Nutrition Program for Women, Infants and Children in the USA. Food subsidy program participants, mostly pregnant or postnatal women, were shown to have 10–20% increased intake of targeted foods or nutrients. Evidence for the effectiveness of these programs for men or children was lacking. The main health outcome observed was a small but clinically relevant increase in mean birthweight (23–29g) in the two higher quality WIC studies. Conclusions Limited high quality evidence of the impacts of food subsidy programs on the health and nutrition of adults and children in high income countries was identified. The improved intake of targeted nutrients and foods, such as fruit and vegetables, could potentially reduce the rate of non-communicable diseases in adults, if the changes in diet are sustained. Associated improvements in perinatal outcomes were limited and most evident in women who smoked during pregnancy. Thus, food subsidy programs for pregnant women and children should aim to focus on improving nutritional status in the longer term. Further prospective studies and economic analyses are needed to confirm the health benefits and justify the investment in food subsidy programs.