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Background: Suicide and self-harm pose significant global public health challenges with substantial economic implications. Recent Australian evidence shows considerable variations in the prevalence of suicidal behaviours and mortality among culturally and ethnically diverse population groups. This study aims to estimate the associated economic cost of suicide among culturally and linguistically diverse (CALD) migrants in Australia. Methods: We evaluated the economic impact of suicide by considering the years of life lost, years of productive life lost, and overall economic costs, including direct, indirect, and intangible costs. We used data on suicide deaths in 2020 from the National Coronial Information System. Results: The estimated economic cost associated with 346 suicide deaths among CALD migrants is$2.9 billion (Australian dollars), with an average cost per fatality equivalent to $ 8.47 million. This estimate varies in the sensitivity analysis from$1.9 billion to $ 3.9 billion, depending on the average age of fatality, with corresponding average costs of$5.59 million to $ 11.35 million, respectively. These estimates do not capture costs associated with suicidal behaviours, which may substantially increase the economic burden. Conclusions: The significant economic impacts of CALD migrants’ suicide in Australia highlight the urgent need for a comprehensive national suicide prevention programme tailored for CALD migrant populations.

In many Western countries, including Australia, construction workers have been identified as being at elevated risk of suicide compared to other workers. A variety of suicide prevention initiatives have been implemented and expanded to reduce suicide in this occupational group; however, the net effect of these is unknown. Using 19 years of national suicide data, this study examined the suicide mortality of Australian male construction workers relative to all other working males, and compared suicide rates over time between the two groups. Age-standardized suicide rates were calculated for construction workers and those employed in other occupations. 2001–2019 trends in age-standardized rates of suicide mortality were analyzed by joinpoint regression analysis. The annual average percentage change (AAPC) measure was calculated for both groups to quantify change over time within each group, complemented by a pair-wise AAPC comparison of changes in trends between the two groups over the 2001–2019 period. Australian male construction workers' overall age-standardized suicide rate was 26.6 per 100,000 persons compared to 13.2 per 100,000 for male workers employed in other occupations (pooled over the entire 2001–2019 period). Over time, the suicide mortality rate declined in both construction workers and those working in other occupations; however, the decline in suicide mortality was greater in construction workers (AAPC: −3.0; 95%CI −4.0, −2.0) compared to other workers (AAPC: 1.5; 95%CI −2.1, −1.0). The AAPC pair-wise comparison showed a significant difference between the rate of decline among construction versus other workers over the 19-year study period (AAPC: −1.4; 95%CI 0.4, 2.5), confirming a rapid decline among construction versus other male workers. This study provides evidence of a decline in suicide rates among Australian construction workers over the last two decades. This decline may be attributable to the combined effects of population-wide, male-specific, and sector-specific suicide prevention efforts over this same period, suggesting that the continuation or expansion of such efforts may lead to further declines.

Background Suicide rates among those employed in male-dominated professions such as construction are elevated compared to other occupational groups. Thus far, past research has been mainly quantitative and has been unable to identify the complex range of risk and protective factors that surround these suicides. Methods We used a national coronial database to qualitatively study work and non-work related influences on male suicide occurring in construction workers in Australia. We randomly selected 34 cases according to specific sampling framework. Thematic analysis was used to develop a coding structure on the basis of pre-existing theories in job stress research. Results The following themes were established on the basis of mutual consensus: mental health issues prior to death, transient working experiences (i.e., the inability to obtain steady employment), workplace injury and chronic illness, work colleagues as a source of social support, financial and legal problems, relationship breakdown and child custody issues, and substance abuse. Conclusion Work and non-work factors were often interrelated pressures prior to death. Suicide prevention for construction workers needs to take a systematic approach, addressing work-level factors as well as helping those at-risk of suicide

The COVID-19 pandemic imposed additional and specific challenges on the lives and wellbeing of informal unpaid carers. Addressing an important gap in the existing literature, this systematic review (prospectively registered with PROSPERO CRD42022376012 ) synthesises and evaluates the quantitative evidence examining the association between unpaid caregiving and mental health (compared to non-caring), during the pandemic. Five databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science) from Jan 1, 2020, to March 1, 2023. Population-based, peer-reviewed quantitative studies using any observational design were included, with screening, data extraction and quality assessment (amended NOS) independently conducted by two reviewers. Of the 3,073 records screened, 20 eligible studies (113,151 participants) were included. Overall quality of evidence was moderate. Narrative synthesis was complemented by Effect-direction and Albatross plots (given significant between-study heterogeneity precluded meta-analysis). Results indicate that the mental health of informal carers, already poorer pre-COVID compared to non-caregivers, was disproportionally impacted as a result of the pandemic and its associated public health containment measures. This review highlights the vulnerability of this group and should motivate political will and commensurate policies to ensure unpaid caregivers are better supported now, in the medium term, and crucially if, and when, another global public health emergency emerges.

PurposeThere is some evidence that employed women report more time pressure and work-life penalties than employed men and other women; however little is known about whether this exerts a mental health effect. This analysis examined associations between household labour force arrangements (household-employment configuration) and the mental health of men and women.MethodsSeventeen waves of data from the Household Income and Labour Dynamics Survey (2001–2017) were used. Mental health was measured using the Mental Health Inventory (MHI-5). A six-category measure of household-employment configuration was derived: dual full-time employed, male-breadwinner, female-breadwinner, shared part-time employment (both part-time), male full-time/female part-time (modified male-breadwinner, MMBW), and female full-time/male part-time. Using fixed-effects regression methods, we examined the within-person effects of household-employment configuration on mental health after controlling for time-varying confounders.ResultsFor men, being in the female-breadwinner configuration was associated with poorer mental health compared to being in the MMBW configuration (β-1.98, 95% CI − 3.36, − 0.61). The mental health of women was poorer when in the male-breadwinner configuration, compared to when in the MMBW arrangement (β-0.89, 95% CI − 1.56, − 0.22).ConclusionThese results suggest that the mental health of both men and women is poorer when not in the labour force, either as a man in the female-breadwinner arrangement, or as a woman in the male-breadwinner arrangement. These results are particularly noteworthy for women, because they pertain to a sizeable proportion of the population who are not in paid work, and highlight the need for policy reform to support women’s labour force participation.

Evidence suggests there are likely to be more COVID-19-related job losses for women than men.2,5 This differential exposure to job loss arises because women are more likely to be employed in sectors at high risk of impacts from COVID-19,5 and also because women are more likely to be employed part time6 or in temporary or casual arrangements.5 Such employment arrangements are often precarious with fewer legal protections, meaning that women are particularly vulnerable to job loss during this pandemic, placing them at increased risk of the adverse health outcomes associated with unemployment.7 Globally, women do more unpaid work than men.8 Much of this is unpaid care work, of which more than 75% is done by women.4 Unpaid care work contributes substantially to global economies, and is estimated to be equivalent to 9% of the global gross domestic product.4 The unequal distribution of unpaid care work serves as a barrier to female labour force participation and is one way that gender inequalities are reinforced.4,8 The COVID-19 pandemic exacerbates this in two main ways. [...]confinement at home due to work at home requirements and school closures may compound the unequal division of domestic tasks. Accurate quantification of unpaid care should be a priority, and estimates should be incorporated into macroeconomic analyses to enable the assessment of gender-differentiated policy effects.4 For unpaid carers, financial support and pension systems that acknowledge unpaid care provision could offer protection from economic disadvantage.19 The COVID-19 pandemic has temporarily reshaped our domestic and working lives and could sow the seeds for change to advance gender equality, and deliver long-term health benefits.

Gender and sexually diverse populations remain understudied and under-represented in research. This is attributable not only to significant and ongoing data collection limitations, where large population-based studies fail to ask adequate questions around gender and sexuality, but also due to continuously evolving terminology in this space. This glossary takes a preliminary step in rectifying these issues by defining and clarifying the application and understanding of key terms related to gender, gender identity, expression and sexuality. In doing so, this glossary provides a point of reference for understanding key differences in gender and sexually diverse terminology to (1) help guide researchers and practitioners in the use and understanding of terms and (2) facilitate the utility of more respectful, inclusive and consistent language application across the public health arena.

Young people with migrant or refugee backgrounds from low- and middle-income countries settle in high-income countries and tend to underutilise sexual and reproductive health (SRH) services. This review aimed to explore perceptions and experiences of SRH services and the factors that shape their use among migrant youth. It focuses on qualitative studies that examine SRH service use among young migrants living in high-income countries. Seven peer-review databases and web-based grey literature were searched using pre-determined search criteria. The review includes 16 articles that met the inclusion criteria. The qualitative evidence synthesis (QES) method was used to synthesise findings. Thematic analysis resulted in five main themes and 11 sub-themes. Findings suggest that despite diversity of countries of origin and host countries, there were considerable similarities in their perceptions of and experiences with SRH services. Some young migrants reported experiences of discrimination by service providers. Cost of care was a deterrent to SRH service use in countries without universal healthcare coverage. Lack of information about SRH services, concerns about confidentiality, community stigma around sexually transmitted infections and premarital sex were key barriers to SRH service use. Health systems should integrate flexible service delivery options to address access barriers of SRH service use in young migrants. Engagement with parents and communities can help to destigmatise sexual health problems, including STIs. Host countries need to equip young migrants with the knowledge required to make informed SRH decisions and access relevant SRH services and resources.

BackgroundThere is evidence that unpaid caregiving can have negative effects on the mental health of female caregivers; however, evidence of impacts on male caregivers is limited. This study addressed this gap by examining associations between becoming a caregiver and depressive symptoms among men.MethodsWe used data from waves 1–2 (2013, 2016) of the Longitudinal Study of Australian Male Health (Ten to Men). Effects of incident caregiving on depressive symptoms were estimated using augmented inverse probability treatment weighting, with adjustment for potential confounders. Incident caregiving was assessed as a binary variable (became a caregiver vs not), and depressive symptoms were measured using the Patient Health Questionnaire (moderate to severe depressive symptoms; yes, no). Main analysis was prospective, drawing on wave 1 (caregiving) and wave 2 (depressive symptoms), and sensitivity analyses modelled cross-sectional associations.ResultsIn the main analysis, incident caregiving in wave 1 was associated with depressive symptoms in the subsequent wave, with an average treatment effect of 0.11 (95% CI 0.06, 0.17) and equating to a risk ratio of 2.03 (95% CI 1.55, 2.51). Associations were robust to several sensitivity analyses, with cross-sectional associations supporting the main prospective analyses.ConclusionThese results provide evidence of the association between caregiving and depressive symptoms among male caregivers. This has important implications for policy and support programmes. As we seek to shift caregiving responsibilities toward a more gender-equal distribution of care, policy must recognise that, like female caregivers, male caregivers also experience mental health impacts related to their caregiving role.