Objective: To examine the association between long‐term health conditions and being out of the labour force among older Australians. Design, setting and participants: Retrospective analysis of cross‐sectional data from the Australian Bureau of Statistics 2003 Survey of Disability, Ageing and Carers for people aged 45–64 years. Main outcome measures: Rates of premature retirement associated with ill health; odds ratios of being out of the labour force associated with each long‐term health condition and number of conditions; weighted population estimates; estimates of gross domestic product lost as a result. Results: 9198 people surveyed were aged 45–64 years, 3010 of whom were not in the labour force. Of these, 1373 (45.6%) had retired because of a chronic health condition, most commonly a back problem (10.4%), or arthritis and related disorders (8.6%). When adjusted for age and sex, all conditions studied except diseases of the ear and mastoid process, other endocrine/nutritional and metabolic disorders, noise‐induced deafness or hearing loss, and high cholesterol were significantly associated with being out of the labour force. Extrapolating from these results, an estimated 663 235 older Australians were not working because of ill health, reducing Australia's gross domestic product by around $14.7 billion per annum. Conclusion: Prevention of long‐term health conditions may help older Australians remain in the labour force longer, thereby increasing revenue to fund health care for the ageing population.

Background Depressive symptoms are common in people with type 2 diabetes mellitus (T2DM). Effective depression treatments exist; however, access to psychological support is characteristically low. Web-based cognitive behavioral therapy (CBT) is accessible, nonstigmatizing, and may help address substantial personal and public health impact of comorbid T2DM and depression. Objective The aim of this study was to evaluate the Web-based CBT program, myCompass, for improving social and occupational functioning in adults with T2DM and mild-to-moderate depressive symptoms. myCompass is a fully automated, self-guided public health treatment program for common mental health problems. The impact of treatment on depressive symptoms, diabetes-related distress, anxiety symptoms, and self-care behavior was also examined. Methods Participants with T2DM and mild-to-moderate depressive symptoms (N=780) were recruited online via Google and Facebook advertisements targeting adults with T2DM and via community and general practice settings. Screening, consent, and self-report scales were all self-administered online. Participants were randomized using double-blind computerized block randomization to either myCompass (n=391) for 8 weeks plus a 4-week tailing-off period or an active placebo intervention (n=379). At baseline and postintervention (3 months), participants completed the Work and Social Adjustment Scale, the primary outcome measure. Secondary outcome measures included the Patient Health Questionnaire-9 item, Diabetes Distress Scale, Generalized Anxiety Disorder Questionnaire-7 item, and items from the Self-Management Profile for Type 2 Diabetes. Results myCompass users logged in an average of 6 times and completed an average of .29 modules. Healthy Lifestyles users logged in an average of 4 times and completed an average of 1.37 modules. At baseline, mean scores on several outcome measures, including the primary outcome of work and social functioning, were near to the normal range, despite an extensive recruitment process. Approximately 61.6% (473/780) of participants completed the postintervention assessment. Intention-to-treat analyses revealed improvement in functioning, depression, anxiety, diabetes distress, and healthy eating over time in both groups. Except for blood glucose monitoring and medication adherence, there were no specific between-group effects. Follow-up analyses suggested the outcomes did not depend on age, morbidity, or treatment engagement. Conclusions Improvement in social and occupational functioning and the secondary outcomes was generally no greater for myCompass users than for users of the control program at 3 months postintervention. These findings should be interpreted in light of near-normal mean baseline scores on several variables, the self-selected study sample, and sample attrition. Further attention to factors influencing uptake and engagement with mental heal...

Background: Rural and remote areas of Australia are facing serious health workforce shortages. While a number of schemes have been developed to improve recruitment to and retention of the rural health workforce, they will be effective only if appropriately targeted. This study examines the factors that most encourage students attending rural clinical placements to work in rural Australia, and the regions they prefer.

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