Applied Epidemiology in Country Western Australia, 2022-2023

Abstract

The WA Country Health Service (WACHS) is one of seven Health Service Providers in Western Australia (WA), and is responsible for the delivery of health services in WA's seven country regions. Between March 2022 and December 2023 I undertook a field placement at WACHS to satisfy the requirements of the Master of Philosophy in Applied Epidemiology (MAE) program. This bound volume describes the four projects I completed to address the core competencies of the MAE.

To meet the competency to investigate an acute public health problem, I investigated two gastroenteritis outbreaks in the South West region, one following an office Christmas lunch and the other at a residential boarding school. As neither outbreak had a confirmed aetiology, I investigated barriers to stool specimen collection and made recommendations to improve this in future outbreaks.

For the data analysis competency, I prepared both annual and quarterly reports for WACHS on notifiable diseases. This included descriptive analyses of notifications by age, sex, Aboriginal status, region, and other variables of interest, and comparison with historical, state and national notifiable disease rates. I made recommendations to improve future editions of these reports, and developed a template to simplify future analyses.

For the surveillance system competency, I contributed to the establishment of a system to record and track family and domestic violence-related Emergency Department (ED) presentations across country WA. This included conducting a quantitative analysis to inform the functionality of the system, co-leading a consultation process with ED staff across seven WACHS sites, and liaising with internal stakeholders to ensure that data collected by the system is disseminated appropriately to inform public health action.

For the epidemiological study competency, I conducted a three-part mixed-methods study investigating Rheumatic heart disease (RHD)-related mortality in Western Australia between 2012 and 2021. This included a comparative quantitative analysis of age-standardised mortality rates by time period, sex, Aboriginal status and jurisdiction; a descriptive quantitative analysis of clinical and demographic characteristics among deceased persons recorded on the WA RHD Register; and a thematic qualitative analysis of nine in-depth stakeholder interviews.

The final chapter in this volume describes my experience teaching epidemiology, including delivering a tutorial on age standardisation to first-year MAE scholars, and delivering a lesson from the field on qualitative interviewing for my MAE peers.

The projects described in this bound volume contribute to public health and epidemiological knowledge, particularly in the areas of rural and Aboriginal health. Each project aims to inform public health action to improve the health of these populations. Show more