Australia’s longest running study of women’s health
Twenty years on, the Australian Longitudinal Study on Women’s Health (better known as Women’s Health Australia) is the largest, longest running study on women’s health in the country. Since the study commenced in 1996, a joint team from The University of Queensland and the University of Newcastle has kept track of some 58,000 women, processed 250,000 surveys, sent 2.5 million emails and analysed 114 million responses to questions. The result is a national research resource like no other.
Women’s Health Australia is funded by the Department of Health to provide an evidence base for women’s health policy and practice. The study has proven to be a goldmine for policy makers, being cited in a host of state and national policies and guidelines – most notably, the 2010 National Women’s Health Policy and the 2014 Australian Physical Activity Guidelines.
As study director Professor Gita Mishra from the UQ School of Public Health explains, the study initially recruited three cohorts from around Australia in 1996. Participants were drawn from various age groups to examine how critical stages across the life course impact women’s health.
The oldest cohort (born 1921-26) was chosen to reveal the factors involved in ageing well. The middle cohort (born 1946-51) helped investigate the transition through middle age and menopause. The youngest cohort (born 1973-78) shared stories of relationships, work, study and becoming mothers as they transitioned into adulthood. In 2013, a new cohort of young women joined the study – millennials born between 1989 and 1995. The many women participating continue to answer regular surveys on a broad range of factors addressing their physical and mental health, lifestyle and sociodemographic factors.
Professor Mishra says the study has built an international reputation as a research resource. “Data sharing and collaboration are fundamental to the role of the research resource."
To date, more than 700 collaborators from around the world have accessed the study data, resulting in more than 600 peer reviewed papers. Researchers can also apply to run sub-studies, which collect additional data from participants. Such sub-studies are carefully considered to limit demands on participants. To date, almost 100 additional surveys have collected data on topics as diverse as sleeping difficulties, domestic violence, menopausal problems, urinary incontinence, leisure, diabetes and the plans of younger women. A new crop of sub-studies is opening exciting new avenues for researchers.
As the study enters its third decade, researchers have begun collecting data on participants’ children for the first time. Launched in August 2016, the Mothers and their Children’s Health sub-study assesses factors such as children’s diet, physical activity, screen time, yard size, sleep patterns, milestones and childcare.
Deputy director of the study, Associate Professor Leigh Tooth, says the new sub-study will offer a broad perspective. “One of the really unique things about this particular sub-study is the inclusion of multiple children from the same family. We can look at outcomes across families, and we can dig down and start to look at differences between siblings.”
The children’s data will be coupled with health and education records, as well as the Women’s Health Australia study, providing 20 years of data on the mother’s health, lifestyle and sociodemographic factors. Dr Tooth is eager to see research begin. “Linked together, the surveys will paint an incredibly rich picture. We’ll have unparalleled insight into the complex relationships between a mother’s health, before and after childbirth, and her children’s health and development.”
The Women’s Health Australia study is also taking the initial steps to expand into collecting biological data. A pilot sub-study is investigating predictors of healthy glucose control for Australian women, and testing for nutritional status and metabolic markers of diabetes control.
Another pilot sub-study beginning in 2017 will investigate the links between female reproductive function (from menarche and menses through to pregnancy and sub fertility) and the risks of cardiovascular disease, diabetes and respiratory conditions. A large sample of premenopausal women from the 1973 – 78 cohort will be asked to provide blood samples, undertake functional tests (including cardiovascular and lung function, hand grip strength, and cognition) and wear physical activity trackers.
Collecting biological data presents new logistical challenges, but Professor Mishra is enthusiastic about the future. “This is a really exciting step that will take the study to the next level,” says the study director. “It bridges the gaps between the self-report of symptoms, while looking at the underlying biological processes.
“These new sub-studies ask a lot more of our participants, but so far the feedback is positive. Part of what keeps these women so committed to the study, year after year, is knowing that their data will add to our understanding of women’s health, and make a real difference to policies and women’s lives.”
The Australian Longitudinal Study on Women's Health is grateful to the Australian Government Department of Health for funding and to the women who provided the survey data.