title: The hidden health burden of environmental degradation: disease comorbidities and dryland salinity.
abstract: Previous studies have linked poor mental human health with environmental degradation, but none have assessed additional diseases that may co-exist with these mental disorders. In previous work, depression was found to be associated with a major form of environmental degradation; dryland salinity. However, little is known about diseases co-morbid with depression in this environmental setting. In rural Australia, dryland salinity is a major form of environmental degradation contributing widely to deterioration and non-viability of farmland. Using georeferenced health record data, Bayesian spatial methods were used to determine the relationship between dryland salinity and a range of human health outcomes. Initial modelling found an increased relative risk for asthma, suicide and ischaemic heart disease in relation to dryland salinity (adjusted for Indigenous and socio-economic status). However, in this follow-up study, a further evaluation of the role of co-morbidities in this population revealed that: (i) the presence of depression was consistently linked to residence in areas with high salinity and (ii) the association of asthma, suicide and heart disease with salinity was most likely attributable to the co-morbidity of the conditions with depression. Given the predicted increase in dryland salinity and the elevated relative risk of depression in impacted areas, the relative risk of the co-morbid conditions can be expected to increase in rural areas in the future, further adding to the burden of disease associated with environmental degradation.
authors: Centre of Excellence in Natural Resource Management, The University of Western Australia, PO Box 5771, Albany, WA, 6332, Australia. peter.speldewinde@uwa.edu.au
authors: Peter C
authors: PC
authors: Speldewinde
authors: Angus
authors: A
authors: Cook
authors: Peter
authors: P
authors: Davies
authors: Philip
authors: P
authors: Weinstein
references: Stat Med. 2000 Sep 15-30;19(17-18):2217-41
references: 10960849
references: Med J Aust. 2003 Mar 17;178(6):272-6
references: 12633484
references: Circulation. 1999 Apr 27;99(16):2192-217
references: 10217662
references: Sci Total Environ. 2006 Oct 1;369(1-3):1-20
references: 16920180
references: J Health Psychol. 1996 Oct;1(4):411-29
references: 22012317
references: Am J Cardiol. 1998 Apr 15;81(8):988-94
references: 9576158
references: Ann Epidemiol. 2004 Jan;14(1):58-65
references: 14664781
references: Am J Psychiatry. 2007 Jan;164(1):134-41
references: 17202555
references: Psychosom Med. 2004 May-Jun;66(3):349-55
references: 15184694
references: Drugs. 1996;52 Suppl 6:12-9
references: 8941499
references: Epidemiology. 1993 Jul;4(4):285-94
references: 8347738
references: Aust N Z J Psychiatry. 2006 Mar;40(3):208-16
references: 16476147
references: Ann Allergy Asthma Immunol. 2005 May;94(5):566-74
references: 15948301
references: Health Place. 2009 Sep;15(3):865-72
references: 19345135
references: Soc Psychiatry Psychiatr Epidemiol. 1999 Jul;34(7):376-82
references: 10477958
references: Acta Trop. 2004 Jan;89(2):249-59
references: 14732246
references: Clin Pract Epidemiol Ment Health. 2005 Sep 27;1:18
references: 16185365
references: Am Heart J. 2005 Nov;150(5):871-81
references: 16290952
references: Psychosom Med. 2005 May-Jun;67 Suppl 1:S34-6
references: 15953798
references: Chest. 2006 Oct;130(4):1034-8
references: 17035435
references: Soc Sci Med. 2003 Feb;56(3):551-67
references: 12570973
references: Am Heart J. 2005 Jul;150(1):54-78
references: 16084151
references: Thorax. 2002 Apr;57(4):317-22
references: 11923549
references: Am Heart J. 2003 Jul;146(1):55-61
references: 12851608
references: Lancet. 2007 Sep 8;370(9590):851-8
references: 17826170
references: Public Health Rep. 2006 Nov-Dec;121(6):746-54
references: 17278410
references: BMJ. 1998 Jun 6;316(7146):1714-9
references: 9614024
references: Curr Psychiatry Rep. 2005 Dec;7(6):441-6
references: 16318822
references: J Am Osteopath Assoc. 2006 May;106(5 Suppl 2):S9-14
references: 16738013
references: J Allergy Clin Immunol. 2005 Dec;116(6):1301-6
references: 16337463
references: Med J Aust. 2003 May 5;178(9):437-41
references: 12720509