Technical Report #43 November 2020 TABLE OF CONTENTS 1 EXECUTIVE SUMMARY .............................................................................................. 6 2 INTRODUCTION ........................................................................................................... 9 3 CONDUCT OF SURVEYS .......................................................................................... 11 3.1 1989-95 cohort............................................................................................................ 11 3.1.1 Pilot Survey 6 ............................................................................................... 11 3.1.2 Survey 6 ........................................................................................................ 12 3.2 1946-51 cohort............................................................................................................ 15 3.2.1 Main Survey 9 ............................................................................................... 15 3.3 1973-78 cohort............................................................................................................ 18 3.3.1 Pilot Survey 9 ............................................................................................... 18 3.4 1921-26 cohort............................................................................................................ 19 3.4.1 Six-Month Follow-up Survey 17 .................................................................. 19 3.4.2 Six Month Follow-up Survey 18 .................................................................. 20 3.5 COVID-19 Mini Surveys ............................................................................................. 25 4 MAINTENANCE OF COHORTS ................................................................................ 26 4.1 Introduction ................................................................................................................ 26 4.2 Update of sample and response rates ..................................................................... 26 4.2.1 First survey of the 1973-78, 1946-51 and 1921-26 cohorts in 1996. ........ 26 4.2.2 1973-78 cohort .............................................................................................. 27 4.2.3 1946-51 cohort .............................................................................................. 28 4.2.4 1921-26 cohort .............................................................................................. 29 4.2.5 Six-month follow-up surveys of the 1921-26 cohort ................................ 30 4.2.6 1989-95 cohort .............................................................................................. 31 4.3 Maintenance strategies ............................................................................................. 31 4.4 National Death Index ................................................................................................. 32 4.5 Cause of Death Codes ............................................................................................... 42 5 DATA LINKAGE ......................................................................................................... 44 5.1 ALSWH linked data holdings .................................................................................... 44 5.1.1 National collections ..................................................................................... 44 5.1.2 State and Territory collections ................................................................... 46 5.1.3 Derived datasets: Chronic conditions from multiple sources ................ 50 1 5.2 Data access procedures ........................................................................................... 50 5.2.1 Data user approvals ..................................................................................... 50 5.2.2 Access options ............................................................................................. 50 5.2.3 Data access conditions ............................................................................... 51 5.3 Use of linked data ...................................................................................................... 53 5.4 Legal and ethical considerations for health record linkage .................................. 53 5.4.1 Applicable legislation and guidelines ........................................................ 53 5.4.2 Consent status of ALSWH participants ..................................................... 55 5.4.3 Communicating with ALSWH participants about health record linkage .................................................................................................... 56 5.4.4 Current HREC approvals for health record linkage .................................. 56 6 ARCHIVING ................................................................................................................ 59 6.1 Archiving Notes ......................................................................................................... 59 7 METHODOLOGICAL ISSUES ................................................................................... 60 7.1 Creation of ADA-Accessed (Core) data ................................................................... 60 7.1.1 Differences between the ALSWH data and the ADA-Accessed (Core) data ......................................................................................................... 60 7.1.2 Items not included in the Core Dataset ..................................................... 60 7.1.3 Participant Status File ................................................................................. 62 7.1.4 Recoded variables ....................................................................................... 62 7.2 Validation of the ALSWH income management survey question ......................... 65 7.2.1 Income within the context of socioeconomic status ............................... 65 7.2.2 Ability to manage on available income ...................................................... 65 7.2.3 Financial resource questions under consideration ................................. 66 7.2.4 Surveys that measure financial resources and education ...................... 67 7.2.5 A note on the household income variable ................................................ 70 7.2.6 Missing data for financial resource and education variables ................. 71 7.2.7 Income management according to household income and stress about money .......................................................................................... 73 7.2.8 Spearman’s rank-order correlation coefficient ......................................... 75 7.2.9 Cronbach’s alpha and Zumbo’s ordinal alpha .......................................... 76 7.2.10 Conclusion .................................................................................................... 77 7.2.11 References .................................................................................................... 78 2 7.3 Comparison of the DASS-21 and GADS anxiety subscales in the 1973-78 cohort .......................................................................................................................... 79 7.3.1 Introduction .................................................................................................. 79 7.3.2 Internal validity of the DASS and GADS .................................................... 80 7.3.3 Correlation between DASS-21 anxiety and GADS anxiety subscales .... 81 7.3.4 Score thresholds .......................................................................................... 83 7.3.5 DASS-21 and GADS anxiety subscales as predictors/correlates of anxiety/mental health ............................................................................ 83 7.3.6 Summary ....................................................................................................... 84 7.3.7 References .................................................................................................... 85 7.4 Assessing agreement between the K10 and MHI-5 measures of psychological wellbeing ..................................................................................................................... 86 8 MAJOR REPORT: THE EFFECT OF MULTIPLE CHRONIC CONDITIONS – FINDINGS FROM THE AUSTRALIAN LONGITUDINAL STUDY ON WOMEN’S HEALTH .................................................................................... 87 8.1 Main findings and recommendations ...................................................................... 87 8.2 Conclusion ................................................................................................................. 92 9 DISSEMINATION OF STUDY FINDINGS .................................................................. 93 9.1 Publications ................................................................................................................ 93 9.2 Conference Presentations ...................................................................................... 105 9.3 Media ........................................................................................................................ 107 9.4 Social media ............................................................................................................. 114 9.5 Website ..................................................................................................................... 114 9.6 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