Mrs Laura Brooks1, Dr Enamul Kabir1, Professor Leah East1
1University Of Southern Queensland, Toowoomba, Australia
Biography:
Laura Brooks is a Master of Research candidate at the University of Southern Queensland, where her research examines socioeconomic and geographic disparities in menopausal healthcare utilisation using longitudinal data from the Australian Longitudinal Study on Women's Health. She holds a Master of Women's Health Medicine (UNSW), a Master of Clinical Chiropractic and Bachelor of Science (CQUniversity) and brings extensive experience as a clinician and allied health practice director. Her research applies a health equity lens to women's midlife health, with a focus on structural barriers to menopausal hormone therapy access across generations of Australian women.
Aims:
To examine socioeconomic gradients in menopausal hormone therapy (MHT) use across two Australian cohorts spanning the pre- and post-Women's Health Initiative (WHI) periods.
Methods:
Longitudinal observational study using data from the Australian Longitudinal Study on Women's Health. The 1946–51 cohort (surveys 1–6, 1996–2010) and 1973–78 cohort (surveys 8–10, 2018–2024) were analysed separately using generalised estimating equations adjusting for age, body mass index, self-rated health, vasomotor symptoms, oral contraceptive use, menopause stage, and survey wave.
Results:
Socioeconomic gradients in MHT use differed between cohorts. In the 1946–51 cohort, lower educational attainment was associated with higher odds of MHT use, whereas in the 1973–78 cohort, higher educational attainment was associated with greater uptake (OR 1.27, 95% CI 1.18–1.38). In the younger cohort, women unable to afford private hospital insurance had lower odds of MHT use (OR 0.50, 95% CI 0.37–0.66). No consistent associations were observed for geographic remoteness or labour force participation.
Conclusions:
The direction of the educational gradient in MHT use differed between cohorts surveyed before and after the WHI. Financial constraint was associated with lower uptake. Within a universal healthcare system, shifts in clinical evidence may widen socioeconomic disparities when access depends on financial resources and evolving guidance.