Adherence to Public Health Recommendations, Restrictions, and Requirements among Priority Populations at Risk for COVID-19 Mortality and Infection in Australia
1
The Burnet Institute, Melbourne, Australia
2
Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Australia
3
Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
4
Department of Infectious Diseases, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Victoria, Australia
5
School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A3148
ABSTRACT
BACKGROUND:
In Australia, priority populations such as culturally and linguistically diverse (CALD) and low socio-economic status (SES) groups experienced higher COVID-19 infection, mortality and a disproportionate impact from public health restrictions. This study examines adherence to COVID-19 public health measures among CALD and low-SES populations in Australia using a longitudinal cohort.
METHODS:
The Optimise Study was a mixed-methods longitudinal cohort and social networks study (2020–2023) assessing the impact of COVID-19 and related public health measures in Victoria, Australia. We used a serial cross-sectional design to analyse adherence to public health recommendations (non-enforced,longer-term), restrictions (mandated during lockdown periods), and requirements (mandated,longer-term). The study compares adherence to the three categories of COVID-19 public health measures across two 28-day periods during the COVID-19 pandemic in Victoria:April 23–May 20,2021 (‘non-lockdown’), and September 13–October 10,2021 (‘lockdown’). Participants were grouped as: 1) non-CALD high-SES (did not meet CALD or low-SES criteria), 2) CALD, or 3) non-CALD low-SES. Primary outcomes were adherence to Recommendations, Restrictions, and Requirements during the two study periods.
RESULTS:
Of 782 participants, 579 (75%) completed a survey or diary during at least one study period and were included in analysis. Of these, 275 (47%) were in the ‘non-CALD high-SES’ group, 114 (20%) in the CALD group, and 190 (33%) in the ‘non-CALD low-SES’ group. Across all groups, risk-reduction behaviours increased during the lockdown. CALD participants showed significantly higher adherence to some Recommendations and Restrictions compared to the other groups. Overall, 28% left home while awaiting a COVID-19 test result, commonly due to work.
CONCLUSIONS:
High adherence among CALD and ‘non-CALD low-SES’ groups suggest structural barriers, rather than behavioural non-compliance, contributed to higher COVID-19 impacts, highlighting the need for tailored support. During future public health emergencies, better supports are needed for individuals working outside home to remain in isolation while awaiting a test result.
In Australia, priority populations such as culturally and linguistically diverse (CALD) and low socio-economic status (SES) groups experienced higher COVID-19 infection, mortality and a disproportionate impact from public health restrictions. This study examines adherence to COVID-19 public health measures among CALD and low-SES populations in Australia using a longitudinal cohort.
METHODS:
The Optimise Study was a mixed-methods longitudinal cohort and social networks study (2020–2023) assessing the impact of COVID-19 and related public health measures in Victoria, Australia. We used a serial cross-sectional design to analyse adherence to public health recommendations (non-enforced,longer-term), restrictions (mandated during lockdown periods), and requirements (mandated,longer-term). The study compares adherence to the three categories of COVID-19 public health measures across two 28-day periods during the COVID-19 pandemic in Victoria:April 23–May 20,2021 (‘non-lockdown’), and September 13–October 10,2021 (‘lockdown’). Participants were grouped as: 1) non-CALD high-SES (did not meet CALD or low-SES criteria), 2) CALD, or 3) non-CALD low-SES. Primary outcomes were adherence to Recommendations, Restrictions, and Requirements during the two study periods.
RESULTS:
Of 782 participants, 579 (75%) completed a survey or diary during at least one study period and were included in analysis. Of these, 275 (47%) were in the ‘non-CALD high-SES’ group, 114 (20%) in the CALD group, and 190 (33%) in the ‘non-CALD low-SES’ group. Across all groups, risk-reduction behaviours increased during the lockdown. CALD participants showed significantly higher adherence to some Recommendations and Restrictions compared to the other groups. Overall, 28% left home while awaiting a COVID-19 test result, commonly due to work.
CONCLUSIONS:
High adherence among CALD and ‘non-CALD low-SES’ groups suggest structural barriers, rather than behavioural non-compliance, contributed to higher COVID-19 impacts, highlighting the need for tailored support. During future public health emergencies, better supports are needed for individuals working outside home to remain in isolation while awaiting a test result.
| eISSN: | 2654-1459 |
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