1535888252 2018 Personal Development, Health and Physical Education Notes PDF

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Health Priorities in Australia Summary

Written by:

D. Jackson B App Sc (Ex & Sp Sc), Grad Dip Ed (PDHPE)

Pdhpe.net Publishing

Copyright © pdhpe.net 2015

Table of Contents How$are$priority$issues$for$Australia’s$health$identified?$..................................$2! Measuring$Health$Status$..........................................................................................................$2! Identifying$priority$health$issues$..........................................................................................$2! What$are$the$priority$issues$for$improving$Australia’s$health?$........................$4! Groups!experiencing!health!inequities?$...................................................................................$4! High$levels$of$preventable$chronic$disease,$injury$and$mental$health$problems$8! A$growing$and$ageing$population$......................................................................................$12! What$role$do$health$care$facilities$and$services$play$in$achieving$better$ health$for$all$Australians?$...........................................................................................$14! Health$care$in$Australia$.........................................................................................................$14! Complementary$and$alternative$health$care$approaches$.........................................$16! What$actions$are$needed$to$address$Australia’s$health$priorities?$..............$18! Health$promotion$based$on$the$five$action$areas$of$the$Ottawa$Charter$.............$18!

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How are priority identified?

issues

for

Australia’s

health

Measuring Health Status measuring health status − role of epidemiology − measures of epidemiology (mortality, infant mortality, morbidity, life expectancy)

critique the use of epidemiology to describe health status by considering questions such as: − what can epidemiology tell us? − who uses these measures? − do they measure everything about health status? use tables and graphs from health reports to analyse current trends in life expectancy and major causes of morbidity and mortality for the general population and comparing males and females

Role of Epidemiology Epidemiology is the study of patterns and causes of health and disease in populations, and the application of this study to improve health. It provides data on health status, particularly the incidence and prevalence of disease and illness. Researchers and government bodies use it to identify priority health issues. Epidemiology does not provide data on quality of life, disease impact or the determinants of health. Measures of epidemiology The key measures of epidemiology are infant mortality (baby death rates), morbidity (ill health), mortality (death), and life expectancy (years of life left at any given age).

Identifying priority health issues identifying priority health issues − social justice principles − priority population groups − prevalence of condition − potential for prevention and early intervention − costs to the individual and community

argue the case for why decisions are made about health priorities by considering questions such as: − how do we identify priority issues for Australia’s health? − what role do the principles of social justice play? − why is it important to prioritise?

Social Justice Principles The principles of social justice (equity, diversity and supportive environments) are used to help achieve equity in health outcomes for all people in Australia. Priority Population Groups Priority population groups are those that do not achieve the same health outcomes in any area as the rest of the population and include ATSI.

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Copyright © pdhpe.net 2015 Prevalence of the Condition Prevalence refers to the number of cases in the population at a given time; the higher the prevalence the higher the priority. Potential for Prevention and Early Intervention Potential for prevention means ability to avoid the condition from occurring CVD, while early intervention refers to the greater success of treatment is the condition is identified early - Cancer Costs to the individual and Community Cost to the individual and the community include money, time, mental health, independence, and time off work – Cancer is a high cost disease, while arthritis is not.

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What are the priority issues for improving Australia’s health? Groups experiencing health inequities? groups experiencing health inequities − Aboriginal and Torres Strait Islander peoples − socioeconomically disadvantaged people − people in rural and remote areas − overseas-born people − the elderly − people with disabilities

research and analyse Aboriginal and Torres Strait Islander peoples and ONE other group experiencing health inequities by investigating: − the nature and extent of the health inequities − the sociocultural, socioeconomic and environmental determinants − the roles of individuals, communities and governments in addressing the health inequities

Aboriginal and Torres Strait Islander peoples The nature and extent of the health inequities ATSI peoples experience the largest gap in health outcomes in Australia. They currently have a life expectancy 10 years lower than other Australians. The ATSI people have higher death rates in each age group and for CVD, edocrine disorders and diabetes than other Australians. The sociocultural, socioeconomic and environmental determinants Australia’s Health 2014 report states: “Many factors contribute to the gap between Indigenous and non-Indigenous health. Social disadvantage, such as lower education and employment rates, is a factor, as well as higher smoking rates, poor nutrition, physical inactivity and poor access to health services.”1 These determinants interact with each other to produce the gap in health outcomes. The roles of individuals, communities and governments in addressing the health inequities Individuals are empowered to make informed choices about their own behaviour. Communities and leaders of ATSI people were and are involved in many of the Closing the Gap programs and interventions. Eg) Aboriginal Community Controlled Health Services. The Close the Gap initiative is a statement of intent signed by Australia’s governments (state, territory & commonwealth). This statement aims to achieve equality in health status by reducing infant mortality, and increasing life expectancy in ATSI people.

1

Australia’s Health 2014.

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Copyright © pdhpe.net 2015 Socioeconomically Disadvantaged People The relationship between SES and health is so clear that it has its own term: “the social gradient of health”. The nature and extent of the health inequities Socioeconomically disadvantaged people have higher rates of chronic disease including: higher death rates from CHD, incidence of lung cancer, more obese, higher mortality rates from all cancer and lower life expectancy. The sociocultural, socioeconomic and environmental determinants Socioeconomically disadvantaged people are more likely to take part in risky health behavior, eg) smoking, overweight or obese, Higher rates of drinking, and lower rates of physical activity. Families pass these behaviours on to their children. Socioeconomically disadvantaged people have lower levels of education and income. This affects health as healthy choices are improved if the choice is an informed decision. They also have higher rates of hazardous work types, and unemployment. A lack of shelter and living on the street or in someone else’s house affects physical and mental health, as well as bringing a social stigma that will affect social health. There are higher rates of socioeconomically disadvantaged people in rural and remote areas. The roles of individuals, communities and governments in addressing the health inequities Individuals can seek to remain in school, or attend university to help individuals make informed choices about their health and health care. Individuals can also choose not to smoke or reduce alcohol intake. Communities can address the health inequities by providing relevant health care and support services. Eg) PCYC, ‘Youth of the Streets’ Finally the Australian Government’s address this inequity by supporting many community programs and providing funding for free or reduced cost health care. Eg) Medicare & PBS. People in Rural and Remote Areas The nature and extent of the health inequities People living in rural and remote areas have shorter lives and higher rates of disease and injury. Death rates increase with increased remoteness. The main causes of this increased death rate are: CHD, circulatory diseases, motor vehicle accidents and COPD. The sociocultural, socioeconomic and environmental determinants In rural and remote areas the proportion of ATSI peoples in higher than other areas. The poorer indicators of health influence children eg) families that have higher smoking rates, have higher rates of second hand smoke. They have lower health literacy. They are more likely to work on farms, in transportation or mines, which are hazardous occupations and have higher rates of tobacco and alcohol use. But have higher levels of social cohesiveness and participation in volunteer work. In rural and remote areas have less GPs, and limited access to general medical services. Eg) People with kidney disease often moved to less remote areas to access medical services. The interactions between remoteness, socioeconomic disadvantage and higher ATSI population along with the gaps in health information make the implications of remoteness hard to determine. The roles of individuals, communities and governments in addressing the health inequities Actions such as remaining in school, or seeking to attend university either online or even at rural or remote based universities such as Charles Sturt will improve their knowledge, employment opportunities and income levels and help individuals make informed choices about their health and health care used. The development of Multi Purpose Service Programs often connect with community

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Copyright © pdhpe.net 2015 services, and the development of community health centres with the services they offer. The government funds many rural and remote programs to assist in the delivery of health care to rural and remote living people. These include: the royal flying doctor service, and the Rural and Remote General Practice Program to help increase the number of GPs available in these areas. Overseas-Born People The nature and extent of the health inequities Overseas-born people often have better health than other Australians, this is because of the vigorous health checks required to migrate. Better health begins to wear off the longer overseas-born people live in Australia. Patterns in morbidity and mortality are highly influenced by their country of origin, their current location, and the process of migration. Overseas-born people have longer life expectancy, lower death rates, lower hospitalisation rates, and lower prevalence of lifestyle risk factors for disease. Overseas-born people had much greater rates of hospitalisation for tuberculosis, especially in Asia and other locations. The sociocultural, socioeconomic and environmental determinants The greatest health determinant is the sociocultural determinant. Overseasborn people face language barriers and other cultural barriers to accessing health services and participating in society. Poor English is linked with lower employment, poorer self-assessed health, lower life satisfaction and low levels of social participation. Language is a barrier to education, employment and income. They have higher unemployment rates resulting in lower income levels and less choice and access to health services. Environmental determinants for overseas-born people mostly relates to language barriers to accessing health information and services and suburbs that are dominated by particular cultures. Eg) Lebanese in Bankstown. The roles of individuals, communities and governments in addressing the health inequities Individuals can improve their health by enrolling in English classes or complete school and seek higher education, as well as promote healthy lifestyle choices. Communities provide adult English classes and can provide support for overseas-born people as they find employment or when they need medical assistance. Eg) Red Cross.2 Community health centres provide brochures in various languages and frequently a translator is available for the major languages in the location. The Australian Governments provide: translation services, crisis payments, multicultural service officers, 510 hours of free English lessons, information to assist new migrants to settle in Australia and a multilingual phone service.

2

See http://www.redcross.org.au/migration-support.aspx

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Copyright © pdhpe.net 2015 The Elderly The nature and extent of the health inequities The elderly refers to people over the age of 65. Chronic diseases and level of independence are of particular importance for the elderly. Conditions are often combined with the most common diseases being: vision or hearing impairment (35%), arthritis (49%) and musculoskeletal problems (such as hip and knee replacements), hypertension (38%), and high cholesterol. The elderly also have higher rates of CVD (22%), diabetes (15%) and cancer (7%0). Another major disease for the elderly is dementia, and high rates of injury by falls or transport. The sociocultural, socioeconomic and environmental determinants The elderly are often cared for by their children and begin to lose friends as they age reducing their support networks. The health of the elderly is affected by their reduced employment, this reduces their support networks and mental health A reduction in income, also restricts choice of health services. Access to services can become difficult with increased chronic illness. Reduced independency reduces access to services. The roles of individuals, communities and governments in addressing the health inequities Elderly can make healthier lifestyle choices such as: Quiting smoking, increasing physical activity levels and eating a healthy balanced diet. Communities provide many health services to assist the elderly. Eg) Meals on Wheels. Retirement villages often offer a range of services such as: social activities, GP home visits and transportation. Other home services will help clean houses and mow lawns for the elderly, such as Australian Unity Home Care. The Australian Government seeks to enable healthy ageing by maintaining and improving the health and quality of life amongst the elderly; by improving management of chronic conditions and enhancing the efficiency of the health-care system. People with Disabilities The nature and extent of the health inequities People with disability experience poorer health than other Australians. Nearly half of people 15-64 years old with disability report fair or worse health compared to other Australians. With higher rates of: young onset arthritis, osteoporosis before age 45, and young onset diabetes. People with disability also smoked more, were more overweight, and had more suicidal thoughts. The sociocultural, socioeconomic and environmental determinants Amongst people with disability ATSI and the elderly are over represented. A number of disabilities are genetic, which makes family and culture very important. Some people with disabilities are limited in their access to education, and employment and have reduced income. They have reduced access to health services and some require technology in order to be mobile. The government has helped to ensure people with disabilities have better access to health services ensuring every health centre, medical centre and hospital have disabled access. The roles of individuals, communities and governments in addressing the health inequities Individuals can be limited in their ability to change their health. Some have no choice of food or activities they are involved in. Others ended up with disability because of lifestyle choices. The Aging, Disability & Home Care community services include: early intervention programs, supported accommodation, living skills programs, social groups, helping find employment, advocacy, and awareness promotion The Australian government has established a National Disability Strategy that seeks to address many of the inequities experienced by people with disabilities. The government also has DisabilityCare Australia and seeks to provide nationally

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Copyright © pdhpe.net 2015 consistent assessment processes, improves service standards and developing the disability workforce. The Australian government also funds many community programs and developed the Disability Support Services and the Home and Community Care Program. Many people with disabilities utilise these programs and services.

High levels of preventable chronic disease, injury and mental health problems high levels of preventable chronic disease, injury and mental health problems − cardiovascular disease (CVD) − cancer (skin, breast, lung) − diabetes − respiratory disease − injury − mental health problems and illnesses

research and analyse CVD, cancer and ONE other condition listed by investigating: − the nature of the problem − extent of the problem (trends) − risk factors and protective factors − the sociocultural, socioeconomic and environmental determinants − groups at risk

Cardiovascular disease (CVD) The nature of the problem Cardiovascular disease refers to all the diseases of the circulatory system (heart and blood vessels). The main cause of many of these diseases is atherosclerosis, which can cause blockage and result in death of cells eg) heart attack. Extent of the problem (trends) Cardiovascular diseases are the leading causes of death in Australia, are the largest burden of disease, and are the most costly diseases. The current trend in death rates is downward mostly due to improvements in medical and surgical treatments. Risk factors and protective factors There are many risk factors for cardiovascular disease, but the main ones are: hypertension (high blood pressure), physical inactivity, obesity, and smoking. Some protective factors include: regular physical activity, regular health checks, and eating a balanced diet low in saturated fats. The sociocultural, socioeconomic and environmental determinants Genetics play an important role in cardiovascular disease. Peers and family also influence individual’s behavioural choices eg) smoking, inactivity. Health literacy and knowledge influences lifestyle choices. Higher income provides access to better health services and certain employment types have higher rates of CVD eg) tradies. People living in rural areas have higher rates of death from cardiovascular disease. This could be because the later access to medical treatment for heart attacks or a stroke.

Groups at risk There are a number of groups at risk of cardiovascular disease. These include: ATSI, socioeconomically disadvantaged, rural and rem...