12 PDHPE - CORE 1 HEALTH PRIORITIES IN AUSTRALIA FOCUS QUESTIONS How are priority issues for Australias health identified? What are the priority issues for improving Australias health? What role do health care facilities and services play in achieving better health for all Australians? What actions are needed to address Australias health priorities? FOCUS QUESTION 1

How are priority issues for Australias health identified? SYLLABUS How are priority issues for Australias health identified? Students learn about: WHAT YOU NEED TO KNOW:

measuring health status role of epidemiology measures of epidemiology (mortality, infant mortality, morbidity, life expectancy)

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 Students learn to: WHAT YOU NEED TO BE ABLE TO DO:

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

MEASURING HEALTH STATUS To identify health priority issues within a population it is necessary to understand the health status of that population and its subgroups. The health status of a nation is the pattern of health of the population in general over a period of time. We measure health status through the process of data and information collection known as epidemiology, which is the study of disease in groups or populations.

KEY WORD DEFINITION Epidemiology: is the study of disease in groups or populations. ROLE OF EPIDEMIOLOGY Epidemiology is used by governments and health-related organisations to obtain a picture of the health status of a population, to identify the patterns of health and disease, and analyse how health services and facilities are being used. Epidemiology considers the patterns of disease in terms of: prevalence (the number of cases of disease in a population at a specific time) incidence (the number of new cases of disease occurring in a population) distribution (the extent) apparent causes (determinants and indicators).

KEY WORDS DEFINITIONS Prevalence: the number of cases of disease in a population at a specific time Incidence: the number of new cases of disease occurring in a population ROLE OF EPIDEMIOLOGY: WHY DO IT? Observations and statistics help researchers and health authorities to: describe and compare the patterns of health of groups, communities and populations identify health needs and allocate health-care resources accordingly evaluate health behaviours and strategies to control and prevent disease identify and promote behaviours that can improve the health status of the

overall population, such as eating less fat and more fibre. DISCUSS 0:38 WHAT TYPE OF DATA IS COLLECTED? The data collected through the epidemiological process focus on quantifiable and direct measures of ill health (or the lack of good health), such as patterns of illness, injury and death, rather than on the positive qualities of health and well-being. Epidemiology commonly uses statistics on:

births deaths disease incidence disease prevalence contact with health-care providers hospital use (treatment received in hospitals for medical problems) injury incidence work days lost money spent on health care. WHY WOULD THIS INFORMATION BE RELEVANT TO HEALTH STATUS

Activity: Justify why these three sources of data would be an important indicator of health status contact with health-care providers hospital use work days lost POSSIBLE HSC QUESTION LIMITATIONS OF EPIDEMIOLOGY

Epidemiology has proved to be an effective approach to measuring health status, but it has some limitations. For example, epidemiological statistics: do not always show the significant variations in the health status among population subgroups (for example, between Aboriginal and non- Aboriginal Australians) might not accurately indicate quality of life in terms of peoples level of distress, impairment, disability or handicap. Statistics tell us little about the degree and impact of illness. cannot provide the whole health picture. Data on some areas, such as mental health, are incomplete or non-existent. fail to explain why health inequities persist do not account for health determinants the social, economic, environmental

and cultural factors that shape health. LIMITATIONS OF EPIDEMIOLOGY CONTINUED Statistics also have limitations due to: the varying reliability of data the numerous sources of information imprecise methods of data collection whether surveys use standard instruments, definitions and classifications LIMITATIONS OF EPIDEMIOLOGY CONTINUED

MEASURES OF EPIDEMIOLOGY Mortality (death rates): indicates how many people die in a particular population, how they died and over what period. Expressed per 100 000. Infant mortality: indicates the number of infant deaths in the first year of

life per 1000 live births Morbidity (disease and sickness rates): examines the prevalence and incidence of disease and sickness in a specific population Life expectancy: indicates the number of years a person is expected to live.

MORTALITY 143473 deaths were registered in 2010 in Australia, of which 73484 (51 per cent) were males and 69 989 (49 per cent) were females WHAT IS THE #1 KILLER OF MALES? WHAT IS THE #1 KILLER OF FEMALES? The standardised death rates (deaths per 100 000 of population) for all categories of overseas-born Australians, both male and female, are lower than those of the Australian-born population WHY DO YOU THINK THIS IS?

In Australia overall, the main causes of death are cardiovascular (heart and blood vessel) diseases, cancers and respiratory diseases. For some of the leading causes of death, such as heart disease, strokes and some types of cancer, the death rates are falling. WHAT IS THE #1 KILLER OF MALES? WHAT IS THE #1 KILLER OF FEMALES? INFANT MORTALITY WHY WOULD DIFFERENT

POPULATIONS WITHIN AUSTRALIA EXPERIENCE DIFFERENT LEVELS OF INFANT MORTALITY? STATE 3 REASONS WHY? 1. 2. 3. INFANT MORTALITY This measure is considered to be the most important indicator of the health status of a nation, and can also predict adult life expectancy.

Infant mortality can be divided into: neonatal (deaths in the first 28 days of life) post-neonatal (deaths in the remainder of the first year of life). The former is influenced by the quality of maternal and neonatal care. The infant mortality rate in Australia has declined steadily over the past few decades. The infant mortality rate was 3.8 infant deaths per 1000 live births in 2011. INFANT MORTALITY The decline in the infant mortality rate over recent decades can be attributed to: improved medical diagnosis and treatment of illness improved public sanitation

health education improved support services for parents and newborn babies and children. Despite a continued decline, infant mortality still accounts for 70 per cent of all deaths of children aged 014 MORBIDITY Morbidity measures and indicators include: Hospital Visits Doctor visits & Medicare statistics Health surveys and reports Disability & Handicap Is it fair to judge morbidity based on disability?

Is it discrimination? MORBIDITY TRENDS Cancer is Australias leading broad cause of disease burden (19% of the total), followed by cardiovascular disease (16%) and mental disorders (13%). The rate of heart attacks continues to fall, and survival from them continues to improve. Around 1 in 5 Australians aged 1685 years has a mental disorder at some time in a 12-month period, including 1 in 4 of those aged 1624 years. The burden of Type 2 diabetes is increasing and it is expected to become the leading cause of disease burden by 2023. The incidence of treated end-stage kidney disease is increasing, with diabetes as

the main cause. LIFE EXPECTANCY For people born in the period 20082010, average life expectancy at birth was 84.0 years for females and 79.5 years for males. Life expectancy is greater now than it was a few decades ago and is increasing. In other words, people are now living longer. Australia has one of the highest life expectancy rates, ranking fifth in the world, with only people in Japan, Andorra, Iceland and Switzerland living longer. POSSIBLE HSC



death rates at all ages. These improvements can be attributed to: lower infant mortality declining death rates for cardiovascular disease declining overall death rates from cancer fall in deaths from traffic accidents. HOMEWORK PLAN A PEEL RESPONSE FOR HSC QUESTIONS: WHAT IS THE IMPACT ON HEALTH SERVICES IF AUSTRALIANS ARE LIVING LONGER? Limitations of epidemiology

IDENTIFYING HEALTH PRIORITY ISSUES In order to improve Australias health, governments and health authorities prioritise particular health issues, based generally on: how much they contribute to the burden of illness in the community their potential for reducing this burden. POSSIBLE HSC QUESTION DISCUSS HOW PRIORITY HEALTH

ISSUES ARE IDENTIFIED? WHAT WOULD CONTRIBUTE TO A BURDEN ON COMMUNITY? (5 ASPECTS) IDENTIFYING PRIORITY HEALTH ISSUES. SOCIAL JUSTICE Social justice principles relate to eliminating inequity in health, promoting inclusiveness of diversity and establishing supportive environments for all Australians. We need to recognise and address inequities in health. These inequities

encompass both differences in the incidence and prevalence of sickness and death, and inequalities in the social, economic, political and cultural factors that influence health. For example, high incidence of diabetes in the indigenous population and the high incidence of injury in the 1524 years age group are significant inequities in health. KEY WORDS DEFINITIONS Inclusiveness: the provision of certain rights to all individuals and groups in society Diversity: comprises the differences among the individuals and among groups of people PRINCIPLES OF SOCIAL JUSTICE

SOCIAL JUSTICE IN ACTION: CLOSE THE GAP https://www.oxfam.org.au/what-we-do/indigenous-australia/close-the-gap/ Answer the following questions: 1. Discuss how the Close the Gap campaign aims to address social justice inequities 2. Identify the health priority issue or issues being focused on a to improve Australias health. PRIORITY POPULATIONS ATSI

LOW SES WHAT HEALTH INEQUITIES DO THEY EXPERIENCE? Indigenous populations have much higher death rates from heart disease, injury, respiratory diseases and diabetes WHAT HEALTH INEQUITIES DO

THEY EXPERIENCE? A higher incidence of disease risk factors such as high blood pressure, high cholesterol levels, smoking and lower use of preventative health services RURAL & REMOTE WHAT HEALTH INEQUITIES DO THEY EXPERIENCE?

Have higher death rates and a higher incidence of heart disease and injury, compared with people who reside in metropolitan areas WHAT IS A HEALTH INITIATIVE THAT AIMS TO REDUCE THE INEQUITIES EXPERIENCED BY THESE POPULATIONS?

PREVALENCE OF CONDITION Epidemiological data provide a guiding path for determining the priority areas for Australias health. High prevalence rates of a disease indicate the health and economic burden that the disease or condition places on the community. Statistics reveal, for example, that cardiovascular disease is the leading cause of preventable death in Australia. POTENTIAL FOR PREVENTION & EARLY INTERVENTION The majority of diseases and illnesses suffered by Australians result from poor lifestyle behaviours.

It would seem easy to improve health status by encouraging individuals to change their poor behaviours, but the situation is not this simple. It is difficult to change individual behaviours because often they reflect the environmental situation in which the individual lives. Identify environmental factors that would create barriers in achieving optimal health? POTENTIAL FOR PREVENTION & EARLY INTERVENTION For change to occur that is, for the burden of the major causes of disease and sickness to be reduced we must address both individual behaviours and

environmental determinants. Most of the chronic diseases, injuries and mental health problems have social and individual determinants that can be modified, so prevention and early intervention may lead to improved health status KEY WORD: POTENTIAL FOR CHANGE Identify an early intervention strategy that is working towards reducing the prevalence of one priority health area. COST TO THE INDIVIDUAL & COMMUNITY

Disease and illness can place a great economic and health burden on the individual, which can be measured in terms of financial loss, loss of productivity, diminished quality of life and emotional stress. The cost of treatment, medication and rehabilitation may be more than the individual can afford. COST TO THE INDIVIDUAL & COMMUNITY Injury and disease may affect the individuals ability to be productive, and often the need to stop work during treatment and rehabilitation reduces the individuals ability to earn and thus to maintain their quality of life. The emotional stress and social upheaval that often result from illness and

injury are another burden. It is difficult to estimate the pain and suffering that an individual experiences as a result of illness and injury, but it is a significant factor. COST TO THE INDIVIDUAL & COMMUNITY Illness results in both direct and indirect costs. Direct costs include the money spent on diagnosing, treating and caring for the sick, plus the money spent on prevention. These costs can be estimated from the expenses of medical services, hospital admissions, pharmaceutical prescriptions, prevention initiatives, research, screening and education, for example. Indirect costs are the value of the output lost when people become too ill to

work or die prematurely (for example, the cost of forgone earnings, absenteeism and the retraining of replacement workers). POSSIBLE HSC QUESTION Cardiovascular disease is the leading cause of preventable death in Australia. EXAMINE THE HEALTH STATUS OF ABORIGINAL & TORRES STRAIT ISLANDERS (ATSI) AND DEMONSTRATE HOW SOCIAL JUSTICE PRINCIPLES



however, it is not trend experienced by all populations. These differences exist in terms of: the unequal distribution of some illnesses or conditions throughout the population (across different cultures, geographic locations, ages and genders) health inequities; that is, the unjust impact on the health status of some groups due to social, economic, environmental and cultural factors, such as income, education, availability of transport and access to health services. KEY WORD: Inequities: are unfair differences in levels of health status between groups in a society.

GROUPS EXPERIENCING INEQUITIES Health to a large extent is the result of peoples decisions about health behaviours (such as regular participation in physical activity) and their every day experiences as they interact and respond to the social, physical and cultural environments in which they live However, an individuals level of health is determined by a broader range of factors. Sociocultural, socioeconomic and environmental factors play a significant role in the achievement of good health Some factors are modifiable eg. choosing to smoke, whilst others are nonmodifiable eg. genetic predisposition to cancer

GROUPS EXPERIENCING INEQUITIES Health is therefore not only the responsibility of the individual. Governments and health authorities recognise that people cannot always choose a particular lifestyle. Health promotion and illness prevention campaigns attempt to address the determinants that have an impact on health or affect peoples ability to make good decisions about their health. These can be classified as: sociocultural determinants of health include family, peers, media, religion and culture.

socioeconomic determinants of health include employment, education and income. environmental determinants of health include geographical location, and access to health services and technology. GROUPS EXPERIENCING INEQUITIES GROUPS EXPERIENCING INEQUITIES Aboriginal and Torres Strait Islander peoples socioeconomically disadvantaged people

people in rural and remote areas overseas-born people elderly people ANALYSIS CRITERIA The nature and extent of the health inequities the sociocultural, socioeconomic and environmental determinants the roles of individuals, communities and governments in addressing the


know about Indigenous health and the inequities they experience. GO TO ATSI HEALTH PREZI HOMEWORK TASK: MINI-PRESO In small groups(3-4 pax) you are to research and create a presentation that: Analyses 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

Compare & contrast to the health status of Aboriginal and Torres Strait Islander peoples PRESENTATION CAN BE DONE IN ANY FORMAT Max. 10 mins long GROUPS MUST PRODUCE AN INFORMATION HANDOUT FOR CLASS POSSIBLE HSC QUESTION HAVE A GO AT THIS. Explain the nature and extent of health inequities within Australia for

one group OTHER than Aboriginal and Torres Strait Islanders. 5 Marks 2012 Question 24 Explain the roles of individuals, communities and governments in addressing the health inequities experienced by ONE group other than Aboriginal and Torres Strait Islander peoples. 8 Marks WHAT DO THEY DO? Individuals? Communities? Government?

WHAT ARE THEIR ROLES IN REDUCING HEALTH INEQUITIES? A GROWING & AGEING POPULATION Australias population is a growing and ageing population. This growing and ageing population is one of Australias health priorities because with a growing and ageing population comes an increase in disease burden and health care demand.

Australias growing and ageing population is a product of increased life expectancy, and decreased birth rates. The increasing survival rates for chronic diseases means that the elderly population have greater prevalence of major diseases, such as: cancer, cardiovascular disease, diabetes, and musculoskeletal disorders, as well as suffering greater levels of disability. As the growing and ageing population increase the population living with chronic disease and disability, they also increase the demand for health services, which causes workforce shortages and a greater need for carers and volunteers. QUESTION: BESIDES AGEING & BIRTH, WHAT IS ANOTHER REASON AUSTRALIAS POPULATION IS GROWING?

HEALTHY AGEING As a consequence of our ageing population, the government has responded by encouraging people to plan for financial security and independence for their later years in life. The government has provided the elderly with a wide variety of services and support, depending on their needs. If people are unhealthy later in life due to sickness or injury, their working years are likely to be shortened, resulting in a reduction in economic growth. Governments are promoting good health throughout life, as well as disease prevention. People who achieve and maintain good health are less likely to access health and aged care services later in life. The government has appointed an Ambassador for Ageing, who is responsible for:

promoting positive and active ageing encouraging the contributions made by older people promoting community government programs and initiatives to the public assisting older people to access these programs. TO WORK OR NOT TO WORK? What are the benefits of staying in the

workforce? Financial earn more, security in retirement Social communication, connectedness Mentally active maintain cognitive function, routine (use it, lose it) Fitness maintaining minimal 30min movement

Empowerment active member of community, contributing INCREASED POPULATION LIVING WITH DISABILITY & CHRONIC DISEASE As well as significant improvements in the number of people surviving heart attacks, strokes and cancers, our ageing population has led to an increase in the number of Australians with a chronic disease or disability. Chronic, noncommunicable diseases account for approximately 80 per cent of the total burden of disease in Australia and it is estimated that they will be responsible for about three-quarters of all deaths by 2020.

WHAT IS THE IMPACT ON OUR HEALTH SYSTEM? DEMAND FOR HEALTH SERVICES & WORKFORCE SHORTAGES The government has recently proposed a number of initiatives to meet the needs of older Australians, including: increased residential aged care places more funding for dementia care in aged care attracting, retaining and training aged care workers DEMAND FOR HEALTH SERVICES &

WORKFORCE SHORTAGES In addition, there has been a concern that many people suffering poor health are unable to contribute to the workforce, thus leading to general shortages of labour. The government has taken action in response to this concern by improving Australias retirement income system in the following ways. A means-tested age pension is available to provide income for people after retirement. All Australian employers are required to provide compulsory superannuation cover for all eligible employees. Under the superannuation guarantee, the minimum level of superannuation cover made by employers is nine per cent of an employees gross salary. Voluntary, private superannuation contributions and other forms of private savings, made by employees, are also encouraged.

Such initiatives encourage people to plan for financial security and independence for their late years of life to reduce the economic burden on the government as Australias population ages. AVAILABILITY OF CARERS & VOLUNTEERS Australias workforce consists not only of paid workers, but also carers and volunteers, who are ageing with the rest of the population. Older Australians can contribute to society in myriad ways, such as by being paid workers, carers, volunteers or family members. Caring and volunteering are recognised as productive activities. Australians over the age of 55, for example, contribute approximately $75 billion per annum in unpaid caring and volunteering activities. Over 50 per cent of this amount

is contributed by people aged over 65. HOMEWORK: AVAILABILITY OF CARERS & VOLUNTEERS Investigate three types of carer or volunteer organisations available to meet the needs of Australias ageing population. Two examples are Carers NSW and Volunteering Australia. WHO ARE THEY? WHERE ARE THEY LOCATED? WHAT DO THEY DO? HOW DO THEY RUN THEIR SERVICE ?

FOCUS QUESTION 3 What role do health care facilities and services play in achieving better health for all Australians? SYLLABUS HEALTH CARE IN AUSTRALIA Because the major causes of sickness and death relate to lifestyle, the aim is to improve quality of life through health promotion initiatives that establish environments that enhance positive health behaviour. The role of health care is to achieve a delicate balance between resources for

prevention and resources for treatment. This changing emphasis towards prevention has been seen in numerous national health campaigns. Examples include HIV/AIDS, breast cancer and mental health. In summary, the role of health care is no longer simply curative. Instead, it is concerned with ensuring an improvement in the health of the population as a whole through a combination of preventative strategies and clinical medical care TYPE RANGE AND TYPES OF HEALTH CARE

SERVICES DESCRIPTION Public Hospital Government owned, used for medical treatments, caters for overnight stays. Medicare covers most payments Private Hospital Individually and community owned, private insurance required. Often has many additional benefits

Psychiatric Hospital Nursing Homes Used for treatment of people suffering mental illness Long term care given to people who cant look after themselves. EG. The elderly/chronically ill Medical Services Refers to GPs and specialists EG cardiologist, dermatologists,

Dental Services Services related to teeth and gum disorders Pharmaceuticals Drugs and medicines. Most drugs are supplied through the pharmaceutical benefits scheme (PBS). Also people can get prescriptions from GP and Over The Counter drugs Professional Services Community Health Services

Other health services such as physiotherapists, chiropractor, ambulance Meals on wheels, baby health centres community based RESPONSIBILITY FOR HEALTH FACILITIES & SERVICES WHO Commonwealth Government DESCRIPTION Sets policy and legislation (PBS)

Provides funding for health care Looks after war veterans and ATSI programs State Government Provides the ACTUAL health services. EG the hospitals Develops state programs. EG ATSI health in NT Controls health facilities and employment of staff Local Government Develops local health promotion campaigns. EG Healthy canteens

Provision of community health services. Private Sector Provides private medical services and private hospitals Contributes to research. EG national heart foundation, cancer council, diabetes Australia Business and companies provide health care facilities. EG workplace gyms Communities Provides community (often voluntary) services such as meals on wheels, home nursing etc

Individual Responsibility lies with individuals to make wise decisions regarding their need for appropriate health care and effective screening behaviours BRAIN STORM WHAT MAY PREVENT OR LIMIT AN INDIVIDUALS ACCESS TO HEALTH SERVICES? EQUITY OF ACCESS TO HEALTH FACILITIES & SERVICES

Access to health services and facilities is essential to health and well-being. The cornerstone of Australias health care system is Medicare. Medicare is designed to allow simple and equitable access to all Australian citizens regardless of location and socio-economic status. Supporting programs, such as the Medicare Safety Net (the amount of what ppl need to pay is capped) and Pharmaceutical Benets Scheme (government subsidising medicines) , are also in place to promote equity of access. Although, in principle, equity of access is the intention, some individuals and groups nd it dicult to access appropriate health services and facilities. Medicare does not fully cover, or provide access to, a range of medical services that are vital for maintaining good health. This places people of low SES at a disadvantage. EG speech therapy and physiotherapy. Access to health services has also been hampered in recent years by overcrowding and lack of bed

availability in public hospitals. Access can also be dicult for people in rural or remote areas People from non-English speaking backgrounds and dierent cultures might also not take full advantage of the services available to them. Actively involving these communities in the establishment and delivery of their health services will result in more eective care and improved health choices. BRAIN STORM WHAT MAY PREVENT OR LIMIT AN INDIVIDUALS ACCESS TO HEALTH SERVICES? EQUALITY


POSSIBLE HSC QUESTION COMMUNITY HEALTH CARE ACTIVITY Identify the ways in which the community takes responsibility for the individual health problems Do you think that the communitys level of responsibility should be greater or less? Justify you answer Outline the factors that influence access to health care facilities and services

A)Identify the health care services most relevant to you at this point in your life. B)Are they easily accessible? C) Is the quality of service adequate? Medicare does cover 85 per cent of the MBS fee for out-of-hospital services provided by registered medical practitioners (for example, GPs, specialists, X-rays, pathology tests) INS & OUTS OF MEDICARE

Medicare does not cover Private patient hospital costs (other than dental examinations and treatment) 75 per cent of the MBS fee for medical services provided in-hospital General dental services The full cost of accommodation and treatment by hospital-appointed doctors for public patients in recognised public hospitals

Ambulance The full cost of X-rays and pathology tests for public patients Home nursing 85 per cent of the cost of eye tests Physiotherapy 75 per cent of in-hospital medical procedures performed by oral surgeons (general dental services are covered by Medicare)

Free out-patient services in some public hospitals Speech therapy Chiropractic services Podiatry Psychology Acupuncture Glasses and contact lenses MEDICARE VS PRIVATE

INSURANCE https://youtu.be/BsSwxFhB6MQ Private vs Public Health https://youtu.be/mmaElbcQj5g Using the health care system ACTIVITY 1) Outline the benefits of private health insurance 2) Propose why some people choose not to take out private health insurance EMERGING NEW TREATMENTS & TECHNOLOGIES Medical technology refers to the procedures, equipment and processes by which medical care is delivered.

High tech medicine is often linked to high quality health care. Enhanced quality of health occurs when new technology produces better diagnosis, quicker and more effective treatment. Technology accounts for a large increase in health care costs Technology advances allow medical workers to diagnose and treat greater numbers Screening improvements result in higher detection, therefore greater costs in care Technology increases peoples ability to survive illness and disease. This means they live longer and therefore may contract illnesses later on in life New cancer and heart disease drugs New vaccine developments Gardasil for cervical cancer Keyhole surgery brings

quicker recovery times Laser surgery is less invasive PET (positron emission tomography) allows detection of tumours that may now be found using MRI or CT scans Use of robots in surgery HEALTH EXPENDITURE VS EARLY

INTERVENTION VS PREVENTION The majority of health expenditure is on health goods and services, such as medications and hospital care. A major matter of consideration for all levels of government is the delicate balance of treatment versus early intervention and prevention. In recent times signicant steps have been taken in the area of health promotion and illness prevention. Health promotion and prevention programs were supported by an increase in funding during the 1990s. Despite this increase, more than 90 per cent of government health expenditure is still allocated to curative services. With Australias leading causes of death and illness being lifestyle-related, the

argument that prevention will be more cost-eective than cure has gained considerable support. HEALTH EXPENDITURE VS EARLY INTERVENTION VS PREVENTION school medical and dental services

immunisation programs anti-smoking campaigns the National Campaign Against Drug Abuse the National Mental Health Strategy Despite the strength of the arguments supporting an increase in preventative measures over curative, there seems little hope for a signicant shift in government expenditure in the short term. Governments are reluctant to cut back on funding to curative health services and divert it towards preventative strategies. The reason for this is that the results, especially nancial savings, are not seen in the short term For example a large amount of expenditure dedicated to reducing the number of young people who smoke

or to limiting sun exposure will not be reected in lower cancer ratesand resultant nancial savingsfor 1530 years. For a government currently in oce, that expenditure might be more benecial politically if used to shorten hospital waiting lists or to provide for other over-burdened curative services Explain why Governments would choose to spend more money on curative services compared to preventative services. COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPROACHES Complementary and alternative health care approaches is a group of diverse medical and health care systems, practices and products that are not generally considered to be part

of conventional medicine. Australians spend approximately $1 billion per year on alternative health care Complementary therapies are so-called because they are not necessarily designed to replace orthodox medicine, but are an additional approach that can be used alongside traditional treatments. Treatments such as acupuncture and osteopathy, and the use of herbal medicines, are now far more common than they once were Another reason for the growth in alternative medicines and health care approaches has been the increase in the number of trained personnel as a result of courses now being provided in some universities The popularity of alternative medicines and health care is also linked to a reaction in the community against the use of conventional drug-based medication, and a preference by some people for the holistic approach oered by natural therapies where diet and lifestyle

are discussed. COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPROACHES People are also starting to show a greater interest in natural health care because it is designed to prevent illness occurring, whereas conventional medicine is largely reactive. Another reason for the growth of alternative health care is that some private insurers are now recognising natural therapies and placing them on their benets list. Type

Acupuncture Aromatherapy Chiropractic Herbal Medicine Iridology Description Uses fine needles to stimulate change in the energy balance of body to restore health. Can be used for pregnancy and stress also http://www.youtube.com/watch?v=WzMUhD8hecU&feature=channel Uses oils from nature (plants, flowers) to stimulate or relax the body. Can also maintain resistance from disease.

Manipulation of the spine to correct spinal displacements http://www.youtube.com/watch?v=O5wB-iSUsYg&feature=related Herbs are used following traditional customs as an alternative to pharmaceutical drugs. Diagnoses the state of the body from examination of the iris (eye) Naturopathy Based on the belief that the body can heal and maintain itself. Herbs, vitamins, and diet are used to help the person take responsibility for their own health. Many terminal cancer patients try this method. Can be used also for adhd treatment also. Reflexology

Reflexes in the feet and hands relate to most the body and can promote healing and relaxation. http://www.youtube.com/watch?v=DRtvN6VLw5s&feature=channel Yoga Yoga has been found to reduce stress and lower blood pressure through a combination of breathing exercises, physical postures and meditation. Osteopathy Osteopathy involves manual deep-tissue massage and the manipulation of the spine, joints and surrounding tissue to

alleviate back pain, joint problems and muscular disorders COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPROACHES How to make informed consumer choice

Despite the increased acceptance of alternative health care approaches there are still many treatment options promoted as cures or remedies that have been designed by unscrupulous dealers attempting to take advantage of people desperate to obtain relief from ailments It can be difficult to gain information regarding alternative health care. Many drug companies fund much of the medical research, therefore not much research is dedicated to alternative medicine research as this could take away some of their earning potential

COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPROACHES The product is only available from 1 source Products are advertised as cure alls and promise quick fix results Warnings to look out

for Impressive medical language is used throughout Case studies with amazing results are provided but are under documented HOMEWORK ACTIVITY 1. Explain why alternative medicines are called complementary therapies.

2. Describe the factors that have contributed to the increased acceptance and popularity of alternative medicines and approaches. 3. Outline how a health consumer can ensure that an alternative approach is of some value. 4. Describe what recourse the consumer has if the treatment is unsuccessful. POSSIBLE HSC QUESTION CARE FACILITIES AND

SERVICES PLAY IN ACHIEVING BETTER HEALTH FOR ALL AUSTRALIANS 1. Evaluate health care in Australia in relation to social justice principles. 2. Describe the advantages and disadvantages of Medicare and private health insurance. 3. There is a range of health services and information available to the individual. Justify the factors you would consider when deciding on the suitability of health services and information.

4. Propose the reasons for the growth of alternative health care approaches in Australia. 5. Describe how many sectors of the community share the responsibility for health care in Australia 6. Explain how a greater focus on health promotion and prevention could lead to HOMEWORK: WHERE UR STUDY AT? Part 1: Summarise GROUPS EXPERIENCING HEALTH INEQUITIES: Aboriginal and Torres Strait Islander peoples (Focus Q2) Part 2: You need to bring in:

All HSC written summaries: All of Focus Q1, all presentation handouts (mental health, Cancer, Diabetes, Respiratory disease, injury, cardiovascular disease) FOCUS QUESTION 4 Actions required to address Australias health priorities SYLLABUS LETS GO BACK... WHAT ARE THE FOUR SECTORS THAT SHARE RESPONSIBILITY FOR HEALTH PROMOTION?

RESPONSIBILITY FOR PROMOTING HEALTH ANALYSE: SHOW YOUR COLOURS DAY 2017 1. Describe the involvement of each sector responsible for Health Promotion in MHS Harmony Day? 2. Justify the effectiveness of the initiative (MHS Harmony Day) based on involvement of individuals and community BENEFITS OF PARTNERSHIPS IN HEALTH PROMOTION Effective health promotion must involve the cooperation of a

variety of government and non-government organisations (NGO). This is known as inter-sectoral involvement. Health promotion success has a strong link to successful partnerships between individuals, communities, governments and NGOs It also emphasises the importance of creating an empowering environment that is fully supportive of positive health behaviours and actively involves the community. BENEFITS OF PARTNERSHIPS IN HEALTH PROMOTION Inter-sectoral action about a health concern makes possible the joining of all the knowledge available about the health concern

It also allows for access to the resources and skills needed to understand and solve complex issues where possible solutions lie outside the capacity and responsibility of a single sector. Effective health promotion relies heavily on how it is planned, delivered & evaluated to optimise its ability to meet individual and community needs. PROPOSE: HOW DO WE ENSURE THE SUCCESS OF A NO HAT, NO PLAY TYPE POLICY IN HIGH SCHOOL?

BENEFITS OF PARTNERSHIPS IN HEALTH PROMOTION Enabling individuals and communities to be a part of the decision-making process about their health & health services, empowers them to make better choices & feel more responsible for their own health. Enabling means allowing or giving the means for something to be carried through Empowering is giving people the support needed to achieve a goal POSSIBLE HSC

QUESTION 2014 HSC EXAMINATION PAPER Explain why individuals, communities and governments should work in partnership on health promotion initiatives. Provide examples. 8 Marks MARKING CRITERIA CASE STUDY: ENEFITS OF PARTNERSHIP

Taxation Governments impose taxes on cigarettes, limiting accessibility Education Compulsory health education in schools equips people with skills to refrain from

taking up smoking in the beginning Media National anti tobacco campaign uses TV and radio commercials to educate people on effects of smoking Life skills support Such as QUIT for life,

aims at giving people the knowledge and skills to quit smoking Lung Cancer Health Promotion Legislation banning or limiting tobacco advertising, minimum age

limits for sales, health warnings on packaging, smoke free areas, This all creates a supportive environment in which to quit smoking OTTAWA CHARTER There are five action areas of the Ottawa Charter in which health promotion can be planned & evaluated: 1)Developing Personal Skills 2) Building Public Policy

3) Strengthening Community Action 4) Creating Supportive Environments 5) Reorienting Health Services DEVELOPING PERSONAL SKILLS Health promotion needs to provide people with information, education and life skills. People can make their own decisions and have control over their own health. Personal skills can be provided in the home (advertising through media), school (compulsory health education), work (seminars) and within the community (info in GPs, billboards) Ask yourself: What personal skills are needed to improve health behaviours that contribute to this

priority issue? What behaviour modifications are needed to improve health? Where can reliable/accurate information be found? Are there support services that can assist in developing positive health behaviours? CREATING SUPPORTIVE ENVIRONMENTS Supportive environments offer people protection from threats to health. We need to take care of each other, our communities and our environment. Health promotion aims to create safe (lights in streets/ 40km school zones), stimulating (exercise equipment in parks), enjoyable (sporting/hobby facilities) living conditions. The main aim of healthy public policies is to create a supportive environment for people to lead healthy

lives. Ask yourself: What community services exist to support/prevent people suffering from the priority issues? Has there been environment modification to reduce the burden of disease? What are some of the factors that influence these priority issues/population groups, for e.g. socio-cultural, physical, political, and economic? STRENGTHENING COMMUNITY ACTION This is increasing a communitys control over the determinants of health. Communities combining their skills and resources for health provide social support for health and

gain increased influence and control over the determinants of health in their community. Local councils, hobby groups, businesses can all aid health promotion Ask yourself: What motivates people to take action and work towards improving the burden of disease? What initiatives have been developed to address priority issues? Are these initiatives addressed by a sole agency or an intersectoral approach? BUILDING PUBLIC POLICY health should be an agenda for all policy makers. Policies should make healthy choices possible and easier for people.

Healthy public policy may include leglislation and regulation (speed limits), financial incentives (baby bonus), taxation (alco pops). Public policies should foster greater equity in health. Ask yourself: Identify public policy developments that address priority issues What impact do these public policies have on health (reducing the priority issue)? REORIENTATE HEALTH SERVICES Emphases inter-sectoral collaboration (governments, NGO, communities, individuals). States that it should not focus solely on treatment (by pass surgery developments), but also on

prevention (breast and skin screening) and health promotion (anti-smoking campaigns). Ask yourself: What health services are available for people suffering from this priority issue? Are these services aimed at prevention, cure or promotion of the issue? Is access to these services equitable for all? What restricts access? What can be done to improve access? WHEEL OF FORTUNE In pairs, for the priority area/population you have be given: Apply the Ottawa Charter action areas to evaluate existing health promotion initiatives

Propose health promotion actions that could be adopted to improve the health status of Australians The 5 action areas of Ottawa Charter The action areas applied to address heart disease: Reorientating health services This could include strategies for screening programs to identify risk factors such as obesity and hypertension. Free check ups for people in high risk categories such as males over 45 and training for doctors to identify high risk patients. Developments personal skills This could include strategies for courses in time management, yoga or other stress management techniques and PDHPE lessons that educate students about nutrition and exercise.

Creating supportive environments This could include strategies for smoke free zones, workplaces that reduce exposure to tobacco smoke and programs such as QUIT that provide social support to smokers who are trying to give up. Building healthy public policy This could include strategies such as no GST applied to fruit and vegetables and high taxes on cigarettes and alcohol. Strengthening community action This could include strategies such as healthy canteens in schools, breakfast exercise groups in local communities or community obesity forums. HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE

The principles of social justice EQUITY, DIVERSITY & SUPPORTIVE ENVIRONMENTS are essential factors in effective health promotion It is imperative (very, very important) that each principle is strongly addressed within health promotion initiatives if gaps in health status are to bridged between communities Activity: For each action area of the Ottawa Charter link examples that promote: EQUITY, DIVERSITY & SUPPORTIVE ENVIRONMENTS CASE STUDY: SOCIAL JUSTICE PRINCIPLES & OTTAWA CHARTER 1)Developing Personal Skills

EQUITY: Assess to education must be assured for all individuals if this social justice principle is to be upheld, particularly in terms of health literacy. For example, access to free online health courses & PDHPE lesson available via distance ed. DIVERSITY: Ensuring information is relevant to all people irrespective of age, gender, culture, geographic location, sexuality or socioeconomic status. For example, pamphlets available with various languages with self-explanatory graphics that can easily be understood by all regardless of level of education SUPPORTIVE ENVIRONMENTS: A supportive environment empowers individuals to make better choices. For example, educating parents/elders who can then pass on information through talks, demonstrations or role modelling. Eg. Health eating habits NATIONAL MENTAL HEALTH

REFORM 2011 1. Evaluate the effectiveness of this Health Promotion initiative using the Ottawa Charter Give reasons for effectives not just dot points 2. Discuss if this reform will meet the needs of; men, woman & young people GET REVISING!!! REVISING FOR EXAMS NOTES QUESTIONS

PALM CARDS KEY WORDS EXAMPLES WHAT WORKS?! MEASURING HEALTH STATUS ROLE OF EPIDEMIOLOGY Epidemiology is the study of the patterns and causes of health and disease in populations, and the application of this study to improve health. It involves the collection of data from hospitals, GPs, health care practitioners, surveys and census information. This data is gathered and analysed in order to provide a picture of Australias health status.

What does it tell us? Epidemiology tells us the basic health status of Australia in terms of quantifiable measures of ill health. This data is gathered and used to provide trends in disease incidence and prevalence along with information about ethnic, socioeconomic and gender groups. Epidemiology uses data on: death rates, birth rates, illnesses, injuries, treatments provided, work days lost, Hospital usage, and money spent by both consumers and the government. Who uses it? Researchers, health department officials, the government, and health or medical practitioners use epidemiology. This data is used to help identify priority health issues and possible causes of disease or illness. Do they measure everything about health status? No. Epidemiology has many limitations that need to be understood. At the basic level, statistics and data like epidemiology can be manipulated by the interpreters and are very open to bias. They also tend to focus on negative measurable aspects of health and not the positive, less measurable aspects such as, wellbeing and quality of life. They also do not

account for the determinants of health: individual, sociocultural, socioeconomic and environmental factors. Epidemiology provides little if any data on the impact of disease and illness. MEASURING HEALTH STATUS MEASURES OF EPIDEMIOLOGY Epidemiology has many various aspects that it measures, but the key ones for determining health status are: Infant mortality rate: The number of deaths among children aged under 1 year in a given period, per 1,000 live births in the same period. Australias infant mortality rate is on the decrease and currently sits at 3.78. Morbidity: Refers to ill health in an individual and to levels of ill health in a population or group. In Australia our disability free years are increasing, meaning people are not just living longer; they are living longer without chronic diseases. The leading issues of morbidity in Australia are: increased rates of diabetes and dementia. While other types

of disease and disability such as: cardiovascular disease, oral health, musculoskeletal, and mental health disorders are the most costly or have the highest burden. Mortality: Number of deaths. The leading causes of death in Australia are: Cardiovascular disease, cerebrovascular disease, Alzheimers and dementia, followed by lung cancer. Australias death rate is on the decline, currently 79 per 100,000. This is still high because of our growing and aging population. Life expectancy: An indication of how long a person can expect to live, depending on the age they have already reached. Technically, it is the number of years of life remaining to a person at a particular age if death rates do not change. The most commonly used measure is life expectancy at birth.[1] In Australia life expectancy is on the rise with a boy born in 2012 having a life expectancy of 79.9 years, while a girl has 84.3 years Epid e m iol ogy

Tells us: m ajo r illnesses a n d caus,es of ,death, 1 identify areas of n e e d , d e t e r m i n e pri ority areas, monitorus,e of health servic,e 1 Does not tell us: explain w h y inequities exist, sociocultural i m p a c t o n health, p r o v i d e a holistic a p p r o a c h, does not focus on all components of health

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