Area of Study 2 Flashcards

1
Q

Old Public Health

A
  • Late 1800s - Early 1900s.
  • Main cause of death = communicable disease.
  • Focus on changing the physical environment.
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2
Q

Old Public Health - Practices and Policies

A
  • Providing safe water.
  • Sanitation
  • Sewage disposal.
  • Improved housing conditions.
  • Better working conditions.
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3
Q

Old Public Health - Effectiveness

A
  • Pretty successful
  • Diseases like TB and smallpox were pretty much eradicated.
  • After a certain point communicable diseases weren’t the primary health issue anymore.
  • Main health issues now had to do with lifestyle
  • Approach to health had to change.
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4
Q

New Public Health

A
  • An organised response by society to protect and promote health and to prevent injury, illness and disability.
  • Demonstrates an understanding of how lifestyle and living conditions influence health status.
  • Aims to improve quality of life.
  • Involves direct funds towards implementing polocies and programs, providing services that protect and promote health and equity.
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5
Q

Biomedical Model

A
  • Focuses on the physical or biological aspects disease and illness.
  • Practised by doctors.
  • diagnosis, cure and treatment (also known as ‘fix-it’ or ‘band-aid’ approach)
  • Works to treat diseases once they are present.
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6
Q

Biomedical Model - Advantages

A
  • Enables many common conditions, illnesses and injuries to be quickly and effectively treated.
  • Many causes of death that were common are able to be quickly diagnosed and effectively treated and cured =↑ life expectancy.
  • Improves quality of life as many chronic conditions can be managed with medication and surgery = ↓ pain and suffering.
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7
Q

Biomedical Model - Disadvantages

A
  • Relies on health professionals and tech which can be costly.
  • Smaller, rural based health clinics may not be able to afford medical tech and resources.
  • Dosen’t focus on the causes of ill-health
  • Doesn’t encourage people to be responsible for their health, meaning that more people may get sick.
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8
Q

Biomedical Model - Improvements in Medical Tech

A
  • Diagnostic Tools and Equipment - MRI scanning, CT scanning, Genetic screening for disease.
  • Pharmaceuticals - Statins (reduce cholesterol), SSRI (antidepressants), Advances in vacines.
  • Medical Procedures - Organ transplants, hip and knee replacements, Reproductive technology (IVF)
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9
Q

Social Model

A
  • Conceptual framework.
  • Improvements in health and wellbeing are achieved by directing effort towards addressing the social, economic and environemental determinants of health.
  • Based on the understanding that in order for health gains to occur social, economic and environmental determinants must be addressed.
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10
Q

Social Model - Guiding Principles (A.R.E.A.S)

A
  • Addresses the Broader Determinants of Health.
  • Acts to Reduce Social Inequites.
  • Empowers Individuals and Communities.
  • Acts to Enable Access to Healthcare.
  • Involves Inter-sectorial Collaboration.
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11
Q

Social Model - ADDRESSES the broader determinants of health

A
  • By taking the focus off the behaviours of an individual, society is able to share responsibility for health among the most vulnerable.
  • Implementing policies and changes to the environment that promote their health.
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12
Q

Social Model - Acts to REDUCE social inequalities

A
  • Reducing social inequalities means addressing _____ and providing extra support to those who need it.

Factors
- Income
- Age
- Race
- Gender
- Location

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13
Q

Social Model - EMPOWERS individuals and communities

A

Community
- Providing information and resources
- Enable individuals to work collectively to address the determinants that impact health.
- Benefit the broader community group.

Individual
- Empowering them with knowledge, confidence, skills and resources.
- Enable them to make decisions and take action to promote their own health.

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14
Q

Social Model - Acts to enable ACCESS to healthcare

A
  • Services and information should be readily available.
  • Based on need, affordability, appropriateness and accessibility to all.
  • Should also address the barriers to access such as:
  • Location
  • Culture
  • Language
  • Transport
  • Discrimination
  • Accessibility of Buildings
  • Cost
  • Knowledge
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15
Q

Social Model - Involver inter-SECTORIAL collaboration

A

Embraces the need for integrated action between:
- Government Departments (Including employment, education, social welfare and transport)
- Private Sector (Including manufacturers and service providers)
- Health Sector

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16
Q

Social Model - Advantages

A
  • Doesn’t just focus on the disease once symptoms are present.
  • Encourages people to make better choices and take care of their health to prevent the onset of disease.
  • Education can be passed on from generation to generation.
  • Less expensive than the biomedical model
  • Focuses on the vulnerable population groups
  • Aims to reduce social inequities
  • Responsibility of health is shared
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17
Q

Social Model - Disadvantages

A
  • Not every condition can be prevented (eg. genetic conditions)
  • Health promotion messages may be ignored
  • Doesn’t address the current health concerns of individuals (ie. those who are already ill)
  • Doesn’t promote the development of technology and medical knowledge
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18
Q

Biomedical Model - Example - CVD

A
  • Prescription of antihypertensive drugs to treat high blood pressure.
  • Open bypass surgery to treat heart attack and blockage
  • Defibrillators are used to induce shock to treat a cardiac arrest patient.
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19
Q

Social Model - Example - CVD

A
  • Promoting education regarding healthy eating in schools
  • Investment in increasing cycling paths or subsidised gym memberships to encourage physical activity
  • Introducing legislation such as no GST on fresh fruits and vegetables.
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20
Q

Ottawa Charter - Building Blocks - Enable

A

To support people with the information, opportunities, resources and skills that they need to make choices that support good health.

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21
Q

Ottawa Charter - Building Blocks - Mediate

A
  • Optimal health cannot be ensured by the health sector alone.
  • Health promotion required coordinated action by all levels of government, the health sector, NGOs, industry and the media.
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22
Q

Ottawa Charter - Building Blocks - Advocate

A

About promoting and supporting initiatives that promote health on behalf of the whole community and protecting health as a resource.

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23
Q

Ottawa Charter - Action Areas - Build Healthy Public Policy

A
  • Relates to decisions made by the government and organisations in relation to laws and policies relating to or affecting health.

-Aim - to put health on the agenda of policymakers

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24
Q

Ottawa Charter - Action Areas - Create Supportive Environments

A
  • Making it easier for people to make healthy choices by providing a physical and social environment that promotes health gains.
  • Aim - Take care of and support each other by encouraging people to make healthy lifestyle choices.
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25
Q

Ottawa Charter - Action Areas - Strengthen Community Action

A
  • Encouraging people from all parts of the community to work together to achieve better health outcomes.
  • Aim - Build links between individuals, communities, key stakeholders, and community centres to develop a shared health strategy in order to achieve a common health-related goal.
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26
Q

Ottawa Charter - Action Areas - Develop Personal Skills

A
  • Educate and equip people with new life skills for managing and making informed decisions about their health.
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27
Q

Ottawa Charter - Action Areas - Reorient Health Services

A
  • Involves individuals, community groups and health professionals and the government working together to achieve a healthcare system that promotes health.
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28
Q

Medicare

A
  • Australia’s universal healthcare system
  • All people have access to healthcare without facing any barriers.
  • Access to healthcare at no out-of-pocket cost.
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29
Q

Services Covered by Medicare

A
  • Doctors (GP)
  • Specialist consultants at public hospitals
  • Public hospitals (including surgery and follow-up procedures)
  • X-rays and pathology tests (blood tests)
  • Eye tests.
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30
Q

Services Not Covered by Medicare

A
  • Treatment in private hospitals
  • Dental services
  • Allied Health services
  • Elective treatments (eg. cosmetic surgery)
  • Home nursing and treatment
  • Ambulances
  • Health aids (eg. glasses, hearing aids, prosthetics)
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31
Q

How is Medicare Funded

A
  • Medicare Levy (2% tax to all Australian taxpayers)
  • Medicare Levy Surcharge (1%-1.5% additional tax to high-earning individuals who don’t take out PHI)
  • General Tax (Taking from the tax pool that all Australian taxpayers pay)
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32
Q

How Does Medicare Work?

A

Medicare covers anything that is deemed ‘medically necessary’ or ‘clinically essential’

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33
Q

Schedule Fee

A
  • Almost like a ‘recommended price’ for services
  • Set by the government for different services
  • Doctors and health professionals can choose whether they want to follow the scheduled fee.
  • If they want to charge more or less for their service.
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34
Q

GAP

A
  • Medicare only pays a portion of the scheduled fee.
  • The remainder of the scheduled fee is called the GAP which the patient has to pay.
  • Out-of-hospital - 85% of the fee
  • In-hospital service - 75% of the fee
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35
Q

Out-of-pocket Expenses

A
  • Any extra money the patient has to pay for a service.
  • Including both the GAP and any extras the doctor may wish to charge.
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36
Q

Bulk-billing

A
  • Services are more financially accessible for patients.
  • The doctor has only chosen to charge 85% of the scheduled fee.
  • No GAP or out-of-pocket expenses.
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37
Q

Medicare Safety Net

A
  • Extra financial support for those who incur significant GAP costs.
  • Scheduled fee is usually covered for the remainder of the year.
  • Only covers the GAP and not any extras the doctor may wish to charge.
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38
Q

Medicare - Advantages

A
  • Patients have a choice of doctors for out-of-hospital services.
  • All Australians can access Medicare’s benefits when in countries with reciprocal agreements.
  • It covers most of the basic health services.
  • Medicare Safety Net provides further financial support for medical services.
39
Q

Medicare - Limitations

A
  • There is no choice of doctor or surgeon for in-hospital treatments.
  • Waiting lists exist for elective surgeries
  • It does not cover all health services
  • Often the full amount of a doctor’s visit is not covered, so patients may need to pay an out-of-pocket cost.
40
Q

Medicare - Sustainability

A
  • Expensive to fund
  • Only covers expensive healthcare services
  • Funded by tax
41
Q

Medicare - Access

A
  • Patients can have a local doctor to meet their social and cultural needs
  • Treats patients based on needs
  • Provides free or subsidised healthcare
  • Access local healthcare
42
Q

Medicare - Equity

A
  • Includes a safety net
  • Some children receive certain government benefits
  • All Australian citizens (regardless of age, gender, race, location, income and/or health status)
43
Q

PBS

A

-Subsidises the cost of many prescription medications listed on the PBS
- Available to all Australians
- Medicines are not free, only subsidised

44
Q

How is PBS Funded?

A
  • General taxation
45
Q

PBS Saftey Net

A
  • Provides extra financial support for those who incur significant co-payment costs.
  • In most cases the safety net still requires payment, but it is just a reduced amount.
46
Q

PBS - Advantages

A
  • Available to all Australians
  • Subsidises the cost of most disease-preventing and life-saving prescription medication
  • Additional support is provided to those with a concession card by having lower patient co-patients.
  • PBS Safety Net provides additional financial support to individuals or families for prescription medication upon reaching a certain threshold in 1 calender year.
47
Q

PBS - Limitations

A
  • Places significant financial burden on the government
  • It doesn’t cover all medications
  • In most cases, it doesn’t cover the entire cost of the medication.
48
Q

PBS - Sustainability

A
  • Only medications that are most efficient at treating conditions are added to the PBS.
  • Includes PSP to protect its integrity
  • Ensuring that only reliable medications are added.
  • ‘Efficient, reliable, cost-effective medicines’
49
Q

Prescription Shopping Program (PSP)

A
  • Part of the PBS
  • Ensures that people aren’t using more medication than they need.
  • Provides health professionals with information on people’s purchasing rates.
50
Q

PBS - Accessibility

A
  • Affordable medications
  • Timely access to medications at local pharmacies.
  • Allows people to get medication they need without having to travel.
51
Q

PBS - Equity

A
  • Safety net
  • All Australian citizens (regardless of race, age, gender, location, income and health status)
  • Further subsidised for concession card holders
52
Q

PHI

A
  • Type of Insurance
  • Members pay a small monthly fee called a premium to cover the health costs of health-related services not covered by Medicare
53
Q

Why do people take out PHI?

A
  • Benefits individuals who regularly require services not covered by Medicare.
  • Covers the cost of emergencies that require ambulance transport, and the costs of treatment in a private hospital
  • Allows people to choose between their types of care.
  • Able to skip the waiting list for elective surgeries.
54
Q

How is PHI Funded

A
  • Members through premium
55
Q

Incentives for PHI

A
  • Medicare Levy Surcharge
  • Rebate
  • Lifetime Health Cover
  • Age-Based Discount
56
Q

Medicare Levy Surcharge

A

1%-1.5% additional tax to high-earning individuals who don’t take out PHI

57
Q

PHI Rebate

A
  • An amount of money that the government will pay towards your health insurance
    -↓ Income = ↑Rebate (refund of some of your premium) and vice versa.
58
Q

Lifetime Health Cover

A

Individuals who are older than 31 and take out PHI pay 2% more for every year over 31.

59
Q

Age-Based Discount

A

Some insurers may give a discount if you’re young

60
Q

PHI - What is Covered

A
  • Choice of treatment in a Private Hospital
  • Choice of hospital and doctor
  • Own room
  • Reduce waiting periods
61
Q

PHI - What is Not Covered

A
  • Specific services that are not at all (exclusions)
  • Cosmetic/elective surgeries won’t be covered by Medicare, increased out-of-pocket.
  • Services that are covered to a limited extent (meaning the individual will have greater out-of-pocket expenses) - ie. Restrictions
62
Q

PHI - Advantages

A
  • There are different levels of coverage and different companies depending on people’s needs.
  • Covers services not covered by Medicare.
  • Alleviates pressure from the public health system and can reduce waiting times for non-emergency treatments.
  • Individuals can choose their doctor and hospital for in-hospital care.
63
Q

PHI -Limitations

A
  • It can be costly for individuals or families to take out this level of cover.
  • Some people pay for services they don’t use.
  • There can still be out-of-pocket costs for some services and policies.
  • Waiting periods may apply for some services (eg. maternity care)
64
Q

PHI - Sustainability

A
  • Placing less burden on the public system.
  • Incentive schemes.
65
Q

PHI - Access

A
  • The government tried to make PHI more financially accessible by implementing incentives.
  • Access to more services.
  • Selection of doctor = ↑social access.
  • Improves access to people who rely on the public health system.
66
Q

PHI - Equity

A
  • PHI incentives.
  • Medicare Levy Surcharge cancelled +65.
  • Older Australians are exempt from paying PHI.
67
Q

NDIS

A
  • Implemented by the National Disability Insurance Agency (NDIA)
  • Provides individualised services and support for Australians with permanent disabilities.
  • Under age 65.
  • Supports families and carers as well.
  • In order to help them live as normal a life as possible.
68
Q

What does the NDIS do

A
  • Enable Australians with disability access to essential services (eg. doctors and teachers)
  • Enable Australians with disability access to community services and support (eg. sports clubs, community groups and libraries)
  • Maintain informal support arrangements
  • Provide funding for reasonable and necessary support.
69
Q

NDIS - Funding

A
  • Funded by Medicare Levy
  • Approx 0.5% of Medicare Levy going towards NDIS
  • Partially funded by participating state and territory governments.
70
Q

NDIS - Advantages

A
  • There are individualised plans for those under the age of 65 with permanent disabilities.
  • It is completely funded (ie. no out-of-pocket costs for participants)
  • There is also help for families and carers.
71
Q

NDIS - Limitations

A
  • Not all people with disabilities are eligible.
  • It can be quite a complicated process to receive approval into the scheme.
  • Misuse of NDIS funds has been reported in the past.
72
Q

NDIS - Sustainability

A
  • Introduced in stages to ensure it was successful and sustainable.
  • Only individuals with a severe, life-long, prolonged disability.
  • Funded by tax.
73
Q

NDIS - Access

A
  • Available to all Australians under the age of 65, irrespective of gender, age, race, income, etc.
  • Increases access to mainstream services for those with disabilities.
  • The provision of funds makes more services accessible to people with disabilities (eg. medications)
74
Q

NDIS - Equity

A
  • Available to all Australians under the age of 65, with a permanent disability irrespective of gender, age, race, income, etc.
    -Individualised plans aid each person’s needs.
  • The ultimate goal is to assist individuals with a permanent disability to live an ordinary life relative to the rest of their community
75
Q

Why is Smoking Targeted?

A
  • Smoking kills around 24,000 Australians per year.
  • Diseases associated with smoking such as Lung Cancer and COPD
  • Affects vulnerable population groups disproportionately
  • Low SES
  • Rural/Remote
  • ATSI
76
Q

Effectiveness of Health Promotion on Smoking

A
  • There has been a delay in the uptake of smoking.
  • Fewer individuals are taking up smoking.
  • Smoking rates are declining over time.
77
Q

Health Promotion Reflect Ottawa Charter - Quit

A
  • Build Healthy Public Policy - Working with the government to ban smoking in outdoor areas.
  • Create Supportive Environments - Quitline, QuitCoach and QuitText are online platforms that have materials assisting smokers to quit, creating a number of supportive environments for smokers quitting.
  • Strengthen Community Action - Quit works specifically with community groups to increase the success of quitting, ensuring they are working together to bring about improvements.
78
Q

Questions Used to Evaluate the Effectiveness of Programs.

A
  • Is affordable in the long term?
  • Does it have adequate funding to continue?
  • Is it affordable to the participants or population groups assessing the programs?
  • Is it culturally sensitive/appropriate and respectful of the values and knowledge of its target group?
  • Does it involve local individuals and/or community groups in the planning and decision-making process?
  • Do the local people have a sense of ownership of the program?
  • Does it focus on empowering through skills and knowledge?
  • Does it allow for feedback?
  • Does it reach those most in need - the most vulnerable population groups?
  • Does it involve partnerships - government, price organisations, local governments and community groups working together in the program’s delivery?
  • Is it accessible?
  • Is it located in areas that people can reach on foot or in public transport?
  • What are the opening hours?
79
Q

Aboriginal Quitline

A
  • Aimed at the prevention of smoking and it caters specifically to ATSI
  • Has people who know the language and culture on the line.
  • Provide callers with specific plans that cater to their needs.
80
Q

Aboriginal Quitline - Ottawa Charter

A
  • Create Supportive Environment - The Quitline is a supportive environment for people wanting to quit.
  • Strengthen Community Action - People from the community including family and friends of active smokers participate in the program.
  • Develop Personal Skills - Provides information to callers on how to quit.
81
Q

Aboriginal Road to Good Health

A
  • Aimed at the prevention of diabetes and other chronic diseases.
  • It does this through the promotion of healthy lifestyles through encouraging healthier food choices and exercise.
82
Q

Aboriginal Road to Good Health - Ottawa Charter

A
  • Create Supportive Environments - Organise group sessions to encourage healthier habits.
  • Strengthen Community Action - Victorian Aboriginal Health Services (VAHS) has a 6-week program for communities aimed at preventing type 2 diabetes.
  • Develop Personal Skills - Individuals are taught skills such as reading labels, getting active and staying on track to maintain their healthy habits.
  • Reorient Health Services - The program encourages doctors to teach their patients about heart disease and how to prevent it.
83
Q

Australian Dietary Guidelines (ADGs)

A
  • Developed by the federal government
  • Provides advice relating to the types and amounts of foods that should be consumed.
  • Aims to prevent, limit and decrease the rates of diet-related conditions, chronic diseases, whilst developing healthy dietary patterns that will improve health and promote wellbeing.
84
Q

5 ADGs

A
  • To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious foods and drinks to meet your energy needs.
  • To enjoy a wide variety of nutritious foods from the 5 food groups every day (vegetables, fruits, grain foods, lean meats and poultry and dairy) as well as drinking plenty of water.
  • To limit intake of foods containing saturated fats, added salt, added sugars and alcohol.
  • To encourage, support and promote breastfeeding.
  • To care for your food; prepare and store it safely.
85
Q

Australian Guide to Healthy Eating

A
  • Developed by the National Health and Medical Research Council (NHMRC) on behalf of the federal government.
  • Addresses ADGs 2 and 3
  • Does not provide an alternative to salt and sugar
86
Q

Examples of the Work of Nutrition Australia

A
  • Prove menu assessments for organisations such as hospitals and schools.
  • Publish free recipes for nutrient-dense on their website
  • Prepare and design publications that cover topics such as healthy living and weight loss.
  • Consult the food manufacturing industry
  • Design, promote and deliver activities for National Nutrition Week
  • Develop food selection models to promote healthy eating.
87
Q

Healthy Eating Pyramid (HEP)

A
  • Simple visual guide to the types and amount of foods that individuals should consume on a daily basis.
  • Visual representation of ADGs 1,2 and 3
  • ADG 1 - “Be active every day”
  • ADG 2 - In the foundation and middle layers
  • ADG 3 - “Limit salt and added sugars”
88
Q

Describing the HEP

A

Inside the Pyramid
- Broken down into the 5 food groups (fruit, vegetables, grains, dairy, lean meats and poultry) and healthy fats
- The foundation layers (vegetables and legumes, fruit and grains) should comprise the majority of an individual’s daily diet.
- The middle layer contains proteins and dairy.
- The top layer contains healthy fats.

Outside the Pyramid
- Use herbs and spices to add flavour instead of salt/sugar (bottom left corner)
- Choose water as the drink of choice (bottom right corner)
- Limit intake of salt and sugar (top left corner)

89
Q

Other works of Nutrition Australia

A
  • Healthy Eating Advisory Service
  • National Nutrition Week
  • Workplace Health and Wellbeing Program
90
Q

Healthy Eating Advisory Service

A
  • Aims to help organisations provide and promote healthier foods and drinks to improve the health of all Victorians
  • Works with schools, workplaces, hospitals and more to provide healthier foods and drinks on their menus.
  • Support menu planning, and menu assessments and provide training for canteen staff and school management.
91
Q

National Nutrition Week

A
  • Annual healthy eating awareness campaign
  • Coincides with the United Nations World Food Day on October 16 each year.
  • Raises awareness around the role of food in our health.
  • Utilises a theme to increase interest.
92
Q

Workplace Health and Wellbeing Program

A
  • Offers a range of services to improve worker’s performance through healthy eating.
  • Provision of information, education and consultation services to promote healthy eating.
  • Cooking demonstrations, nutrition seminars and vending machine assessments.
  • healthy eating = healthy business.
93
Q

Challenges to Bringing About Dietary Change

A

Sociocultural Factors
- Income
- Culture
- Family and Peers
- Attitudes and Beliefs
- Education (knowledge and skills)

Personal Factors
- Personal Taste Preferences
- Meal Patterns

Biological Influences
- Age
- Stress levels

Environmental influences
- Food availability and Security.