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.
2
Q
Old Public Health - Practices and Policies
A
- Providing safe water.
- Sanitation
- Sewage disposal.
- Improved housing conditions.
- Better working conditions.
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.
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.
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.
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.
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.
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)
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.
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.
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.
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
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.
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
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
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
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
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.
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.
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.
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.
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.
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
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.
25
Ottawa Charter - Action Areas - Strengthen Community Action
- 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.
26
Ottawa Charter - Action Areas - Develop Personal Skills
- Educate and equip people with new life skills for managing and making informed decisions about their health.
27
Ottawa Charter - Action Areas - Reorient Health Services
- Involves individuals, community groups and health professionals and the government working together to achieve a healthcare system that promotes health.
28
Medicare
- Australia's universal healthcare system
- All people have access to healthcare without facing any barriers.
- Access to healthcare at no out-of-pocket cost.
29
Services Covered by Medicare
- Doctors (GP)
- Specialist consultants at public hospitals
- Public hospitals (including surgery and follow-up procedures)
- X-rays and pathology tests (blood tests)
- Eye tests.
30
Services Not Covered by Medicare
- 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)
31
How is Medicare Funded
- 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)
32
How Does Medicare Work?
Medicare covers anything that is deemed 'medically necessary' or 'clinically essential'
33
Schedule Fee
- 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.
34
GAP
- 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
35
Out-of-pocket Expenses
- Any extra money the patient has to pay for a service.
- Including both the GAP and any extras the doctor may wish to charge.
36
Bulk-billing
- 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.
37
Medicare Safety Net
- 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.
38
Medicare - Advantages
- 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
Medicare - Limitations
- 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
Medicare - Sustainability
- Expensive to fund
- Only covers expensive healthcare services
- Funded by tax
41
Medicare - Access
- 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
Medicare - Equity
- 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
PBS
-Subsidises the cost of many prescription medications listed on the PBS
- Available to all Australians
- Medicines are not free, only subsidised
44
How is PBS Funded?
- General taxation
45
PBS Saftey Net
- 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
PBS - Advantages
- 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
PBS - Limitations
- 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
PBS - Sustainability
- 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
Prescription Shopping Program (PSP)
- 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
PBS - Accessibility
- Affordable medications
- Timely access to medications at local pharmacies.
- Allows people to get medication they need without having to travel.
51
PBS - Equity
- Safety net
- All Australian citizens (regardless of race, age, gender, location, income and health status)
- Further subsidised for concession card holders
52
PHI
- 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
Why do people take out PHI?
- 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
How is PHI Funded
- Members through premium
55
Incentives for PHI
- Medicare Levy Surcharge
- Rebate
- Lifetime Health Cover
- Age-Based Discount
56
Medicare Levy Surcharge
1%-1.5% additional tax to high-earning individuals who don't take out PHI
57
PHI Rebate
- 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
Lifetime Health Cover
Individuals who are older than 31 and take out PHI pay 2% more for every year over 31.
59
Age-Based Discount
Some insurers may give a discount if you're young
60
PHI - What is Covered
- Choice of treatment in a Private Hospital
- Choice of hospital and doctor
- Own room
- Reduce waiting periods
61
PHI - What is Not Covered
- 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
PHI - Advantages
- 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
PHI -Limitations
- 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
PHI - Sustainability
- Placing less burden on the public system.
- Incentive schemes.
65
PHI - Access
- 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
PHI - Equity
- PHI incentives.
- Medicare Levy Surcharge cancelled +65.
- Older Australians are exempt from paying PHI.
67
NDIS
- 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
What does the NDIS do
- 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
NDIS - Funding
- Funded by Medicare Levy
- Approx 0.5% of Medicare Levy going towards NDIS
- Partially funded by participating state and territory governments.
70
NDIS - Advantages
- 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
NDIS - Limitations
- 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
NDIS - Sustainability
- Introduced in stages to ensure it was successful and sustainable.
- Only individuals with a severe, life-long, prolonged disability.
- Funded by tax.
73
NDIS - Access
- 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
NDIS - Equity
- 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
Why is Smoking Targeted?
- 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
Effectiveness of Health Promotion on Smoking
- There has been a delay in the uptake of smoking.
- Fewer individuals are taking up smoking.
- Smoking rates are declining over time.
77
Health Promotion Reflect Ottawa Charter - Quit
- 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
Questions Used to Evaluate the Effectiveness of Programs.
- 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
Aboriginal Quitline
- 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
Aboriginal Quitline - Ottawa Charter
- 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
Aboriginal Road to Good Health
- 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
Aboriginal Road to Good Health - Ottawa Charter
- 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
Australian Dietary Guidelines (ADGs)
- 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
5 ADGs
- 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
Australian Guide to Healthy Eating
- 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
Examples of the Work of Nutrition Australia
- 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
Healthy Eating Pyramid (HEP)
- 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
Describing the HEP
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
Other works of Nutrition Australia
- Healthy Eating Advisory Service
- National Nutrition Week
- Workplace Health and Wellbeing Program
90
Healthy Eating Advisory Service
- 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
National Nutrition Week
- 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
Workplace Health and Wellbeing Program
- 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
Challenges to Bringing About Dietary Change
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.
