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
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.
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.
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.
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.
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.
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)
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)
32
Q
How Does Medicare Work?
A
Medicare covers anything that is deemed ‘medically necessary’ or ‘clinically essential’
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.
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
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.
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.
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.
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.
