Core 1 Flashcards
What is epidemiology?
The study of patterns and cause of health issues / diseases in populations, and study of this study to improve health.
Where do you collect epidemiology from?
The collection of data from hospitals, GP’s, health care and census information.
How is the information for epidemiology used to improve health?
Data and trends are gathered and analysed to help identify priority health issues and possible causes of disease or illness.
What is mortality?
The leading causes of death in Australia
Examples of mortality and trend:
• Cardiovascular disease
• Cerebrovascular disease
• Alzheimer’s and dementia
• Lung cancer
- Australia’s death rate is on the decline.
what is infant mortality?
The number of deaths among children aged under 1 year in a given period
what is the current trend for infant mortality?
Australia’s infant mortality rate is on the decline.
What is morbidity?
Refers to ill health within an individual
examples of morbidity and trend:
Increased rates of diabetes and dementia.
what is life expectancy?
An indication of how long a person can expect to live
What is the life average life expectancy of women and men?
• Women live to the age of 84.9
• Men live to the age of 80.7
Define equity:
The quality of being fair and impartial.
What is an example of Equity?
ATSI is a group of people who require additional funding and resources in order to improve health outcomes, as they have poorer health.
Define diversity:
The differences that exist between people.
What is an example of diversity?
Having language interpreters in hospitals.
Define supportive environments:
Where people live, work and play, to protect people from health threats and that increase their ability to make health-promoting choices.
What is an example of supportive environments?
Rural and remote people whose environment is not as supportive as others, as they don’t have as much access to health care facilities.
What are population groups that have poorer health compared to the rest of Australia?
- ATSI (Aboriginal and Torres Strait Islanders)
- Rural and remote living people
- Elderly
- Low socioeconomic status
What is an example of a priority populations group?
ATSI males and females can expect to live 10 years less than the non-ATSI population.
What is prevalence?
The number of cases in a population at a given time.
What is an example of high prevalence?
diabetes
What is a disease that has a high potential to be prevented and why?
Type 2 Diabetes as It is a lifestyle disease caused by inactivity and poor dietary choices.
What is a disease with a higher rate of successful treatment when identified and treated early?
All cancers have a higher chance of a successful treatment when treated early as the cancer will not have spread much at stage one. Therefore, it is easier to remove.
What is a disease that comes as a cost to the individual when treated?
CVD is very expensive to treat, often involving large surgical procedures, lengthy recovery periods, loss of independence, loss of income, and is linked with lower self-esteem levels.
What is a disease that comes as a cost to the community when treated?
With CVD, the community pays for the surgery, the company the person works for loses money and family and friends often take time off work and become anxious about their relatives health and may be needed to be a carer for their relative.
Social justice principles: equity
As cancer is prevalent in our community it must be a priority health issue
Social justice principles: diversity
Cancer education is high priority in order to prevent it.
Social justice principles: supportive environments
Will help prevent cancer as people will ensue there is access to screening units.
Define health inequity:
Something that a population group has a higher percentage of, e.g. ATSI have a higher prevalence of cancer.
What is the nature and extent of health inequities for ATSI?
- ATSI peoples experience the largest gap in health outcomes in Australia.
- They currently have a life expectancy 10 years lower than other Australians.
Life expectancy for ATSI:
(males and females)
- Males= = 71.6 - ATSI
- Females = 75.6 - ATSI
Mortality rates for ATSI:
higher than non-indigenous
ATSI Infant mortality rates:
Declining
ATSI socioeconomic factors:
- Higher rates of homelessness
> Due to less education and lack of money.
ATSI environmental factors:
- Harder to access healthcare facilities as they live in rural/remote areas
> Contributes to the gap in health outcome
Roles to improve health for the individual (ATSI):
- Must take control of their own health and develop a positive attitude.
> Done by aiming to increase their knowledge on health by education
For example: The government funds this knowledge by giving ATSI peoples a special entry into universities so they can be educated and get a job.
Roles to improve health for the community (ATSI):
- Provides healthy and supportive environments
For example: Purple House provides kidney dialysis units in 10 remote Indigenous communities so they don’t have to travel as far to receive treatment.
Roles to improve health for the government (ATSI):
- Aim to reduce ill health, suffering, distress and helplessness.
For example: Close the Gap is a government initiative that was sspecifically designed and implemented programs to address risk taking behaviours of individuals.
R/R areas life expectancy:
- Have shorter lives and higher rates of disease and injury.
> Due to lack of health care facilities
R/R major sickness:
Diabetes, suicide, stroke
- linked with lack of healthcare facilities
(Longer wait for diagnosis and treatment)
R/R morbidity rates:
- Higher levels of disease & injury
> less access to health services
R/R sociocultural factors:
- Poor indicators of health, e.g. smoking, influences family members such as children to be brought up normalising smoking.
R/R socioeconomic factors:
- Lack of education and employment, which ultimately leads to lack of income.
- They are more likely to work on farms or transportation mines, which have a higher rates of smoking and alcohol usage.
R/R environmental factors:
- Very limited to access to healthcare facilities.
- People often need to travel far for help, depending on what their medical condition is.
For example: If you have cancer, there are screening units placed in R/R areas
R/R individual roles to improve health:
- Take responsibility for their own health.
(If you know you have an untreated medical condition, make time to travel out of the area to get help) - Can promote family to do the same.
R/R community roles to improve health:
- Develop programs that encourage healthy behaviours
R/R government roles to improve health:
- The government funds programs to assist in delivery of health.
For example: The royal flying doctors service is an air service that comes to people in R/R areas that don’t have time to travel out for medical help.
Nature of CVD:
used to describe many different conditions affecting the heart and blood vessels.
- CVD covers all diseases of heart & circulatory system in 3 major forms:
- Coronary heart disease – poor blood supply to the heart
- Stroke – interruption of blood to the brain
- Peripheral vascular disease – disease of arteries & capillaries that affect limbs
- Main cause = raised blood pressure
Extent of the problem of CVD:
- Second leading causes of deaths, after cancer
- Trend = steady decline since the 1960’s (both)
Risk and protective factors of CVD:
RISK:
- Having a high calorie diet
- Lack of exercise
PROTECTIVE:
- Regular physical activity
- Eating a balanced diet
- Regular health check ups
Sociocultural determinants of CVD:
- Lifestyle: Children who grow up in a household that is obese, are more likely to grow in a similar lifestyle.
Socioeconomic determinants of CVD:
- Education: The more educated you are, the more likely you are to be employed and get an income, thus less likely of living an unhealthy lifestyle.
Environmental determinants of CVD:
- R/R areas: The speed of treatment for heart attacks or strokes, greatly affect the results.
Groups at risk for CVD:
- ATSI: have an increased chance of a heart attack over non Indigenous Australians.
- Rural and remote people: who have a higher burden form stroke compared with people in major cities.
Nature of Cancer:
*Cancer= Cells that have become abnormal and begin to multiply rapidly.
- Abnormal growth of cells = tumour
- Benign tumour (non-cancerous)
- Malignant tumour (cancerous)
Extent of the problem of Cancer:
- Skin cancer: mortality and morbidity = decreasing
- Breast cancer: Mortality = increasing, morbidity = decreasing
- Lung Cancer: Decline for men – Increase for women
Risk Factors of cancer:
- Skin: UV radiation
- Breast: Genetics: women with a history of breast cancer.
- Lung: Smoking
Protective Factors of cancer:
- Skin: Wear protective clothing, Sunscreen
- Breast: Screen testing, Being physically active
- Lung: Avoid smoking
Sociocultural determinants of Cancer:
- Advertisement: in the media has helped Australians understand the importance of sunscreen.
Socioeconomic determinants of Cancer:
- Education: If children don’t go to school, they won’t understand the risk factors that come with not wearing sunscreen.
Environmental determinants of Cancer:
- R/R areas: lack of access to cancer specialists for treatment.
Groups at risk for cancer:
- ATSI: – more likely to be diagnosed due to lack of education (not knowing their symptoms).
- Rural and remote people: less access to doctors, delays diagnosis and treatment.
Define diabetes:
*Diabetes: A chronic disease that relates to the body’s ability to produce insulin and control blood sugar levels.
Nature of T1D:
- The body no longer produces insulin to control blood sugar levels.
- People with T1D require insulin injections to control BGL.
- Thought to be caused by genetics.
Nature of T2D:
- Where the body becomes resistant to the normal effects of insulin.
- Also gradually losing the capability to produce insulin.
- Caused by lifestyle / eating
Nature of Gestational diabetes:
- Occurs during pregnancy.
- Is a risk factor for complications after birth for the baby.
> Baby is at risk for developing hypoglycaemia after birth.
Which underlying causes can diabetes be of other complications:
> Liver failure
Limb amputation
Blindness
Extent of the Problem for diabetes:
OVERALL decreasing in mortality and morbidity for all 3 types of diabetes.
Risk factors of diabetes:
- A family history of the disease
- High carb & sugar diet
- Obesity
Protective factors of diabetes:
- Good management of BGL (T1D, e.g. CGM)
- Regular physical activity
- Well-balanced diet
Sociocultural determinants of diabetes:
- Cultures: ATSI groups are more likely to be diagnosed with T2D, due to poor diet. This lifestyle is likely to produce children who grow up to be similar. ^ Diagnosis’s in the future.
Socioeconomic determinants of diabetes:
- Smoking/drug/poor diet: People with SES have higher rates of smoking, drug usage and poor diet, contributing to diagnosis’s of T2D.
Environmental determinants of diabetes:
- R/R areas: Less access to healthcare facilities, later the diagnosis, the more complications there are with diabetes.
Groups at risk for diabetes:
- Those who have a family history
- ATSI
- The elderly
- Women who are pregnant
Define a growing and ageing population:
Increases the demand of health workers, ultimately resulting in less volunteers.
What is healthy ageing?
*Healthy ageing: A process that includes various behaviour and choices that affect health, such as regular physical activity, good dietary choices etc.
What is the goal of healthy ageing?
- To enable the elderly to maintain their health into old age.
> allows them to contribute to the workforce longer, and engage in society better.
> Increases economic growth
Decreases the use of health services by the elderly, who are the largest users of the health care system.
Increased population living with chronic disease and disability description:
- Chronic disease and disability are more prevalent in the elderly. Survival rates from many chronic diseases increases.
- With an increased population living with chronic disease and disability, comes an increase in health care expenditure and the need for aged care facilities.
Example of Increased population living with chronic disease and disability:
Type 1 diabetes is a chronic disease that leads to further health issues when blood sugar levels are not managed correctly and kept in a safe range. E.g. leads to kidney and liver failure.
Describe the demand for health services and workforce shortages:
- A growing and ageing population increases the demand for health services and facilities
- An increase in age means an increase in health conditions and disability, making the elderly high uses of health services.
- Elderly visit health professionals more frequently meaning more specialists are needed
- Increased use of Medicare means more funding to be allocated and taken away from other areas of need.
Describe carers and an example:
A growing and ageing population, with the increase in chronic disease, requires increase in carers and volunteers.
For example:
- Informal = unpaid, family member
- Formal = paid, professional
Describe volunteers and examples:
- Rates of volunteers have decreased
- Volunteer work is unpaid
For example: Meals on Wheels
> Provide nutritious meals and companionship to aged people.
For example: Anglicare
> Christian, supporting people through all stages of life.
> Provide homecare for people, e.g. cleaners, gardeners.
TO AGED CARE > AT RETIREMENT LIVING
What is primary health care?
Focuses on prevention, health promotion and clinical care (e.g. GPs, nurses, midwives, dentists, pharmacists)
What is secondary health care?
Provided by those who don’t have first point of contact with patients. Usually occurs after a referral from primary health provider (e.g. specialists, physiotherapists)
What is an institutional health facility? include examples
Provides a bed for overnight care.
> E.g. Hospitals & nursing homes
Different types of Hospitals:
PUBLIC: Provides free healthcare for all Australians.
PRIVATE: Not free
PSYCHIATRIC: Can be public or private
Define Hospitals:
Provides care for illness, disease and chronic conditions.
Define Nursing Homes:
Provides long term care for the elderly and patients with severe disability or chronic illness.
Types of Nursing Homes:
PUBLIC: Non-profit and state government funded
PRIVATE: Often run as profit making businesses
Define Non-institutional health services, include examples:
Facilities and services that do not involve an overnight stay.
> E.g. medical services and health related services such as GP’s
Non-institutional Health related services:
Dentists
RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES:
The federal Government:
*This is the highest level of Government.
- Responsible for the development of national health policies.
Initiatives:
- Medicare
- PBS
RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES:
The State or Tertiary Government:
*Receive funds from the federal government.
- They create state health policies, regulate private hospitals and ensure accessibility of immunisation programs.
They Manage:
-Public hospitals
-Medical practitioners
-Family health services
RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES:
The Local Government:
*Responsible for implementing policies instated by federal or state and territory governments.
- They regulate environmental issues, enforcing health and safety regulations.
They are in charge of:
-Restaurant hygiene
-Drug and alcohol services
-Counselling and sexual health clinics.
RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES:
The Private Sector:
*These services are usually privately owned, funded and controlled by businesses, charities or religious organisations.
- The government may sometimes provide funding, FOR EXAMPLE, the cancer council.
Services offered in the private sector:
-Private hospitals
-Alternative health services, e.g. dentists, physiotherapists, occupational therapists.
RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES:
Community Groups:
*Take on the role of raising awareness about particular issues, health promotion and organising support services.
-Include school groups
Community groups:
-Diabetes Australia
-The red cross
-Alcoholics anonymous.
What is commonwealth?
- policy and legislation
- funding to state/territory, hospitals, Medicare and PBS, and health promotion strategies
EQUITY OF ACCESS:
Equity of health care means easily accessible and equitability of distribution. Those living in urban areas have higher access compared to other groups (e.g. low SES, R/R, ATSI). The gov. has introduced initiatives to help those with lower access (e.g. Royal Flying Doctors, Purple Truck).
Barriers of equity of access include:
• Long waiting times
• Cost
• Unavailable services
• Culturally inappropriate services
• Lower levels of education and limited knowledge
Define Health Care expenditure:
All expenditure by the Australian federal, state and tertiary governments, private health insurances, householders and individuals on health.
Prevention strategies of health care expenditure:
• Immunisations
• Cancer screenings
• Health promotion
Advantages of emerging new treatments and technologies:
• Less risky/more chance of success e.g. keyhole surgery
• Early detection improves health care and mortality rates E.g. an MRI
Disadvantages of emerging new treatments and technologies:
• Cost increases, e.g. keyhole surgery
• Access, e.g. R/R areas
Health Insurance: Medicare
*Australia’s universal health care system, established to provide individuals with affordable and accessible health care.
Private Health insurance:
Allows people to have cover for private hospitals and ancillary extras, but it is charged on top of Medicare.
Private Health insurance benefits:
• Shorter waiting times
• Choose hospital and doctor in a private room
• Ancillary benefits (e.g. dentistry)
• Insurance whilst overseas
Medicare benefits:
• Free treatment as a public patient in a public hospital
• Free or subsidised treatment by medical professionals (e.g. GPs, specialist)
HOW EQUITABLE IS THE ACCESS AND SUPPORT FOR ALL SECTIONS OF THE COMMUNITY?
. Gov. introduced services which are mobile and travel between priority areas, to create a more economical approach of increasing access. E.g. Purple Truck for ATSI, which offers kidney dialysis for free and travels to those who need it.
HOW MUCH RESPONSIBILITY SHOULD THE COMMUNITY ASSUME FOR INDIVIDUAL HEALTH PROBLEMS?
The community has a deeper understanding of the behaviours of individuals,
E.g. ATSI have high levels of obesity and CVD, so by targeting them, it reduces overall spending and improves Australia’s health.
Define complimentary health care:
Using unconventional practices in addition to traditional western medical approaches to treat and manage an illness.
Define alternative health care:
Using only untraditional methods to treat and manage an illness.
REASONS FOR GROWTH OF COMPLEMENTARY AND ALTERNATIVE HEALTH PRODUCTS AND SERVICES
• Improved access to information and less acceptance of traditional medical practices due to multiculturalism and migration
• Greater control over health through empowerment as it is a choice
• WHO’s recognition of the usefulness of many alternative approaches
RANGE OF PRODUCTS AND SERVICES AVAILABLE
- Naturopathy:
uses natural products to strengthen the immune system and speed up the healing process. Naturopaths often treat patients by improving their diets or providing nutritional supplements, using homeopathic treatments, or herbal medicines.
RANGE OF PRODUCTS AND SERVICES AVAILABLE
- Homeopathy:
recognises the symptoms unique to each person. It aims to stimulate the individual’s healing powers to overcome the condition. Homeopathic medicines work gently and rapidly to alleviate symptoms.
RANGE OF PRODUCTS AND SERVICES AVAILABLE
- Acupuncture
involves inserting very fine needles into the skin. They are left in either briefly or for up to 20–30 minutes. Acupuncture is claimed to be effective in a wide range of conditions, stimulating the mind and the body’s own healing response.
HOW TO MAKE INFORMED CONSUMER CHOICES
Individuals should make sure they make good decisions regarding CAM, as many of these approaches are not regulated.
Ask Questions:
• What qualifications do you have?
How to make informed decisions:
• Relevant information from reliable sources from professionals (e.g. doctors, professional associations, registration bodies)
Define Health Promotion:
the process of enabling people to increase control over, and to improve, their health.
Why was the ottawa charter created?
due to an increase in lifestyle diseases.
LEVELS OF RESPONSIBILITY FOR HEALTH PROMOTION
• Individuals and families
• Groups in the community and industry (e.g. schools, workplaces, media)
• Non-gov. organisations – domestic and international
PRINCIPLES OF SOCIAL JUSTICE UNDER THE ACTION AREAS OF THE OTTAWA CHARTER: DPS
GOV: Develop policies and provide funding
-e.g. K-10 PDHPE compulsory and advertisements)
>EQUITY + SUPPORTIVE ENVIRONMENTS
COMM: -Run education and training programs to develop skills in relation to health
-e.g. community health centre education
> SUPPORTIVE ENVIRONMENTS
INDIV: -Take charge of their own health
-e.g. research behavioural choices for health
> SUPPORTIVE ENVIRONMENTS
PRINCIPLES OF SOCIAL JUSTICE UNDER THE ACTION AREAS OF THE OTTAWA CHARTER: RHS
GOV: -Fund, research and create policies around prevention and health promotion. Looking at all the determinants of health
-e.g. tv advertisements)
> EQUITY, DIVERSITY + SUPPORTIVE ENVIRONMENTS
COMM: -Conduct research, and be involved in the promotion of health.
-e.g. cancer council conducts research around cancer, promotes better health choices
> DIVERSITY + SUPPORTIVE ENVIRONMENTS
INDIV: -Seek to make healthy life choices, and help others to do the same
-e.g. getting advice from a GP on quitting smoking
> SUPPORTIVE ENVIRONMENTS
PRINCIPLES OF SOCIAL JUSTICE UNDER THE ACTION AREAS OF THE OTTAWA CHARTER: SCA
GOV: -Engage with community groups in creation of policies
-e.g. allowing communities to provide feedback on policies
> DIVERSITY + SUPPORTIVE ENVIRONMENTS
COMM: -Contribute to policies and implementing them
-e.g. Aboriginal community-controlled health services
> DIVERSITY
INDIV: -Promote and be involved in activities that improve health
-e.g. promote fun runs
> SUPPORTIVE ENVIRONMENTS
PRINCIPLES OF SOCIAL JUSTICE UNDER THE ACTION AREAS OF THE OTTAWA CHARTER: BHPP
GOV: -Creation and maintenance of policies that improve health
-e.g. Closing the Gap
> EQUITY + DIVERSITY
COMM: -Develop and carry out health policies
-e.g. ATSI involvement in the development and implementation of ‘close the gap’
> DIVERSITY
INDIV: -Act in accord with the policies delivered
-e.g. not smoking in public areas
> SUPPORTIVE ENVIRONMENTS
PRINCIPLES OF SOCIAL JUSTICE UNDER THE ACTION AREAS OF THE OTTAWA CHARTER: CSE
GOV: -Planning, implementation and management of infrastructure
-e.g. location of hospitals
> EQUITY + DIVERSITY
COMM: -Maintain healthy environments and promote healthy behaviours
-e.g. fun runs
> DIVERSITY + SUPPORTIVE ENVIRONMENTS
INDIV: -Make better health choices using the environment
-e.g. putting rubbish in the bins provided
> SUPPORTIVE ENVIRONMENTS
THE BENEFITS OF PARTNERSHIPS IN HEALTH PROMOTION
• It ensures all areas of the Ottawa Charter are covered
• Creates optimal conditions for achieving health promotion goals
• Individuals and communities should be involved for personal empowerment
• Addresses the needs of individuals and communities
• More comprehensive health promotion
• More efficient
BENEFITS OF HEALTH PROMOTION BASED ON: THE FIVE ACTION AREAS OF THE OTTAWA CHARTER
• Better results of health promotion
• Health promotion that addresses all the determinants of health
• Greater empowerment of individuals and groups
• Health promotion that is based on the principles of social justice
HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE: DPS
EQUITY: -Access to education for all individuals. Access can be restricted by money, distance or lack of exposure
>e.g. access to free online health courses
DIVERSITY: -A personalised program to target all individuals
>e.g. information pamphlets in many different languages
SUPPORTIVE ENVIRONMENTS: -Empowerment of individuals by giving them knowledge and skills to pass onto others in their area
> e.g. healthy food habits
HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE: RHS
EQUITY: -All individuals should have equal opportunity to receive professional education and training.
DIVERSITY: Health services must be culturally sensitive and respect the needs of all people
>e.g. doctors should be aware of how a patient’s culture influences health
SUPPORTIVE ENVIRONMENTS: -Services are reoriented in a way that increases the support for communities.
HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE: SCA
EQUITY: -Resources must be equally available to all communities through equitable distribution by gov.
DIVERSITY: -Each community should be consulted about the development of health promotion strategies to improve their health.
> e.g. ATSI understand what they need more than anyone else
SUPPORTIVE ENVIRONMENTS: -When communities are united, it creates a sense of support, which means individuals can rely on others to improve their health.
HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE: BHPP
EQUITY: -All people need access to the same legislation and policies
> e.g. Medicare, PBS
DIVERSITY: -Different policies are implemented into specific areas where they have different needs.
SUPPORTIVE ENVIRONMENTS: -Workplaces and schools have policies to improve health
>e.g. no smoking at work and no-hat-no-play at schools
HOW HEALTH PROMOTION BASED ON THE OTTAWA CHARTER PROMOTES SOCIAL JUSTICE: CSE
EQUITY: -If an environment is not supportive, it cannot provide equity
>e.g. increasing access to health facilities for R/R
DIVERSITY: -All environments are different, meaning they need different types of support, which can be done through recognising diversity.
SUPPORTIVE ENVIRONMENTS: -Encourages healthy choices
> e.g. improving lighting of run tracks at night will increase the use
Define the Ottawa charter:
the main framework for health promotion, which was designed by WHO in Canada (1986) to promote prevention of a disease.
National road safety strategy:
Aim and intersectional collaboration
Aim: To decrease road fatalities (zero by 2050)
Intersectional collaboration: • Individual – take responsibility of safe driving (e.g. parents educate children on road safety)
• Government – responsible for most areas of road safety regulations and management (e.g. funding and laws)
• Organisations – NRMA
• Community – lion Driver reviver stations, RYDA
(further research case study)
Healthy schools canteen:
Aim and intersectional collaboration
Aim: To increase student access to healthy food and drink options, to reduce intake of unhealthy foods and to encourage children to drink water rather than sugar-sweetened drinks.
Intersectional collaboration: • Individual – students, parents and school leaders work together to make initiative successful
• Government – overseas campaign and works with NESA to ensure initiative is running in all Government schools
• Community – Canteen managers work with parents and community to ensure canteen is successful (e.g. try and source healthy food ay a subsidized price) Schools work with students to ensure food introduced is what they like and what they will buy.
(further research case study)
