CORE 1. Flashcards
What is the role of epidemiology?
The study of the patterns and causes of health & diseases in populations. This study is applied to improve health
What can epidemiology tell us?
The basic health status of Australia and the trends in mortality/morbidity over a period of time. It:
- Monitors major causes of illness and death (emerging issues and inequalities)
- Identifies and targets areas in need of prevention, treatment and funding
- Monitors use of health care services
Who uses the measures of epidemiology?
- Policymakers (three levels of government i.e. local, state, federal)
- Manufacturers of health products (drug) and providers of health services (gym/helplines)
- Governments to compare our health with other countries
Identify the limitations of epidemiology?
- Doesn’t show variations between health status among subgroups E.G. ATSI & non – AB people
- Doesn’t accurately indicate the quality of life in terms of people’s health
- Can’t provide whole picture health E.G. mental health is non-existent in data
- Imprecise methods, source and reliability of data collections E.G. R/R areas
Identify the 4 measures of epidemiology?
- Morbidity
- Mortality
- Infant mortality
- Life expectancy
- Morbidity + examples
= refers to ill health in an individual and to levels of ill health in a population
E.G. the number of cases of obesity is increasing, whereas CHD is declining in both females and males in AUS
= Has two indicators
- Prevalence: the number of cases of disease at a specific time
- Incidence: the number of new cases occurring
- Mortality + examples
= measures the number of deaths from a particular cause over a given period of time
- E.G. lung cancer (the leading cause of death) is decreasing for males and increasing for females
- 2nd leading cause = dementia & Alzheimer
- Infant mortality + examples
= measures the number of deaths among children aged under 1 year in a given period per 1000 live births
- predicts adult life expectancy
- E.G. infant mortality is decreasing & relatively low
- Indicates better health education & improved medical diagnosis
- Life expectancy + examples
= the average number of years a person will live
E.G. females = 84.4 yrs,
E.G. males = 80.3 yrs
- Death rates continue to fall due to better healthcare, immunisation, the decline in CVD and cancer deaths, reduced traffic accidents, etc
Identify the priority health issues
- Social justice principles
- Priority population groups
- Prevalence of conditions
- Potential for prevention and early intervention
- Cost to individuals and communities
- Social justice principles
SJ = the elimination of inequity, the promotion of inclusiveness and the establishment of supportive environments for all
- Equity = everyone has fair access to health services, support & resources
E.G. Centrelink (financial aid) - Diversity = recognises social, cultural factors that impact an individual’s health/wellbeing
E.G. brochures in multiple languages within hospitals - Supportive environments = physical and social aspects of where people live, play & work + access to resources & opportunities
E.G. National Road Safety Strategy i.e. additional speed cameras
- Priority population groups
PPG = groups in society with significantly different health statuses, disadvantages & inequalities:
- ATSI people = higher death rate (10.6% male, 9.5% female), smoking rates, rates of disability
- Low SES = higher rates of smoking & diabetes levels, death from avoidable causes, less likely to seek dental check-ups to cost
- R & R Area = higher levels of smoking, rates of obesity, levels of risky drinking, blood pressure and lack of activity
- Prevalence of conditions
- Prevalence of a condition assists in the identification of risk factors = indicates the potential for change for the health issue
- High prevalence of specific diseases places a significant economic & health burden on the community
- E.G. CVD is the leading cause of preventable death in AUS
- Potential for prevention and early intervention
- Intervention should be aimed at modifying the environment which can change people’s lifestyle behaviours
- Educating people & making them aware of the risk factors
- Sociocultural: E.G. men with a high tendency to part-take in high-risk activities i.e. drugs
- Physical: E.G. affect a person’s ability to attain work/socialise
- Environmental: E.G. . R & R areas have less access to health services/treatment
- Economic: E.G. $$ treatment & health services impacts their health literacy
- Costs to individuals and communities
INDIVIDUAL = cost/burden measure in terms of:
- Direct effect = the cost of medication and treatment, loss of income
- Indirect effect = the cost of emotional stress, depression, the burden on others, reduced quality of life
COMMUNITIES = economic burden of illness, disease & death
- Direct effect = the cost of hospitalisation, Medicare, prevention programs, pharmaceuticals, education and screening
- Indirect effect = the cost of foregone earning, retraining replacement workers and absenteeism
Difference between health inequity vs. health inequality
- Inequity refers to unfair/unjust differences in health
- Inequality refers to the differences in the health of individuals and groups
Nature & extent of health inequities within ATSI populations?
- Significantly poorer outcomes than the rest of the Australian population
- Lower life expectancy (17 years less than other Australians)
- Higher levels of cancer (1.5x more likely), higher prevalence of cancer & higher levels of diabetes/CVD (5x more likely)
- This is due to lower levels of education, employment & income
3 Health determinants within the ATSI population
SOCIOCULTURAL:
- Long history of racism & discrimination
- ATSI is intergenerational & impacts physical health
- More likely to participate in high-risk activities i.e. drugs
- Low self-esteem and poor mental health
SOCIOECONOMIC:
- Low levels of education can significantly limit employment opportunities
- Earn a lower gross income which can affect lifestyle behaviours (physical activity & diet)
ENVIRONMENTAL:
- Large proportion live in rural areas which have limited access to health care services and facilities
- Employment opportunities are labour intensive this increased risk of injury
Role of communities, individuals & governments within ATSI population
INDIVIDUALS: access information & health services
- encourage choices promoting good health
- E.G. ATSI should pursue careers in health care
COMMUNITIES: responsibility to address inequities
- provide support, educate the community, create awareness E.G. QUIT smoking groups
GOVERNMENTS: creating health policies
- health initiatives specifically designed to improve the health of ATSI E.G. Closing the Gap
Nature & extent of health inequities within R/R areas
- Death rates 1.5 x more prevalent
- High rates of cancer, high levels of disability and suicide, high death rates of liver cirrhosis
- Poor oral health
- Links to the access of health facilities
3 Health determinants within R/R areas
SOCIOCULTURAL:
- children growing up around smokers are subject to 2nd hand smoking & more likely to smoke when they are older
- Obese families influence their children’s diets & lifestyle
- lower levels of P.A. & higher levels of risky drinking
SOCIOECONOMIC:
- Education: lack of education opportunities leads to lower health literacy
- Employment: more likely to work on farms, in transportation or mines which is hazardous with higher rates of tobacco and alcohol use
- Income: lower average income
ENVIRONMENTAL:
- Poor distribution of medical specialists and medical technology E.G. GPs & cancer services in R/R areas
- Number of GP’s is rising but still lower than in major cities
Role of communities, individuals & governments within R/R areas
INDIVIDUALS: good decision making and taking responsibility for their own health
- remaining in school or going to uni E.G. Charles Stewart
- improves knowledge, employment opportunities and income levels
- promotes good health choices in R/R families
COMMUNITIES: provides relevant health care and support services
- Developing of multi-purpose service programs
- Community health centres with the health services
GOVERNMENTS: funds programs to assist the health care of R/R living people
- E.G. Royal Flying Doctor Service provides health care, clinics, medical evacuations, provides medical check-ups and remote consultations
What are chronic diseases + examples
Chronic diseases are long term and persistent conditions that can lead to a gradual deterioration of health & are responsible for 80% of the total disease burden
- Cardiovascular disease
- Cancer (skin, lung, breast)
- Diabetes
Nature & Extent of CVD
CVD = Condition affecting the blood vessels and heart (poor supply of blood to muscular walls of the heart)
- Atherosclerosis is the main cause of CHD, stroke due to the build-up of fatty tissues in vessels causing narrowing and decrease in blood
- 1 in 6 Australians affected & cause 27% of deaths
- Decreasing mortality rate for both males/females
Risk & Protective Factors of CVD
Non-Modifiable Risk Factors:
- Age (older) and gender (males ignore warnings)
- Family history E.G. genetic heart conditions
Modifiable Risk Factors:
- Smoking = increases risk x2
- Raised blood fats, blood pressure (cholesterol, heart overload)
- Obesity, no PA = type 2 diabetes damage blood vessels & arteries
Protective Factors
- 30 mins physical activity per day – manage stress and provides a positive mindset
- Healthy diet = low salt and fat intake, safe alcohol consumption
- Medical check-ups for cholesterol and BP
3 Determinants linked to CVD
- Sociocultural = family history E.G. diet, Asians less prone, ATSI more at risk, media exposure of smoking reduces rates
- Socioeconomic = less money limits food choices, lower education decreases knowledge about risk behaviours
- Environmental = rural and remote less access to info, services and technology E.G. ECG (heart monitors), mass media campaigns of less fatty foods to improve nutrition
Groups at Risk for CVD
- ATSI = 2.6 x more likely to have a heart attack & 1.7x more likely to have a stroke over the age of 25 compared to other Australians
- Smokers = higher rates of CVD
- Socioeconomic disadvantaged = 40% death rate of CVD
- Overweight
Nature & extent of diabetes
- Relates to the body’s ability to control blood sugar levels using insulin and can be either hereditary or developmental
- Caused by improper functioning of pancreas, little insulin and high blood glucose levels
- Type 1 (juvenile) – no insulin produced to control blood sugar levels: genetics
- Type 2 (non-insulin) – characterised by a breakdown in the efficiency of insulin controlled by tablets, exercise and diet
- More than 1 in 20 Australians have diabetes (1.2 million)
- Men (6.8%), females (5.4%)
- E.G. ATSI = highest prevalence in the world of type 2
Breast cancer
- Highest incidence in women, death rates have fallen
Risk factors:
- Modifiable = high fat diet, physical inactivity, last first pregnancy
- Non-modifiable age, gender, family history, early menstruation
Protective factors: self-breast examination and mammograms every 2 years after 50, known family history, early detection
- Sociocultural: family history and modern lifestyle, pregnant after 40
- Socioeconomic: less education and knowledge, unhealthy diet
- Environmental: free breast screening
- Groups at risk: women who haven’t given birth, obesity, over 50, no self-check, late menopause
Lung cancer
- The leading cause of cancer death, but preventable
- Decreased in males, increased in females
Risk factors:
- Modifiable = Tobacco smoking, being exposed 2nd hand to smoke
- Non-modifiable = gender, age, family history
Protective factors: Avoid or quit smoking, moderate alcohol consumption, healthy balanced diet
- Sociocultural: family history of cancer, less tolerance to smoking in culture E.G. ATSI, low SES and some stressed females more likely to smoke
- Socioeconomic: more likely to smoke
- Environmental: no smoking laws
- Groups at risk: smokers, blue-collar, men and women over 50
Skin cancer
- Most common incidence and AUs rates are highest in the world
- Types include basal cell carcinoma, squamous cell carcinoma & malignant melanoma
Risk factors:
- Modifiable = Unprotected exposure to the sun
- Non – modifiable = Having fair skin, large amounts of moles/freckles
Protective factors: sun protection, sunscreen, wearing sunglasses and hats
- Sociocultural: teens sunbake due to culture and media reports of tan, etc
- Socioeconomic: lifeguards/ outdoor workers, low education linked to poor health choices and less knowledge about how to access and use health services
- Environmental: school rules ‘no hat no play’ and Gov. laws outdoor workers provided with sunscreen
- Groups at risk: fair skin, no hat or sunscreen for outdoor workers
3 Determinants linked to diabetes
- Sociocultural – poor diets and sedentary lifestyles 4x more likely to be hospitalised and die from diabetes
- Socioeconomic – ATSI due to smoking, alcohol consumption, imbalanced diet
- Environmental – less access to health services, info, pollution, 2 x more likely to be hospitalised
Groups at Risk for diabetes
- ATSI, low SES, R & R, 55+, overweight, poor diet, frequent alcohol users, inactive populations
Growing and Ageing Population
- Australia’s growing and ageing population is a product of increased life expectancy and decreased birth rates
- 15% over 65 yrs. (2017)
- This is because families are having fewer children (fertility issues) and the population is living longer (education, PA and healthy lifestyle)
- The proportion of older Australians is growing at a faster rate than younger Australians
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
- AIM = to enhance an individual’s physical, mental and emotional health and reduce the risk of the early onset of disabilities and diseases
- Able to contribute to the workplace for a longer period of time, resulting in a greater economic growth
E.G. Superannuation significantly reduces the dependence that retirees have on pensions
- Healthy lifestyle saves money, prevents functional decline and enhances quality of life
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
- AIM = to enhance an individual’s physical, mental and emotional health and reduce the risk of the early onset of disabilities and diseases
- Able to contribute to the workplace for a longer period of time, resulting in a greater economic growth
E.G. Superannuation significantly reduces the dependence that retirees have on pensions
- Healthy lifestyle saves money, prevents functional decline and enhances the quality of life
Increased population living with chronic disease and disability
AGEING POPULATION:
- increase in the number of aged people = increase of chronic diseases and disabilities
- survival rates from many chronic diseases increases = quality of living and independence decreases
E.G. cancer, dementia, etc
PEOPLE’S LIFESTYLE:
- Technology makes people more sedentary
- People are more engaged in phones than doing physical exercise and sport
DEVELOPMENT OF MEDICAL TECHNOLOGY:
- Increased awareness encourages people to be screened for diseases E.G. signs, symptoms & risk factors of cancer
- Allows early diagnosis = appropriate treatment = mortality rates decrease
E.G. elderly: 53% have disabilities, 1 in 5 have CVD, 38% have high BP
Demand for health services & workforce shortages
- As people age, they become more susceptible to developing chronic diseases and other illnesses thus a greater need for health professionals, aged care workers & facilities and services is created
E.G. in the last 10 years, the number of people living in aged care facilities has risen by 20%
- Creates a strain on the public health system, Medicare and the PBS as more people will be utilising health services and require medication
Availability of carers and volunteers
CARERS
- the increase in chronic disease and disability = increase in carers and volunteers
- family members/friends may be responsible for caring for the elderly (dressing, feeding, giving medication)
- either part-time or full time
VOLUNTEER ORGANISATIONS
- Members of the community that offers their services to others for free - heavily rely on charity and donations
- Volunteer/carers will face increased workload & decreasing rates of people volunteering
E.G. Meals on Wheels - meals for the elderly who are unable to cook a nutritious meal
E.G. Red cross – checks on people’s overall wellbeing and helps support isolated people
Healthcare in Australia
- Health care facilities and services provide treatment and management options for injuries and illness and better health for all
- Promotes early intervention and prevention of death
- Health system encompasses diagnoses, treatment, rehabilitation, care for the ill and improvement of health
Range & types of health facilities & services:
- Institutional services
INSTITUTIONAL SERVICES - mental health facilities, hospitals, aged care homes, ambulance services
- Hospitals are either private or public:
- PUBLIC = operated by state and fed government, everyone has access to Medicare, no choice of Dr.
- PRIVATE = covered by private health insurance, the user pays, choice of Dr, E.G. SAN Hospital, patients have their own room