Core 1: Health Priorities in Australia Flashcards
Role of epidemiology
- Epidemiological data assists in the identification of Australia’s health needs, resources and priorities.
- Health promotion and expenditure is determined by data collected in relation to the current and future health needs of a population.
Who uses epidemiology?
Governments, public health researchers (Sydney Research School of Public Health), Health Departments (for eg. NSW Health, Vic Health)
Incidence
The number of cases (new and existing) in a population at a given time (covid cases (omicron and delta), influenza)
Prevalence
The number of new cases in a population at a given time
Mortality
Refers to the standardized death rate- deaths per 100, 000 people of the population. (The standardized death rate for Australia was 5.4 per 1000, with Indigenous Australia sitting at 9.6)
Infant mortality
The number of infant deaths. This is often regarded as the most important health indicator as it can predict adult life expectancy. It can be separated into neonatal (the first 28 days of life), post neonatal (after 28 days- the rest of the 1st year)
Morbidity
-Rates of prevalence and incidence of disease, illness, injury, hospital use, doctor admissions and disability.
Limitations of epidemiology
- Doesn’t account for significant variation amongst different communities and populations (Indigenous and Non-Indigenous Australians), doesn’t indicate levels of happiness, quality of life or impact of the illness.
- Doesn’t account for reasons of risk factors or circumstances
- Impact of the illness on the quality of life
- Doesn’t show why patterns or inequtities exist
- Data may be incomplete, inconsistient etc
Social justice principles
Principles which promote equity, diversity and supportive environments.
-They aim to increase autonomy and empowerment by increasing participation, access to health resources and information, and ensuring diversity to take into account people’s cultural beliefs.
Where are the social justice principles applied is Aus society?
Medicare: Public health care for all Australians is provided at no or little cost to the individual under medicare.
- Medicare safety net: A pre-determined amount set by the Australian Government for which medical expenses are subsidised once an individual or family have incurred the medical costs.
- PBS (Pharmaceutical Benefits Scheme):Prescription treatments considered to be lifesaving or for chronic illnesses are subsidised under the PBS (Cheaper medication- all people have access to equitable health)
Priority population groups
Priority population groups are identified as groups within Australian society who experience health inequities.
- these groups are identified as experiencing poor health with the implementation of the social justice principles, such groups should have equitable access to health.
- Promotion strategies must be put in place
Costs to the individual and community
When identifying priority health issues, its essential to identify the cost of the disease, illness or injury to the individual and the community- doesn’t have to be in a monetary sense
- Health issues have both direct and indirect costs to the individual and the community.
- When the health issue has a high cost to either the individual or the community then this gives reason as to why it is a priority
What are individual and community costs (direct and indirect)?
ID-Cost of medication, diagnosis, treatment, loss of income
II-The emotional stress, depression, burden on others (family and friends) and a reduced quality of life, social and emotional impact, emotional trauma of loss, lifestyle changes
CD-The cost of hospitalization, Medicare, prevention programs, pharmaceuticals, education and screening
CI-The cost of forgone earning, retraining replacement workers, absenteeism
Prevalence of a condition (IHI)
Priority health issues can be determined by how prevalent the health condition is.
- In Australia, this is usually concerned with chronic disease, injury and mental health issues
- These can place a burden on a population and due to this, it is important to priorities health funding and resources in these areas.
Potential for prevention and early intervention
- When identifying priority health issues it is essential to identify which issues are more likely to be preventable
- In the long run- resources can be used elsewhere
- Most health issues in Australia are caused by modifiable (preventable) risk factors (smoking, high fat diet, drinking etc)
- Early intervention strategies enable diseases to be identified before they become an increasing burden on a population
ATSI health issues extent and nature
When compared with non ATSI people, ATSI people have:
- An increased mortality rate
- Decreased lfie expectancy
- Increased youth suicide
- Increased kidney disease
- Increased chronic disease (Higher rates of cancer, diabetes and cardiovascular disease)
SC deteriminant- ATSI
History of being oppressed and exploited, intergenerational trauma.
- Still experiencing the consequences of the Stolen Generation- severing cultural, spiritual and family ties, Subject to racism and discrimination- low self-esteem and poor mental health, more likely to participate in excessive alcohol consumption and tobacco smoking.
- Increased domestic violence, disempowerment, decreased income effecting family life and relationships
SE determinant- ATSI
Low income, low education, no graduation from yr12 ( half as likely), low health literacy and awareness, unemployment
ENV determinant- ATSI
Remote areas, low medical access, labour intensive work opportunities, injury, waiting times, overcrowding (COVID), inadequate infrastructure
Individuals- ATSI
- Individuals have the responsibility to access information and participate in health promotion activities that are available to them- making choices that promote good health
- For example, eating healthy, engaging in physical activity
- Many communities are also encouraging ATSI people to pursue cares in health care to create strong support networks of health in ATSI communities.
Communities- ATSI
-Communities must work together to promote better health- involvement in design and implementation of health initiatives, Aboriginal medical services, Australian Indigenous Doctor’s Association, Community health initiatives should,
-Encourage community participation
Provide support for groups
-Creating awareness
-Working close with health professionals
-Reflecting the culture and values of the Indigenous community.
Governments- ATSI
-Responsible for creating health policies and health initiatives
-Improvements to infrastructure (housing, water, electricity, sewerage, transport)
-There are government agencies dedicated to improving the health of Indigenous Australians
The Office of Aboriginal and Torres Strait Islander Health (OATSIH)
Close the Gap iniative
Indigenous Chronic Disease Package
SC determinant- RAR
Greater ATSI population
- Family behaviours smoking and alchohol consumption
- Geographical isolation aids in children being raised in communities with higher smoking rates and rates of drinking- community and low health literacy
SE determinant- RAR
Decreased access to education and employment- especially at the tertiary level and limited opportunities for jobs
-Limited access to goods and services, such as healthy fresh food, heavy labour employment- mining, machinery, agriculture- physically laborious
ENV determinmant- RAR
Highrates of injury.
- Geographic and social isolation -decreasd access to health professionals- health facilities, specialist services and screening, increased need for transportation to such services
- Low health literacy leads to lack of health services access
- Environmental factors such as droughts, floods and bushfires.
- Occupational hazards in rural industries.
- High rates of accident and death in farming
- Poor access to health services.
Individuals- RAR
- Autonomy and self efficacy
- Decision making
- Remaining in school (CSU)
- Encouraging choices such as not smoking
Communities- RAR
Communities can address the health inequities by providing relevant health care and support services. This includes the development of Multi Purpose Service Programs that often connect with community services, and the development of community health centres with the services they offer.
Governments- RAR
- Funding of services- RFDS, Rural and remore general practice
- SARRAH
Nature- What is arterio and atherosclerosis?
Blood vessels HARDEN and lose their elasticity- narrowing of the arteries
Blood vessels become BLOCKED by fat or cholesterol- reducing or preventing blood flow
CHD and PVD
-Caused by a reduced supply of blood to the heart as coronary arteries narrow- could be a result of atherosclerosis
Affects the blood vessels in the limbs as the vessels becpme blocked or damaged- risk factors of smoking and diabetes.
Risk and protective factors for CVD
Age -Gender-Hereditary -Smoking-High fat diet -HBP -Obesity
High blood cholesterol -Lack of physical activity- sedentary lifestyle
Regular physical activity- Low fat diet -Low alcohol consumption -Low saturated fat diet- Low-salt deit- Stress management -Avoiding smoking
SC- CVD
- Men are less likely to access health care and ignore the symptoms of CVD
- ATSI, rural and remote peoples and low SES
- Family history- family habits
- Media exposure to effects of risk behaviours- smoking and diet
- Cultural diets- Asian (low fat)
SE- CVD
- Low SES or unemployed
- People in stressful working roles- high stress jobs
- People with low or no education levels
- Lack of physical activity, tobacco smoking, alcohol consumption- more inclined to eat cheap, fatty fast food as it is cheap.
ENV- CVD
Rural and remote people have decreased access to health services and information
- People in cities have increased access to health services and facilities
- Less preventative and treatment services available.
Groups at risk of CVD
People of low socioeconomic stauts, ATSI, Males, people over 65, smokers, high fat diet and low levels of physical activity, HBP, history of CVD
What is cancer?
Condition in which the body’s cells divide -Uncontrollably- random multiplication forms tumors and interrupts the normal function of the organ where it is located (skin, breast, lung etc) and can spread to other parts of the body
-Cancer can also be caused by carcinogens- radiation, alcohol, tobacco smoke