FQ1: How are priority issues for Australia's health identified?

Question 1

What are the 4 measures of epidemiology? (LIME)

Answer 1

1. Infant mortality rate
2. Mortality rate
3. Morbidity Rate
4. Life expectancy

Question 2

Define epidemiology

Answer 2

gathering and studying of information about illness, disease and death within certain populations

Question 3

What are the general trends for Australia’s health?

Answer 3

Long LE
Declining DR
Reduced IM
Greater access to healthcare

Question 4

What is the key objective of the Australian government to improve health?

Answer 4

Improving the health status of ATSI

Reflected in health expenditure: 17% higher for ATSI people than it is for other Australians

Question 5

What are the measures for patterns of disease?

Answer 5

1. Prevalence: total cases in a pop. at a specific time
2. Incidence: new cases in a pop.
3. Distribution: extent
4. Apparent causes: determinants and indicators

Question 6

What are the purposes of epidemiology?

Answer 6

1. Identify emerging issues and inequalities between groups
2. SPECIFIC TARGETING of specific prevention and treatment interventions
3. Government Funding
4. Monitoring the use of health care services and facilities
5. Evaluating the effectiveness of any prevention and treatment programs

Question 7

What are the limitations of epidemiology?

Answer 7

1. May not accurately judge (QoL)
2. Does not provide the whole health picture
3. Little about degree and impact of illness

Question 8

MORTALITY RATE: State reasons for decline.

Answer 8

1. Control of infectious disease
2. Better hygiene and nutrition
3. Improvements in road safety measures
4. Falls in smoking rates
5. Improvements in prevention, detection and treatment of disease

Question 9

MORTALITY RATE: Statistics

Answer 9

STATS: AUS overall mortality rate has declined over the last 20 years (1998-2018)

Mortality rate for men > mortality rate for women (but gap is decreasing)

Question 10

INFANT MORTALITY: State the 2 types of infant mortality rates and reasons for its decline.

Answer 10

Neonatal: deaths in the first 28 days of life
Post-neonatal: deaths in the remainder of the first year of life

1. Improved medical diagnosis and treatment of illness
2. Improved public sanitation (cleanliness)
3. Health education
4. Improved support services for parents and newborn babies and children

Question 11

INFANT MORTALITY: Statistics

Answer 11

STATS: AUS overall infant mortality rate is decreasing
(3.78 infant deaths/1000 live births)

ATSI infant mortality rate is higher than non-ATSI

Question 12

MORBIDITY RATE: Define key terms (disease burden, burden of disease) and measures/indicators.

Answer 12

DISEASE BURDEN: combination of disability and premature death

BURDEN OF DISEASE: combines the years of healthy life lost due to living with ill health (non-fatal burden) with the years of life lost due to dying prematurely (fatal burden)

MEASURES/INDICATORS:
1. Hospital use
2. Doctors visits and Medicare statistics
3. Health surveys and reports
4. Disability and handicap

Question 13

MORBIDITY RATE: Statistics

Answer 13

2015: AUS lost 4.8 million years of healthy life due to illness or premature death (DAHY - half of this burden was non-fatal)

2015: Males experienced more burden than females

Question 14

LIFE EXPECTANCY: State reasons for decline.

Answer 14

1. Socioeconomic conditions
2. Good quality of healthcare
3. High standard of living
4. Good education
5. Low infant mortality rates
6. Programs for prevention, screening and treatment of diseases

Question 15

LIFE EXPECTANCY: Statistics

Answer 15

AUS: living more years in good health + living longer + life expectancy at birth is continuing to rise
7th in females, 8th in males around the world

Impact on LE Difference: Modest decrease in the gap

Life Expectancy for Indigenous Australians (2015–2017):
Gap: 8.6 years lower for males and 7.8 years lower for females

Positive Trends in LE (2005–2007 to 2015–2017):
Gap: reduced by 2.9 years for males and 1.9 years for females

Question 16

State the 3 principles of social justice, and an example of the 3rd.

Answer 16

1. Equity
2. Diversity
3. Supportive Environments

EXAMPLE: PushUp Challenge
At schools and workplaces: creates a supportive environment by supporting those suffering from mental illness, specifically depression and lower suicide rates
Reducing the prevalence of a highly preventable illness

EXAMPLE: anti-smoking, tobacco laws (Tobacco Act 1987)
Cannot smoke in pubs, clubs or near buildings

Question 17

Explain how Medicare satisfies the social justice principles.

Answer 17

EQUITY: all Australian citizens must access Medicare

DIVERSITY: lowers out of pocket medical costs for all individuals
Extra benefits for those who are handicapped, ATSI, lower SES, pensioners, etc.

Question 18

How does identifying priority population groups improve health conditions?

Answer 18

1. Determine disadvantages of groups
2. Social determinants
3. Prevalence of disease and injury in groups
4. Needs of groups in relation to SJ

Question 19

Name some priority populations. Describe their health outcomes.

Answer 19

ATSI: higher DR from CVD, injury, respiratory disease, diabetes

Socioeconomically disadvantaged (low SES): increased disease risk factors → increased BP, increased cholesterol, less preventative health services (low education = low use/understanding of strategies)

Rural and remote: higher DR from CVD, injury, lack of access to medical services - e.g. Royal Flying Doctor Service

Born overseas

Elderly

People with disabilities

Question 20

Explain how prevalence impacts health outcomes. Provide an example.

Answer 20

DEFINITION: the number of proportion (of cases, instances, so forth) in a population at a given time

CAUSE: Increased prevalence rates of disease = health + economic burden on community
EFFECT: Helps identify risk factors → potential for change in health area = improve

EXAMPLE: CVD - leading cause of preventable death (16.6% of AUS live with CVD)
- Increased exercise → e.g. NSW Premier’s Sporting Challenge
- Better diet → e.g. Crunch n Sip
- Increased education → e.g. mandatory K-10 PDHPE

Question 21

Explain how prevention and early intervention programs impact health outcomes.

Answer 21

• Identify preventable: resources can be used elsewhere
• Essential to prioritise preventable issues (Caused by modifiable risk factors - E.g. smoking, high fat diet, sedentary behaviour)

1. Early intervention by modifying risk = reduced burden of disease
   E.g. Cancer Screening = lowered mortality rates due to early detection and treatment
   Higher rates of successful treatment when identified + treated early
2. Change in behaviour - challenging!
   E.g. Low SES, access to health services, employment status, housing, infrastructure

Question 22

What are the costs to the individual and community within prioritising health issues?

Answer 22

INDIVIDUAL: economic and health burden
1. Financial loss
2. Loss of productivity
3. Lower QoL
4. Emotional Stress

COMMUNITY
Direct Costs:
E.g. money spent on diagnostics, treatment + care for sick + money for prevention

Indirect Costs: value of output loss when people get too ill to work / die prematurely
E.g. cost of forgone earnings, absenteeism, retaining of replacement workers