FQ2: What are the priority issues for improving Australia’s health? Flashcards
Groups experiencing health inequities - ATSI - nature + extent
Nature + extent
- life exp gap is 10 years lower than other Aus
- death rate = 2x higher (improving)
- more likely to suffer from chronic health conditions e.g. CVD, cancers, asthma, diabetes → more than ⅔ (70%) of the total health gap
- Burden of disease is 2.5x higher than Aus pop.
Groups experiencing health inequities - R&R - nature + extent
Nature + extent
- Roughly 30% live in R&R areas
- Have shorter lives, higher rates of disease + injury
- Death rates increase w/ increased remoteness; very remote 1.5x major cities
- Main causes: CHD, circulatory diseases, motor vehicle accidents, COPD
- ↑ rates of diabetes, transport accidents, suicide (stigma)
high levels of preventable chronic disease, injury and mental health problems - CVD (nature + extent)
Nature:
- A general term covering all diseases of the heart and circulatory system
- Refers to damage to, or diseases of the heart, arteries, veins, and/or smaller blood vessels
- Major health & economic burden on Aus (27% of all deaths in Aus - 2017)
- Males more likely to die from CVD than females
- Indigenous people die at twice the rate from CVD
- Most evident as: CHD, stroke, heart attack, angina, heart failure, peripheral vascular disease - atherosclerosis is the underlying cause of most conditions, arteriosclerosis
Extent (trends):
- 1 in 5 Aus suffers from a CVD
- CVD = second leading cause of death in Aus (after cancer), but CHD is still the leading single cause of death with cerebrovascular disease coming in second
- Accounted for 27% of all deaths in Aus (2017) - 26% for males, 28% for females.
- CVD second largest burden disease (Aus) = most costly
- CHD is downward, falling 73% last 30yrs
high levels of preventable chronic disease, injury and mental health problems - CVD (protective + risk factors, groups at risk)
Risk: NM: family history/hereditary, gender, age, M: smoking, high BP, overweight + obesity, physical inactivity
Protective: Maintain healthy levels of BP + cholesterol, quit smoking, healthy eating, regular doctor visits, physically active
Groups at risk: smokers, males, low SES, ATSI, R&R
Groups experiencing health inequities - ATSI - Determinants
Determinants
SC: Family and peers: exposure to drug use/ alcohol → increase risk (as a child), Culture: subject to discrimination/racism → disempowerment e.g. low self-esteem, poor mental health, equity of access → more likely to risk behaviour
SE: Edu: less-educated → lower health literacy leads to poor behavioral choices (smoking) and physical inactivity, income: less money → impact chronic illness and treatment, ↑ cost of living, employment: 3x higher (as a result of lack of edu = less income)
Env: Access to health services: poorer than other Aus = long wait times, GL: more likely to live in R&R locations
Role of indiv, comm, govt = intersectoral approach
Groups experiencing health inequities - ATSI - indiv, comm, govt
Role of indiv, comm, govt = intersectoral approach
Indiv: reduce risk behaviour, promote their own health/others, keep well informed in health education → health literacy e.g. parent modeling healthy eating
Comm: Involved in design of many of closing the gap programs, advocate for change, initiate and support community activities and services that provide empowerment e.g. Aboriginal Medical Services (AMS)
Govt: formulating health policies, provide ongoing funding to health care and initiatives for ATSI, larger HP e.g CLOSE THE GAP - aims to achieve equality in health
Groups experiencing health inequities - R&R - determinants
Determinants:
SC: Family/peers: poorer indicators influence children in R&R e.g. child raised in fam w/ ↑ smoking rates/obese, second-hand smoke → more likely to become smokers/obese, Culture: a higher proportion of ATSI
SE: Edu: disadvantaged regarding edu opportunities - leading to lower health literacy, income: have a lower average income, less employment opp, employment: disadvantaged employment opp, more likely to work on farms, transportation, mines → hazardous occupations → w/ ↑ rates of tobacco and alcohol use
Env: Access to health services: GP lower than rates major cities → limits access to general medical services, poorer distribution of medical specialists and tech e.g. cancer (skin) screening programs, GL: some ppl w/ chronic conditions required to travel long distances regularly → transport costs, time-consuming
Groups experiencing health inequities - R&R - indiv, comm, govt
Role of indiv, comm, govt = intersectoral approach
Indiv: good decision making, actions such as: remaining in school, attending uni either online e.g. Charles Sturt → improve knowledge, employment opp, income → help make informed choices
Comm: providing relevant health care and support services e.g. Multi-Purpose centres → development of community health centers, work in partnership w/ health care sector to deliver necessary services e.g. Country Women’s Association (CWA)
Govt: funds many R&R programs → assist in delivery of health care e.g. Royal Flying Doctor Service → provides health care clinics, remote consultations, implemented a no. of strategies e.g instituted the R&R General Practice Program to help ↑ no. of GP’s
high levels of preventable chronic disease, injury and mental health problems - CVD - (determinants)
SC: Family history = more at risk, ATSI more at risk → associated w/ lower SES and education levels, growing up in a family =obese, diet high in sugar + saturated fats or lives a sedentary lifestyle (children grow up and live a similar lifestyle)
SE: Low SES or unemployed have higher death rates → income can limit health choices e.g. purchasing fresh fruit + veg, using ex facilities, Low education levels → more at-risk → poor education linked to poor health choices, Edu: influences employment, CVD has higher rates in blue-collar e.g. trades + labour → linked w/ other lifestyle choices such as higher rates of smoking and drinking
Env: R&R more at risk → tend to have less health info, services and tech e.g. electrocardiogram monitors
high levels of preventable chronic disease, injury and mental health problems - cancer - (nature + extent)
Nature
- refers to cells that have become abnormal + begin to multiply rapidly = cannot be controlled by the body
- This random multiplication forms tumours and can interrupt the normal functioning of an organ and spread to other parts of the body
- Tumours can be both benign (non-cancerous) and malignant (cancerous → ability to spread)
- Multiple cancers, most of which are named according to their location in the body e.g. skin, lung, bowel etc
Extent (trends)
- Cancer is the leading cause of death in Aus, despite survival rates improving and death rates declining
- Increased incidence → due to increased screening, increased survival, decrease death rates, resulting in an increase in cancer prevalence
- The risk of dying from cancer is 1 in 4 for males and 1 in 6 for females
- Lung cancer incidence is on the decline for men but increasing for females
- The incidence of melanoma (main skin cancer) has almost halved over the last 30 years dropping from 5% to 2.8% → increased awareness and behavioural choices
- Breast cancer incidence has risen since the introduction of breast screening in 1992, but mortality rates have steadily declined and survival rates have improved
high levels of preventable chronic disease, injury and mental health problems - cancer - (protective + risk factors)
Skin:
Protective: Sun protection: Slip slop slap, protective clothing, stay out of sun
Risk M: Unprotected exposure to sun → e.g. occupation, beach, etc
Risk NM: Fair skin, having moles
Lung:
Protective: avoid/quit smoking, moderate alcohol consumption, healthy balanced diet
Risk M: Tobacco smoking, passive smoking
Risk NM: Gender, age, family history
Breast:
Protective: self-examination, screenings (mammograms, ultrasounds), maintain healthy weight, avoid alcohol consumption, fat foods, white foods
Risk M: high-fat diet - obesity, physical inactivity, late first pregnancy, not having children
Risk NM: Gender, age, early-onset menstruation/ menopause, family history
high levels of preventable chronic disease, injury and mental health problems - cancer - (groups at risk)
Skin: People with fair skin, low SSE, elderly, people constantly exposed to the sun, R&R,
Breast: Diets high in fats (overweight), low SES, R&R, family history (mainly women), ATSI
Lung: tobacco/ other smokers, blue-collar, ATSI, low SSE, family history, R&R
high levels of preventable chronic disease, injury and mental health problems - cancer - (determinants)
SC: family history = more at risk or fair skin (light genes in fam), Aus beach + sun culture increase cancer risk → tanning (linked to peers), behavioural factors e.g. smoking, sedentary → impacted by family + peers, ATSI → higher lung cancer rates → culture, fam influence (second-hand smoke)
SE: Low SES or unemployed have higher death rates, low income can limit health choices e.g. purchasing fresh fruit + veg, using ex facilities, low edu = poor decisions, occupations involving exposure to asbestos → increase risk of lung cancer, outdoor occupations e.g. lifeguard, tradie etc
Env: R&R more at risk → tend to have less health info, services, treatment and tech e.g. pap smears, breast screenings, Aus sun exposure = higher risk, are hotter areas (inland)
high levels of preventable chronic disease, injury and mental health problems - diabetes - (nature + extent)
Nature of the problem
- A disease that relates to the bodies ability to control blood sugar levels using insulin
Type 1 Diabetes:
- autoimmune disorder –> when the body no longer produces insulin to control blood sugar levels
- Require insulin injections in order to control blood sugar levels (insulin-dependent)
- Caused by a combination of genetic predisposition and environmental factors
Type 2 Diabetes
- Characterised by a breakdown in efficiency of insulin
- Blood sugar levels high and body releases more insulin in the hope of reducing some of the blood sugar
- Lifestyle-related - caused by: physical inactivity, high sugar diet, hypertension, obesity, smoking, and high blood lipids
Gestational
- Similar to type 2 but occurs during pregnancy
Extent (trends)
- 1 million Aus diagnosed w/ diabetes
- Over last 20 years has doubled to 4.2% in Aus
- 6th leading cause of death in Aus, contributing to 10% of deaths
- 92% of type 2 diabetes occurs in adulthood, though 8% occurs in children (increases w/ age)
- ATSI people have one of the highest prevalence rates of type 2 diabetes
- Expensive → 8.2 mil prescriptions filled each year
high levels of preventable chronic disease, injury and mental health problems - diabetes - (protective + risk behaviours, groups at risk)
Protective: doctor visits, living a healthy lifestyle → regular physical activity, well-balanced diet, maintaining a healthy body weight, managing BP, not smoking, Aus Dietary guidelines → provide foundation for a healthy diet, state Prevention Programs: “NSW Beat It” → gym, aerobic activity
Risk NM: Family history
Risk M: physical inactivity, obesity / overweight, imbalanced diet (high sugar, fats or alcohol), smoking, hypertension
Groups at risk: family history, ATSI - 3x more likely, also Chinese, PI, Indian → type 2, elderly - affects 15% of people over 65, overweight, low SES, type 2 more common in men, amongst low SES and R&R
high levels of preventable chronic disease, injury, and mental health problems - diabetes - (determinants)
SC: family history, Chinese, Indian, PI, ATSI → more likely type 2 diagnosis, cultures + fam w/ poor diet/ behaviours → child grows up similar
SE: low SES have higher rates of smoking, alcohol consumption, imbalanced diets, obesity, and physical inactivity → type 2, less educated = higher risk
Env: people outside of MC = more likely to be diagnosed with type 2 diabetes, tech has led to higher levels of physical inactivity = greater risk of diabetes
A growing and ageing pop including healthy ageing
- Is a health priority as with growing & ageing pop comes an increase in disease burden + health care demand
Healthy ageing - Goal: enable elderly to maintain health into old age = allows them to contribute to the workforce longer, + engage in society better
- HA involves reducing risk factors throughout life → reduction + delay of developing disease or illness + reducing morbidity + mortality
- If ppl unhealthy later in life = working years shortened → reduction in economic growth, aims to prevent
E.g. ‘Ageing Well, Ageing Productively’ → Govt research program, Ambassador for Ageing (provide positive/active ageing) - Benefits: extended longevity, enhanced QOL, less economic burden, less chronic disease, (also benefits of staying in workforce e.g. financial, social etc)
A growing and ageing pop (increased pop living w/ chronic disease + disability
- result in increase in HC expenditure + need for aged care facilities
- Risk of disease increases with age due to greater exposure to the risk factors that cause chronic disease (85+ every person has at least one condition and 65% of older people have 5 or more chronic conditions)
- Increased incidence due to ageing pop (increased survival rates / LE), sedentary lifestyle, increased awareness and medical development
A growing and ageing pop (demand for health services and workforce shortages)
The health system and services
- concerns the ageing pop. will increase public spending on health = unsustainable strain on the health system
- Age = increase in health conditions + disability → elderly increase use of health services
- Visit professionals more frequently → 98% last year
- last 10 yrs no. of people living in aged care facilities has risen by 20% → require more funding, staff + management
- Aged care = high burden on health system → majority of residents have chronic disease/illness = increased demand for health services
- Govt has no. of initiatives + improved retirement income system e.g. pensions, supa
Health service workforce
- increase in aged care facilities = increase in workforce training in aged care
- Need to focus on efficient coordination of care + on safe use of meds = decrease demand for health services + workforce
- 2012 Aus govt = ‘Living Longer, Living Better aged care’ reform package → increase attraction, remuneration, education, training → in order to address workforce shortages
A growing and ageing pop (availability of carers and volunteers)
Carers of the elderly
- Increase in chronic disease + disability = increase in C+V
- Carer = provides assistance in a formal paid role or informal unpaid role for someone due to illness, disease or disability
- Increasing demand for care = limiting availability of formal aged health carers + volunteers e.g. Red Cross → increasing need for informal care e.g. family or friends
- help with tasks such as feeding, bathing, transport → unpaid care: huge financial saving for govt
- Many come from charities, religious institutions, or govt
- Aus Govt fund residential aged care services e.g. Home and Community Care (HACC) program → nursing services, delivered meals, etc
Volunteer Organisations
- Volunteering = unpaid wilful help given as time, service, or skill to a formal organisation
- Rate of volunteers = falling → needs to be turned around if Aus going to appropriately care for needs of G&A pop.
- Formal groups: social e.g. sport or rec, religious groups
- Often cook, drive, do housework, visiting, help shopping
- V orgs include:
→ Anglicare (home care, residential aged care, food + financial assistance, mental health support)
→ Meals on Wheels (meals to elderly)
→ Community nursing + health care centres
To what extent does Australia’s health care system benefit from having a healthy ageing population?
- Very beneficial
- Reduces economic burden on govt - less need for treatment + aged care facilities
- Able to contribute to economy = improving economy
- less pressure + burden on health care services + facilities - volunteers
- Preventative - ‘Living longer, stronger’
- Decreased expenditure = put it towards other preventative methods + EI helping other health issues that are more prevalent
- Decreasing pressure on hospitals - hospital admission beds, less pressure of GPs
- Carers less demand on volunteers - aged make a big percentage of volunteer network
- Chronic diseases + disability that they help look after becomes less of a burden
