FQ3: How may the gap in health status of populations be bridged? Flashcards
State the 4 key areas in FQ3.
- Funding to improve health
- Actions that improve health
- SJ framework for addressing health inequities
- Characteristics of effective health promotion strategies
Discuss Medicare as a government intervention that provides funding for health.
MEDICARE SAFETY NET: highly effective as 97% of AUS use it - widely available
$103B subsidised for SES disadvantaged pops (bulk billing), geographically remote pops (Royal Flying Doctor Service)
ADVANTAGES:
Basic medical services (doctor and specialists, Choice of GP,
Basic hospital services in public hospitals, Specialist health care,
Cover for 85% of the scheduled fee for medical services
DISADVANTAGES:
No choice for in hospital care, Long waiting list for elective (non-emergency surgery),
Does not cover all health services (Alternative therapies - chiro, acupuncture, Allied health services (physio), Ancillary services (dental, optical, ambulance)
Discuss PBS as a government intervention that provides funding for health.
PHARMACEUTICALS BENEFITS SCHEME: effective as it is a key component of National Medicines Policy (NMP) by providing wide access and use of meds, however budget increase from $13B to $21B still remains small in GDP
ADVANTAGES:
Equal access to medication for all Australians, especially those on long-term treatments
Some overseas visitors eligible for some PBS medicines through reciprocal health care agreements
Expenditure is uncapped - can increase as new drugs are added and demand grows
DISADVANTAGES:
The PBS limits the amounts of a PBS-listed medicine in a prescription and the number of repeat prescriptions before you must be re-examined by your doctor
Lack of routine process for actively managing the PBS budget to ensure it remains an efficient scheme
Discuss NDIS as a government intervention that provides funding for health.
NATIONAL DISABILITY INSURANCE SCHEME: Not effective - provides funding to eligible individuals to increase QoL but is often exploited
ADVANTAGES:
Each plan is individualised and person-centred → support given based on type of disability
Limits disability discrimination
Directed towards specific populations - Meals on Wheels (ageing population), retirement homes (Anglicare, Bupa), HIV and Hepatitis
DISADVANTAGES:
Limited access to supports in remote and very remote areas
Lack of culturally appropriate services for First Nations communities
Shortages of some supports in non‑remote communities
Pricing framework: not working for participants with high and complex needs - no access to adequate services
Policies are very loose: people are claiming washing machines - misusing the system
2024: cut NDIS growth by $14 billion in 4 years (mention Bill Shorten - minister for NDIS) due to unsustainable growth
Outline how local and district governments provide funding for specific populations.
- working with councils to promote and provide healthy outcomes for everyone
- Receive considerably lower funding than the federal gov. services as they are not taxable
- Also receive considerably less advertising + media knowledge
- Local governments have responsibility for a range of local public health and environmental issues (community services and waste disposal) + implement policies and programs that serve to improve health and reduce health inequities: but may respond differently depending on resources and local needs
Discuss, using examples, organisations that provide funding for specific populations.
MEALS ON WHEELS: Aged populations - effective
ADVANTAGES:
Provision of a nourishing, ready-to-eat meal, with a cognitive and sensory trigger to eat, directly reduces health expenditures by preventing hospital presentations, admissions and readmissions, reducing the length of hospital stays, and supporting both early discharge and post-acute care
DISADVANTAGES:
Quality of food delivered is bad
For most Meals on Wheels programs, meals cannot be customised for specific dietary concerns and/or food preferences.
Due to increased demand, many local Meals on Wheels programs have a long wait list for their services.
Many Meals on Wheels programs require that you meet certain qualifications to participate, such as “homebound” status or income below a set threshold.
LIVING WELL, LIVING LONGER (since 2015) - mental health issues - somewhat effective
Aims to provide regular access to quality and appropriate healthcare to prevent treatable conditions being missed
E.g. Redfern Legal Centre - Independent, non-profit, community-based company which provides free legal services to disadvantaged populations within redfern area
ADVANTAGES:
Significant increases over time in the number of consumers who visit and are having regular checks with a GP
partnership with ccCHIP has been a huge success → numbers of referrals increased from 2014 to December 2016
Client benefits: increased energy, increased confidence, reduction in the symptoms of psychosis, such as auditory hallucinations
DISADVANTAGES:
Consumers are less likely to receive metabolic screening
Diagnostic overshadowing: symptoms attributed to mental illness
Less intensive/appropriate treatments offered
Follow-up is often missed/reactive approach to care rather than preventative
CAMPERDOWN PROJECT: Homeless pops - very effective
Provides long term housing for homeless people and people on low incomes in inner-city of Sydney
Address the needs of older people, residents with mobility impairment and those with priority needs
ADVANTAGES:
Provides permanent homes and onsite support services to vulnerable people and provides 52 of 104 units to former rough sleepers, affordable and social housing
Purpose designed commercial kitchen which operates once a week as a Community Kitchen for mental health consumers and people at risk of mental illness - practise their cooking skills, come together and enjoy a nutritious meal in a safe environment
Also offers job and skills training, drug and alcohol counselling and financial management
Cost-effective
Screening: placed along the northern facade of the building → controls sun and dust exposure
Climbing plants
Commercial areas + parcel outdoor area + public art integrated onto the Parramatta Road facade
DISADVANTAGES: n/a
Describe the limited resources available for funding.
- Public healthcare system: pushed to its limits (large waiting lists for public hospitals)
- Lifetime Health Cover as a GOV INITIATIVE: Aims to encourage a larger proportion of the population back into private health insurance = Resources may then be directed to more disadvantaged groups - more equitable access to healthcare
- Rising cost of wages and modern tech: Closure of some hospitals, opening of others in higher demand areas
- Increased accountability - achieved because of improved data collection and greater awareness in community of the importance of good health
- Commonwealth and state governments: more accountable for delivering health services that are cost effective, maximise use of resources: Increase in number of area health centres aims to improve people’s access to healthcare and information
Explain ONE example pertaining to increasing limited resources for funding health.
Priority Area: Healthy Ageing Population
- Assessing superannuation
- Life expectancy increasing, Workforce is increasing - healthy ageing population to be working
- Encouraged to improve mental health and social attributes
- But also takes away from government funding from other priority areas such as cancer: Gov budgets are very tight → Seek to meet the increased demands that come with an ageing and growing population
- More expensive treatments and services
- Challenge for policy makers to decide where more money needs to be spent to achieve health equity
- Seeking to improve the health of future generations
- Sometimes money is directed away from curative services - to more preventative health measures = seen as irresponsible
- To ease the burden on the healthcare system both now and into the future - gov has established policies
E.g. compulsory superannuation for self-funded retirees, incentives for private health insurance and health ageing promotion programs
Define the key terms; enabling, mediating and advocating.
Enabling → individual’s control over the cultural + social + economic factors that affect health + health potential
Mediation → working to bring about consensus + reconciling different interests of individuals, communities and sectors in a way that promotes + protects health
Advocating → combination of individual + social actions designed to: Speak up for specific groups, Gain political commitment, Policy support, Social acceptance, Systems support for particular health goal/program
Explain how 2 populations experiencing health inequities are enabled, mediated and advocated for.
ATSI:
ENABLING: Deadly Choices program
- Motivates regular health checkups
- Promotes healthy lifestyle choices to reduce prevalence of chronic diseases, poor housing, daily living conditions
- Incentives: support from Queensland’s NRL Franchises - E.g. Broncos, Titans and Cowboys
Indigenous Ambassadors
- Sporting and cultural offerings
- Deadly Choices Education Programs
- Smoking cessation appointments
- Follow-up appointments with Allied Health staff
MEDIATING: Aboriginal Medical Service Redfern
- Culturally appropriate healthcare
- “Not just the physical wellbeing of the individual but the social, emotional and cultural wellbeing of the whole community, this is a whole-of-life view and also includes the cyclical concept of life-death-life” (National Aboriginal Health Strategy 1989)
- Medical, dental, mental health, drugs and alcohol, public health
ADVOCATING: Close the Gap initiative
- Improve healthcare access for ATSI communities
- AIM: reduce LE and health gap between Indigenous and non-Indigenous
HOMELESS:
ENABLING:
- Household Organisational Management Expenses Advice: helps plan budgets
- Network Job Placement and Employment Training Program: finding jobs for younger people
- Stronger Family and Communities Strategy: Build support networks
MEDIATING: Matthew Talbot Hostel
- Provides shelter
- Basic healthcare
- Mental and physical health - nutrition
- Mediates the challenges to access to traditional healthcare facilities with the local council
- Placed in Woolloomooloo: used to be a very poor, drug heavy, ATSI area
ADVOCATING: Big Issue Magazine
- Increasing awareness of inequities in society
- Documents stories relate to people in difficult living situations + promotes employment for homeless people as vendors
State the sections of the SJ framework.
- Empowering individuals in disadvantaged circumstances
- Empowering disadvantaged communities
- Improving access to facilities and services
- Encouraging economic and cultural change
Outline how empowering individuals in disadvantaged circumstances helps reduce health inequities. Include an application to a plan.
- Improving health literacy
- Cope with circumstances + develop problem-solving skills
- More likely to pursue healthier lifestyles + HP behaviours
- Fosters positive attitude towards health and wellbeing → enabled to take more control
- Positive role models + support networks → encourage change
- Education: must be culturally specific to the specific population
Case Study: Get Healthy Program
Demonstrated success in helping participants make positive lifestyle changes
Improvements in diet, PA levels, overall wellbeing
Effectiveness of empowering individuals with knowledge and support to address health inequities
Outline how empowering disadvantaged communities helps reduce health inequities. Include an application to a plan.
- Instil a sense of connectedness = creating a network
- SC factors: peers, families, subculture, religion + media
- Individuals feel empowered by being a part of a group → involved in decision making affecting their health
- Improves health attitudes and behaviours - empowering disadvantaged groups
- Plan and implement programs: culturally sensitive and specific to their needs
- Changing aspects of environment
- Finding information + Reallocating resources
- Advocating review of policies
- Lobbying governments: increase awareness in the wider community + help to educate members in other similar communities
Case Study: Deadly Choices Program
Contributed to increased health awareness and better access to healthcare services within ATSI communities
Partnering with local clinics and healthcare providers - program has successfully improved health outcomes - leading to early detection of health issues + improved overall community wellbeing
Outline how improving access to facilities and services helps reduce health inequities. Include an application to a plan.
- Improvements to infrastructure → seek treatments earlier + more regularly
- Factors that affect one’s access to health facilities and services: Financial status, Education, Geographic location, Transport availability, Language barriers
Case Study: Close the Gap
Improving primary healthcare access for ATSI in geographically remote areas
Case Study: The Matthew Talbot Hostel
Physical and mental health resources for homeless populations
Outline how encouraging economic and cultural change helps reduce health inequities. Include an application to a plan.
- Government funding: building supportive environments (OC) - promote better health for disadvantaged groups
- Provision of adequate health infrastructure
- Positively shift the strong determinants for health
- Economic policy must be reviewed and based on valid research
- Cultural forces need to be identified and appropriately managed
- Health budget!
- Attitude of empathy + care for minority groups who live in disadvantage → greater funding
- Health promotion campaigns must seek to change the cultural forces that reinforce this message - Combined efforts of police, RTA and schools required
Case Study: Close the Gap
Increased funding for ATSI individuals given greater health gap (The Closing the Gap Outcomes and Evidence Fund (the Fund) provides up to $38.6 million in funding from 2021 to December 2026.)
Providing economic and cultural change by providing funding for primary, culturally-relevant healthcare
State the characteristics of effective health promotion strategies.
- Working with the target group in program design and implementation
- Ensuring cultural relevance and appropriateness
- Focusing on skills, education and prevention
- Supporting the whole population while directing extra resources to those in high risk groups
- Intersectoral collaboration
Describe how working with the target group in program design and implementation contributes to an effective HP strategy, including an example.
OVERVIEW:
Target audience in design + implementation of programs
Active engagement → empowers communities to shape programs according to their needs
Fosters sense of ownership + commitment
POTENTIAL FOR SUCCESS:
Strategies that directly engage the intended beneficiaries
CASE STUDY:
E.g.. Youth Driven Health Initiatives program
Encourages young people to actively contribute to the development of health programs that matter to the
By giving participants a role in program design - initiative bolsters their decision making abilities, PA levels and overall well-being
Describe how ensuring cultural relevance and appropriateness contributes to an effective HP strategy, including an example.
OVERVIEW:
HP strategies must recognise the significance of diverse cultural backgrounds
Ensure interventions are culturally relevant + suitable
Adapting messaging, materials and approaches
Aligns with values, beliefs and preferences of different communities
POTENTIAL FOR SUCCESS:
Strategies that acknowledge and respect cultural differences → more likely to be embraced by diverse pop. = higher acceptance + more impactful outcome
CASE STUDY:
E.g. Culturally Inclusive Nutrition Education campaign in AUS
Tailoring health messages to dietary preferences of different cultural groups → vital health info + encourages healthier eating habits
Describe how focusing on skills, education and prevention contributes to an effective HP strategy, including an example.
OVERVIEW:
Equip individuals with the knowledge, skills and resources → make informed decisions about their health
POTENTIAL FOR SUCCESS:
Empowering individuals with health literacy + practical skills → sustained behaviour change and improved health outcomes
CASE STUDY:
E.g. Healthy Lifestyle Choices for All initiative
Provides workshops + resources to educate individuals about making healthier choices
Offers practical skills + knowledge → supports lasting behaviour change + improved overall health
Describe how supporting the whole population while directing extra resources to those in high risk groups contributes to an effective HP strategy, including an example.
OVERVIEW:
Effective HP strategies provides additional resources + tailored interventions to vulnerable/high-risk populations
AIM: to directly address health inequities + enhance health outcomes of those disproportionately affected by health disparities
POTENTIAL FOR SUCCESS:
Focusing on high-risk groups → specific health challenges are appropriately addressed = better overall health outcomes for entire community
CASE STUDY:
E.g. Care and Support for Vulnerable Communities initiative
Offering healthcare services and resources tailored to needs of vulnerable populations
Address unique health needs of groups → promotes healthier living = enhanced community health
Describe how intersectoral collaboration contributes to an effective HP strategy, including an example.
OVERVIEW:
Various sectors collab → creating comprehensive and impactful programs
Gov agencies, NGOs, businesses, healthcare providers, community groups → to achieve shared health objectives
POTENTIAL FOR SUCCESS:
Collab through diverse perspectives, resources and expertise → enhances the effectiveness of HP strategies
CASE STUDY:
E.g. Health Harmony Partnership campaign
Schools, healthcare professionals, community organisations, local businesses
Pooling resources + knowledge → holistic approach to combating childhood obesity and promoting healthier lifestyles
Outline the benefits of intersectoral collaboration.
IC is a powerful approach for bridging the gap between those who have positive health outcomes and those who don’t
- Efficient Resource Allocation: e.g. funding and expertise - allocated efficiently to address health disparities, avoiding duplication of efforts
- Holistic Approach: diverse range of perspectives and expertise → more comprehensive and holistic approach to HP strategies
- Shared responsibilities: enhances accountability and impact of interventions to improve health outcomes
- Innovative Solutions: innovative thinking + development of creative solutions to complex health issues by combining different viewpoints → more sustainable in the long term
- Sustainability: by involving multiple sectors, interventions are more likely to be sustainable over the long term as they benefit from a wider support network
