HEALTH PRIORITIES IN AUSTRALIA CORE 1

Question 1

Measuring health status

Answer 1

refers to the pattern of health of a general population over time. Necessary in order to identify health priority issues.

Question 2

Role of epidemiology

Answer 2

refers to the study of patterns & causes of health & disease in populations
- Involves the collection of data from Hospitals, GP’s, surveys
- Reports on the major causes of disease, illness, death and injury/understand patterns of health through analysing prevalence (no. of cases), incidence (rate of new diagnosis cases in disease), trends and determinants

Question 3

Measures of epidemiology (mortality, infant mortality, morbidity, life expectancy)

Answer 3

The common indicators of the health of a community
Mortality – Is the number of deaths from a disease over a specific time period
Infant mortality – rates of infant deaths in the first year of life per 1000 live births.
Morbidity – the level/condition of disease in a specific population
Life expectancy – length of time a person can expect to live.

Question 4

Who uses epidemiology

Answer 4

Governments (policy developers) - setting legislations, policy
Manufacturers of health - developing/modifying products to enhance health
Providers of health services - predict onset, progression and treatment of a disease
Individual consumers - to identify and reduce risk factors and increase protective behaviours for specific disease

Question 5

Does epidemiology measure all aspects of health?

Answer 5

Fails to explain the socio-cultural factors that contribute to negative behaviour e.g. family, peers, media, religion. Often manipulated and open to bias, some topics are not connected, has a very negative focus, little data into wellbeing or quality of life, little data on impact of the disease, doesn’t focus on where someone sits in their socioeconomic status or environment.

Question 6

current trends of epidemiology

Answer 6

Women:
1. Dementia and Alzheimer disease (INCREASED FOR BOTH)
2. Coronary heart disease (DECREASED FOR BOTH)
3. Cerebrovascular disease (DECREASED FOR BOTH)
4. Lung cancer

Male:
1. Coronary heart disease
2. Lung cancer
3. Dementia and Alzheimer disease

• Life expectancy in Australia: Trend is going up, females have a higher life expectancy than males by about 4 years.
• cardiovascular disease: Decreasing for both genders.
• Trend for diabetes: increasing.

Question 7

The nature and extent of health inequities: ATSI

Answer 7

ATSI peoples experience the largest gap in health outcomes in Australia
➢ Lower life expectancy – 10 years lower
➢ Higher mortality rates - ATSI 3x higher than non-ATSI
➢ Infant mortality rates - ATSI 3x higher than non-ATSI
➢ Injury rates - ATSI 3x higher than non-ATSI
➢ 7 x more kidney disease
➢ 3 x more diabetes
➢ 1.5 x more obesity and cancer rates (high smoking rates)
➢ more likely to suffer from mental health and substance disorders
- Life expectancy, infant mortality gap slowly decreasing

Question 8

Sociocultural determinants: ATSI

Answer 8

Factors which someone is exposed to as a result of culture, peers and religion
Higher rates of domestic violence
 They have been majorly disempowered and have a large mistrust to western systems and a lot of western people in power
 Lacking role model for ATSI children, youth influenced by attitudes and behaviours of elders = cycle of smoking rates, alcohol abuse, domestic abuse, higher single parent families = stressed, no support.
 Higher rates of smoking, risky alcohol consumption, exercise less, greater risk of high blood pressure

Question 9

Socioeconomic determinants: ATSI

Answer 9

Factors such as employment, education and income
 indigenous population are dropping out of school earlier – means they are less likely to find employment – almost 1 in 2 don’t have a job – their choices change if they can’t afford things
 Lower median incomes = poor housing & nutrition & health choices
 Higher unemployment rates (3x higher rate) = increased risk behaviours

Question 10

Environmental determinants: ATSI

Answer 10

Geographical location, access to technology and access to health services
 Higher percentages of indigenous Australians who are living in rural and remote areas – this means that diseases such as cardiovascular disease is more likely to kill individuals rather than cause a chronic disease as it takes them longer to get them to a hospital and health services and facilities
 There is less supply in technology for things like screening cancer in rural areas than there is in the city = harder for them to get access to these services
 Higher rates of homelessneness which makes it harder for them to get a job, and harder for them to get payments from Centrelink, they can’t get the support
 Households lack in facilities: some indigenous peoples don’t have facilities such as running water, plumbing, and electricity functions – their health will be affected by this environment
 Overcrowded and run-down housing, higher rates of homelessness/renting
 Surrounding environments, eg people using illicit substances

Question 11

The roles of individuals, communities and governments in addressing the health inequities: ATSI

Answer 11

Community groups: Advocating for specific health issues/developing local initiatives. Provide feedback into government organisations. Local community e.g. Aboriginal controlled health services- help them find work, encouraged to talk about their issues, providing information in their own languages – improves trust, choices, and empowerment. E.g. purple house provides mobile dialysis to remote communities to increase access, Indigenous leaders working close with government and making policies.

The Australian Government: increased funding, Indigenous doctors, and development of closing the gap policy  addresses health inequities: aims to reduce indigenous disadvantage with respect to life expectancy, child mortality, access to early education  TARGETS e.g. trying to improve attendance to early education to improve literacy rates and to make positive health choices.

Individuals: Taking control of own health, having knowledge to help others and make informed choices for their children, responsible for seeking out health literature and info e.g. making informed health decisions e.g. engaging researching dietary guidelines and applying it, physical activity  decreased likelihood of obesity and CVD.

Question 12

Nature and extent of health inequities: R&R

Answer 12

Higher rates of health inequities linked with poorer indicators of health and access to care in R&R areas e.g. smoking, risky alcohol consumption
➢ increase diabetes, CVD, Cancer, injury, MVA (speeding, roads, long distances), suicide, workplace injuries e.g. mining, farming.

Question 13

Sociocultural determinants: R&R

Answer 13

 Children raised in families that have higher smoking rates, have higher rates of second hand smoke, more likely to become smokers. Children of overweight and obese parents are more likely to be overweight or obese.

Question 14

Socioeconomic determinants: R&R

Answer 14

 Lower levels of education and income,
 Have a lower average income and poorer levels of education – leading to lower health literacy, creates a barrier where they cannot make health promoting choices.

Question 15

Environmental determinants: R&R

Answer 15

 Number of GP’s employed is lower that the rates in major cities  limits access to general medical services = Poorer distribution of medical specialists and medical technology
 worse environmental factors [Higher rates of injury] (Farming, mining) (Low quality roads) (Less access to health care) hazardous occupations with higher rates of tobacco and alcohol use.

Question 16

The roles of individuals, communities and governments in addressing the health inequities: R&R

Answer 16

Community groups: – Increase of community health centres that provide health services. E.g. development of Multi-Purpose Service Programs that connect with community services, community health centres with the services they offer

The Australian Government: Government funds assist in the delivery of health care to rural and remote living people. E.g. the royal flying doctor service, which provides: health care clinics and medical evacuations.

Individuals: remaining in school, seeking to attend university online/locally  improve their knowledge, employment opportunities and income levels and help individuals make informed choices about health  also help promotes health in their family and friends by encouraging good health choices e.g. not smoking/reducing alcohol intake. These decisions reduce the risk factors to health and will help address the health inequities.

Question 17

skin cancer nature of problem

Answer 17

out-of-control growth of abnormal cells in the outermost skin layer due to damaged skin cells e.g. overexposure to UV e.g. melanoma

Question 18

skin cancer extent of problem

Answer 18

More than 2 in 3 Australians will be diagnosed with skin cancer in their lifetime
Morbidity increasing (more people getting tested)
Mortality decreasing

Question 19

skin cancer determinants of health

Answer 19

SOCIOCULTURAL  Australian culture/ values & attitudes has often revolved around the heat of summer, beaches and getting a tan. Media campaigns highlights the dangers of sun exposure e.g slip, slop, slap influenced individuals’ perceptions and attitudes towards sunscreen +protective strategies

SOCIOECONOMIC  Education = increase understanding of health protective and risk factors for e.g through compulsory PDHPE However, those in rural and remote areas and with a low socioeconomic status often neglect education; hence awareness of skin protection is not known making them at risk

ENVIORNMENTAL  Lack of technology particularly in rural and remote location decreases access to machines for preventative screening for skin cancer –> increasing morbidity rates, people in R&R often work outside e..g. farming.

Question 20

skin cancer risk /protective factors

Answer 20

Blue eyed, Blonde hair, Fare skin, Large number of moles, Personal or family history —- getting regularly checked, protective clothing, sunscreen

Question 21

skin cancer groups at most risk

Answer 21

Australia has the highest rates of skin cancer putting people within this country at risk.
most popular with the ageing population around age 70. Rural and remote  spending frequent amount of time for work

Question 22

Breast cancer nature of problem

Answer 22

A cancer that forms in the cells of the breast. risk factors include: family genetic history, inheritance of mutations in the genes BRCA2, BRCA1

Question 23

Breast cancer extent of problem

Answer 23

In 2022, the most commonly diagnosed cancer in females was breast cancer. Mortality is decreasing, survival rate is increasing, incidence is increasing

Question 24

Breast cancer determinants of health

Answer 24

SOCIOCULTURAL  Family genetics and a history of cancer in the family increases the risk of breast cancer diagnosis

SOCIOECONOMIC  Lower levels of education results in lower health literacy meaning that individuals are less aware of the risk and protective factors of breast cancer
Low income restricts access to health services and doctors meaning that individuals cannot get screening tests for early detection of breast cancer or for treatment

ENVIRONMENTAL  People living in rural and remote areas have less access to specialists in cancer and breast cancer screening technology

Question 25

Breast cancer risk/protective factors

Answer 25

Risks: Being female over 50, Increasing age, A personal or family history of breast conditions.
Protective factors:
* Breast cancer screening and discuss with your doctor when to begin screening exams and tests, e.g., clinical breast exams and mammograms and about the benefits and risks of screening.
* Breast self-exam for lumps, or other unusual changes

Question 26

Breast cancer groups at most risk

Answer 26

• Women are most at risk of breast cancer, particularly if they have family members who have had breast cancer, over 50, Females in R&R areas: limited access to screening checks

Question 27

Lung cancer nature of problem

Answer 27

Lung cancer forms in tissues of the lung, usually in the cells lining air passages, abormal cell growth

Question 28

Lung cancer extent of problem

Answer 28

• In 2020, the most common cause of cancer death in Australia.
• Lung cancer incidence is on the decline for men but increases for females. Due to the decreased smoking rates amongst men, which began later for women.

Question 29

Lung cancer determinants

Answer 29

SOCIOCULTURAL  If an individual’s family smokes, they are more likely to adopt the same risky behaviour, increasing their risk of skin cancer.

SOCIOECONOMIC  With low income, they may not be able to afford basic necessities, though people may spend their money on cigarettes.

ENVIRONMENTAL  Living in communities where smoking is accepted as a social norm would also increase the risk due to exposure of second-hand smoke. They may also adopt this behaviour due to societal pressure such as rural and remote or among those also with a low SES

Question 30

Lung cancer protective/risk factors

Answer 30

Risks:
* Smoking, Exposure to second-hand smoke, Family history of lung cancer
Protective factors:
* Making healthy decisions (not smoking), Limit exposure to second-hand smoke, radon, and asbestos, Have regular check-up and screening.

Question 31

Lung cancer groups at most risk

Answer 31

Smoking is more common in lower SES, rural & remote. Mainly occurs in elderly people. The average age of people when diagnosed is about 70. Approximately 90 percent of lung cancers are caused by cigarette smoking.

Question 32

CVD nature of problem

Answer 32

Any disease of the cardiovascular system e.g. stroke, angina, heart attack, coronary heart disease, heart failures

Question 33

CVD extent of problem

Answer 33

• 2nd largest mortality contributor
• 1/5 Australians have cardiovascular disease
• counts for around 30% of deaths in Aus
• Downward trends due to medical and surgical advancements

Question 34

CVD determinants of health

Answer 34

SOCIOCULTURAL  Family history of CVD increases risk, family and peers eating junk food/smoking influences people, in Aus  growing culture of sport and gym, but also eating out and eating junk food.

SOCIOECONOMIC  people with low socioeconomic status are more likely to participate in risk behaviours and are more likely to have CVD – lower income, education = more likely to be smoking, drinking, eating cheap junk food, lack of health literacy and knowledge

ENVIRONMENTAL  R/R more risk because less access to services and technology

Question 35

CVD risk/protective factors

Answer 35

Risk factors: hypertension, physical inactivity, poor diet, obesity, smoking and family history.
Protective factors: regular physical activity, health checks and balanced diet low in saturated fat, early screening,

Question 36

CVD groups at most risk

Answer 36

Elderly, smokers, inactive family history, ATSI population, R&R areas, low SES.

Question 37

Diabetes nature of problem

Answer 37

A disease that relates to the bodies ability to control blood sugar levels using insulin. Type 1 is an autoimmune disorder + non-functional pancreas, Type 2 is when the body does not respond well to insulin, more lifestyle and diet caused.

Question 38

Diabetes extent of problem

Answer 38

The most common type of diabetes is type 2, and diabetes rates have doubled over the last 20 years. Diabetes is the 6th leading cause of death in Australia.

Question 39

Diabetes determinants of health

Answer 39

SOCIOCULTURAL  People who have Chinese, Indian, Pacific Island or ATSI backgrounds are more likely to be diagnosed with type 2 diabetes, as are people with a family history.

SOCIOECONOMIC  Socioeconomically disadvantaged people have higher rates of type 2 diabetes.

ENVIORNMENTAL  People outside of major cities are more likely to be diagnosed with type 2 diabetes.

Question 40

Diabetes risk/protective factors

Answer 40

Risk factors: a family history, obesity, imbalanced diet (high sugar, fats or alcohol), physical inactivity, smoking

Protective factors: good management of blood sugar levels, regular physical activity, well balanced diet, managing blood pressure, and not smoking.

Question 41

Diabetes groups most at risk

Answer 41

The main group at risk are: those who have diabetes in their family history. ATSI, Pacific Islanders, and people from Chinese or Indian backgrounds, males, socioeconomically disadvantaged, people living outside major cities, and the elderly.

Question 42

healthy ageing

Answer 42

 The process of developing and maintaining functional ability to enable wellbeing in older age. Influenced by healthy behaviours e.g. good nutrition, physical activity, access to healthcare and social engagement
 can still have health conditions as can be well managed and have little impact on wellbeing.

Question 43

Increased population living with chronic disease and disability

Answer 43

 Growth of ageing population = growing numbers of use of health services + people with chronic diseases and disabilities e.g. dementia, lung cancer, coronary heart disease
 Mortality most from lung cancer, coronary heart disease, cerebrovascular disease, dementia

Question 44

Demand for health services and workforce shortages

Answer 44

 Older people are more likely to enter residential age care
 Daily assistance needed for aged people of 85 and above - stress on family carers
 Increased funding required to increase the number of services to allow easier access
 General shortage of nurses and aged care accommodation
 Long waiting lists for residential care = services are strained
 Rapidly increasing ageing population = amount workers needed to increase
 This is due to higher survival rates of cancer, CVD, and people living longer with chronic diseases

Question 45

Availability of carers and volunteers

Answer 45

 More people with disabilities and increased demand for health services by a growing and ageing population = increased need for carers, services, staff, volunteers to look after them.
 Governments, business sectors and all areas of society will need to adopt carer friendly work practices and support the needs of carers to assist and ease the pressure off them.
 Volunteer organisations e.g. Anglicare, meals on wheels, nursing on wheels
 Carers may need special consideration from their own employers
 Assess the impact: need more volunteers to cater for growth in aged population.

Question 46

Assess the impact of a growing and ageing population:

Answer 46

Health system less likely to be required if healthcare increased quality of life, less dependent on constant care, reduces cost of age-related health services and costs, faster recovery from illness, reduces the risk of chronic illness, reduces risk of falls, due to healthy ageing, maintain independence e.g. stay in own home = less strain on healthcare system e.g. hospitals, nursing homes + Medicare + reduced shortages of carers and nurses.

An increased demand will occur as the elderly have more chronic diseases and have larger rates of disability and use of GP and specialists. Aged care in Australia is expected to grow as the aged population continues to grow. More money will be required from raising taxes in order to care for aged population and suffering from chronic diseases and disabilities.

An increase use of the health service requires an increase in the workforce that supplies and services those health services and systems  More physios and health practice practioners need to be trained.

Question 47

Range and types of health facilities and services

Answer 47

Health facilities and services – can be institutional such as: hospitals or nursing homes. Can be non-institutional such as: General practitioners, dentists, pharmaceutical services.
- Public health services: health promotion/education, cancer screening, immunisations
- Primary health care: focuses on prevention, GP, dental
- Hospitals provide a wide range of services e.g. emergency care, surgery, midwifery services.
- Nursing homes: provide services for people suffering chronic diseases/ disability, care for elderly.
- Allied health providers/Specialists: physiotherapist, chiropractor, occupational therapist, psychologists

Question 48

Responsibility for health facilities and services

Answer 48

• Focus on achieving a better health service for Aus
• Commonwealth gov  formation of health policy, funding many aspects of health
• State and territory  hospital services, mental health programs, health promotion
• Local gov  immunisations, health care services, preventative services, regulate supply of tobacco/alcohol.
• Community groups  promote health, address specific problems e.g. meals on wheels
• Private sectors  provides private medical specialists, dentistry
• Individuals  responsible for their decisions regarding need for appropriate health care

Question 49

Equity of access to health facilities and services

Answer 49

• Health care needs to be easily accessible when needed and equitable distributed amongst the population.
• Barriers include: costs, long wait, unavailable services
• Most Australians live in metropolitan areas = readily available access and equity. R&R areas have less access to services e.g. hospitals and specialists
• Government has instituted services such as the Royal flying Doctors, and Telehealth.
• The government supports equity through Medicare and Pharmaceutical benefits scheme, however some services are not covered e.g. dentists, psychologists

Question 50

Health care expenditure versus expenditure on early intervention and prevention

Answer 50

• (Funding allocated to health services.) Australia implements more early intervention and prevention strategies for an effective health care system.
• Prevention strategies: immunisations, cancer screenings, focus on health promotion campaigns e.g. ‘every cigarette is doing you damage’, early intervention programs e.g. cancer screening programs (breast, prostate, skin)
• Money on early intervention must increase: strain on health care system, higher success rates and higher quality of life, saves gov money and resources.

Question 51

Impact of emerging new treatments and technologies on health care, eg cost and access, benefits of early detection

Answer 51

• Advantages: not as invasive, less risky, more chance of success, early detection, decreased mortality rates
• Disadvantages: cost and access
• Examples: artificial organs, genetic testing, MRI scans, treating eye conditions with drugs not laser

Question 52

Health insurance: Medicare and private

Answer 52

Medicare: Australia’s universal health care system, established to provide individuals with
affordable and accessible health care  Subsidised medical services, free treatment in public hospitals, Cover is limited to basic health needs e.g. no dentists/physiotherapy
Private health insurance: charged on top of Medicare  allows people to cover for private hospitals + additional services, choice of doctor, shortened waiting time, expensive.