Unit 3 : Outcome 2 Flashcards
What is a barrier to assessing Australia’s health over time?
- There have been changes in the disease groupings and classifications
- The incidence and prevalence of diseases also need to take into account population increase
Death rates
Over the past 100 years, they have declined due to the control of infectious diseases, better hygiene and improved nutrition
Life expectancy
Increased over time due to introduction of vaccines, better sanitary conditions and better treatment of diseases
Circulatory diseases
Death rates have decreased but is the leading cause of death due to the reduction in the rate of smoking and better treatment
Cancer
Cancer death rates have increased over time due to the ageing population, and better diagnosis
Respiratory diseases
Decreased over time due to a reduction in smoking rates and better diagnosis and treatment of non-communicable diseases
Injury and poisoning
The death rate for injuries and poisoning has declined over the past century due to increased saftey measures, and government initiatives and improved road safety measures
Infectious diseases
The death rate due to infectious diseases has significantly reduced over this century due to the vaccinations
Diabetes
Increased incidence of type 2 diabetes due to poor nutrition and higher levels of obesity within the population
Infant mortality
The rate has dropped dramatically due to immunisation, neonatal health, sanitation and hygiene
Child and youth mortality
Declined for both age groups due to higher vaccination rates and control of infectious diseases
Adult mortality
Both sexes have declined due to the decrease in infectious diseases and circulatory diseases and respiratory diseases, due to higher incomes, better education and better treatment for disease
Public Health
The organised response by society to protect and promote health, and to prevent illness, injury or disability
Why is public health important?
Targets the factors causing illness
Public health initiatves has social and economic benefits that reduce demand on health services.
Examples of public health
Improving water quality
Improve sanitation
Improve immunisations
Implement anti smoking education
Public health activities
Public health intelligence - info that identifies trends of ill health in population
Public health programs- development of policy and planning of strategies for health
Public health infrastructure - including administrative, legislative, information, research and the workforce to implement them
Old public health
- Focused on improving hygiene, sanitation and environmental health to help control the prevalence of infectious (communicable) diseases
- Focused on specific medical intervention to treat illness and prevention of communicable diseases
Biomedical model of health
- a medical model which is practised by doctors and health professionals
- Focuses on the physical and biological aspects of the disease specifically the diagnosis, treatment and cure.
- aims to return patients to their pre-illness health
- focuses on the individual
Advantages of the biomedical model of health
Creates advances in technology and research
It enables common problems to be effectively treated
Extends life expectancy
Improves the quality of life
Limitations of the biomedical model of health
It relies on professional health workers and technology and is therefore costly
It doesn’t always promote good health and wellbeing
It doesn’t take into account behaviours and attitudes of people.
New public health
- Identifies there are a number of physical, environmental and sociocultural factors that impact health
- prevent illness disease and injury
- health promotion at a population level
What was developed in new public health?
The social model of health
The Ottowa charter
Difference between old and new public health
Old - improving infrastructure - medical professionals - treatment - prevention of infectious disease New - on behaviours and lifestyles - intersectoral action - disease prevention and health promotion - equity
The social model of health
A conceptual framework within which improvements in health and well-being are achieved by directing effort towards addressing the social, economic and environmental determinants and factors of health with the aim of reducing the impacts these factors have on individual health and wellbeing and health status
AREAS
A - Addresses the broader determinants of health
R - acts to Reduce social inequities
E - Empowers individuals and communities
A - Acts to enable access to healthcare
S - involves inter-Sectorial collaboration
Addresses the broader determinants of health
- Focus on more than the behavioural factors
- Social, economic and environmental determinants and minimise their impact on health
(social)
Acts to Reduce social inequities
Reducing the inequities attributed to gender, age, race, socioeconomic status, location and physical environment especially in terms of access to healthcare and providing more support to those who need it most
(social)
Empowers individuals and communities
Provides individuals and communities with the resources and skill base to address the factors that influence their health and enabling to make decisions and take action to promote their own health(social)
Acts to enable access to healthcare
Improving the affordability, appropriateness and accessibility to enable everyone to access health services and information(social)
Involves inter-Sectorial collaboration
Promotes the collaboration of government departments, the private sector and the health sector.(social)
The Ottowa charter for health promotion
An approach to health-promotion development by the World Health Organisation that attempts to reduce inequalities in health. Developed from the social model of health to help individuals to take control over their health and defines health promotion as the process of enabling people to take control over their health. The Ottawa charter identifies 3 basic strategies for health promotion; mediate, advocate and enable.
Health promotion
The process of enabling people to increase control over and improve their health
3 basic strategies for health promotion (ottowa charter)
Enable - Support people with information, opportunity and resources and skills that they need to make good choices that support good health
Mediate - Health promotion requires coordinated action by all levels of government, the health sector, non-government organisations, industry and the media.
Advocate - Health promotion aims to make the necessary political, economic, social, cultural, environmental, behavioural and biological factors favourable to support good health and wellbeing. Promoting and supporting initiatives that promote health on behalf of the whole community.
Five priority actions important for health promotion (ottowa charter)
- Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services
- Build healthy public policy
The changes in policy made by the government that will help to make healthier choices easier and contribute to healthier, safer and cleaner, and more enjoyable services and environment (ottowa)
- Create supportive environments
The sociocultural and physical environments should be manipulated so that healthier choices are made easier(ottowa)
- Strengthen community action
Communities working together to set priorities, make decisions, and plan and implement strategies that will help achieve better health.(ottowa)
- Develop personal skills
Involves an individual gaining life skills and information through health promotion and education to enable individuals to make choices that will enhance their health and to take control over their own health(ottowa).
- Reorient health services
Involves individuals, community groups, health professionals and the government working together to achieve a health system that focuses on health promotion instead of just treating disease(ottowa)
Medicare
Australia’s universal healthcare system, which aims to improve the access to healthcare for all Australians and to provide access to adequate healthcare at little or no cost to all Australians in need of treatment, regardless of age or income.
Health system
All the activities whose primary purpose is to promote, restore, and/or maintain health.
How are public hospitals funded?
It is the responsibility of the state/territory governments, and the Commonwealth government
How are private hospitals funded?
Are the responsibility of the non-government or private sector.
Primary healthcare
Refers to an individual’s first contact with the healthcare system. ie; health promotion, prevention initiatives, early detection/intervention, treatment of illnesses and management of chronic diseases. Delivered by GP’s, nurses, allied health professionals etc.
Secondary care
Includes health services and medical care provided by specialists after a referral from a primary healthcare professional. ie; dermatologist, specialist doctors
3 main objectives of Medicare
To make healthcare more affordable for all Australian’s
To give all Australians access to healthcare services with priority according to clinical need
To provide a high quality of care
How does Medicare work?
Medicare covers both in-hospital and out-of-hospital services. It provides free or subsidised treatment by general practitioners and optometrists. For out-of-hospital services patients can choose to be treated by their own GP and are reimbursed part or all of the doctors fee.
Medicare Benefits Schedule MBS
A schedule of fees fo a range of services that is set by the federal government.
Bulk billing
When the doctor chooses to charge the schedule fee for the cost of the appointment
Out of pocket expenses
When a doctor chooses to charge more than the schedule fee and patients must pay the difference
Schedule fee
A fee set for a service by the Commonwealth government
Who can access a Medicare card?
Anyone over the age of 15
Medicare saftety net
An additional rebate scheme introduced by the federal government for the benefit of patients, covering a range of doctors visits and tests received out of the hospital. It provides for reimbursement of 100% of the MBS fee for out-of-hospital services once the relevant threshold has been reached.
What is covered by Medicare?
Free or subsidised treatment by health professionals
Test and examinations that are needed to treat illness
Optometrists eye tests
Most procedures performed by GP’s
Treatment and accommodation as a public patient in a public hospital
75% of the Medicare Schedule fee for a private patient in a public or private hospital
What is not covered by Medicare?
General dental examinations Ambulance Home nursing Allied health services Hearing aids, contacts and glasses Medicines (except for PBS) Medical costs incurred overseas Acupunture Private hospital costs other than treatment
Exceptions to medicare not covering things
Governements provide basic dental checkups for children aged 2-17
Allied health services are covered when the GP recommends Management plan for someone with a chronic illness
Advantages of Medicare
Enables people to access essential healthcare with little or no cost
Being able to recieve treatment by a GP of the patients choice
Being able to recieve a range of tests at a subsidised cost
Available to all Australian citizens regardless of age or income
Disadvantages of Medicare
Places significant financial burden on the Commonwealth Government
Long waiting lists
Doesn’t cover allied health services
Often out-of-pocket expenses
No choice of doctor or in-hospital treatment
How is Medicare funded?
By the federal government, by general income taxes, 2% Medicare levy, Medicare levy surcharge
Role of Medicare in terms of sustainability
By reducing the cost of healthcare now it is hoped that people will access healthcare sooner and therefore improve health outcomes and reduce cost of treatment in the long term so we can financially support future generations.
Role of Medicare in terms of Access
Medicare promotes access because it makes healthcare financially accessible, treats patients based on need, allows access in local area and allows people to choose their own doctor.
Role of Medicare in terms of equity
Medicare promotes equity as it includes a safety net for people who need it most, and allows those who need it most access to healthcare.
Pharamceutical Benefits Scheme
An Australian government program that provides subsidised prescription medication to Australian residents, as well as foreign visitors covered by a Reciprocal Health Care Agreement.
Repetriation Pharmaceutical Benefits Scheme
Is available to provide subsidised medication to war veterans and their dependants.
Advantages of PBS
Provides access to essential medication with very little or no cost
It enables access to medications from local pharmacies
It includes the PBS safety net and RPBS
Available to all Australian citizens
it provides additional support to those with concession cards
Disadvantages of PBS
Places significant financial burden on Commonwealth Gov
It does not cover all medications
Still has to pay 38.80
Funding of PBS
By Commonwealth gov through taxes
Role of PBS in sustainability
It helps to ensure financial sustainability by not spending more than necessary on medications, which means gov will be able to meet health needs of current generation and be able to provide medications to future generations to help treat illness.
Role of PBS in access
Allows them to access the medication for less and at their local pharmacy
Role of PBS in equity
It is further reduced for Indigenous
Safety net for people with chronic illness, many medications, expensive medications, concession cards, large families and veterans
Also available to all Australians
Private health insurance
Is a subscription or policy for which a person pays to provide them with different levels of cover. Additional services to those provided by Medicare.
Advantages of private health
To give them the choice of being treated in a private hospital
Enable them to choose the hospital and doctor
Private room
Reduce the waiting period
More choice about the timing of non-emergency procedures
Covers more than Medicare
Has extras options
PBS safety net
When people reach a certain amount of money per year they spend on medication they can access medication for cheaper.
How much does Medicare cover in private hospitals?
Up to 75% then private health insurance covers the rest, however private hospitals tend to charge above the schedule fee and then that leaves families out-of-pocket.
What is not covered by private health insurance?
services that are excluded
Services are only covered to a limited extent
Cosmetic or elective surgery that is not covered by Medicare
Why do we need private health insurance?
To support the public health system
To support all Australians
To support an ageing australians
Disadvantages of private health
It is costly for individuals and families to pay for private health cover
There can be out-of-pocket costs for some services in some policies
There may be a waiting period
Individuals may feel that they are paying for a service they don’t use
Private health insurance rebate
Most australians with privste health insurance recieve a rebate from the government to help cover the cost of premiums. Rebate depends on income, family structure and age.
Medicare levy
At tax times 2% of taxable income is taken to help cover the cost of Medicare
Medicare levy surcharge
An additional surcharge of between 1 and 1.5% is charged of higher income earners who do not have private health insurance
Lifetime health cover
Anyone who does not have private health insurance before july 1st on their 31st birthday and then takes out cover later in life they will pay an extra 2% loading on their premiums for each year over the age of 30 with a maximum loading of 70%. If you hold the cover for 10 continuous years you can remove the loading
Funding of private health insurance
Is funded by the members
Role of private health in sustainability
It helps place less of a burden on the public healthcare system so that we can meet the needs of the current generations and implementing incentive schemes to make access to private health insurance more affordable.
Role of private health in access
Private health insurance rebate gov has tried to make it more financially accessible
Gives access to a wider range of services
Improves access for people using the patients who rely on public health
Role of private health in equity
People who earn more pay more for private health insurance
Medicare levy surcharge also protects those who earn less
The incentives allow people relying on the public system to have better access
National Disability Insurance Scheme
The support that is given to the disabled, their families and carers to ensure they recieve the best care and can access the support they need
What does NDIS do
Access mainstream services and supports
Access community services and supports
Maintain informal support arrangements
Receive reasonable and necessary funded support
Funding of NIDS
Funded by all levels of government
An increase in the Medicare levy in 2019 will help cover the NIDS
Role of NIDS in sustainability
It is being introduced in stages all over australia
The extra .5% on the Medicare levy will help make it more sustainable
Role of NIDS in access
It aims to ensure all australians with a disability receive reasonable and necessary support
Role of NIDS in equity
It provides support to the vulnerable in the community the disabled who need the funding most
Why is smoking targeted for health promotion?
It is modifiable/preventable
Risk factor for many chronic diseases
Leading risk factor contributing to death and disease in Australia
QUIT purpose
Is to encourage, support and promote people to quit smoking for preventative health reasons as well as the economic impacts that smoking can have on the individual and the healthcare system
How QUIT reflects the Ottowa Charter
Build healthy public policy - QUIT helped the banning of tobacco advertising, banning smoking in public places, tobacco taxation, plain packaging
Strengthen community action - Worked with state gov to change legislation, working with vic health to develop health promotion initiatives, providing resources to schools and communities
Develop personal skills - provides information on smoking and how to quit, invests in media campaigns
Create supportive environments - provides a supportive social environment online and improved the physical environment by banning smoking in public places.
Reorient health services - provides a range of face-to-face and online learning opportunities designed to help health professionals support their patients
How does QuitNow reflect the Ottowa charter?
Develop personal skills - through its website and information
Create supportive environments - creates social supportive environments and supports people trying to quit
Reorient health services - Through providing specialised info for health professionals to assist them to support individuals to quit
Effectiveness of health promotion to reduce smoking
Mass media campaigns, changes to policy, legislation and taxation have drastically changed the amount of people smoking for the better
What do federal government look after?
Medicare
PBS
NDIS
Regulation of private health
What does state gov look after?
Hospitals (public and private) Public community based services Deliver preventative services Ambulance services Handle health complaints
What does local gov look after?
Provide environmental health services
Deliver some community and home based support services
Deliver some public health and health promotion activities
Sustainability
Taking care of the needs of the current generation without compromising the needs of the future
generation
Provide workforce, infrastructure and high-quality care
Interventions and research
How Road to good health reflects Ottowa charter (indigenous)
Strengthen community action - works with Victorian aboriginal health service to improve community health
Develop personal skills - taught lots of different skills to improve and maintain a healthy lifestyle
Create supportive environments - by providing support for indigenous through health professionals
Reorient health services - Provides support to health professionals to help indigenous prevent chronic lifestyle diseases
Why are indigenous targeted?
Indigenous have suffered more than any other minority in Australia, they have a life expectancy of up to 10 years less than non-indigenous, it is modifiable and preventable and they are one of the vulnerable population groups
What is the Close The Gap campaign?
Aims to improve health and life expectancy of Australia’s Indigenous people so that they are equal to the rest of Australia’s population by 2030
Access
Providing timely access to quality healthcare services based on their needs, not ability to pay, regardless of where they live
Access to services without any barriers
Equity
It is fairness and justice for everyone and so everyone has the support they need despite socioeconomic status. It protects the vulnerable in the community.
Gap amount
The difference between the Medicare benefit and the schedule fee.
Why were nutrition initiatives created?
To bring about dietary change
To improve health status, health outcomes and PMSES
What is the Australian Dietary Guidelines?
Is a publication that seeks to encourage healthy eating to reduce the risk of diet related disease and chronic conditions, and to improve the community’s health and wellbeing
3 main objective of Australian Dietary Guidelines
To promote health and wellbeing
To reduce the risk of diet related conditions that act as biological factors influencing overall health and wellbeing
To reduce the risk of chronic diseases
Guideline 1
To achieve and maintain a healthy weight, be physically active and choose amounts of nutritous food and drinks to meet your energy needs
Guideline 2
Enjoy a wide variety of nutritious foods from these 5 groups every day
- Vegetable /legumes and beans
- Fruit
- Grains
- Lean meats and poultry, fish, eggs, tofu, nuts and seeds
- Dairy and alternatives
And drink plenty of water
Guideline 3
Limit intake of foods containing saturated fat, added salt, added sugars and alcohol
Guideline 4
Encourage, support and promote breastfeeding
Guideline 5
Care for your food; prepare and store it safely
Significance of Guideline 1
Being inactive and regularly over consuming energy-dense food and going over energy needs will cause excess weight gain which is linked to many chronic diseases
Significance of guideline 2
By enjoying a wide range of foods enables the attainment of all required nutrients without excess energy intake
Water is essential for life and is required for digestion, absorption of nutrients, elimination of waste products and thermoregulation
Phytochemicals
Bioactive chemical compounds found in plants aka antioxidants
Significance of guideline 3
Limit sat fats and replace high fat foods to reduce overall energy intake
Children under 2 still need fat for growth
Limiting salt can decrease the chance of hypertension
Reducing alcohol intake can reduce overall energy intake and reduce risk of chronic diseases avoiding it during preganancy is especially improtant as it inhibit the grwoth of the baby
Significance of guideline 4
Breastfeeding is important becuase it is the most natural, appropriate method for feeding infants and can reduce the risk of chronic diseases in the long term
Significance of guideline 5
Correct handling of food is essential to preventing food-borne illnesses
Nutrition Australia
A non-government organisations which promote healthy eating and improving health status of australians
Healthy eating pyramid
A guide to provide a visual guide to the types of food and quantities that should be consumed of the 4 levels each day, encourages the intake of water and physical activity which is easy to understand
Roy Royce healthy food
Is a healthy eating education workshop which is in Victorian primary schools to help educate children on the good food and the effects unhealthy food can have on your body, it also includes a resources pack for home to promoting healthy eating in the home
VHEE fruit and veggie network
network of organisations corrdinated by Nutrition austalia that works towards improving the supply and consumption of fruits and veggies in victoria, allows health professionals to use their resources to promote eating fruits and veggies in and out of the home
Sociocultural challenges to bringing change in dietary intake
Income - energy-dense foods are usually cheaper and take less prep with high portion sizes
Culture - Food is an important part of culture and can influence heavily on what you eat
family and peers - Food can be used as a reward for good behaviour and parents can control the types of food their child is exposed to, people are also more likely to eat more/less in the presence of friends/peers
Attitudes and beliefs - people can have a positive or negative attitude towards food which can affect the type and amount of food consumed
Education, knowledge and skills - Lower levels of education usually means a higher amount of energy-dense foods as they lack nutritional knowledge. They may also lack abilities to cooks
Behavioural challenges to bringing change in dietary intake
Personal taste preferences- people choose energy-dense foods because they taste good and healthier foods are more likely to be unsatisfying compared to energy dense food
Meal patterns - Skipping breakfast is a common meal pattern which can lead to a higher amount of snacking and less likely to consume nutritional food
Biological challenges to bringing change in dietary intake
Ageing - changes that are associated with age may cause peoples taste to change and cause them to eat less nutrient dense food
Stress - in short-term causes the shut down of appetite but id that persists it can cause people to reach for comfort foods as a stress release usually fatty or sugary foods which counteract stress
Environmental challenges to bringing change in dietary intake
Food availability - sufficient quantities of food are available
Food access - sufficient resources are available to obtain appropriate foods
Food use - appropriate use and storage of food
Food stability - continued access over time to nutritious fresh food
if people have food insecurity or lack of food availability this can increase the chance of undernourishment and malnutrition
Addressing the challenges in bringing about dietary change
Involving all sectors of society - families, kids, communities, educators
Tailoring the approach - so that it is suitable for all
Helping the unmotivated - through education and motivation
Focusing on the environment - making it easier to access healthy foods especially for vulnerable groups
Making it affordable
Targeting children - because then it is educating children to carry on these behaviours for the rest of their life
Examples of biomedical model
Medical technology - diagnostic tools and equipment (MRI/CT scanning)
Pharmaceuticals - Vaccines, Tamoxifen
Medical procedures - organ transplants, hips and knee replacements, gene therapy
How the biomedical model addresses lung cancer?
Chemotherapy
Development of tools, equipment and testing to help diagnosis
How does the social model address lung cancer?
Increased taxation on tabacco
Media campaigns
banning smoking in public place
Increasing legal age to buy tabacco
Biomedical approach to address type 2 diabetes
BG meters
Insulin injections/tablets
Blood test to diagnose type 2
Social approach to address type 2 diabetes
Development of Australian guide to healthy eating and Star Rating system
Including insulin in the PBS to remove cost as a barrier and reducing social inequities
Biomedical appriach to road traffic accidents
Rehab for people suffering road trauma
Surgical procedures who have been injured
Research the best ways to treat brain injuries
Social approach to road traffic accidents
Changes in legislation to address broader determinants of health
Creating safer roads and addressing broader determinants
Changes in rules for P plates which reduces social inequities faced by younger less experienced drivers
Implementation of 120 hours for learners to empower individuals by improving driving skills
Biomedical approach to address infectious disease rates
Development of new vaccines
New treatments for diseases
Gp consultations
Development of diagnostic tests
Social approach to address infectious disease rates
Immunise Australia programs which reduce social inequities by removing cost as a barrier
No jab no pay stops tax benefits for families unless they have had all immunisations, addressing broader determinants
How close the gap reflects the ottowa charter
Create supportive environments - By ensuring that there are primary health care services and health infrastructure to help improve health
Strengthen community action - involving the community by making sure the program is respecting and promoting indigenous health in the right way
Develop personal skills - providing education on behaviours that will promote indigenous health
Reorient health services - All parts of the gov, health services and communities are working together to support indigenous health especially on preventing disease
Advantages of the social model
Promotes good health and wellbeing and preventing disease
Relatively inexpensive
Focuses on vulnerable population groups
Can contribute to sustainable improvements
Responsibility for health and wellbeing is shared
Limitations of the social model
Not every condition can be prevented
It does not promote the development of medical tech or research
Health promotion messages may be ignored
The difference in old public health and biomedical
Old publich health is about infreastructure and preventing infectious diseases
Biomedical is about treating disease with medicine and technology
The difference in new public health and social model
New public health focuses on health promotion and addressing other factors that influecne health
Social model is directing efforts towards determinants that impact health
Difference in new public health and ottawa charter
New public health focuses on health promotion and addressing other factors that influecne health and people’s lifestyles to prevetn NCD
Ottawa charter is about health promotionand reducing inequalities and health
