Health Priorities in Australia

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 How are priority issues for How are priority issues for
Australia’s health identified? Australia’s health identified?
Measuring Health Status Measuring Health Status
Role of epidemiology

How are priority issues for How are priority issues for
Australia’s health identified? Australia’s health identified?
Measuring Health Status Identifying priority health issues
Measures of epidemiology

How are priority issues for How are priority issues for
Australia’s health identified? Australia’s health identified?
Identifying priority health issues Identifying priority health issues
Social justice principles Priority population groups

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 Role of Epidemiology
Epidemiology is the study of patterns and causes of
health and disease in populations, and the
application of this study to improve health. It provides Measuring health status
data on health status, particularly the incidence and  Role of epidemiology
prevalence of disease and illness. Researchers and  Measures of epidemiology (mortality,
government bodies use it to identify priority health infant mortality, morbidity, life
issues. Epidemiology does not provide data on expectancy)
quality of life, disease impact or the determinants of
health

Eg) data collected by the ABS in a senses

Identifying priority health issues Measures of epidemiology

 Social justice principles The key measures of epidemiology are infant
 Priority population groups mortality (baby death rates), morbidity (ill health),
 Prevalence of condition mortality (death), and life expectancy (years of life left
 Potential for prevention and early intervention at any given age).
 Costs to the individual and community
Eg) life expectancy is increasing

Priority Population Groups Social Justice Principles

Priority population groups are those that do not The principles of social justice are used to help
achieve the same health outcomes in any area as the achieve equity in health outcomes for all people in
rest of the population. Australia.

Eg) Indigenous. Eg) equity, diversity and supportive environments

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 How are priority issues for How are priority issues for
Australia’s health identified? Australia’s health identified?
Identifying priority health issues Identifying priority health issues
Prevalence of the condition Potential for prevention and early intervention

What are the priority issues for

How are priority issues for improving Australia’s health?
Australia’s health identified?
Groups experiencing health inequities
Identifying priority health issues
Costs to the individual and community

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
Aboriginal and Torres Strait Islander peoples Aboriginal and Torres Strait Islander peoples
(Nature & Extent) (Determinants)

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 Potential for Prevention and Early Intervention
Potential for prevention means an ability to avoid the Prevalence of the Condition
condition from occurring Prevalence refers to the number of cases in the
Eg) CVD population at a given time; the higher the prevalence
the higher the priority.
Early intervention refers to the greater success of
treatment is the condition is identified early Eg) CVD is prevalent
Eg) Cancer

Groups experiencing health inequities

 Aboriginal and Torres Strait Islander Costs to the individual and Community
peoples
Cost to the individual and the community include
 Socioeconomically disadvantaged money, time, mental health, independence, and time
people
off work
 People in rural and remote areas
 Overseas-born people Eg) Cancer is a high-cost disease, while arthritis is
 The elderly not.
 People with disabilities

The sociocultural, socioeconomic and The nature and extent of the health inequities
environmental determinants Indigenous peoples experience the largest gap in
Australia’s Health 2014 report states: health outcomes in Australia.
“Many factors contribute to the gap between
Indigenous and non-Indigenous health. Social Eg) They currently have a life expectancy 10 years
disadvantage, such as lower education and lower than other Australians. The Indigenous people
employment rates, is a factor, as well as higher have higher death rates in each age group and for
smoking rates, poor nutrition, physical inactivity and CVD, endocrine disorders and diabetes than other
poor access to health services.”1 These determinants Australians.
interact with each other to produce the gap in health
outcomes.

1 Australia’s Health 2014.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
Aboriginal and Torres Strait Islander peoples Socioeconomically disadvantaged people
(Roles) (Nature & Extent)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?

Groups experiencing health inequities Groups experiencing health inequities

Socioeconomically disadvantaged people
Socioeconomically disadvantaged people
(Roles)
(Determinants)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
People in rural and remote areas People in rural and remote areas
(Nature & Extent) (Determinants)

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 The roles of individuals, communities and
governments in addressing the health inequities
Individuals are empowered to make informed choices
The nature and extent of the health inequities about their own behaviour. Communities and leaders
of Indigenous people were and are involved in many
Socioeconomically disadvantaged people have of the Closing the Gap programs and interventions.
higher rates of chronic disease. Eg) Aboriginal Community Controlled Health
Services. The Close the Gap initiative is a statement
Eg) higher death rates from CHD, incidence of intent signed by Australia’s governments (state,
of lung cancer, more obese, higher mortality rates territory & commonwealth). This statement aims to
from all cancer and lower life expectancy. achieve equality in health status by reducing infant
mortality, and increasing life expectancy in
Indigenous people.

The sociocultural, socioeconomic and

The roles of individuals, communities and
environmental determinants
governments in addressing the health inequities
They are more likely to take part in risky health
Individuals can seek to remain in school, or attend
behaviour, eg) smoking, overweight or obese, Higher
university, and to not smoke. Communities can
rates of drinking, and lower rates of physical activity.
provide relevant health care and support services.
Families pass these behaviours on. They have lower
Eg) PCYC, ‘Youth of the Streets’ Finally the
levels of education and income. Limiting healthy
Australian Government’s can support many
choices. They also have higher rates of hazardous
community programs and provide funding for free or
work types and unemployment. A lack of shelter and
reduced cost health care. Eg) Medicare & PBS.
living on the street affects physical and mental health.
They often live in rural and remote areas.

The sociocultural, socioeconomic and

environmental determinants
The proportion of Indigenous peoples in higher than
The nature and extent of the health inequities
other areas. Family influence children. They have
People living in rural and remote areas have shorter
lower health literacy. They are more likely to work on
lives and higher rates of disease and injury. Death
farms, in transportation or mines, and have higher
rates increase with increased remoteness. The main
rates of tobacco and alcohol use. But have higher
causes of this increased death rate are: CHD,
levels of social cohesiveness and participation in
circulatory diseases, motor vehicle accidents and
volunteer work. In rural and remote areas have
COPD.
limited access to medical services. Eg) People with
kidney disease often moved to less remote areas to
access medical services.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
People in rural and remote areas Overseas-born people
(Roles) (Nature & Extent)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
Overseas-born people Overseas-born people
(Determinants) (Roles)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
The elderly The elderly
(Nature & Extent) (Determinants)

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 The nature and extent of the health inequities
The roles of individuals, communities and
They often have better health because of the
governments in addressing the health inequities
vigorous health checks required to migrate. This
Actions such as remaining in school, or seeking to
wears off the longer they stay. Patterns in morbidity
attend university will improve their knowledge,
and mortality are highly influenced by their country of
employment opportunities and income levels. Multi-
origin, their current location, and the process of
Purpose Service Programs often connect with
migration. They have a longer life expectancy, lower
community services and the development of
death rates, lower hospitalisation rates, and lower
community health centres. The government funds
prevalence of lifestyle risk factors for disease. Asian
programs to assist in the delivery of healthcare to
had much greater rates of hospitalisation for
them. Eg): the royal flying doctor service
tuberculosis.

The sociocultural, socioeconomic and

The roles of individuals, communities and
environmental determinants
governments in addressing the health inequities
The greatest health determinant is the sociocultural
Individuals can improve their health by enrolling in
determinant. They face language barriers and other
English classes or complete school and seek higher
cultural barriers to accessing health services and
education, as well as promote healthy lifestyle
participating in society. Poor English is linked with
choices. Communities provide adult English classes
lower employment, poorer self-assessed health,
and provide support. Eg) Red Cross. Community
lower life satisfaction and low levels of social
health centres provide brochures in various
participation. Language is a barrier to education,
languages and often a translator is available for the
employment and income. They have higher
major languages in the region. The Australian
unemployment rates resulting in lower income levels
Governments funds services. Eg) translation
and less choice and access to health services. Some
services, crisis payments, multicultural service
suburbs are dominated by particular cultures. Eg)
officers, 510 hours of free English lessons
Lebanese in Bankstown.

The sociocultural, socioeconomic and

The nature and extent of the health inequities
environmental determinants
People over 65. Chronic diseases and level of
They are often cared for by their children and begin
independence are of particular. Conditions are often
to lose friends as they age reducing their support
combined, the most common diseases are: vision or
networks. Their health is affected by reduced
hearing impairment, arthritis and musculoskeletal
employment, this reduces their support networks and
problems, hypertension, and high cholesterol. They
mental health A reduction in income, also restricts the
have higher rates of CVD, diabetes and cancer.
choice of health services. Access to services can
Another major disease is dementia, and high rates of
become difficult with increased chronic illness, and
injury by falls or transport.
reduced independence.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
The elderly People with disability
(Roles) (Nature & Extent)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
Groups experiencing health inequities Groups experiencing health inequities
People with disability People with disability
(Determinants) (Roles)

What are the priority issues for

What are the priority issues for improving Australia’s health?
improving Australia’s health?
High levels of preventable chronic
High levels of preventable chronic disease, injury and mental health
disease, injury and mental health problems
problems CVD
(Nature)

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 The roles of individuals, communities and
governments in addressing the health inequities
Make healthier lifestyle choices such as: Quiting
The nature and extent of the health inequities
smoking. Communities provide many health services
People with disability experience poorer health than
to assist the elderly. Eg) Meals on Wheels.
other Australians. Nearly half of people 15-64 years
Retirement villages often offer a range of services eg)
old with disability report fair or worse health
social activities. Other home services will do house
compared to other Australians. With higher rates of:
work eg) Australian Unity Home Care. The Australian
young-onset arthritis, osteoporosis before age 45,
Government seeks to enable healthy ageing by
and young-onset diabetes. People with a disability
maintaining and improving the health and quality of
also smoked more, were more overweight, and had
life amongst the elderly; by improving management of
more suicidal thoughts.
chronic conditions and enhancing the efficiency of the
health-care system.

The roles of individuals, communities and The sociocultural, socioeconomic and

governments in addressing the health inequities environmental determinants
Individuals can be limited in their ability to change Amongst people with disability Indigenous
their health. Some have no choice of food or activities and the elderly are over-represented. A number of
they are involved in. Others ended up with a disability disabilities are genetic. Some people with disabilities
because of lifestyle choices. The Ageing, Disability & are limited in their access to education, and
Home Care community services provide various employment and have reduced income. They have
services eg) living skills programs. The government reduced access to health services and some require
has established a National Disability Strategy that technology in order to be mobile. The government
seeks to address many of the inequities experienced has helped to ensure people with disabilities have
by people with disabilities. better access to health services.

High levels of preventable chronic disease,

The nature of the problem injury and mental health problems
Cardiovascular disease refers to all the
 Cardiovascular disease (CVD)
diseases of the circulatory system (heart and blood
 Cancer (skin, breast, lung)
vessels). The main cause of many of these diseases
is atherosclerosis, which can cause blockage and  Diabetes
result in the death of cells  Respiratory disease
 Injury
Eg) heart attack.  Mental health problems and illnesses

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
CVD CVD
(Extent) (Risk/Protective factors)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
CVD CVD
(Determinants) (Groups)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Cancer Cancer
(Nature) (Extent)

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 Risk factors and protective factors
Extent of the problem (trends)
There are many risk factors for cardiovascular
Cardiovascular diseases are the leading causes of
disease, but the main ones are: hypertension (high
death in Australia, are the largest burden of disease,
blood pressure), physical inactivity, obesity, and
and are the most costly diseases. The current trend
smoking.
in death rates is downward mostly due to
Some protective factors include: regular physical
improvements in medical and surgical treatments.
activity, regular health checks, and eating a balanced
diet low in saturated fats.

The sociocultural, socioeconomic and

environmental determinants
Genetics play an important role in cardiovascular
disease. Peers and family also influence individual’s
Groups at risk behavioural choices eg) smoking, inactivity. Health
There are a number of groups at risk of cardiovascular literacy and knowledge influences lifestyle choices.
disease. These include: Indigenous, socioeconomically Higher income provides access to better health
disadvantaged, rural and remote people, the elderly, services and certain employment types have higher
smokers, and males. rates of CVD eg) tradies. People living in rural areas
have higher rates of death from cardiovascular
disease. This could be because the later access to
medical treatment for heart attacks or a stroke.

The nature of the problem

Extent of the problem (trends) Cancer refers to cells that have become abnormal
Cancer is the second leading cause of death in and begin to multiply rapidly and cannot be controlled
Australia, despite survival rates improving and death by the body. Tumours can be both benign (non-
rates declining. The main cancers in Australia are: cancerous) and malignant (cancerous), where
prostate, bowel, breast, skin and lung cancers. malignant tumours contain cells that grow out of
Current trends in Australia for cancer are: increased control and can invade surrounding tissue. There are
incidence (due to increased screening), increased multiple cancers, most of which are named according
survival, and decreased death rates, resulting in an to their location in the body
increase in cancer prevalence.
Eg) skin, lung, prostate, bowel, cervical etc.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Cancer Cancer
(Risk/Protective factors) (Determinants)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Cancer Diabetes
(Groups) (Nature)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Diabetes Diabetes
(Extent) (Risk/Protective factors)

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 Risk factors and protective factors
The sociocultural, socioeconomic and
Risk factors include: tobacco smoking, alcohol, diet,
environmental determinants
obesity and physical inactivity; Family history, genetic
The Australian beach and sun culture affects cancer
susceptibility and reproductive and hormonal factors;
risk. Recent educational actions, including advertising
Occupational and environmental exposures (for
in the media, have helped reduce risk. Genetics
example, radiation, asbestos, ultraviolet light and
affect risk. Poor health literacy makes people less
chronic infection); Medical and iatrogenic factors
aware of the risk factors and protective factors.
Protective factors for cancers include: HPV
People who work outside have a greater risk for skin
vaccination, regular check-ups, balanced diet, and
cancers. People with lower SES and rural living have
being sun-smart.
higher mortality rates for cancer.

The nature of the problem

Diabetes is a disease that relates to the bodies ability
to control blood sugar levels using insulin. Type 1 is Groups at risk
an autoimmune disorder, Type 2 is characterised by Groups at risk include: the elderly, males,
a breakdown in the efficiency of insulin, and Indigenous, low SES, and rural and remote living
Gestational diabetes is similar to type 2, but occurs people.
during pregnancy. Diabetes can be the underlying
cause of other chronic diseases (heart disease, liver
disease, blindness)

Risk factors and protective factors

Risk factors for diabetes include: a family history,
obesity, imbalanced diet (high sugar, fats or alcohol),
Extent of the problem (trends)
physical inactivity, smoking, polycystic ovarian
The most common type of diabetes is type 2, and
syndrome, gestational diabetes, and hypertension.
diabetes rates have doubled over the last 20 years.
Diabetes is the 6th leading cause of death in
Protective factors include: good management of
Australia..
blood sugar levels (especially in type 1), regular
physical activity, well-balanced diet, manageing blood
pressure, and not smoking.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Diabetes Diabetes
(Determinants) (Groups)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Respiratory disease Respiratory disease
(Nature) (Extent)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Respiratory disease Respiratory disease
(Risk/Protective factors) (Determinants)

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 The sociocultural, socioeconomic and
environmental determinants
Groups at risk People who have Chinese, Indian, Pacific Island or
The main group at risk are: those who have diabetes Indigenous backgrounds are more likely to be
in their family history. Indigenous, Pacific Islanders, diagnosed with type 2 diabetes, as are people with a
and people from Chinese or Indian backgrounds, family history. Socioeconomically disadvantaged
males, socioeconomically disadvantaged, people people have higher rates of type 2 diabetes. People
living outside major cities, and the elderly. outside of major cities are more likely to be
diagnosed with type 2 diabetes.

The nature of the problem

Extent of the problem (trends)
Respiratory diseases include: chronic obstructive
29% of Australian’s suffer from a chronic respiratory
pulmonary disease (COPD – which includes
disease; hay fever and asthma are the most common
emphysema and chronic bronchitis), and asthma.
diseases. Asthma is Australia’s most widespread
COPD are diseases that destroy lung tissue and
disease and is one of the most common chronic
result in a narrowing of the airways, limiting oxygen
diseases amongst children. COPD has fallen in
uptake. Asthma is an inflammatory disease of the
prevalence over the last 10 years. COPD is the 3rd
airways. During major asthma attacks, airways
highest burden of disease. The death rate for COPD
narrow so far that there is not enough oxygen for the
has fallen for males but there has been a small rise in
body to maintain the function of its vital organs.
the death rate for females, reflecting the changes in
Inhalers normally manage asthma.
smoking rates amongst males.

The sociocultural, socioeconomic and

environmental determinants
Family history increases the likelihood of respiratory Risk factors and protective factors
diseases. Indigenous & low SES are more likely to be Major risk factors for respiratory diseases include:
diagnosed with COPD Some forms of employment family history, smoking, physical inactivity, certain
(mining) expose people more frequently to air viral infections and exposure to air pollutants.
pollution. People in rural and remote areas have
higher rates of mortality from asthma, because of Protective factors include: not smoking, and regular
their greater distance to emergency services. People physical activity.
who live close to air pollutants are more likely to be
diagnosed with other respiratory diseases.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Respiratory disease Injury
(Groups) (Nature)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Injury Injury
(Extent) (Risk/Protective factors)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Injury Injury
(Determinants) (Groups)

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 The nature of the problem Groups at risk
An injury is an adverse effect on the body resulting The major groups of people at risk of respiratory
from an event. Injury includes accidents such as: diseases are: smokers, people whose employment
falls, transport accidents, and drowning; as well as has air pollutant exposure, the elderly (especially for
intentional events such as: suicide, homicide or COPD), people with low socioeconomic status, young
assault. Injury is a significant cause of mortality and children (for Asthma), ASTI, and rural and remote
morbidity in Australia living people who have higher mortality rates for
asthma.

Risk factors and protective factors

Falls – working in a high-risk job (building).
Protective WH&S regulations Extent of the problem (trends)
Transport –risk factors: speeding, drink driving, and 7.6% of all deaths. Higher rates in the elderly, and is
fatigue. Protective factors: seatbelt, and avoiding the highest cause of death in those under 35. Most
fatigue. injury deaths result from falls, self-harm and road
Self-harm – risk factors include: mental health accidents. The injury death rate has remained fairly
issues, depression, and powerlessness. Protective constant over the last 10 years.
factors: employment, and a positive sense of self.
Work – risk factors: poor attitude to safety, unsafe Eg) falls and transport injuries.
work behaviours,. Protective factors: risk
assessments, and proper utilisation of WH&S
legislation.

The sociocultural, socioeconomic and

environmental determinants
Risk taking is very high amongst youth, particularly in
Groups at risk
males, The media has helped address many injury-
Indigenous, people under 44, males between
related mortality and morbidity issues, (road safety
15-25 years of age, unsafe drivers, workers in high-
and mental health issues). Socioeconomically
risk employment, people in rural and remote
disadvantaged are more likely to suffer serious injury,
locations, and the elderly.
particularly if employed in dangerous work. They also
can’t afford safer vehicles or devices. The labour or
blue-collar work force is more likely to suffer injury.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Mental health problems and illnesses Mental health problems and illnesses
(Nature) (Extent)

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
High levels of preventable chronic High levels of preventable chronic
disease, injury and mental health disease, injury and mental health
problems problems
Mental health problems and illnesses Injury
(Risk/Protective factors) (Determinants)

What are the priority issues for

improving Australia’s health?
What are the priority issues for
High levels of preventable chronic improving Australia’s health?
disease, injury and mental health
problems A growing and ageing population
Mental health problems and illnesses
(Groups)

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 The nature of the problem
Extent of the problem (trends)
Mental health problems and illnesses include a wide
Almost half of Australians between 15 and 85
range of mental disorders, the most prevalent being:
reported suffering from a mental health problem or
anxiety, affective disorders (such as depression), and
illness in their lifetime. The overall trend in mental
substance-use disorders (such as alcohol
health problems and illnesses is a slight incline as
dependency). Severity of mental health problems or
seen in the graph on the right. Mental health
illnesses is determined by diagnosis, intensity and
problems and illnesses are the third most costly
duration of the symptoms, and the degree of
disease in Australia.
disability.

The sociocultural, socioeconomic and

environmental determinants
Australia’s media and society have worked hard to
reduce the stigma around mental health disorders
Risk factors and protective factors
and illnesses through advertising and other media
Risk factors for mental health problems and illnesses
programs. People brought up in families that are
include: genetics, chemical imbalances in the body,
broken or dysfunctional have higher rates of mental
hard life experiences, poor up-bringing or family
health problems and illnesses, as are people with a
relationships, and drug use.
family history of mental health problems. Mental
health problems and illnesses are commonly
Protective factors include: positive social life, positive
associated with socioeconomic disadvantage. People
relationships, positive sense of self, self-control, good
who work in high-stress jobs are more likely to suffer
support networks, and resilience.
a mental health problem or illness. People living in
rural areas have less access to mental health
services and also have a culture of a tough male who
does not suffer emotionally or mentally.

A growing and ageing population

 Healthy ageing
Groups at risk
 Increased population living with chronic Groups at risk of mental health problems and
disease and disability
illnesses include: males, Indigenous males, traumatic
 Demand for health services and workforce life experiences, family history, socioeconomic
shortages disadvantage, young (16-24) especially males.
 Availability of carers and volunteers.

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 What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
A growing and ageing population A growing and ageing population
Increased population living with chronic disease and
Healthy ageing
disability

What are the priority issues for What are the priority issues for
improving Australia’s health? improving Australia’s health?
A growing and ageing population A growing and ageing population
Demand for health services and workforce shortages Availability of carers and volunteers

What role do health care facilities What role do health care facilities
and services play in achieving and services play in achieving
better health for all Australians? better health for all Australians?
Health care in Australia Health care in Australia
Range and types of health facilities and services

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 Healthy ageing
Healthy ageing is a process that includes
Increased population living with chronic disease
various behaviour and choices that affect health,
and disability
such as regular physical activity, good dietary
Chronic disease and disability are the greatest issue
choices, regular family contact and social activities,
for Australia’s health. With rising survival rates from
as well as resilience to life’s circumstances. The goal
cancers, cardiovascular disease and other major
of healthy ageing is to enable the elderly to maintain
diseases, prevalence of people living with chronic
their health into old age, which allows them to
disease and disability is rising and increases the
contribute to the workforce longer, and engage in
population of the elderly. With an increase in people
society better. This decreases the use of health
living with chronic disease and disability, comes an
services by the elderly. Healthy ageing involves
increase in health care expenditure and the need for
people reducing their risk factors for disease, and
aged care facilities.
preventing the progression of the disease after its
onset and reducing morbidity and mortality.

Availability of carers and volunteers. Demand for health services and workforce
A carer is someone who provides assistance in a shortages
formal paid or informal unpaid role for someone due There is concern that the ageing population will place
to illness, disease or disability. Care provided often an unsustainable strain on the health system. How
includes daily activities eg) cooking. Most informal will the health system and its workforce manage the
unpaid carers are family members and many carers ageing population, with increasing chronic disease?
come from charities, religious institutions, or the An increase in workforce training in aged care
government. and issues surrounding chronic diseases and
Volunteering is unpaid wilful help given as time, disability is needed. An adequate workforce is
service or skill to a formal organisation. Formal needed with equitable distribution. Particular concern
groups include social groups such as sport or is the demand for aged care and specialists. The
religious groups. Volunteer organisations include: Living Longer, Living Better aged care reform
Anglicare, Independent Community Living Australia, package, aims to address the attraction, retention,
and Nursing on Wheels. Rates of volunteers had remuneration, education, training and career
increased between 1995 and 2010, but from 2010- development of aged care workers, in order to
2014 the rate of volunteers fell. Many elderly address workforce shortages.
volunteer.

Range and types of health facilities and services

They can be institutional, eg) hospitals, or
non-institutional, eg) GPs. Hospitals provide a wide Health care in Australia
range of services, eg) emergency care, elective  Range and types of health facilities and
surgery, and midwifery services. Nursing homes services
provide services mostly care for the elderly. GPs are  Responsibility for health facilities and services
often the first point of access to medical and health  Equity of access to health facilities and
services. Allied health providers eg) physiotherapist, services
osteopath, and psychologists. Pharmaceutical  Health care expenditure versus expenditure on
services are funded through the Pharmaceutical early intervention and prevention
Benefits Scheme.  Impact of emerging new treatments and
technologies on health care, eg cost and
access, benefits of early detection
 Health insurance: Medicare and private

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What role do health care facilities What role do health care facilities
and services play in achieving and services play in achieving
better health for all Australians? better health for all Australians?
Health care in Australia Health care in Australia
Responsibility for health facilities and services Equity of access to health facilities and services

What role do health care facilities What role do health care facilities
and services play in achieving and services play in achieving
better health for all Australians? better health for all Australians?
Health care in Australia Health care in Australia
Health care expenditure versus expenditure on early Impact of emerging new treatments and technologies
intervention and prevention on health care

What role do health care facilities What role do health care facilities
and services play in achieving and services play in achieving
better health for all Australians? better health for all Australians?
Health care in Australia Complementary and alternative health
Health insurance: Medicare and private care approaches

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Equity of access to health facilities and services
Health care needs to be easily accessible Responsibility for health facilities and services
when needed and equitably distributed amongst the The people responsible for health care are the
population. The nature of Australia’s population Australian health ministers (Commonwealth & state)
distribution makes equity of access difficult. Most – referred to as the Standing Council on Health. The
Australians live in metropolitan areas and have running of the individual systems falls to the relevant
readily available access to health facilities and health ministers and health departments in each
services. This is not the same for people living in jurisdiction. All Governments are responsible for:
rural and remote areas Eg) private hospitals and health goods and services, some primary health care
specialists. The biggest action by the government for (dental services). The state and territory governments
equity is Medicare and the Pharmaceutical Benefits regulate the health system and are responsible for
Scheme. However, health services such as dentists, public hospitals. Private providers are responsible for
physiotherapists, psychologists or occupational private hospitals, and many primary health providers
therapists are not covered. (medications).

Impact of emerging new treatments and

Health care expenditure versus expenditure on
technologies on health care, eg cost and access,
early intervention and prevention
benefits of early detection
Early intervention and prevention can help reduce
The impact of emerging new treatments and
health care cost. Major prevention activities include:
technologies on health care includes many benefits
good hygiene, sanitation, and clean water. Currently
to health outcomes, but also an increase in cost and
there is a focus on: smoking, physical activity, diet
raises questions of equity of access. Some of the
and drug use. Other policies include: seat belts and
new treatments and technologies include: HPV
immunisations. Early intervention strategies include:
vaccine, keyhole surgery, ultrasound and MRI. These
cancer-screening programs (breast, prostate, skin),
new treatments and technology help improve early
Making a decision about early intervention and
detection, treatment and prevention, which improve
prevention strategies often comes down to cost and
treatment outcomes, quality of life, and life
health benefits. Cost should be kept low, while gains
expectancy. However, some are only available to
in health should be high. The WHO (2013) has a list
those willing and able to pay.
of ‘best buy’ policies.

Health insurance: Medicare and private

The provision of Medicare in Australia has improved
Australia’s health and reduced inequities in health
throughout the country. Medicare is funded through
the tax system (Medicare levy). It provides free
Complementary and alternative health care hospital care and free or subsidised treatment by
approaches GPs, specialists, optometrists, and in special
 Reasons for growth of complementary and circumstances dentists and allied health
alternative health products and services professionals. Under Medicare the patient has little
 Range of products and services available choice of care provider. Medicare does not cover
 How to make informed consumer choices most ancillary care providers.
Private insurance has benefits eg) not paying the
Medicare levy surcharge. It benefits those of higher
SES (social justice issue), but also releases funds for
low SES. It provides greater choice, and covers some
ancillary and preventative action cost. It allows faster
access to elective surgery.

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What role do health care facilities What role do health care facilities
and services play in achieving and services play in achieving
better health for all Australians? better health for all Australians?
Complementary and alternative health Complementary and alternative health
care approaches care approaches
Reasons for growth Range of products and services

What role do health care facilities What actions are needed to

and services play in achieving address Australia’s health
better health for all Australians? priorities?
Complementary and alternative health Health promotion based on the five action
care approaches areas of the Ottawa Charter
How to make informed consumer choices

What actions are needed to What actions are needed to

address Australia’s health address Australia’s health
priorities? priorities?
Health promotion based on the five action Health promotion based on the five action
areas of the Ottawa Charter areas of the Ottawa Charter
Levels of responsibility The benefits of partnerships

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 Reasons for growth of complementary and
Range of products and services available alternative health products and services
The range includes: natural medicines (herbs, Complementary health products and services are
nutrition, homeopathy, Chinese medicine etc), used together with western medicine, while
supplementation (vitamins, minerals, oils, protein, alternative health products and services are used
vegetable powders etc), physiological treatment instead of western medicine. Reasons for growth
(physiotherapy, osteopathy, chiropractic therapy, include: the increased credibility of many
exercise physiology, remedial massage, occupational complementary and alternative health services, the
therapists, acupuncture etc), and energy based growing multiculturalism of Australia, health
treatments (crystals, some forms of massage, insurance cover, regulatory bodies and professional
acupuncture, reiki etc). associations being made, and Australians seeking a
more holistic approach to health.

How to make informed consumer choices

Health promotion based on the five action areas
Consumers need to critically analyse complementary
of the Ottawa Charter
and alternative health care approaches by asking:
 Levels of responsibility for health promotion
How do you know who to believe? Look for,:
 The benefits of partnerships in health qualifications, registration, regulations and research.
promotion, eg government sector, non- What do you need to help you make informed
government agencies and the local decisions? Gather a reasonable amount of relevant
community information from reliable sources, such as Journal
 How health promotion based on the Ottawa articles or academic websites. Information should
Charter promotes social justice include: the philosophy, the process, possible side
 The Ottawa Charter in action effects, qualifications needed, and academic
evidence.

The benefits of partnerships in health promotion,

Levels of responsibility for health promotion
eg government sector, non-government agencies
Australian governments, communities and individuals
and the local community
all play a role in responsibility for health promotion
In order for the health promotion to be most effective
and should all be involved to achieve the best health
all involved in health must be utilised. The benefits of
results possible. Individuals develop personal skills,
partnership in health promotion include: addresses
and communities strengthening community action,
needs of individuals and communities, more
and help create supportive environments. The
comprehensive health promotion, better results in
government is particularly vital in building healthy
health promotion goals, empowers individuals to act,
public policy, creating supportive environments and
more efficient health promotion (no doubling up and
re-orienting health services. But, the government is
reduced wasted time/money)
involved in each action area, as are communities and
individuals.
Eg) Healthy Spaces and Places.

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 What actions are needed to What actions are needed to
address Australia’s health address Australia’s health
priorities? priorities?
Health promotion based on the five action Health promotion based on the five action
areas of the Ottawa Charter areas of the Ottawa Charter
promotes social justice The Ottawa Charter in action

What actions are needed to What actions are needed to

address Australia’s health address Australia’s health
priorities? priorities?
Health promotion based on the five action Health promotion based on the five action
areas of the Ottawa Charter areas of the Ottawa Charter
The Ottawa Charter in action The Ottawa Charter in action
(Closing the Gap) (Road Safety)

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 The Ottawa Charter in action
The Ottawa Charter recognised the many
determinants of health and developed five (5) action How health promotion based on the Ottawa
areas to be used in health promotion: Build Healthy Charter promotes social justice
Public Policy, Create Supportive Environments, WHO state that health promotion should advocate,
Strengthen Community Actions, Develop Personal enable, and mediate. That is, health promotion
Skills, and Reorient Health Services. The benefits of should seek to make political, economic, social,
this approach include: cultural, environmental, behavioural and biological
 Better results of health promotion factors promote health, through advocating for health.
 Health promotion that addresses all the Health promotion aims to reduce inequities in health
determinants of health status, ensuring equal opportunities and resources
 Greater empowerment of individuals and for health. This enables people to achieve the best
groups health possible as they have a supportive
 Health promotion that is based on the environment, access to information, life skills and
principles of social justice opportunities for making healthy choices.
Eg) Closing the Gap (2008) & Road Safety (2010)

BHPP – Legislation: fixed speed cameras in NSW, &

50Km/h urban speed limit. CSE – Road Safety has BHPP – the ‘Close the Gap Statement of Intent’. CSE
sought to make speeding socially unacceptable using – Close the Gap seeks to train health professionals,
the ‘Speeding – no one thinks big of you’ campaign. ensure fresh healthy food and develop housing and
Roads have also been upgraded with higher safety waste supplies/removal systems to improve housing
standards, and cycleways have been constructed to quality. SCA – Closing the Gap involves Indigenous
separate cyclists from traffic. SCA – Road Safety people and community groups/elders in the panning
works with community-based organisations to provide at local and regional levels. DPS – Closing the Gap
‘driver reviver’ stops to combat fatigue related seeks to increase Indigenous education levels and
accidents. DPS – Road Safety introduced the provides primary health care services through
Graduated Licensing Scheme and school education Aboriginal Community Controlled Health Services.
programs to improve the knowledge and driving RHS – Closing the Gap seeks to utilize primary
ability of young drivers. RHS – The many campaigns health care to both prevent and promote health in
increase road safety awareness and promote a balance with curative services. The latest Prime
preventative approach to road safety issues. This Ministers Report on Closing the Gap identifies that
health promotion has been successful in reducing the Closing the Gap health promotion is only partially
road fatalities since 2010 and reduced on track to meet its targeted goals.
hospitalisations from road-related accidents

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