HHD: Promoting Health in Australia

Old Public Health

Actions taken by the government to improve the physical environment and reduce the spread of infectious diseases. For example through initiatives such as more hygienic birthing practices, better quality housing and fewer slums and improved water and sanitation.

Health promotion

The process of enabling people to increase control over and improve their health

Biomedical approach to health

Focusses on the physical or biological aspects of disease. It is a model practised by doctors and health professionals who work to diagnose, treat and cure disease.

Strengths of the biomedical approach to health

• Focus on funding to improve technology and research to better understand disease and how to diagnose and treat conditions.

• Treatments such as medication enable illnesses and conditions to be effectively treated so they do not cause considerable ill health

Limitations of the biomedical approach to health

• Not all individuals may be able to afford the expensive technologies and equipment such as MRI machines and robotic surgery systems which may contribute to disparities in the population

• Quick fix approach that does not prevent these same health issues occurring again in the future

Social Model of Health

An approach that recognises improvements in health and wellbeing can only be achieved by directing efforts towards addressing the physical, sociocultural and political environments of health that have an impact on individuals and population groups.

Build healthy public policy

Decisions made Government and organisations regarding law and policies that affect health and wellbeing

Create Supportive environment

Making healthy choices easier choices by providing a physical and social environment that promotes health and wellbeing by being safe, stimulating, satisfying and enjoyable

Strengthen community action

Centres on the community working together to achieve a common goal by building links between individuals and the community to give the community a sense of ownership.

Develop Personal skills

Individuals gaining health related knowledge and skills that improve their ability to take control over and make informed decisions about choices that affect their health and wellbeing

Reorient health services

Changing the direction of the health system so that it promotes health and wellbeing rather than only focussing on diagnosing and treating illness.

Strengths of the social model of health

• While initial health promotion can be expensive these measures to prevent disease and illness often end up being less expensive than needing to diagnose and treat these conditions later on

• Takes a more holistic approach to health that recognises health goes beyond just the physical dimension to consider the impact that all dimensions have on health and wellbeing

Limitations of the social model of health

• Relies on public cooperation and it is easy for the public to ignore health promotion messages

• Not every illness or condition can be prevented for example it is very difficult to prevent genetic conditions

Social Justice

Equal rights for all regardless of personal traits such as sex, income, class, ethnicity, religion or age. Relates to fairness within society.

Human rights

The freedoms and conditions that every person in entitled to regardless of difference

Access

All people must have adequate access to resources and opportunities as well as participate in decisions that affect them.

Participation

Everyone in society has the opportunity to participate in their community and have their voice represented.

Equity

Disadvantages groups and individuals have their specific challenges addressed so they can achieve the same level of health and wellbeing as others in the population

The Australian Dietary Guidelines

A set of five guidelines developed by the National health and medical research council with advice relating to the types and amounts of foods, food groups and dietary patterns with the aim of decreasing diet related diseases and conditions

Australian Dietary Guideline 1

To achieve and maintain a healthy body weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.

Australian Dietary Guideline 2

Enjoy a wide variety of foods from the following five food groups every day; vegetables, fruits, grains, lean meat and alternatives, milk, yoghurt, cheese and alternatives and drink plenty of water.

Australian Dietary Guideline 3

Limit intake of foods containing saturated fat, added salt, added sugars and alcohol

Australian Dietary Guideline 4

Encourage, support and promote breastfeeding

Australian Dietary Guideline 5

Care for your food, prepare and store it safely

Strengths of the Australian Dietary Guidelines

• Available to download for free from the Eat Well website which means that cost doesn’t act as a barrier to accessing this resource

• Provides information about the number of serves and what constitutes a serve which may assist individuals to consume adequate amounts of food from each food group

Limitations of the Australian Dietary Guidelines

• Only available in English making them difficult for non-English speaking groups to follow and benefit from

• Serving sizes are based on the requirements of an average person so it might not be appropriate for all people

Australian Guide to Healthy Eating

A food selection model designed to visually represent the Australian Dietary Guidelines 2 and 3 by showing the proportions of food that should be consumed from the five food groups as wedges on a plate

Key wording on the Australian Guide to Health Eating

• ‘Enjoy a wide variety of nutritious foods from these five food groups every day’

• ‘Drink plenty of water’

• ‘Use small amounts’ = healthy fats bottom left corner

• ‘Only sometimes and in small amounts‘ = discretionary foods bottom right corner

Strengths of the Australian Guide to Healthy Eating

• Applies to people of all ages which means parents can use the guide for themselves and their children without having to refer to separate models

• Based on the Australian Dietary Guidelines 2 and 3 which are based on the latest scientific research which may make them more effective

Limitations of the Australian Dietary Guidelines

• The guide shows the proportions of foods that should be consumed from each food groups but does not have information about recommended serving sizes which may mean people still consume too much or too little

• Does not make provisions for composite foods such as a salad roll which may make it difficult for people to use and follow the guide

Aboriginal and Torres Strait Islander Guide to Healthy Eating

A food selection model adapted from the Australian Guide to health eating designed to visually represent Australian Dietary Guidelines 2 and 3 by showing the proportions of food that should be consumed from the five food groups as wedges on a plate in a way that is more culturally appropriate and accessible for Aboriginal and Torres Strait Islander people who often have lower literacy levels and live in rural areas.

Differences of the Aboriginal and Torres Strait Islander Guide to Healthy Eating

• Simpler wording of ‘Eat different types of foods from the five food groups everyday’ which makes it easier to understand as they often have lower literacy levels

• Images of traditional foods such as a goanna and damper make the guide more culturally appropriate and recognisable

Personal Factor

Relates to characteristics of individuals that influence food intake. For example willpower and taste preferences, attitudes and beliefs and health and wellbeing factors

Sociocultural factors

Relate to aspects of a person’s society and culture that influence food intake. For example socioeconomic status, employment status and family and peer group

Commercial factors

Relates to the impact that the private sector has on health and wellbeing in particular food consumption patterns. For example marketing strategies, packaging and labelling and processing.

Environmental factors

The elements in the physical environment that influence food intake. For example geographical location, workplaces, housing environment and transport.

Healthy System

All the activities whose primary purpose is to promote, restore and/or maintain health.

Medicare

Australia’s Universal health insurance scheme that is funded by the Federal Government to provide all Australians, permanent residents and people from countries with reciprocal agreements such as New Zealand access to essential healthcare that is subsidised by the Government.

Medicare Levy

A 2% tax placed on the taxable income of most taxpayers excluding low income earners.

Medicare Levy Surcharge

An additional 1-1.5% tax charge on the taxable income of high income earners who can afford to pay for private health insurance but chose not to.

Schedule fee

The amount that the Government considers to be a reasonable price for the treatment and so Medicare will contribute towards it.

Patient co-payment

When the health professional charges above the schedule fee, it is the amount the patient will pay above the schedule fee.

Bulk billing

When the doctor charges only the schedule fee and so there is no out of pocket expense to the patient.

Medicare Safety Net

When an individual spends over a certain threshold on out of pocket costs for Medicare services, the Government will provide extra financial assistance by making Medicare services cheaper for the remainder of the calendar year. 

Advantages of Medicare

• Available to all Australian citizens

• Reciprocal agreements with other countries mean that Australians have access to healthcare in those countries when travelling

Disadvantanges of Medicare

• No choice of doctor for in hospital treatments

• Long waiting lists for many treatments

Pharmaceutical Benefits Scheme

A Federal Government Initiative that is available for all Australian Medicare card holders, providing a range of listed essential medications at a subsidised cost where consumers make a co-payment of maximum $25.00 or $7.70 for concession card holders. 

Pharmaceutical Benefits Scheme safety net

Protecting individuals and families who have large overall expenses for PBS listed medicines as once they reach a certain threshold of spending on PBS listed pharmaceuticals each year, the government will further subsidise the patient co-payment for the remainder of the calendar year 

Pharmaceutical Benefits Scheme Advisory Committee

An independent panel of health professionals that review the medicines on the list to ensure they are clinically effective, safe and cost-effective and can recommend new medicines to be included. 

National Disability Insurance scheme

Australian Government’s national disability insurance scheme that funds reasonable and necessary supports for Australians with a permanent and significant disability and their families to help them to live an ordinary life. 

Eligibility requirements of NDIS

• Aged under 65 years

• Australian citizen, permanent visa or protected special category visa

• permanent, significant and lifelong impairment

Individualised plan in NDIS

Based on the goals and aspirations of the individual now and in the future a plan is made that identifies the support they will need for daily living and participation to pursue these goals. Goals and aspirations may include greater independence, community involvement, employment or improved health and wellbeing 

Private Health Insurance

Optional form of health insurance that can be purchased in addition to medicare whereby patients pay a premium in order for a private company to make a contribution towards certain healthcare costs not covered by medicare. The individual can chose their level of cover which can vary the price of the premium as more cover means a more expensive premium.

Private health insurance rebate

An income tested rebate where people who take out private health insurance may received up to 30% of their premium back from the Federal Government depending on their income. High income earners do not receive any rebate.

Lifetime health cover

An incentive to take out private health insurance before the age of 31 by adding an extra 2% on the premium for every year someone over the age of 30 takes out private health insurance that remains for 10 years and is then removed.

Age-based discount

Insurers have the option to offer young people aged 18-29 years a discount of up to 10% for hospital cover to incentivise younger people to get private health insurance.

Funding

The financial resources that are provided to keep the health system adequately staffed and resourced so a high level of care is available to those who need it.

Access

Can provide all people with timely access to quality health services based on their needs not just their ability to pay regardless of where they live in the country.

Sustainability

The capacity of the Australian healthcare system to provide a workforce and infrastructure such as facilities and equipment now and into the future so a high quality of care is continually available for everyone in need.

Equity

Takes the different circumstances of individuals and gorups into account so that those who need more support can receive it by targeting disadvantaged groups to attempt to create a level playing field.