CORE 1: WHAT ARE THE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH?

nature and extent of health inequities (ATSI)

• ATSI Peoples experience the largest gap in health inequities in Australia → health outcomes are a lot lower than other Australians

• Life expectancy 10 years lower than other Australians → increasing but the gap isn’t decreasing

• Mortality → higher death rates in each age group than other Australia → gap is decreasing but still considerable

• Morbidity → more likely to suffer long term health conditions →1.5x more likely to develop obesity

sociocultural (ATSI)

Sociocultural = Youth are influenced by the attitudes and behaviours of their elders → intergenerational cycle of high smoking rates, alcohol consumption and domestic violence

socioeconomic (ATSI)

• Limited education = limited health literacy which leads to increased rates of risk behaviours eg. smoking

• Limited employment and income = poor nutrition and limited access to housing

environmental (ATSI)

Environmental = limited access to health services, higher rates of renting, homelessness and more likely to live in rural and remote living

government (ATSI)

developing policies and funding initiatives eg. “Closing the Gap” → national agreement and stretegy in Australia aimed at improving the life outcomes of ATSI peoples by focusing on the signficant disparities between ind. and non ind.

communities (ATSI)

advocating to the government for specific health issues and developing their own local initiatives

individuals (ATSI)

• taking control of their own health eg. making informed health decisions and engaging with their community eg. not smoking

• can create supportive environments for others and help improve the knowledge for other ATSI people

nature and extent of health inequities (the elderly)

• More susceptible to disability and disease

• More likely to die from chronic diseases

• The leading causes of death among the elderly are coronary heart disease, dementia and Alzheimer’s disease

• The burden of disease is also significant among this group

sociocultural (the elderly)

the health of older people is often subject to the availability of others → have to rely on family of support → for some this may lead to relationships becoming forced or strained

socioeconomic (the elderly)

affected by retirement → reduced income → limit access to health services and other recreational activities which can impact physical and mental health

environmental (the elderly)

• commuting to doctors and specialist services becomes more difficult with limited mobility

• some older people move into retirement villages and nursing homes, where they can be supported by a network of medical staff

governments (the elderly)

• responsible for developing initiatives that address health inequities and improving the efficiency of the health-care system

• When it comes to preventing chronic disease and disability, it's important for the government to promote healthy ageing by funding campaigns like the National Tobacco Campaign

communities (the elderly)

• offer local initiatives that support local people eg. Meals on Wheels provides food delivery to those who are less mobile and unable to access food easily

• Community programs also provide a place for socialising

individuals (the elderly)

responsible for taking control of their own health and making informed health decisions like eating a balanced diet

what are CVDs

Any disease related to the heart or circulatory system

atherosclerosis

The build up of fatty, fibrous material in the arteries

arteriosclerosis

hardening of the the arterial walls, loss of flexibility and therefore blood slows down

coronary heart disease

blockage of oxygenated blood through the coronary artery

heart attack

heart dysfunction caused by a momentary blockage

angina

chest pain caused by a partial blockage

Cerebrovascular disease

blockage of oxygenated blood to the brain

stroke

brain dysfunction caused by limited blood circulation

Cardiomyopathy

disease of the heart muscle, making it difficult to pump blood strongly

heart failure

heart dysfunction caused by weak blood flow

Peripheral vascular disease

limited circulation of oxygenated blood through limbs, caused by narrowed blood vessels

mortality of CVD

• One of the leading causes of death in Australia

• Approximately ¼ of all deaths

• Death rates for CVD are decreasing and are expected to continue to due to advancements in medicine and technology

morbidity of CVD

• The prevalence of CVD is high in Australia

• Approximately 18% of adults have CVD

• Prevalence and incidence are decreasing

modifiable risk factors (CVD)

• Physical inactivity

• Poor diet

• Smoking

• Stress

• Type 2 diabetes

• Obesity

• High blood pressure

non modifiable risk factors (CVD)

• Age (elderly)

• Sex (males)

• Family history

protective factors (CVD)

• Regular physical activity

• Balanced diet (high fibre, low saturated fat)

• Avoid smoking

• Manage stress

sociocultural determinants (CVD)

• Family history increases risk of CVD

• Family can influence lifestyle and behaviours

• Physical activity

• Diet

• Stress

• Peers can also influence unhealthy choices e.g. smoking

socioeconomic determinants (CVD)

• Education increases knowledge of chronic conditions like CVD and the risk and protective factors with it → reduces the risk of developing it → can make more informed health decisions

• Education enables greater choice of employment

• Income influence access to a healthy lifestyle because they can’t afford it

environmental determinants (CVD)

• Geographic location - people living in rural areas have higher rates of death from CVD → often because of longer wait times for ambulances

• People living in rural areas also have limited access to doctors and medical checks → less likely to be diagnosed early with a heart condition

groups at risk (CVD)

• Males - females produce more oestrogen, which protects the artery walls

• Elderly people - physical effects of ageing increase risk of CVD

• Those with family history - family history of heart conditions increases risk of CVD

• Those with unhealthy lifestyles - physical inactivity, poor diet, smoking and stress increase risk of CVD

• ATSI

nature of cancer

disease caused by uncontrolled division and growth of abnormal cells in the body —> when cells divide and grow at an excessive rate they form a sack called a tumour

benign

non cancerous (do not spread)

malignant

cancerous cells (spreading to surrounding tissues)

mortality of cancer overall

• deaths are decreasing

• aproximately 1/3 of all deaths

• survival rates are increasing

morbidity of cancer overall

incidence is increasing —> could be due to improved detection technologies

risk factors for skin cancer

• Prolonged sun exposure → working outdoor, tanning

• Fair skin, red hair, light-coloured eyes, freckles, moles or skin lesions

• Family history

protective factors skin cancer

• Avoid prolonged sun exposure

• Wear sunscreen, hat, protective clothing and sunglasses

• Regular skin checks

risk factors breast cancer

• Females over 50

• Family history

• Early menstruation or early menopause

• Physical inactivity, poor diet and excessive consumption of alcohol → affects oestrogen production

protective factors of breast cancer

Get regular screening tests → improves the chance of early protection and therefore chance of survival

risk factors for lung cancer

• Exposure to carcinogens (eg. smoking)

• Secondhand smoke

• Working near chemicals eg. asbestos

• High air pollution

protective factors for lung cancer

avoid exposure to carcinogens

skin cancer sociocultural determinants

• Family history

• Beach and tanning culture → excessive sun exposure

• Media - encourages sun safety → increasing awareness

skin cancer socioeconomic determinants

• Education → health literacy = greater awareness of the risk and protective factors

• Education → influence choice of employment

• Employment → outdoor occupations eg. trade are more exposed to sun

skin cancer environmental determinants

• Geographic location → coastal towns

• Rural and remote areas have limited access to health services → early diagnosis and treatment for skin cancer is less likely

breast cancer sociocultural determinants

• Family history

• Growing culture of women in the workforce = more late age pregnancies = hormone production

breast cancer socioeconomic determinants

• Education → health literacy = greater awareness of the risk and protective factors

• Education → influence choice of employment

breast cancer environmental determinants

Rural and remote areas have limited access to health services → early diagnosis and treatment for breast cancer is less likely

lung cancer sociocultural determinants

family and peer influence behaviour → increases engagement in risky behaviours e.g. smoking or exposure to secondhand smoke

lung cancer socioeconomic determinants

• Education → health literacy = greater awareness of the risk and protective factors

• Health data shows that people in certain occupations are more likely to smoke eg. hospitality, construction and transportation

lung cancer environmental determinants

• Geographic location → people who work in hazardous workplaces are exposed to carcinogens

• Rural and remote areas have limited access to health services → early diagnosis and treatment for lung cancer is less likely

groups at risk skin cancer

• People with a low socioeconomic status: low health literacy, outdoor occupations

• People in rural and remote areas: limited access to skin checks

• Young people: tanning and beach culture

groups at risk of breast cancer

• Females with a low socioeconomic status, poor diet, more alcohol consumption

• Females in rural and remote areas: limited access to screening tests

• Females who have late-pregnancies (greater hormone production)

groups at risk of lung cancer

• People with a low socioeconomic status: low health literacy, more hazardous workplaces, greater smoking rates

• People in rural and remote areas: limited access to lung specialists

nature of diabetes

• Diabetes is a condition that affects the body’s ability to control blood glucose (sugar) levels.

• It is caused by the improper functioning of the pancreas (the organ that produces insulin) → the hormone that regulates blood glucose, and allows it to be used as energy

• When there are insufficient insulin levels, too much glucose stays in the blood, which can then onset a lot of serious health problems including CVDs

type 1 diabetes

an autoimmune condition where the pancreas doesn’t produce any insulin

type 2 diabetes

the body does produce insulin, but not in sufficient quantities so it doesn’t work to effectively regulate blood glucose levels

gestational diabetes

occurs when the hormones produced during pregnancy stop insulin from working effectively → temporary but may lead to the development of type 2 diabetes

morbidity of diabetes

• An estimated 1 in 20 Australians were living with diagnosed diabetes (2024)

• Increasing over time

mortality of diabetes

Contributed to around 21,900 deaths in 2022

risk factors of diabetes

non modifiable: family history
modifiable: poor diet, physical inactivity —> leads to being overweight or obese

protective factors of diabetes

• Following a health diet

• Regular physical activity

• Smoking

diabetes sociocultural determinants

Family → family influences can individual’s health behaviours → families that follow poor diets, don’t engage in physical activity or smoke are more likely to raise children at risk of developing diabetes

diabetes socioeconomic determinants

• Employment and income → people with a low SES have higher rates of obesity, physical activity, alcohol consumption → are unable to buy pricier healthy foods and have a lack of access to facilities like gym memberships

• Education → due to low levels of education, these groups also have less awareness of the risk and protective factors of diabetes eg. 7-10 PDHPE lessons where healthy habits are taught

diabetes environmental determinants

Rural or remote areas → limited health services and information

groups at risk

The groups most at risk of developing diabetes are those:

• With a family history

• With a low socioeconomic status

• Live in rural and remote areas

what is a growing and ageing population

• Total population is growing

• Proportion of older people is increasing

• Population aged 65 and over in 1937 = 5% and is expected to reach 25% in 2097

• This means that people are living for longer

increase population living with chronic disease and disability

• As the proportion of older people in Australia increases, the proportion of people with chronic disease and disability also increases

• Therefore, these individuals require support → greater pressure on the Australian healthcare system

demand for health services

• As the proportion of people with chronic disease and disability grows, there is greater demand for health services —> doctors, nurses and ambulances and residential, at home and community aged care services

• residential care is expensive as it requires full time medical support —> government subsidies but it places economic stress on the taxpayer

availability of carers

• Shortage of aged care workers in Australia and is expected to remain this way → most facilities are understaffed and overworked → workers are unable to provide adequate care for all patients

• Carers can be paid workers but are often people in unpaid roles eg. family members

• These family members decrease their workload so that they can provide care for their loved ones → therefore they are not earning as much money as they otherwise would, reducing their contributions to the economy

availability of volunteers

Volunteers → essential community-based care, offering care the eases the burden for older people

• Eg. uniting care assists older people around the home with chores

• In recent years the rate of volunteers have decreased

healthy ageing

“The process of developing and maintaining functional ability that enables wellbeing in older people” (WHO)

what is the aim of healthy ageing

Optimising opportunities for better health so people can maintain a good quality of life for as long as possible ultimately reducing the demand for health care

how does uniting care promote healthy ageing

By offering exercise classes for Australian seniors to encourage healthy behaviours.

how does the government encourage older people to stay in the workforce

• by raising the age of the pension

• stimulates the economy

• improves social and mental health —> allows friendships and support networks to develop and a source of self worth and acheivement

how does the government relieve demand for aged care workers

• by encouraging older people to live at home for longer through the Commonwealth Home Support Program, delaying the need for residential care

how does the government reduce workforce shortages

Living longer living better aged care package to attract, retain and further train aged-care workers