Year 12 Health Studies (WACE students)

What are the social determinants of health inequities

Work, Addiction, Transport, Early life, Food, Unemployment, Stress, Social Gradient, Social Support, Social Exclusion, Gender, Culture

What are the socioeconomic determinants of health inequities

Housing/Neighbourhood, Access to services, Migration and Refugee status, Family, Income, Education, Employment, Food Security.

What are the environmental determinants of health inequities

Features of natural and built environments & Geographic location

What are the biomedical determinant of health inequities

Birth weight and body weight

What are the factors that create health inequities

Access to services, Discrimination, Dislocation of land, Gender, Geographic location, Government policy, Education, Social Isolation, Poor health literacy, Occupation, Unemployment, Racism, Socioeconomic Status

Definition of Access

The ability to obtain or make use of services or products

Definition of Equity

Fairness, inclusivity and justice for all

What are the strategies to reduce inequities of specific groups

Mediate, Enable, Advocate

Identify the actions to address health inequity

Improve health literacy, Improve access to health care, Ottawa action areas.

Improving health literacy includes what four steps

Locating information, Interpreting the information, Evaluating the information to see its credibility and quality, Analysing the risks and benefits.

What are the Ottawa action area's

Building public policy, Creating supportive environments, Developing personal skills, Strengthening community action, Reorienting health services.

Actions to achieve social and health equity in the Rio Declaration on social determinants of health

Adopt better governance for health and development

Monitor the progress and increase accountability

Promoting participation in policy making and implementation

Further reorient the health sector towards reducing health inequities

Strengthening global governance and collaboration

What world events impact personal, social and cultural identity of population groups

Conflict

Natural disasters

Violence

War

Dislocation of traditional homelands

What are the global and local barriers to addressing social determinants of health

Availability of clean drinking water

Disease outbreak

Drought

Famine

Poverty

Steps in a health Inquiry

Planning a health inquiry

Using a range of information to explore the health issue

Interpretation of information

Presentation of findings in an appropriate format to suit the audiences.

What are the two steps in planning a health inquiry

Identification and analysis of the health issue

Development of focus questions to research a health issue

What are the two steps of using a range of information to explore the health issue

Identification and use of a range of reliable information sources

Identification and application of criteria for selecting information resources.

What are the four steps in interpretation of information

Summary of information

Identification and analysis of trends and patterns in data

Development of argument

Development of evidence based conclusions.

What is the role of Australian Aid

promote Australia's national interests by contributing to sustainable economic growth and poverty reduction. Pursue this purpose by supporting the private sector development and strengthening human development.

What is the function of Australian Aid

Promotes sustainable economic growth and poverty reduction through relations with different groups. In particular, private sector partnerships, bilateral partnerships, multilateral organisations and non-government organisations (NGOs).

Australia Aid's two developmental outcomes

Supporting the private sectors development (Non-gov)

Strengthening human development

What does Australian Aid invest in

4. Education and Health

5. Building Resilience: Humanitarian Assistance, Disaster Risk Reduction and Social Protection

What are WHO's leadership priority goals

Universal health coverage

International health regulations

Increasing access to medical products

Social, economic and environmental determinants

Non-communicable diseases

Health related millennium developmental goals

What is the role of WHO

To promote health for all, - eradicating poverty, ensuring essential medicine are accessible.

Play an essential role in global governance of health and disease.

Core global functions including establishing, monitoring and enforcing international norms

What is the function of WHO

Provide leadership on matters critical to health.

Monitoring health situations and assessing health trends

Providing technical support, catalysing change and building sustainable institutional capacity.

Articulating ethical and evidence based policy options.

Shaping the research agenda and ensuring the world has access to valuable health knowledge.

Setting norms and standards and promoting their implementation.

What is Goal 2 of the SDG's

End hunger, achieve food security, improved nutrition, promote sustainable agriculture

What is Goal 3 of the SDG's

Ensure healthy lives, promote wellbeing for all, at all ages.

What is Goal 4 of the SDG's

Ensure inclusive, equitable quality education and promote lifelong learning opportunities for all

What is Goal 5 of the SDG's

Achieve gender equality and empower all women and girls

What is Goal 6 of the SDG's

Ensure availability, sustainable management of water and sanitation for all.

What is the socio-ecological role in understanding and addressing public health problems

A conceptual model which outlines how health status of an individual is influenced by their personal relationships, community and societal factors.

What is involved in the socio-ecological model of health

Society, Community, Organisation, Interpersonal, Individual

What is the purpose of Maslows' hierarchy of needs

Wanted to understand what motivates people. Individuals possess a set of motivational systems unrelated to rewards or unconscious desires.

What are the levels in Maslow's hierarchy of needs

Biological / physiological needs

Safety needs

Belonging / love needs

Esteem needs

Self actualisation

Social justice principles in health

Supportive environments

Access

Diversity

Equity

The five A's of access

Affordability

Availability

Adaptability

Acceptability

Accessibility

What is Diversity

Used to describe members who have identificable differences in their backgrounds or lifestyles

Failure of diversity is discrimination violation of human rights

Examples where people can be diverse

Geographic location

Cultural backgrounds

Religions

Genders

Ages

Steps in the PABCAR health decision making model

Problem = identifying the problem

Amenability to change

Benefit

Cost of implementing the intervention

Acceptability of proposed measures

Recommend Action and monitoring

What is involved in P, of PABCAR

Identifying the problem

- target group

- Epidemiology

- Cost to the community

- Community perception

What is involved in A, of PABCAR

Is the community open and responsive to the idea = will things change

What is involved in 'B' and 'C', of PABCAR

Are the benefits greater than costs?

- Assess costs

- Social impact

- Ethics

- Economic

- Efficiacy

What is involved in the second A, of PABCAR

Acceptability

- Who is accepting it

- Are there low levels of acceptance or high levels of action

What is involved in R, of PABCAR

Recommended Action

- Discontinue

- Advocate

- Implement

- Monitor

What is the purpose of a needs assessment

A systematic process for gathering information to determine and address individual, community and population needs.

What are the types of needs

Comparative needs

Normative needs

Expressed needs

Felt needs

What is comparative needs

Derived from examining the services provided in one area to one population and using this information as the basis to determine the sort of services required in another area with a similar population.

What is normative needs

Refers to need based on research that defines many people within a population

e.g Perth=> Exercising Regularly, China=> Smoking

What is expressed needs

Refers to what has been DEMANDED by a community

e.g smoking free areas in public places

What is felt needs

Refers to what the community SAYS or FEELS they need through public meetings, calling for submissions, household opinion surveys or phone ins

What are the steps in a needs assessment

Identifying health issues

Analysing the problem

Prioritising issues

Setting Goals

Determining strategies

Developing action plans

Evaluating outcomes

What is involved in step 1 of a needs assessment

1. Identifying health issues

- Which specific population

- How is the population different than others

- Resources required

- Risks involved

What is involved in step 2 of a needs assessment

2. Analysing the problem

- Characteristics of a population

- Gather health data (Qualitative/Quantitative)

- Identify and assess the risks

What is involved in step 3 of a needs assessment

3. Prioritising issues

- Choose interventions

- Strategies or actions

What is involved in step 4 of a needs assessment

4. Setting Goals

- Specific

- Measurable

- Attainable

- Realistic

- Time - bound

What is involved in step 5 of a needs assessment

5. Determining strategies

- Use PABCAR

- Identify the problem

- Amenability

- Benefit

- Cost

- Acceptability

- Recommended Action

- Research previous strategies

- Ask community members

What is involved in step 6 of a needs assessment

6. Developing action plans

- What needs to be done to implement change

- Lists of step by step actions

- Develop timeline and plan

What is involved in step 7 of a needs assessment

7. Evaluating outcomes

- Have you achieved your goal?

- Measurable data

- How well or how much was achieved

- What can be done better next time

Definition of health promotion advocacy

Active support of an idea or cause, in particular the act of pleading or arguing for something.

When is health promotion advocacy best used

Best used in health settings

What strategies for health promotion advocacy?

Mobilising groups

Building Capacity

Creating Debate

Developing partnerships

Framing the issue

Raising Awareness

Using champions

Influencing policy

Lobbying

What are the communication and collaboration skills in health settings

Arbitration

Compromise

Facilitation

Leadership

Managing conflict

Mediation

Negotiation

What are skills that support positive health behaviours

Assertiveness

Stress Management

Resilience

Health Indicators

Mortality

Morbidity

Life Expectancy

Health promotion actions to improve national health priority area's

OTTAWA Action Area:

- Building public policy

- Creating supportive environment

- Developing personal skills

- Strengthening community action

- Reorient health services

Influences of culture on personal beliefs, attitudes and values towards health care

Belief + Values = Attitudes

An individual's beliefs about health and the values imbedded within their family and culture will result in either negative or positive attitudes towards the health care system and particular treatment options

Influence of environmental factors on the health behaviour of cultural groups

Geographical location

Social networks

Influence of environmental factors on the health behaviour of cultural groups: Geographic Location

If the person's suburb has no parks or open spaces where people can congregate and enjoy then the norms of this group woould become centred around lifestyles that live in a physical environment that encourages less healthy choices.

Influence of environmental factors on the health behaviour of cultural groups: Social Networks

Can encourage healthy behaviours or unhealthy behaviours depending on the norms and culture of social groups

Having a strong, well connected social network will undoubtedly improve social and emotional health.

Groups with well connected and functional social support have better health.

Impact of culture on health decision making

Blood Transfusions

Organ Donations

Childbirth

Blood Transfusions

Jehovah Witnesses: Refuse blood transfusion

Sikhs: Non dominant hand/arm only

Islam: Volunteered, not complied. Not dangerous to either life. Not a purchased exchange.

Organ Donations

Gypsies: (AGAINST) Due to after life belief that the soul retraces its steps, the body needs to remain in tact for one year

Amish: Consent donations if they know its for a health and welfare of the recipient

Chinese: (AGAINST) due to after life belief

Muslims: Only to save a life

Shintoism: Injuring a dead body is a serious crime

Donating = injuring a dead body

Childbirth

African cultures: Mother and child remain indoors for 40 days

Sudanese: Accustomed to kneeling/squatting to give birth

Malaysian: Pray during labour, not to cry or scream

Brazil: New mother to give gifts to people.

Japan: Encouraged not to cry during labour

Drug free - due to being natural

Language and Cultural influences on relationships building in health settings (barriers)

Past experiences of trauma

Experiences of racism and discrimination

Alienation, Isolation, Community attachment

Loss of status

Loss of Self Esteem

Communication difficulties

Influence of government policies and regulations on Beliefs, Values and attitudes

When an individual is externally forming beliefs they look to authority figures and experts for guidance. If they determine that something is important enough to debate and act upon, they will influence the beliefs of the population.

Government policies and regulations that restricts or promotes healthy behaviours

Law for wearing a bike helmet

Drink Driving

Tobacco tax policy

Drinking age

Pool and spa fencing

Advertisement of junk food, alcohol and tobacco restricitions

Relationship between health behaviours and proscriptive, Prescriptive and popular norms

Proscriptive: Norms that prohibt you from doing something.

Behaviour you should NOT do.

Prescriptive: Norms that prescribe you to do something.

Behaviours you should do.

Popular: Norms made by people who are considered popular or who hold power

Conflict between norms of specific groups and majority norms

Majority norms: unwritten rules/standards that more than 50% of the population or community believe in/obey.

Norms of Specific Groups: Social or cultural norms that are unique to a particular group of people within a population

Health Care Reforms

Pharmaceutical Benefit Scheme (PBS)

Private health Insurance rebate

Vaccination programs

Public Screening

- Bowel

- Breasts

- Cervix

Key features of Private health insurance rebate

Initiative for those who use private health insurance to earn a percentage of their premium to be paid back to them through their taxes. It encourages high income earners to use private health insurance and frees the availability of pubic health insurance for low income earners

Key features of Pharmaceutical benefit scheme

Aims at subsidising the cost of medicine for most medical conditions. It thus provides timely, reliable, affordable access to necessary medicines for Australian's. PBS allows pharmacists to dispense the listed medication to patients and be used at home. It is available to all Australian residents who hold a current medicare card or overseas visitors from countries which Australia has a reciprocal health care agreement (RHCA)

Key features of Public screening

Bowel Cancer Screening:

- Australians aged over 50

- Fecal occult blood test to be done at home

Cervical Cancer Screening:

- Recommends all women aged 18-70 with previous sexual activity to regularly have PAP smears at least every 2 years

- Cells are collected from the surface of the cervix, and tested for cellular abnormalities

Breast Cancer Screening:

- Women aged 50-74

- Free mammogram

- Women with family history of breast/ovarian cancer strongly encourage.