HHD - Sac 3

Personal factors

relate to characteristics of individuals that influence food intake

• willpower + taste preferences

• attitudes and beliefs

• health and wellbeing factors

Sociocultural factors

relate to aspects of a person’ s society and culture that influence food intake

• ses

• employment status

• family and peer group

• commercial factors

Commercial factors

a sociocultural factor relating to the private sector’s impact health and wellbeing, either positively or negatively

• supply chains

• distribution and affordability

• processing

• packaging and labelling

• lobbying

• marketing strategies and use of media

Environmental factors

relate to elements of the physical environment that influence food intake

• geographic location

• workplaces

• housing environment

• transport

Willpower

Related to self-control.

• Foods high in fat, salt and sugar stimulate taste buds and brain’s reward system by releasing dopamine (feel-good chemical)= creating cravings= dietary change difficult.

Housing environment

Meals are often consumed in the home and the facilities available in the housing environment influence the options available.

• E.g. refrigerators, freezers, ovens, stoves, air fryers, microwaves, mixers. 

  • Lack of access to these facilities impacts the manner in which people store and prepare  their food, which can limit the options available to them.

Attitudes and beliefs

refers to a way of thinking or feeling about food and one's diet.The below examples can make dietary change difficult.

• perceptions that healthy foods are bland or tasteless.

• ignoring potential negative effects of unhealthy foods.

• philosophical beliefs such as vegetarianism or organic preferences.

• restricting certain foods, which leads to under-consumption of certain nutrients.

Taste preferences

Preferring certain foods to others.

• Preference for discretionary foods and fast food/ convenience products.

• Dislike for fruits/vegetables, meat products etc

Geographic location

Where people live influences the foods available to them.

• People outside major cities, food options may be limited, e.g. rely on non-perishable (long shelf-life foods). 

• General trend, lower the SES higher the number of fast food-outlets; closer in proximity may increase consumption. 

Distribution & affordability

the way in which food products are shared out among a group or spread over an area, which can consequently impact affordability.

• Prices for food are generally set by retailers (supermarkets, restaurants), which is influenced by factors such as:
  → the wholesale price initially paid
  → transport

  → storage

  → staffing costs

  = can make food more/less affordable than other options.

• E.g. transport costs: foods that are flown, shipped or transported by road/rail to remote parts of the country= more expensive.

• E.g. rural areas often suffer with reduced availability of fresh fruits and vegetables= reduction in food choices and also increased prices when available.

Transport

Many people require some form of transport to access food outlets in their neighbourhoods. 

• E.g. roads and related infrastructure, cycling paths and public transport networks.

  →Lack of access to transport can mean that people must rely on foods close to their homes or that can be delivered, reducing their ability to make nutritional change. 

Family + peer group

• Young people are more likely to choose foods their friends eat, this can be a negative influence if friends are not selecting healthy food choices. 

• Earliest food experiences are shaped by family- e.g. traditions, culture, religion, role modelling. 

• Family is a significant influence in personal preferences for food (in particular during childhood).

SES

refers to a persons education, income and occupation in comparison to others

• lack of cooking skills often predisposes people to consume unhealthy meals.

• Lack of education= may have reduced health literacy and associated health knowledge of nutrition, reading food labels, portion sizes. 

• Income has a direct relationship with affordability of food= influences what people can eat. 

• Occupations such as truck drives and trades may rely on convenience and fast food options near places of employment. 

Health and Wellbeing

Food allergies and intolerances: can be difficult to follow health initiatives (e.g. ADGs, AGHE), especially if poor health related knowledge of substitutes → dietary change difficult.

Lobbying

Many food companies are huge corporations that operate both in Australia and overseas. These companies often lobby (influence decision-making) governments in relation to issues such as: 

• Trade deals – So they can sell more food in different countries.

• Fast food ads – So they can keep advertising to kids or during sports.

• Health rules – Like stopping a sugar tax, which would make soft drinks more expensive.

→ it can make it harder to eat healthy if the government lets junk food be everywhere and super cheap

Packaging+ labelling

a marketing tool by food manufacturers to make foods more desirable and appealing for consumers.

• E.g. cartoon characters on packaged foods for children= visually appealing= increased consumption

• Claims made on products may still mislead consumers. For example, a product may be ‘fat free’, but may contain high amounts of sugar, if people do not know how to read nutritional panels of food products, these sorts of statements can provide another challenge in bringing about nutritional change.

Workplace

The foods and facilities available in places of work. 

• Some workplaces provide canteens on site- can be a negative influence if only energy-dense processed foods are available. 

• Workplaces that do not have access to cooking facilities (e.g. trade & transport industries (e.g. truck drive)) decrease the types of foods that employees can prepare for themselves, which can make nutritional change difficult.

employment status

• Both parents employed= more time may be spent working and less time preparing food= increased consumption of convenience foods.

The Australian’s Dietary Guidelines

gives advice on eating for good health and wellbeing

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

• Enjoy a wide variety of nutritious foods from these five groups every day and water

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

• Encourage, support and promote breastfeeding

• Care for your food; prepare and store it safely

The Australian Guide to Healthy Eeating

• shows a circle divided into five wedges, each representing one of the five food groups (representing Guideline 2)

  → grains → carbohydrates for energy

  → vegetables and legumes/beans → fibre and antioxidants

  → lean meats → protein for growth and repair of cells

  → fruits → fibre and antioxidants

  → dairy products + alternatives → calcium

• outside the circle

  → drink plenty of water

  → small amounts of healthy fats

  → The ‘only sometimes and in small amounts’ represents discretionary foods (Guideline 3)

Strengths of guidelines - 3

• access → are available for free online to be downloaded → overcomes the barrier of cost

• ease of understanding → are available in other accessible formats, those with low vision

• inclusiveness → guidelines provide advice for individuals with different needs, such as people in different life span ages, different backgrounds → more easily applied into peoples lives

Weakness of the guidelines - 3

• ease of understanding → are written and not adjusted for different literacy levels → harder to follow guidelines if low literacy levels

• ease of understanding → 5 guidelines are only available in english → non- English speaking backgrounds this makes the guidelines more difficult to understand; this could lead them to not follow the guidelines

• inclusiveness → based on the requirements of the average person → not appropriate for all people, decreasing desire to follow

Strengths of healthy guide to eating - 5

• ease of understanding → translated into more than 10 languages, increases the ability of those from linguistically diverse groups to understand and utilise the guide

• inclusiveness → the guides apply to people of all ages, parents can use them to guide the food intake of themselves and their children without having to refer to separate models, increasing its ability to be utilised by families

• ease of understanding → guides provide a visual representation of ag2 and 3, low literacy can increase ability to follow

• inclusiveness → foods included from different cultures → can assist different groups to apply guide to their lives and cultural needs

• inclusiveness → separate guide has been created for Aboriginal and torres strait islander → they able to apply + cultural needs

Weaknesses of healthy guide eating - 3

• ease of understanding → guides show the proportion but not information on serving sizes or numbers, guides can be used incorrectly

• ease of understanding → guides do not make provisions for composite foods, can make it different to follow people’s everyday life and cooking styles → decrease usage

• inclusiveness → guide do not provide specific advice for people with dietary conditions or needs, could reduce the no. of people using the guide

strategies to overcome challenges

• Preparing meals in advance

• Taking nutritious meals to work

• Using apps on line to manage nutrition intake

• Using apps with QR codes to check foods for nutritional intake

• Turning off notifications on phones for adds and close by food venues

• Using meals programs that deliver to your house nutritious meals - lite’n’easy

• Using a home delivery service for shopping

• Attending information sessions when available

• Seeking advice from GP or maternal health care nurse for dietary information

• Attending cooking classes

Public sector

• public hospitals

• medicare

• pbs

• ndis

Medicare

Australias universal health insurance scheme

• administered by the FEDERAL government

• all australians and countries with reciprocal agreements access to basic healthcare → SUBSIDISED BY THE GOVERNMENT

• funded by medicare levy, medicare levy surcharge and general taxation

what does medicare cover?

• x-rays

• eye tests performed by optometrists

• pathology such as urine and blood tests

• fee-free treatment and accommodation in PUBLIC hospitals

• dental services for SOME CHILDREN under the child dental benefits scheme

• 75% of the schedule fee for treatment in a private hospital

• provides patients with the ability to choose their own doctor for consultations conducted outside the public hospital system

what DOESN’T medicare cover

• Most costs associated with private hospital care (Medicare will pay 75 per cent of the schedule fee for treatment in private hospitals but will not contribute to accommodation and other costs.)

• Cosmetic surgery

• Most dental examinations and treatment

• Home nursing care

• Ambulance

• Allied health services eg. Physiotherapy, podiatry, osteo

• Alternative therapies e.g. acupuncture 

• Health-related aids eg. glasses, contact lenses, hearing aids, artificial limbs

how is medicare funded

• the medicare levy

• medicare levy surcharge

• general taxation

Medicare Levy

an additional 2% tax placed on the taxable income of most taxpayers

Medicare Levy Surcharge

People without private patient hospital cover earning more than a certain amount have to pay an extra 1-1.5% tax.

• increases as income increases

• This is an incentive for those on higher incomes to take out private health insurance, which takes some of the financial pressure off Medicare

General Taxation

income generated through general taxation

schedule fee part of medicare

• Standard costs for medical services are set by the federal government

  → GP ONLY charges the schedule fee → no out of pocket expense for the patient (patient co-payment)

Funding

financial resources that are provided to keep the health system adequately staffed and resourced.

eg. hospitals, well trained health professionals, essential medicines

why is healthcare csts increasing

• an aging population

  → the average age is increasing in Australia. This results in a higher proportion of chronic conditions requiring care.

• more expensive technologies and services

  → as research and development progress, there are more medical technologies and services available the cost to develop and implement, creating, testing, and approving new treatments (e.g. new cancer drugs or surgical equipment) can cost millions or even billions of dollars

SAFE

Sustainability, Access, Funding, Equity

Sustainability

the capacity to provide a workforce and infrastructure that is able to respond to healthcare needs now and into the future

Why is sustainability important

• As the population grows and ages, different needs emerge. 

• continue to provide high-quality care by adapting and improving to meet the needs of all people, now and into the future

• Currently the health system in Australia is under significant pressure. 

how does medicare promote health in relation to sustainability

• Only subsidises essential services= preserve funds for the most necessary services → not funding comsetic procedurs can mean more funding for resources for treating mental health etc. NOW AND INTO THE FUTURE

• Medicare levy is based on a percentage of a person’s income= as incomes increase, the money raised for Medicare increases as well= more $ for treatments → more money available to invest in treatments for disease → developing tech for cancer etc

how does pbs promote health in relation to sustainability

• Not every medicine is available on the PBS- those with the greatest benefits are prioritised= more financially stable scheme now and into the future → ensures government spending is used effectively

• Continually reviewing the medicines available through the PBS= medicines with greatest benefits are prioritised= more people benefit from the drugs available now and into the future → enhancing health outcomes at the population level, especially for vulnerable or low-income groups.

how does ndis promote health in relation to sustainability

• Funded by the federal government= if running costs increase, the government could increase taxes to generate more funding → no ceiling on the service → individuals with a disability are more likely to receive timely and appropriate care

• Specific criteria- only those who qualify are provided support through system → more people who are in greater need can get the help they require

how does phi promote health in relation to sustainability

• incentives such as the rebate, assist in maximising the funding gained through the private system= more people are treated through the private system= reduces the strain on the public system= more people gain treatment when needed

Access

a health system that can provide all people with timely access to quality health services based on their needs, not their ability to pay or where they live. 

increased by:

• Medicare

• PBS

• NDIS

• Private health insurance

how does medicare promote health in relation to access

• Providing SUBSIDISED treatment in public hospitals → people of all socioeconomic groups can access necessary hospital treatments → reducing financial stress related to hospital bills.

• Australian citizens

• Safety Net → are more likely to continue accessing healthcare such as specialist visits or diagnostic tests can improve life expectancy

how does ndis promote health in relation to access

• provides access to assistive technologies such as wheelchairs.

  → reduce morbidity, as assistive technologies help manage physical conditions and prevent secondary complications

  → increases the ability of people to access resources such as supermarkets which can promote food security → reduce mental stress, promote social,

how does pbs promote health in relation to access

• All Australian citizens and permanent residents are entitled to access subsidised medicines through the PBS. →This increases access for low income earners → reduce stress,…

• Safety Net → are more likely to continue accessing the medication they need can improve life expectancy

how does phi promote health in relation to access

Private health insurance rebate increases access to private health insurance for those on lower incomes

→ more affordable, allowing a wider range of people to access private hospital services → individuals receive quicker treatment, particularly for surgeries or specialist care, reducing the risk of conditions worsening over time
→ mental

Advantages of Medicare

• Choice of doctor for out-of-hospital services

• Available to all Australian citizens

• Gives reciprocal subsidised healthcare in some countries

• Covers GP and specialist schedule fee, accommodation in public hospital and tests such as x-rays, eye tests and pathology

• Medicare Safety net offers additional assistance for those who need additional financial assistance

Disadvantages of Medicare

• No choice of doctor for in-hospital services

• Waiting lists for many treatments (not life threatening)

• Doesn’t cover allied health or alternative therapies

• Patients may need to make co-payments

Pharmaceutical Benefits Scheme

a federal government scheme that subsidises the cost of essential medicines

• (patients then make a co-payment; medication is not free)

• more than 5000 brands of prescription medicine are covered by the PBS. 

• There are also a number of drugs not covered by the PBS. 

  → require the patient to pay the full amount. 

• Available medications are reviewed three times a year by the Pharmaceutical Benefits Advisory Committee (PBAC).

  → ensures a priority for those medicines that bring the greatest benefits. (i.e. not every medicine is on the scheme- it is a selective process)

Pharmaceutical Benefits Scheme safety net

similar to the Medicare safety net. Once a patient (or immediate family) have spent above a certain amount of money within a calendar year on PBS-listed medicine, the patient has a lower concessional co-payment rate to pay for the rest of the year

National Disability Insurance Scheme

provides services and support for people with permanent, significant disabilities and their families and carers

• funded by the federal and state/territory governments, the NDIS works to assist individuals with disabilities to live an ordinary life.

eligibility requirement

• citizenship criteria

  → aged under 65

  → australian citizen or permanent visa

  → live in australia where NDIS is available

• disability requirement

  → permanent impairment or condition (i.e. likely to be lifelong)

  → Substantially reduced ability to participate effectively in activities or perform tasks or actions unless you have:

  → assistance from other people, or

  → you have assistive technology or equipment (other than common items such as glasses), or

  → you can’t participate effectively even with assistance or aides and equipment

  → Impairment affects capacity for social and economic participation

  → Likely to require lifelong support

NDIS Plan

• Individualised plan is developed based on each person’s current and future goals and aspirations.

→ Greater independence, employment, improved health and wellbeing

• The plan identifies the functional support needed for daily life, support needed to achieve goals and how the individual wants to manage their plan over time.

• assists participants to:

  → Access mainstream services and supports (education, health services, housing, justice)

  → Access community services and supports (sports clubs, libraries, community groups)

  → Maintain informal support arrangements (family and friends)

  → Receive reasonable and necessary funded supports (mobility aids, technology, bed rails, shower chair, etc.)

Private Health Insurance

 a type of insurance for which people pay a premium (or fee) in return for payment towards health related costs not covered by Medicare. 

• it is OPTIONAL

• individuals can choose their level of private hospital cover in addition to whether they would like to receive cover for general treatments (“extras”) or combined cover. 

  → Premiums will vary based upon how many people are being covered, and options included. 

Government incentives to encourage people to get PHI

• phi rebate

• lifetime health cover

• medicare levy surcharge

• age-based discount

Private Health Insurance Rebate

• Policyholders receive a rebate (refund) on their private health insurance premiums

• Rebate is income tested for individuals and families the less you earn, the more rebate you get

Lifetime health cover

• People who take up private health insurance after the age of 31 pay an extra 2% on their premium for every year they are over the age of 30, until they have had insurance for 10 consecutive years.

  → encourages more young people to get PHI → take off pressure on public health care

Medicare Safety Net

Offers extra financial support for those who incur significant out-of-pocket costs towards Medicare services.

• Once an individual or family has contributed a certain amount out of their own pocket to Medicare services in a calendar year medicare services cheaper for the remainder of that year.

Age-based discount

• Insurers have the OPTION of offering young people aged 18–29 a discount of up to 10% for hospital cover.

• The discount allows for a 2% reduction in premiums for each year that the person is aged under 30, to a maximum of 10%

Advantages of PHI

• Access to treatment and accommodation in a private hospital

• Choice of doctor when being treated in a public or private hospital

• Shorter waiting times for some procedures e.g. elective surgery 

• Access to additional services not covered by Medicare, and these services could be fully paid for (depending on level of cover)

• 75% of schedule fee still covered by Medicare when being treated in a private hospital

• Contribution of funding to healthcare helps keep operating costs of Medicare down

• Relieves pressure on public hospitals

• Avoid paying the Medicare Levy Surcharge

• Government rebate for eligible policyholders

• Age-based discount may provide cheaper cover for those aged 18-29

Disadvantages of PHI

• Premiums can be expensive

• Often there is a gap between what the insurance pays and the actual cost, so individuals must pay the difference. 

• Qualifying periods apply for some conditions and pre-existing conditions

  • Eg 12 months for pregnancy

• Policies can be complex to understand and so create confusion for the average person

Equity

health system that takes the different circumstances of individuals and groups into account, so that disadvantaged groups and individuals are targeted to receive more support, making it equitable and fair for all people to reach their health potential.

how does medicare promote health in relation to equity

Medicare Safety Net provides extra financial assistance to those who incur a significant amount of out of pocket payments from Medicare.
→ ensures that people can continue to access specialist care, diagnostics, and other essential services, even if they require frequent treatment → reduce morbidity as they can more easily manage conditions
→ mental

how does pbs promote health in relation to equity

PBS Safety Net provides extra financial assistance to those who incur a significant amount of out of pocket payments for PBS medicines.
→ this ensures that people can continue to access medicine → reduce morbidity
→ mental

how does ndis promote health in relation to equity?

provides support for people with disabilities. Those who experience more significant challenges in relation to their disability receive more support which promotes equity.
→ social

→ can improve self-assessed health status, as individuals with higher support levels are more likely to feel that their needs are being met through services like personal care, therapy, or assistive technology

how does phi promote health in relation to equity?

Those on lower incomes receive more financial assistance through the private health insurance rebate.

→ more affordable, allowing a wider range of people to access private hospital services and avoid long public waiting lists → can improve life expectancy receive quicker treatment, particularly for surgeries or specialist care
→ mental

general equity interventions

• Interventions to increase access to healthcare (e.g Royal Flying Doctors Service)

• Public dental health services — the Victorian Government funds the Royal Dental Hospital of Melbourne and dental clinics in metropolitan and regional Victoria to provide dental treatment for that is generally fee-free vulnerable groups (e.g. Aboriginal & Torres Strait Islanders)

• Mental health treatment plans - 10 sessions covered by Medicare

similarities between guidelines and australian guide to heathy eating

• use the same five food groups (breads and grains, lean meat and alternatives, fruit, vegetables and dairy and alternatives). This can assist Australian’s in consuming a balanced diet and weight management.

• both recommend making water the main drink. Water does not contain energy which can assist Australian’s in reducing their energy intake and assist in weight management.

differences in and australian guide to healthy eating and guidelines

• The Australian Dietary Guidelines provide information in written form about what people can do to maintain a healthy food intake whereas the Australian Guide to Healthy Eating provides a visual representation of the proportions of foods that should be consumed to maintain a healthy food intake.

• The Australian Dietary Guidelines include detailed information about serving sizes and the number of serves people should have based on age and sex whereas the Australian Guide to Healthy Eating provides proportions of the food groups, but not amounts or serving sizes.

• The Australian Dietary Guidelines include information about storing and caring for food (Guideline 5) which can reduce the risk of infectious diseases whereas the Australian Guide to Healthy Eating does not include this information

how does Medicare promote health in relation to funding

Funded by General Taxation, Medicare Levy, Medicare Levy Surcharge
- subsidise cost of doctors consultations → can receive treatment for → chronic conditions such as hypertension, depression, ventolin etc.
- money can be used to fund treatment in public hospital → stroke, can reduce stress knowing they have access to emergency treatment if required

how does PBS promote health in relation to funding

government funding → allows for essential medicines subsidised → allow for affordable medication to treat conditions → can receive treatment for → chronic conditions such as hypertension, depression, ventolin etc.

how does ndis promote health in relation to funding

Government funding →The NDIS can provide funding for assistive technology + personal plans, home modifications, or allied health services. .g. wheelchairs → social, mental physical
→ improve morbidity

how does PHI promote health in relation to funding

Money from premiums re-invested into healthcare system → allows to provide a lot of funding for private hospitals → this takes the pressure off public hospitals and increases the number of people they can treat → reduce stress people know they can get the treatment they need