PDHPE CORE 1

Role of Epidemiology

Identify patterns, analyze usage, allocate resources

Mortality

Number of deaths within a specified time period

Mortality examples

Cancer surpassed CVD as leading cause of death in 2013

Infant Mortality

Measures number of infant deaths within first year of life per 1000 babies

Post Natal

death in remaining first year

Neonatal

death in first 28 days

Infant Mortality example

2022 Australian rate was steady at 3.2

Morbidity

Patterns of illness, disease and injury not resulting in death

morbidity example

2021-22, around 47% of Australians had one or more chronic conditions

Life Expectancy

Length of time a person is expected to live based on current death rates in a population, typically calculated at birth

Life expectancy example

2022, life expectancy at birth was 81.2 years for males and 85.3 years for females

Why is epidemiology limited in describing health status?

It focuses on statistics (mortality, morbidity) but overlooks quality of life, mental health, and social determinants.

Why might epidemiology not accurately show health differences between groups?

Data collection issues can underrepresent groups like Aboriginal and Torres Strait Islander peoples.

What does epidemiology often fail to capture after a diagnosis?

Pain, emotional distress, and daily life impact beyond just disease rates.

Why is mental health underrepresented in epidemiology?

Stigma, underreporting, and lack of diagnosis make conditions like anxiety and depression hard to measure.

Why doesn’t epidemiology fully explain health inequalities?

It shows disparities but not underlying causes like income, education, and healthcare access.

What key factors are often ignored in epidemiology?

Social, economic, and environmental factors that impact health outcomes.

Factors determining disease burden

Social justice priorities, priority population group, costs to individuals/community, relevance of conditions, potential of prevention

Social justice: Equity in Health

resources and funding is distributed fairly

Social justice: Diversity in Health

Planning and making decisions about health whilst recognizing the cultural and societal differences

Social justice: Supportive environments in Health

refers to the physical and social aspects of our surroundings, resources for living and opportunities for employment.

Social justice in health example

Provision of equal access to resources, health services, education and information may reduce the incidence of type 2 diabetes in the indigenous population

Priority groups in Australia

Indigenous Australians, Socio-economically disadvantages, Rural and remote residents, Veterans, Prisoners and Overseas-born.

What is prevalence in health?

refers to the current number of cases of an illness or condition. Higher prevalence indicates a greater issue

How does prevalence relate to the burden of disease?

The greater the prevalence, the more significant the burden of disease

Why is cardiovascular disease a major concern in Australia?

has been a priority health issue for a long time and is expected to continue impacting

What is the trend of cancer prevalence in Australia?

Cancer is a growing priority, but reduced smoking rates are helping lower some cancer rates.

Who is most affected by dementia and Alzheimer’s disease?

primarily affect the elderly, making them a significant health concern in Australia.

Why is diabetes a priority health issue in Australia?

highly prevalent but also has an increasing incidence

How is cerebrovascular disease related to cardiovascular disease?

similar underlying causes and remains a major health issue in Australia.

Early Intervention

Can also decrease disease burden by enabling effective treatment and recovery

Early Intervention example

Successful cervical cancer screening and HPV immunizations programs.

Direct costs of ill health

Prevention (health campaigns, vacx programs), Diagnosis (testing, screening, consultations), treatment (hospitals, rehab, pharamacy)

Indirect Costs of Illhealth

Quality of life (reduced wellbeing), Relationships (strain and potential breakdown), Productivity (loss of work hours and economic output)

ATSI: Life Expectancy gap

overall improvement, ASTI still approximately 10 years lower than the general population

ASTI: adult morality

Aged 35-44 face have a 4 times higher mortality rate

ATSI: infant mortality

twice more likely die to early life challenges, nutrition and healthcare access

ATSI: Prevalence of Chronic diseases

Circulatory, Endocrine, Metabolic Disorders, Mental health, Substance Abuse, Digestive conditions

ATSI: Sociocultural determinants of Health

Family structure, Education, Cultural, Community disempowerment

ATSI: Socioeconomic and Environmental Determinants of Health

Income disparity, housing conditions, geographical location, Environmental hazards

ATSI: Addressing health inequities

Culturally appropriate Healthcare, Community lead initiatives, addressing social determinants, Continued research and monitoring.

Low SES: Health outcomes

Poorer Health due to limited resources, and healthy living activities/education

Low SES: Smoking Rates

23% compared to 10% in high SES

Low SES: Physical Inactivity

66% compared to 48% in high SES

Low SES: Risky Alcohol

22% compared to 17%

Low SES: Obesty outcomes

33% in women, 66% higher in children

Low SES: Chronic illness

Circulatory, Endocrine, Metabolic Disorders, Mental health, Substance Abuse, Digestive conditions

Low SES: Socio-cultural determinants

Limited Access to Healthcare, Education, Environmental, Poor living conditions, lifestyle, economic instability, nutrition, family influence, media, peer pressure

Low SES: socio-cultural example family influence

drinking to heavy levels is acceptable, children are more likely to drink at early ages e.g. 12 years old in the home, promoting unhealthy relationship with alcohol

Low SES: Socioeconomic and Environmental Determinants

Education, employment, income, living conditions

Low SES: addressing inequities: Individual

Need to focus on education, making healthy choices and personal responsibility

Low SES: addressing inequities: Community

Programs like PCYC and 'Youth of the Streets' provide crucial services

Low SES: addressing inequities: Government

Medicare, PBS, and social welfare programs aim to reduce inequities

Cardiovascular Disease

All diseases of the circulatory system (heart and blood vessels)

CVD Types

Coronary Heart disease, stroke (Cerebrovascular disease), Myocardial arrhythmia, Heart Failure

CVD: Coronary Heart Disease

arteries of the heart cannot deliver enough oxygen-rich blood to the heart, usually because of Atherosclerosis.

CVD: Stroke (cerebrovascular disease)

Damage to the brain from interruption either of its blood supply, because blockages or sudden bleeding in the brain

CVD: Myocardial arrhythmia

Improper beating of the heart, electrical impulses in the heart don't work properly

CVD: Heart Failure

heart doesn't pump blood as well

CVD: Arteriosclerosis

Hardening or narrowing of arteries.

CVD:Atherosclerosis

buildup of fat and plaque inside the arteries, blocking blood vessels

CVD: Trends

1 in 5 Australian's suffer. Second leading cause of death. Downward trend. Strokes incident decreasing, prevalence increasing

CVD: Risk Factors

Hypertension (high blood pressure), Physical inactivity, Obesity, Smoking

CVD: Protective Factors"

Regular physical activity regular health checks, and eating a balanced diet low in saturated fats

CVD: Socio-cultural

Influenced by Family (provides foods and influence activity), peers(pressure ie starting to smoke), media, religion and culture. Genetics can play a role

CVD: Socioeconomic

employment, income and education. CVD is higher in blue collar

CVD: Environmental

Geographical isolation can limit health/services access which results in high death rates because of lagged time between stroke or heart attack and treatment.

CVD: Groups at Risk

ATSI, LSES, Rural/remote, Elderly, Smokers, Men, Genetic history

Cancer

When cells become abnormal and begins to multiply rapidly and cannot be controlled by the body

Cancer: Tumour

where cancer is located/originated from

Cancer: Benign Tumour

Non-cancerous tumour

Cancer: Malignant Tumour

Cancerous, can invade surrounding tissue

Cancer: Metastasis

When a malignant tumour moves away from its primary site

Cancer: Most Common

Prostate, Bowel, Breast, Skin and Lung

Cancer: Trends

Leading case of death, rates declining. Increased incidence. Lung cancer declining for men, increase for women. Bowel cancer and Melanoma decreasing. Breast increasing

Cancer: Lung Cancer Death Rates

Decreasing in men. Increasing smoking rates, only slightly decreasing amongst women. Incidence for women is not expected to decline.

Cancer: Lung Cancer, Risk Factor Smoking

Increases Incident by 10, increases through amount and length of smoking

Cancer: Lung Cancer, Risk Factor Smoking, Highest risk group

Children/Adolescents: lung tissue is easily damaged.

Cancer: Lung Cancer, Risk Factor Environmental/Occupational

No-smokers are less than 10% lung cancer cases. Contributing factors, nonsmoking -> Occupational hazards, air pollution, other environmental factors

Cancer: Lung Cancer, Protective Factors

Smoking cessation, public education, work place and environmental safety regulations

Cancer: Breast Cancer, Incidents

Second leading cause of cancer-related deaths in women. 1 in 8 women in Australia will be affected. Risk increases with age.

Cancer: Breast Cancer, Risk Factors

Age, Family History, lifestyle, Reproductive history

Cancer: Breast Cancer, Early Detection

Increases survival rates: Self-examination and Mammograms

Cancer: Breast, Prevention/awareness

Regular checks and mammograms are vital. Awareness campaigns and public health programs Lifestyle changes -> Healthy diet, Maintain a healthy weight.

Cancer: Skin Cancer, Types

Non-Melanoma and Malignant Melanoma

Cancer: Skin Cancer, Non-Melanoma

Basal cell carcinoma & Squamous cell carcinoma, common, rarely fatal

Cancer: Skin Cancer, Melanoma

Most dangerous, can spread around the body

Cancer: Skin Cancer Trends

Over 2 000 Australians die each year. Deaths can be prevented; early detection and skin protection

Cancer: Skin Cancer, Prevention/Awareness

Skin Checks, Sunscreen, Sun Safety Campaigns

Cancer: Socio-cultural

Influenced by Family history , ATSI , Family practices

Cancer: Socio-economic/environ

Influenced by occupation, Lower SES, Lower Education

Cancer: Environmental

Rural Living → less access

Cancer: Groups at risk

ATSI, LSES, Remote/Rural, Elderly, Smoker’s, Genetic History, Women with no children

Diabetes

Effects the body's ability to take glucose from the blood stream and use it for energy.

Diabetes: Type 1

Genetic: Caused by issues in the pancreas with insulin production and management of glucose

Diabetes: Type 2

Pancreas produces insulin but it is insufficient or ineffective. Managed through diet, exercise and medication. Caused by obesity and high fat diets

Diabetes: Gestational

Occurs during pregnancy and increases the risk of developing type 2 diabetes later in life

Diabetes: Trends

Risen, upward trend, 7th highest cause of death in Australia

Type 2 Diabetes: Risk Factors

Family history, Age, high blood pressure, obesity, PCOS, overweight, Aboriginal, Torres Strait Islander, Pacific Islander, Indian, or Chinese background, High-fat and high sugar diet, physical inactivity

Type 2 Diabetes: Protective Factors:

Maintaining healthy body weight, Regular physical activity, Balanced diet, Limiting alcohol intake, Regular health checks