HHD outcome 3 promoting H&W

Infectious diseases

diseases caused by micro-organisms, such as bacteria, viruses, parasites or fungi, that can be spread, directly or indirectly, from one person to another.

Parasitic diseases

when parasites such as worms, skin mites, body lice and protozoa enter the body through contaminated food or water, or from contact with others who have parasites on their skin or hair.

Pattern of mortality: infectious and parasitic diseases

Poor living conditions such as contaminated water caused them to be the most common causes of death in Australia in the early 20th century. These living conditions led to outbreaks of diarrhoea, cholera, polio, etc.

Pattern of mortality: cancer (neoplasms)

Mortalities reached a peak in mid 1980’s, reduced 2000-2018. Stomach cancer was largest cause of cancer death 1920.

Cardiovascular disease

Cardiovascular diseases involve the heart and blood vessels, and interfere with how the blood is circulated throughout the body.

Two of the most significant forms of cardiovascular diseases are

**Ischaemic heart disease** (coronary heart disease, notably heart attack).

**Cerebrovascular disease** (mainly stroke).

Patterns of mortality: cardiovascular diseases

Mortalities peaked in 1960s but have steadily decreased. Has been major cause of death for past 100 years.

Respiratory diseases

affect the lungs and other parts of the body that are involved in breathing.

They include:

●COVID-19

●Pneumonia

●Influenza

●Asthma

Patterns of mortality: respiratory diseases

Apart from Spanish Flu in 1919, death rates from respiratory diseases have declined over the years

Patterns of morality: injury and poisoning

Has halved over the last 100 years, most rapid decline.

Public health

the ways in which governments monitor, regulate and promote health status and prevent disease.

Old public health

government actions that focused on changing the physical environment to prevent the spread of disease, such as providing safe water, sanitation and sewage disposal, improved nutrition, improved housing conditions and better work conditions.

Policies and practices associated with old public health

\-Improved water and sanitation

\-Quarantine laws

\-Elimination of housing slums and introduction of better-quality housing

\-Improved food and nutrition

\-Improved work conditions

\-Mass vaccinations

Contributions to improvements in Australia’s health status: Improved water and sanitation

\-Implementation of sewerage and garbage systems as well as clean water reduced parasitic diseases.

Contributions to improvements in Australia’s health status: Quarantine laws

\-Bubonic plague put the Commonwealth Quarantine Act into place which prevents the arrival and transmission of infectious diseases from other countries.

Contributions to improvements in Australia’s health status: Elimination of housing slums and introduction of better-quality housing

\-Regulations were put in place which meant drains connected to a sewerage systems were required.

\-Ventilation and building codes reduced overcrowding

\-There were attempts to clean up slums in major cities

\-Reduced typhoid, cholera and diarrhoea.

Contributions to improvements in Australia’s health status: Improved food and nutrition

\-OHS regulations which improved safety and standards of food

\-Widespread refrigeration which reduced harmful preservatives reducing stomach cancer.

\-School Milk Program, reducing protein and calcium deficiencies.

Contributions to improvements in Australia’s health status: Improved work conditions.

\-Better ventilation and toilets in workplaces

\-Prohibiting employment of children under 13, regulating employment of minors reducing industrial child mortalities

\-Minimum wage, giving reasonable standard of living

\-Regulations for dangerous occupations.

Contributions to improvements in Australia’s health status: Mass vaccinations

\-Reduced mortality/morbidity from diseases such as smallpox, polio, diphtheria, pertussis, tuberculosis, tetanus, polio, measles, mumps, rubella and hepatitis B

\-Eliminated polio and smallpox from most parts of the world

Contributions to improvements in Australia’s health status: More hygienic birthing practices

\-Emphasis on providing safe and hygienic birthing conditions

\-Trained and registered midwives and doctors

\-Reduction in maternal and infant mortalities.

Health promotion

the process of enabling people to increase control over, and to improve, their health.

The biomedical model of health

focuses on the physical or biological aspects of disease and illness. It is a medical model practised by doctors and health professionals and is associated with the diagnosis, treatment and cure of disease.

Positives of the biomedical model of health

\-Increased life expectancy

\-Funding brings about improvements in technology and research

\-It enables many illnesses and conditions to be effectively treated

\-It improves quality of life and HALE

Negatives of the biomedical model of health

\-Affordability

\-Not every condition can be treated

\-It doesn’t always promote H&W

\-Relies on professional health workers and technology, therefore costly

New public health

an approach to health that expands the traditional focus on individual behaviour change to one that considers the ways in which physical, sociocultural and political environments impact on health. Also referred to as the social model of health.

Social model of health

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

Principles of the social model of health

\-Involves intersectoral collaboration

\-Addresses the broader determinants (or factors) of health

\-Empowers individuals and communities

\-Acts to enable access to healthcare

\-Acts to reduce social inequalities

Principles of the social model of health: Involves intersectoral collaboration

social and environmental determinants of health cannot be addressed by the health sector alone and require coordinated action among different government departments (such as those responsible for employment, education, finance, etc.) and the private sector.

Principles of the social model of health: Addresses the broader determinants (or factors) of health

Addressing behavioural factors such as reducing tobacco smoking and eating healthily has strong relationship with health status and H&W.

Principles of the social model of health: Acts to reduce social inequalities

To improve H&W and health status, factors such as gender, culture, race, SES, access to healthcare, social exclusion and the physical environment must be taken into consideration.

Principles of the social model of health: Acts to enable access to healthcare

Providing access to healthcare means that it is readily available to everyone, simple to understand and takes into consideration culture, gender and ethnicity.

Principles of the social model of health: Empowers individuals and communities

Means people can participate in decision making about their H&W. By building health knowledge and skills means they are more able to make positive changes to their own H&W.

Positives of the social model of health

\-It promotes good H&W and assists in preventing diseases

\-Takes more holistic approach to H&W

\-Less expensive than biomedical model

\-Focuses on vulnerable population groups

\-Education can be passed down generations

\-The responsibility for H&W is shared

Negative of social model of health

\-Not every illness or condition can be prevented

\-It does not promote technology and medical knowledge development

\-It doesn’t address the H&W concerns of individuals

\-Health promotion messages may be ignored.

Ottawa Charter for Health Promotion

an approach to health developed by the World Health Organisation that aims to reduce inequalities in health.

The Ottawa Charter strategies

\-Advocate

\-Enable

\-Mediate

Ottawa Charter strategies: advocate

Lobbying governments and other organisations to make necessary changes to improve factors that influence health & wellbeing. Include media campaigns, public speaking, conducting and publishing of research and public opinion.

Ottawa Charter strategies: enable

Focuses on achieving equity. Aims to reduce differences in health status between population groups by ensuring equal opportunities. Through access to education, employment, housing, healthcare and nutritious food.

Ottawa Charter strategies: mediate

Health promotion demands coordinated action by all concerned, For example Governments, health and other social economic sectors, non governmental, voluntary organisations, local authorities and the media must work together.

Action areas of the Ottawa Charter

\-Building healthy public policy

\-Create supportive environments

\-Strengthen community action

\-Develop personal skills

\-Reorient health services

Action areas of the Ottawa Charter: Building healthy public policy

This relates directly to the decisions made by government and organisations in relation to laws and policies that affect health and wellbeing.

Action areas of the Ottawa Charter: Create supportive environments

A supportive environment is one that promotes health by being safe, stimulating, satisfying and enjoyable. Supportive environments promote health by helping people practise healthy behaviours.

Action areas of the Ottawa Charter: Strengthen community action

This priority area focuses on building links between individuals and the community and centres around the community working together to achieve a common goal. Giving the community a sense of ownership of health & wellbeing increases the likelihood of its effectiveness.

Action areas of the Ottawa Charter: Develop personal skills

Education is the key aspect of this priority area. Education refers to gaining health-related knowledge and gaining life skills that allow people to make informed decisions that may indirectly affect health & wellbeing.

Action areas of the Ottawa Charter: Reorient health services

This priority area refers to reorienting the health system so that it promotes health as opposed to only focusing on diagnosing and treating illness, as is the case with the biomedical model.

Medicare

Medicare is Australia’s universal health insurance scheme. Medicare is known as a universal health insurance scheme as it is available to all Australian residents, regardless of income, location, and culture.

How Medicare is funded

\-The Medicare levy

\-The Medicare levy surcharge

\-General taxation

Services covered by Medicare

\-Doctor and specialist consultations

\-Most surgical and other therapeutic procedures performed by GPs

\-X-rays

\-Eye-tests performed by optometrists

\-Pathology, blood and urine tests

\-Fee-free treatment and accomodation 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

Services not covered by Medicare

\-Most private hospital costs, only 75% of schedule fee is paid by Medicare

\-Most dental examinations and treatment

\-Home nursing care or treatment

\-Ambulance services

\-Most allied health services (services provided by trained professionals which are not doctors, dentists and nurses.)

Advantages of Medicare

\-Choice of doctor for out-of-hospital services

\-Available to all Australian citizens

\-Reciprocal agreement between Australia and other

\-Countries allows Australian citizens to access free healthcare in selected countries

\-Covers tests and examinations, doctors’ and specialists’ fees (schedule fee only), and some procedures such as X-rays and eye tests

\-The Medicare Safety Net provides extra financial contributions for medical services once an individual’s or family’s co-payments reach a certain level

Disadvantages of Medicare

\-No choice of doctor for in-hospital treatments

\-Waiting lists for many treatments

\-Does not cover alternative therapies

\-Often does not cover the full amount of a doctor’s visit

PBS (The pharmaceutical benefits scheme)

\-The PBS is a key component of the federal government’s contribution to Australia’s health system.

\-The aim was to provide essential medicines to people who needed them, regardless of their ability to pay.

\-The purpose of the PBS remains the same today, but instead of being free, medicines are now subsidised and consumers must make a patient co-payment. 

NDIS

The NDIS is a national insurance scheme that provides services and support for people with permanent, significant disabilities, and their families and carers.

Private health insurance

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

Co-payment

payment made by the customer in addition to the amount by the government

Medicare safety net

aims to protect those who have heavy reliance on medical services from high out of pocket expenses once they reach a certain threshold

Eligibility criteria for NDIS

\-Must be under the age of 65

\-Must be an Australian citizen

\-Has a permanent impairment which reduces ability to effectively perform tasks or participate in activities

Private health insurance incentives

\-Private health insurance rebate

\-Lifetime health cover

\-Medicare levy surcharge

\-Age-based discount

Advantages of PHI

\-enables access to private hospital care

\-choice of doctor in public/private hospital

\-shorter waiting times for some medical procedures

\-depending on the level of cover purchased, services such as dental, chiropractic, physiotherapy, optometry and dietetics could be paid for

\-helps to control the cost of operating Medicare

\-high income earners with private health insurance don’t have to pay the Medicare levy surcharge

\-government rebate for eligible policy holders

“lifetime health cover” incentive

\-age-based discount provides cheaper cover for those 18-29

disadvantages of PHI

\-costly in terms of the premiums that have to be paid

\-sometimes have a ‘gap’ meaning the insurance doesn’t cover the entire fee and the individual must pay the difference

\-qualify periods apply for some conditions (such as pregnancy)

\-policies can be complex to understand and create confusion for the average

Funding

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

Funding- Medicare

Medicare funds part or all fees associated with health services, including doctor consultations, pathology tests and treatment in public hospital

Funding- PBS

Essential medicines are subsidised through the PBS, providing treatment for many conditions, promoting health outcomes

Funding- NDIS

The NDIS can provide funding for a range of resources that promote health status, including carers and assistive technology

Funding- Private health insurance

\-PHI provides much of the funding for private hospitals, which is responsible for approximately 40% of hospital treatments.

\-Government funds the PHI rebate making PHI more affordable for more people

Sustainability

capacity to provide a workforce and infrastructure such as facilities and equipment into the future, and to be innovative and responsive to emerging needs through interventions such as research and monitoring.

Sustainability- medicare

\-determining which services will be subsidised by Medicare, preserving funds for necessary services

\-change in the Medicare levy, helps maintain Australia’s health system

Sustainability- PBS

\-continually reviewing medicines available through the PBS, leading to greatest benefits

\-The Therapeutic Goods Administration verifies the effectiveness of all PBS medicines

Sustainability- NDIS

\-each participant in the NDIS has an individualised plan. This means only necessary funds are spent on each person.

Sustainability- Private health insurance

-Incentives such as PHI rebate, lifetime health cover and age-based discount. Assisting maximising funding gained through PHI, meaning more people are treated through private health reducing the strain on public health.

Access

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

Access- Medicare

\-Medicare provides access to people of all socioeconomic backgrounds to services such as doctors’ consultations

\-Medicare provides funding for telephone and video consultations which can assist those living outside major cities.

Access- PBS

\-All Australian citizens and permanent residents are entitled to medicine from PBS

\-PBS promotes access to essential medicine for low income earners

Access- NDIS

\-NDIS improves access to health services for people with significant, lifelong diseases.

\-NDIS has been rolled out in every region of Australia

Access- Private health insurance

\-The PHI rebate increases access to PHI for lower income earners

\-PHI can increase access to healthcare services which would have otherwise been too expensive

Equity

All Australians have different healthcare needs so an equitable systems provides more support for those who need it.

Equity- Medicare

\-Medicare safety net for people who require frequent visits, have additional financial support

\-Mental Health Treatment Plans for those with mental health disorders

Equity- PBS

\-PBS safety net protects individuals with large overall expenses for PBS listed medicines

\-concessional co-payment provides greater assistance to those who are unemployed or on low incomes

\-Many Aboriginal and Torres Strait Islander peoples can qualify for reduced PBS co-payment under Closing the Gap intiative

Equity- NDIS

\-Individualised plan helps people who have more significant needs for more assistance

\-Those who don’t require NDIS don’t have to pay more towards funding it.

Equity- Private health insurance

\-Those on lower incomes receive more financial assistance through the PHI rebate

\-Those ages 65 and over receive greater rebate if they have PHI

\-People who use PHI more often do not have to pay a higher premium

Why is smoking targeted in improving population health

1) Smoking kills an estimated 15,000 Australians each year

2) Smoking costs Australia $31.5 in social and economic costs each year

3) Smoking affects vulnerable populations disproportionately than any other groups. (People living outside major cities, Aboriginal and Torres Strait Islanders, and people of low SES)

4) Half of all long-term smokers will die prematurely because they smoked

5) Exposure to environmental tobacco smoke also causes disease and premature death in adults and children who do not smoke

Health promotion

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

Evaluating initiatives in relation to their capacity to promote Indigenous H&W

1. Have improvements been made?
2. Is it culturally appropriate?
3. Has the program had a large number of people participate?
4. Has the feedback from the participants been positive?
5. Have the action areas of the Ottawa Charter been used to develop the initiative?
6. Have the specific needs of the community been addressed?
7. Have adequate funding been provided to ensure the program can run until the desired improvements are achieved?
8. Does the initiative address a significant health issue for Aboriginal and Torres Strait Islander peoples?

The Australian Dietary Guidelines

1. To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious foods and drinks to meet your energy needs.
2. Enjoy a wide variety of nutritious foods from the following 5 groups every day and drink plenty of water.
3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
4. Encourage, support and promote breastfeeding
5. Care for your food prepare and store it safely.

Examples of work of Nutrition Australia

\-Healthy eating advisory service

\-Education resources

\-National nutrition week

\-Healthy eating pyramid

Healthy eating advisory service- nutrition australia

Provides:

\-phone advice and support to assist in providing nutritious tasty and cost-effective food and drink choices including assistance with menu planning

\-staff training on developing and modifying menus, menu assessments, considering options for healthy vending machines and developing a healthy food policy.

\-training for cooks, chefs, food service and other key staff to produce healthy food options

\-advice to the food industry and health professionals to promote healthy eating in these settings

Education resources- nutrition australia

Produces a range of publications and resources including nutrition books, portion bowls and plates and booklets to enjoy optimal H&W through food variety.

National nutrition week- nutrition australia

Nutrition Australia dieticians and nutritionists conduct a range of seminars on the topic of:

\-Nutrition 101

\-Healthy eating for corporate lifestyles

\-Nutrition for shift workers

\-Understanding food labels

\-Healthy habits for a healthy heart

Healthy eating pyramid- nutrition australia

\-a simple visual guide to types and proportion of food that individuals should eat for H&W.

\-encourages Australians to enjoy a wide variety of food from every food group in a representative portion.

Challenges in bringing about dietary change

\-Personal preference

\-Attitudes and beliefs

\-Willpower

\-Food security

\-Time constraints and convenience

\-Education, nutrition knowledge and cooking skills

\-Family, culture, society and religion

\-Food marketing and media

Personal preference

\-Most people prefer certain foods to others

\-Taste preferences are often established over a large period of time and can be difficult to change

Attitudes and beliefs

\-People may think healthy food options are bland or tasteless

\-People may not feel the negative effects of consuming unhealthy foods will not happen

\-Consuming foods based on philosophical beliefs.

Willpower

\-Changing food intake requires commitment

\-Choosing healthy foods can be challenging

Food security

\-Having enough money to afford nutritious food and means to access them, including geographical access and transport.

Time constraints and convenience

\-Meals are planned with consideration of time available and convenience of foods to be consumed.

\-Accessing fast food may be more convenient but it reduces their ability to consume healthy food.

Education, nutrition knowledge and cooking skills

\-Lack of education can lead to consumers believing they are consuming healthy foods as they don’t have the skills to accurately access food intake.

\-Low education, nutritional knowledge and cooking skills can mean people that want to change dietary choices may lack necessary resources.

Family, culture, society and religion

\-Family influences the personal preferences that people have in relation to food

\-The cultural and religious backgrounds of people may include ties to traditional foods which have been consumed through generations

Food marketing and media

\-Advertisements in newspaper and magazines, on television, radio and the internet

\-The information provided through marketing and media can create conflicting messages for individuals, potentially affecting ability to choose healthy foods.

Anti-smoking media campaigns

\-educates the population on the dangers and consequences of smoking

\-provides information on how to access resources to assist in quitting

Quit campaigns

\-a program of the Cancer Council Victoria, which is funded by the Victorian government and Vichealth

\-providing information regarding tobacco smoking and the benefits associated with not smoking

\-Quit undertakes research and provides advice to the state government to implement

\-Quit provides a free online learning training program for health professionals

My Quitbuddy

\-allows users to record personal goals and motivation using pictures, words and audio messages. Has a community board where users can gain motivation and support from other quitting people

\-program danger times where the app sends reminders of the H&W benefits of quitting, has games for distraction

\-share quit journey and success stories

\-provide information that can assist in reducing smoking related diseases.