Studied by 0 peoplewhat impacted health status in the 1900s
poor housing/environmental conditions
lack of safe water and sanitation lead to higher rate of infectious diseases
healthcare was expensive; many were untreated
reasons why infectious diseases increased
poor air quality
inadequate food storage
human waste collection; resulted in waterborne diseases
Trend in life expectancy
increased drastically
Why did life expectancy increase?
increased due to access to healthcare
decline of infant mortality/U5MR
things have become more safe/less accidents
patterns of mortality
infectious and parasitic
cancers
CVD
injury and poisoning
respiratory diseases
Infectious and Parasitic Diseases
infectious - transmitted from person to person (TB, small pox, hepatitis, STI's)
parasitic - occurs when. parasites enter the body (worms, skin mites, lice)
^^ these conditions increased due to living conditions
Cancers
group of conditions in all parts of the body where cells become abnormal and multiply.
peak in cancer in 1900 due to smoking
advances in med tech can result in increase as diagnoses increase
CVD
circulatory disease: circulation of blood: heart attack, angine, stroke, high bp
peak in 1960s -> mortality decreased
rates of CVD diagnosis are increasing, but mortaality is decreasing due to more med tech
injury and poisoning
Deaths from injury and poisoning include those from motor vehicle and other accidents, suicide, assault, poisoning, drowning, burns and falls, and complications from medical and surgical care.
safety laws brought in place have decreased this
respiratory diseases
diseases which impact and affect lungs and other parts that are involved in breathing (pneumonia, asthma)
pneumonia and influenza, now replaced with COPD
Define 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
1900 to 1950
Old public health policies and practices
the establishment of government funded water and sewage systems and better sanitation. (reduce diarrhoea, typhoid, cholera)
quarantine laws
better quality housing
improved nutrition
improved working conditions
establishment of public health campaigns
more hygienic birthing practices
antenatal and infant welfare services
discovery of vaccines eradicated many diseases
biomedical approach
focus on physical or biological aspects of disease and illness. it is a medical model practiced by doctors and health professionals and is associated with the diagnosis, treatment and cure of disease.
1900 to current
features of biomedical approach
focuses on individuals who are ill
Concerned with disease, disability, illness
Relies on services provided by professionals
Quick fix
Relies on tech to diagnose, treat and cure
Strengths of the biomedical model
funding brings improvements in tech and research
many illnesses and conditions to be effectively treated
extends life expectancy
improves quality of life and HALE
limitations of biomedical model
relies on professionals, med equipment so costly
doesn't always promote good HW (things can be repeated as it doesn't focus on the cause)
not every condition can be treated
expensive
advancement in medical technology
X-rays: improved ability to diagnose conditions, improved treatment options
medicines: developed meds such as antibiotics to treat and reduce symptoms
CT scans: make diagnoses of diseases such as CVD more accurate, improves treatment
drugs such as blood thinning meds can reduce risk of heart attack
stethoscope: invention of this tool allowed health professionals to listen for fluid on lungs so infections can be detected
vaccines: vaccines reduced and eradicated many leading causes of death such as polio, TB, small pox
social model of health/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.
1970s to now
Why was new public health introduced?
there was a concern towards the 1970s as mortality and morbidity of lifestyle disease increased.
five key principles of social model of health (IAREA)
involves intersectoral collaboration: groups (public and private) working together to focus on improving health
acts to enable access to healthcare: ensuring that services are available and affordable, taking into consideration aspects such as culture, gender and ethnicity.
acts to reduce social inequalities: Reduce inequalities (eg: gender, SES, location, physical environment) in relation to health status and health services.
empowers individuals and communities: Provides individuals and the community with the resources they need to address factors that influence their HW, therefore individuals are able to participate in decision making about their HW. empower with knowledge
addresses the broader determinants (or factors) of health: Examining underlying factors that contribute to health and addressing those determinants. Includes social, economic and environmental factors. Broader discriminants include gender, culture, race, SES, location.
examples of social model policies
unprocessed do not have GST tax - making healthier foods affordable, encouraging healthy eating
no hat no play - reduces exposure to UV, prevents skin cancer
banning smoking in public places - reduces risk of passive smoking and exposure to tobacco smoke -> asthma
speed limit laws - prevent road accidents
120 hour learner permit driving
Advantages of the social model of health
promotes good HW and assists in preventing disease
less expensive
focuses on vulnerable population groups
education can be passed on through generations
responsibility for HW is shared
disadvantages of social model of health
Not every condition can be prevented
It does not promote the development of technology and medical knowledge
It does not address the health concerns of individuals
Health promotion messages may be ignored
relationship between biomedical and social
both models work together
CVD: prevented by reducing risk factors (exercising and eating healthy) <- social. medical treatments and advancements help with diagnosis and treatment (bypass surgery, blood thinner meds)
Define health promotion
the process of enabling individuals to increase control over and to improve their health
overview of ottawa charter
It was developed from the social model of health by the WHO to reduce inequalities in health.
This Charter was introduced at a health conference in Ottawa, Canada 1986.
3 strategies for health promotion
Enable, Mediate, Advocate
enable
support people with information, opportunities, resources and skills that they need to make choices that support good health.
mediate
actions by all levels of government, the health sector, non-government organisations, industry and the media to achieve good health.
advocate
Favourable advocacy for health through political, economic, social, cultural, environmental, behavioural and biological factors. Promoting and supporting initiatives that promote health on behalf of the whole community.
priority areas of ottawa charter
bad cats smell dead rats
build health policy
create supportive environments
strengthen community action
develop personal skills
reorient health services
build healthy public policy
Relates to decisions made by government and organisations in relation to healthcare policy, rules and regulations.
Include changes that will help to make healthier choices easier and contribute to healthier, safer, cleaner and more enjoyable services and environments.
create supportive environments
a supportive environment is on that promotes HW by being safe, stimulating, satisfying and enjoyable
Build links between individuals and their environment
Promotes environments that encourage safe, stimulating and enjoyable living and working conditions.
Encourages individuals to support and help each other to make healthy choices
strengthen community action
Focuses on building links between individuals and the community and centres around the community working together to achieve a common goal
gives community sense of ownership
develop personal skills
Individuals need to gain life skills and information through health promotion and education.
Skills and knowledge should be gained and supported at home, school or work and used to make choices that will improve health
Reorient health services - Ottawa charter
Groups to work together to support healthcare professionals in moving beyond biomedical services
Stronger emphasises on health promotion as opposed to focusing only on diagnosing and treating illness.
Healthcare services need to focus on their care on the needs of the whole person
Funding the health care system
financial resources that are provided to keep the healthcare adequately staffed and resourced so they are able to provide a high level of care.
more ppl can receive treatment by reducing the amount they contribute
sustainability in the healthcare system
sustainability: meeting needs of present without compromising ability of future generations to meet their needs.
relates to capacity of health system ti provide a workforce and infrastructure into the future and to be innovative and responsive to emerging needs through interventions such as research and monitoring
Access to health care
an accessible health system is one that can provide all ppl with timely access to quality health services based on needs (not ability to pay and regardless of where they live)
equity in health care system
health system must take into account the differences to make sure it is fair and equitable
differences include: social, economic, geographic, etc
describe medicare
Medicare refers to Australia's universal health insurance scheme,
it provides subsidized health services for all Australians by fed government
established in 1984
medicare safety net
Provides extra financial assistance for those that incur significant out of pocket costs for Medicare services
What is covered by Medicare?
in hospital expenses:
accomodation and treatment for patient in public hospital
if patient chooses to be treated in private hospital or private patient in public hospital, govt will pay 75% of schedule fee
out of hospital expenses:
consultation fees for doctors
test such as x-rays
What is not covered by Medicare?
cosmetic/unnecessary procedures
most costs associated with private hospital care
ambulance services
allied services; physio, psychologists,
most alternative medicines; acupuncture, remedial massage
health related aid; glasses, hearing aids
advantages of medicare
choice of doctor for out fo hospital expenses
reciprocal agreement between countries
for all Australian citizens
covers test and examinations, doctors and specialist fee and some procedures
medicare safety net
disadvantages of medicare
no choice of doctor for in hospital
waiting lists for many treatments
doesn't cover alternative therapies
often doesn't cover full amount
How is Medicare funded?
medicare levy: 2% income tax payable by taxpayers
medicare levy surcharge: high income earners without private health are to pay an extra tax of 1-1.5%
general taxation
how can medicare improve health status/HW ?
medicare provides health services to individuals at a subsidised rate by fed govt, this can affect health status by providing cheap access to health services to those who may not have been able to afford it meaning disease are caught early or prevented increasing life expectancy and decrease morbidity.
how is funding reflected through medicare
Medicare funds part or all of the fees associated with health services, including doctor and specialist consultations, pathology tests and fee-free treatment in public hospitals.
funded through general taxation, medicare levy and surcharge
how is sustainability reflected in medicare
determining which services will be subsidised through medicare, preserve funds for the necessary services. not all services are covered therefore more sustainable
medicare levy increased to assists in providing necessary funds to maintain health system
highly trained staff -> efficient health system
co payment and safety net amounts increased each year
how is access reflected through medicare
provides access to all ppl of all backgrounds
medicare provides funding for phone/vid consultations for those out of major cities
those who require treatment urgently/more urgent get it first hence waiting times
ppl can choose out of doctor hospital therefore make the right choice for them.
how is equity reflected through medicare
ppl who access services more are given additional financial support (safety net)
mental health treatments (therapy sessions) covered by medicare for those who have mental health disorders
advantages and disadvantages of PBS
advantages:
access subsidised medication
concessional co payment
safety net
disadvantages:
not all medication listed
describe the PBS
pharmaceutical benefits scheme
administered by fed govt which subsidises essential medication to people with prescription
covers more than 5000 brands
How can the PBS improve the health status/HW of Australian citizens?
Australians who require essential medications to treat/cure chronic conditions such as asthma can obtain medicines due to reduced cost, prolonging life expectancy
how is funding reflected through PBS
funded by federal govt
essential medications are subsidised through PBS providing treatment fo many conditions
how is sustainability reflected through PBS
review medicines available continually therefore those that are most needed are available. not sustainable to fund all medications
fed govt body verifies effectiveness of medications, improved treatment, less costly treatment in future, less reliance on healthcare
cost of copayment increases each year
PBS is biomedical and social - treat and prevent, reduce need for costly treatment
how is access reflected through PBS
all citizens and permanent residents are entitled to access subsidised medication through PBS
concessional co payments promote access to essential meds for low income earners
available to all AUS regardless of income, culture, location
how is equity reflected through PBS
PBS safety net provides further assistance to those who require essential medications
concessional co payment provides assistance to low income/unemploymed ppl
many indigenous can qualify for reduced PBS co payment amounts under closing the gap iniative.
NDIS
national disability insurance scheme
funded by federal, state, territory governments
provides services and support for people with permanent, significant disabilities and their family/carers
aims to help individuals under 65years with a permanent, significant disability to live an ordinary life
key assistance areas of NDIS (x4)
access to mainstream services and supports (education, healthcare, public housing, aged care)
access to community services and supports (sport clubs, libraries, community groups)
maintain informal support arrangements (unpaid help from family and friends)
receive reasonable and necessary funded supports (financial support and funding for assistive technology)
how can NDIS improve HW/health status ?
The NDIS provides support to people suffering from a permanent or significant disability and assists them in living an 'ordinary life', The NDIS provides assistance to ppl to access to community services, which can improve spiritual HW as they may feel as they belong
how is funding reflected in NDIS
funded by fed and state/territory govts
NDIS provides funding for a range of resources (assistive tech)
how is sustainability reflected through NDIS
each person receives individualised support, therefore only neccessary funds are spent
NDIS aims to provide support which will assist in improving a persons lifetime, making it sustainable as it is lifelong
allows ppl to go workforce -> earn and pay tax
ppl with disability are encouraged to live an 'ordinary' life, ongoing reliance on healthcare is reduced
how is access reflected through NDIS
rolled out in every region of AUS, those in major cities can access it
NDIS improves access to health services and other mainstream services for ppl with disability
how is equity reflected through NDIS
individualised support ensures that those with more significant needs receive more assistance. those that have more sever disabilities receive care and support they need
focus is those who experience disability and enables ppl to access mainstream services such as healthcare so they can receive treatment for common conditions
NDIS promotes equity as it enables eligible people to work -> sense of purpose (spiritual HW)
those who need NDIS dont need to pay more towards funding that those who dont. NDIS is not income tested
NDIS targets ppl with disability and have extra needs such as the need for assistive tech. promote social HW
describe private health insurance
optional for of health insurance in addition to medicare
consumers must may a premium in return for payment towards health related costs not covered by medicare
two main components:
private hospital care
extra's cover (physio, dentists)
advantages of private health insurance
Access to private hospital care
Choice of doctor in private and public hospital
Shorter waiting times for some procedures
Other allied services are covered depending on premium paid
Helps to keep the costs of operating Medicare under control
High income earners with private health insurance do not have to pay the additional tax, called the Medicare levy surcharge
Government rebate for eligible policy holders 'Lifetime Health Cover' incentive
disadvantages of private health insurance
Costly in terms of the premiums that have to be paid
Sometimes have a 'gap', which means the insurance doesn't cover the whole fee and the individual must pay the difference
Qualifying periods apply for some conditions (such as pregnancy)
Policies can be complex to understand and so create confusion for the average person
private health incentives
private health insurance rebate
lifetime health cover
medicare levy surcharge
Private health insurance rebate
income tested rebate(refund) provided to private health holders on premiums paid.
rebate varies from 9% - 27% based on income
INCREASES AFFORDABILITY OF PRIVATE HEALTH INSURANCE
Lifetime health cover
People who take up private insurance after the age of 31 pay an extra 2 per cent on their premiums for every year they are over the age of 30.
ENCOURAGES YOUNGER PPL TO TAKE PHI AND KEEP FOR LIFE
Medicare levy surcharge
an additional 1-1.5 per cent tax on high income earners who do not have private health insurance
ENCOURAGES HIGH INCOME EARNERS TO TAKE OUT PHI
how can private health insurance improve health status/HW ?
those that take out PHI have greater level of cover and choice in their medical treatment. therefore, they may be able to diagnose and treat health conditions earlier, which could result in a higher life expectancy.
This also helps those in the public sector as there is less pressure placed on public health system therefore decreasing wait times for surgery which can decrease mortality and morbidity.
how is funding reflected through PHI
PHI mainly funded through individual
PHI provides most of the funding for private hospitals
fed govt funds the PHI rebate; more affordable
how is sustainability reflected through PHI
PHI takes pressure off medicare making the health system more sustainable
incentive schemes put in place by govt assist in maximising funding for private system . reduces strain on public system
how is access reflected in PHI
PHI provides access to other services not covered by medicare
PHI reduces waiting times for elective surgery, therefore those in public system can access it quicker
incentive schemes make PHI more affordable therefore more ppl can access it
how is equity reflected through PHI
low income earners receive more rebate
those aged 65+ receive greater rebate and lifetime cover is waived if they have PHI
medicare levy surcharge is only applicable for high income earners
Why is smoking targeted?
it is a preventable risk factor
a leading cause of preventable, premature death
smokings costs a significant amount in australia
affects vulnerable population groups
exposure to environmental tobacco smoke causes disease and premature death to those who dont smoke
who is at risk of smoking?
disadvantaged populations
smoking related laws
Smoking was banned at areas commonly used by children and young people for recreational sporting activities.
It is an offence to smoke in a vehicle where there is a person under the age of 18 present. Ban applies regardless of car moving, windows open, etc. (since Jan 2010)
Ban on smoking in government school grounds became effective (July 2009)
Smoking was banned in covered areas of train station platforms, tram stops, bus stops. (2006)
bans complement those implemented in December 2012, which prohibit smoking at all Victorian patrolled beaches.v
how does the quit campaign address smoking
anti smoking health promotion campaign
joint venture between vic govt, Vichealth, health foundation, cancer council
PROGRAM INITIATIVES:
Mass media campaigns
community support
quitline - phone/online counselling
quit coach
quitbuddy app
i can quit calculator
quit txt
online resources
QUIT- build healthy public policy
provide research and advice to government to implement policies and laws relating to banning smoking in public places, tobacco tax, tobacco packaging, tobacco advertising
they do not implement laws
QUIT create supportive environments
quitline is staffed with highly trained professionals to provide support
aboriginal quitline creates a culturally safe and supportive environment by using aboriginal specialists with additional training in cultural sensitivity
quit program provides personalised counselling services
online support through the website
QUIT- strengthen community action
quit program developing specific campaigns working with specific population groups; aboriginal Quitline enhancement project
a joint venture between organisations
QUIT - develop personal skills
health warnings on cigarette packages and mass advertising fact sheets on the quit website
tips on the website
QUIT - Reorient health services
government and non government investment in anti smoking policies to prevent smoking → health services are working towards ways to prevent people from engaging in smoking behaviours
quit provides a free training program for health professionals which provide health professionals with knowledge and skills relating to assisting smokers to quit.
effectiveness of QUIT (HW and health status)
QUIT is helping to improve the health promotion of populations health as it helps individuals to stop smoking, not only reducing there risk of Lung Cancer and other forms of cancer, but reduces the rate of Second Hand smoke in the air, reducing the risk of others suffering from Asthma. In this, The physical dimension of health and wellbeing is achieved as individuals are able to have a healthier functioning respiratory system, reducing the rate of morbidity and Mortality in Populations.
effectiveness of quit in relation to HW (3 marks)
the quit campaign has been effective in promoting HW in australia specifically physical HW with. a reduction of smoking related disease. This is due to quit leading to a reduction in the percent fo the population that smoke over the last decade, causing a reduction in the total burden of disease caused by smoking related diseases and conditions.
effectiveness of QUIT (action areas)
there have been many improvements since quit was established. The Quit campaign produces factsheets which can be found on their website as well as creating graphic images to educate individuals about the impacts of smoking which enable individuals to develop personal skills. Additionally, the quit campaign creates supportive environments as it has a support phone line which allows individuals to communicate with professionals to assist with their quitting journey. Furthermore, the Quit campaign also has an aboriginal quit line which can make it more appropriate and make it more accessible for vulnerable population groups such as the indigenous community. In addition, Quit provides government bodies with advice to build public policies which is an example of building healthy public policy. Overall, Quit includes all aspects of the Ottawa Charter and has proved to be extremely effective as it provides education, it is culturally appropriate and there it has been successful in helping many help quitting.
name of indigenous initiative
fitzroy stars football club
describe initiative
A football club, based in Melbourne, which aims to promote a healthy lifestyle
Aims to provide opportunities and open pathways to employment and education
Aims to form strong connections between indigenous and nin indigenous communities.
how does the FSFC improve HW of indigenous ppl
physical HW: encourages and builds healthy habits such as fitness, nutrition -> maintain healthy body weight
social HW: enables people to spend time together developing meaningful relationships. aims to foster reconcilliation and can improve social HW
FSFC and action areas
strengthen community action:
vichealth, oxfam and aboriginal advancement league worked together to reactivate the program
families and community memebrs work together which keeps club running
create supportive environments:
creates supportive social and physical environment as it provides a saafe place to participate in sport and socialise. bot build links between individual and environment and encourage healthy behaviours.
develop personal skills:
educates ppl with skills that relate to nutrition and employment. enables ppl to be more health literate. employment skills enable individuals to gain a job and earn an income
reorient health services:
use health professionals to present sessions on a weekly basis on importance of preventative healthcare such as quitting smoking and receiving regular health checks
evaluate the indigenous initiative criteria x7
is the program culturally approapriate?
feedback
have improvements already occurred
are ppl and communities being empowered
education is provided
a specific need of the group is being targeted
is the program receiving adequate funding
FSFC - is program culturally approapriate
based in aboriginal community
many indigenous ppl are able to volunteer
inclusiv eof culture
health professionals arent indigenous, having indigenous staff may make it more culturally approapriate.
is effective but could be improved
FSFC - education is provided
forms of education is the program include skills learnt to maintain nutrition and skills needed to seek employment
professionals present weekly sessions which relate to preventative healthcare and its importance ^^ info helps many improve their health
some info that is provided may be ignored or individuals may not pay attention to it
overall is effective, but info could be portrayed multiple ways to improve
aboriginal road to good health
type 2 diabetes six week prevention program
work with indigenous communities and aims to promote healthy lifestyles including how to prevent type 2 diseases
program is free
run by indigenous health workers
educates participants on:
how different foods affect HW
what food is food, cheap and easy to make
how to spend money wisely
how to maintain a healthy weight
what to look for on a food label
how to choose healthy foods
how to prevent disease
how does the aboriginal road to good health improve HW
physical HW: • Educating Indigenous people about what foods have a negative impact on your health, making them less likely to consume these foods and more likely to consume nutritious foods. As a result their body is more likely to function optimally and free of disease, which can positively impact physical health and wellbeing.
social HW: as the program is free, ppl are able to bring other ppl which can enhance their bonding and help to maintain a meaningful relationship which improves social HW.
Note
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