HHD UNIT 3: AOS 2

• Public health relates to government funded actions directed towards improving health and wellbeing and health status

• Old public health includes government actions from 1900 to around 1950-60

• During this period of time there was a focus on reducing infectious disease and injuries, mainly through actions that altered the physical environment and focused on individual behaviours
  

Examples of actions related to old public health:

• Quarantine laws

• Mass immunisation programs

• Provision of safe water and sanitation

• Improved food and nutrition

• Improved housing conditions

• Improved working conditions

Biomedical approach:

• An approach focused on the use of health professionals and medical technology to diagnose, treat and cure health conditions

• For instance: x-rays and medications

• Focused on intervention once health condition is present

Examples of biomedical approach:

• X-rays

• Medication such as antibiotics and chemotherapy

• Surgery

• Blood tests

• MRI

Strengths:

• It can help extend the life expectancy of people and a population

• It can help to improve the quality of life for people if their illness can be treated and cured

• Can lead to advances in medical technology as people seek to come up with new ways to diagnose and treat conditions

Limitations:

• It can be an expensive approach as it relies on medical technology and health professionals

• Not all conditions can be treated

• Doesn’t necessarily promote healthy behaviours and lifestyles

Social model:

• A model of health focused on preventing health conditions by directing efforts towards addressing physical, sociocultural and political environments

• For instance, health promotions, campaigns and road safety laws

• Focused on prevention of health conditions

Examples of social model:

• Policies and laws:

  • Seatbelt laws

  • Smoking restrictions

  • Sun-safe policies

• Education such as government:

  • Government health promotion campaigns on TV/social media for risks such as smoking/drugs

  • Websites that provide free health-promoting information such as healthy recipes

  • Free workplace seminars on how employees can reduce risk of harm

• Health promotion programs:

  • SunSmart

  • Driver Reviver

Strengths of social model (know around 3):

• Focused on promoting healthy behaviours that can promote good health and wellbeing and prevent diseases and illness

• Not costly

• Heath education can be passed down for future generations

• Promotes overall health and wellbeing

• Focuses on vulnerable population groups

Limitations of social model (know around 3):

• Not all health conditions can be prevented such as genetic conditions so the approach can’t always improve health outcomes

• Doesn’t focus on diagnosing, treating or curing health conditions

• Health education is often ignored or not acted upon by people

Ottawa Charter:

• Developed in 1986

• Aims to assist government and non-government organisations in implementing the social model of health

• Health promotion is defined as:

  • Enabling people to take control over and improve their health

Bad Cats Smell Dead Rats:

• Build healthy public policy

• Create supportive environments

• Strengthen community actions

• Develop personal skills

• Reorient health services

Name strategy, explain strategy, provide examples, pick strategy out of case studies

Building healthy public policies:

• Laws and policies:

  • Can be made by government and non-government organisations that promote health

Create supportive environments:

• Sociocultural and physical environments should be manipulated so that healthier choices are easily made

• Examples: reducing price of healthy foods or installing bicycle paths

Strengthen community actions:

• Maximum benefits to health are achieved when all groups work together to achieve a common goal

• Government and non-government and private sector should work together to promote health

• Example: road safety

Develop personal skills:

• This area is concerned with education

• When people have the skills to improve their health and wellbeing they are more likely to do so

• Example: teaching people how to select and prepare healthy foods

Reorient health services:

• The health system must change focus to health promotion instead of just focusing on treating disease

• For instance, health professionals, members of the public, government and non-government groups and private sectors

• Example: doctors prescribing exercise before a person has a health attack

Health care systems:

• All the activities whose primary purpose is to promote, restore and/or maintain health

Australia’s health system:

• Public sector:

  • Medicare

  • PBS

  • NDIS

• Private sector:

  • Private health insurance

Medicare:

• Australia’s universal insurance scheme that provides access to health care that is subsidised by the government

• Not free

• Gives all Australians, permanent residents and people from countries with a reciprocal agreement

Medicare covers:

• Consultation fees for doctors/specialists

• Tests and examinations, x-rays, pathology tests, eye tests

• Most surgical and other therapeutic procedures

• Some dental services for children 2-17

Medicare does not cover:

• Treatments in private hospitals

• General dental treatments

• Ambulance services

• Medications

• Health aids such as glasses and hearing aids

• Also to provide adequate care

Medicare Charges:

• Schedule fee:

  • The amount that Medicare contributes towards certain treatments

• Patient co-payment:

  • Payment made by the patient for the service if it is more than the schedule fee

• Bulk billing:

  • When the schedule fee is the same as what is charged so the government pays for the whole thing and therefore you pay nothing

Medicare Levy:

• Additional 2 percent tax placed on taxable income

Medicare Levy Surcharge:

• People with private health insurance earning more than $90,000 for individuals and $180,000 for families must pay an extra tax

• General taxation

Medicare advantages:

• Available to all Australian citizens

• Provides extra financial contributions for medical services

• Covers tests and examinations, doctor’s and specialist fees

  • Reciprocal agreement between Australia and other countries

Pharmaceutical Benefits Scheme (PBS):

• Provides essential medicines to people who need them, regardless of their ability to pay

• The federal government funds the PBS and decides which medications will be included under the scheme

National Disability Insurance Scheme (NDIS):

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

National Disability Insurance Agency (NDIA):

• Independent agency responsible for implementing the NDIS

NDIS Eligibility:

• Person must be under 65 and meet residency and disability requirements

• Residency requirements:

  • Be and Australian citizen or hold permanent visa

  • Live in Australia where NDIS is available

• Disability requirements:

  • You have an impairment or condition that is likely to be permanent

  • Your impairment substantially reduces your ability to participate effectively in activities or perform tasks or actions unless you have:

    • Assistance from other people

    • You have assistive technology or equipment

    • You can’t participate effectively even with assistance or aides and equipment

  • Your impairment affects your capacity for social and economic participation

  • You are likely to require support under the NDIS for your lifetime

NDIS Focus:

• Develop individualized plans based on goals and aspirations such as:

  • Greater independence

  • Community involvement

  • Employment

  • Improved health outcomes

Private Health Insurance:

• Type of insurance under which members pay a premium fee in return for payment towards health-related costs not covered by medicare.

• Additional insurance purchased on top of medicare

Private health insurance covers:

• Private hospital cover

• General treatment cover (dental, physiotherapy, etc.)

• Combined cover (both hospital and general treatment)

PHI Incentives:

• Private Health Insurance rebate:

  • Based on income

  • Some people with PHI are eligible for a rebate/refund from federal government ranging from 9-27%

• Lifetime Health Cover:

  • Those who take out insurance after the age of 31 pay an extra 2% on their premium for every year they are over the age of 30

• Medicare levy surcharge:

  • High income earners who do not have private health insurance pay a higher premium

  • Those with higher incomes pay a higher surcharge

Advantage of PHI:

• Access to private hospital care

• Choice of doctor

• Shorter waiting times for medical procedures

Disadvantages of PHI:

• Costly in terms of premiums that have to be paid

• Policies can be hard to understand and can confuse people

• May have a gap which means the insurance doesn’t cover the whole fee and the individual needs to pay the difference

SAFE of Australian Health System:

• Sustainability:

  • Relates to its capacity to provide a workforce and infrastructure such as facilities and equipment and to be innovative and responsive to emerging needs through interventions such as research and monitoring

  • Sustainable health systems:

    • Ensuring efficient health workforce and systems

    • Promoting disease prevention and early intervention

    • Research and monitoring

    • Ensuring adequate funding and regulation of the health systems

• Access:

  • Providing people with access to quality health services based on their needs

• Funding:

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

• Equity:

  • All Australians should be able to access healthcare when required

  • Equal access

  • Doesn’t necessarily mean the system is equitable

  • Disadvantaged groups should be able to access

  • Interventions to promote equity:

    • Medicare safety net

    • PBS safety net

    • Public dental health service

    • NDIS

Nutrition

Australian Dietary Guidelines:

• Intended to be used by health professionals, educators, industry bodies and other groups interested in promoting healthy eating

• They are aimed at all people

• Developed to provide advice relating to the types and amounts of foods, food groups and dietary patterns that will help Australians to:

  • develop healthy dietary patterns that will promote health and wellbeing in the community

  • reduce risk of developing diet-related conditions such as hypertension and impaired glucose

  • reduce risk of developing chronic disease

Guideline 1:

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

  • Children should eat sufficient nutritious foods to grow and develop normally

  • Older people should eat nutritious foods and keep physically active to help maintain muscle strength and a healthy weight

Guideline 2:

• Enjoy a variety of nutritious foods from 5 food groups every day:

  • Vegetables

  • Fruit

  • Grain

  • Lean meats/poultry

  • Milk, yoghurt, cheese

  • Lots of water

Guideline 3:

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

Guideline 4:

• Encourage, support and promote breastfeeding

Guideline 5:

• Care for your food, prepare and store it safely

Australian Guide to Healthy Eating:

• Intended to be used by consumers to assist them in planning, selecting and consuming adequate proportions of foods from the five food groups

• It is a visual tool that reflects dietary advice and detailed in Guidelines 2 and 3

5 Food groups:

• Grain foods: have carbohydrates

• Vegetables and legumes: consist of fibre and antioxidants

• Meats: consists of iron and protein

• Fruit: consists of many vitamins

• Dairy: consists of calcium

Aboriginal and Torres Strait Islander healthy Guide Eating:

• Shows the 5 food groups and their proportions

• Promotes water consumption

• Suggests to limit discretionary foods

• Recommends to include small amounts of healthier fats

• Main difference:

  • Includes reference to traditional foods such as kangaroo, goanna, crab meat, bush fruits/vegetables, damper

Guideline Strength:

• Translated into more than 10 languages

• Applies to all ages

• Provides visual presentation

• Based on latest scientific research

• A range of foods from different cultures

Guideline Limitations:

• Does not show serving sizes so people might overeat

• Guides do not make provisions for composite foods such as pizza

Challenges in bringing about dietary changes:

• Food intake in Australia has changed from nutrient dense whole foods to energy dense processed foods

• Personal factors:

  • Willpower to taste preferences

  • Attitudes and beliefs

  • Health and wellbeing factors

• Sociocultural factors:

  • Socioeconomic status

  • Employment status

  • Family and peer group

  • Commercial factors:

    • Supply chain

    • Distribution and affordability

    • Processing

    • Packaging

    • Lobbying

• Environmental factors:

  • Geographic location

  • Workplaces

  • Housing environment

  • Transport