Health Priorities in Australia
How are priority issues for Australia’s health identified?
Measuring health status is done through: role of epidemiology, measures of epidemiology (mortality, infant mortality, morbidity, life expectancy).
Overview:
Allows for the identification of priority health issues, monitor progress and re-evaluate health promotions.
Measurements of health status uses epidemiology to provide a picture of many aspects of Australia’s health and to help health authorities determine future actions required.
Australia is one of the world's healthiest countries but has many lifestyle diseases and other illnesses that need to be addressed.
Epidemiology plays a vital role in determining the priority areas for Australia’s health and provides info.
Role of Epidemiology
Definition: the study of the patterns and causes of health and disease in populations and the applications of this study to improve health.
Involves gathering data from hospitals, GPs, healthcare practitioners, surveys, and census information.
Data is gathered and analysed to provide a picture of Australia's health status.
Helps shape policy decisions and evidence-based practice by identifying risk factors for disease and targeting preventative healthcare.
What can epidemiology tell us?
The basic health status in terms of quantifiable measures of ill health (objective measure).
Uses data on death rates, birth rates, illnesses, injuries, treatment provided, workdays lost, hospital usage, and money spent by both the consumer and government.
Example: Used to provide trends in diseases (COVID-19) incidence and prevalence, along with information about ethnic, socioeconomic, and gender groups.
Incidence
The number of new cases diagnosed in a specific time period.
Example: If the number of new cases in a 6-month period is less than it has been over the previous 6 months, the trend will be downward, showing a decreasing trend in the disease.
Prevalence
The number or proportion (of cases, instances) in a population at a given time.
Example: Cardiovascular disease has been a priority health issue for a long time in Australia and will continue to be long into our future.
Who uses these measures?
Researchers, health department officials, the government, and health or medical practitioners use epidemiology.
They use these to evaluate the most effective strategies for treatment and prevention.
Does epidemiology measure everything about health status?
It does not measure everything about the health status of Australia.
It can be manipulated by the interpreters and is very open to bias (subjective).
Tends to focus on the negative measurable aspects of health and not on positive, less measurable aspects such as wellbeing and quality of life.
It does not account for the determinants of health (individual, sociocultural, socioeconomic, and environmental factors).
Example:
Can be difficult to obtain in emergency situations.
Can be difficult with regional health workers, as they often lack the resources to conduct adequate data collection, and lack of access may also present difficulties in communicating these data in a timely manner.
Epidemiology is constrained as well by the rapid changes in health status of at-risk populations.
Measures of Epidemiology
Definition: the study of how often diseases or illnesses occur in different groups of people and why.
Infant Mortality Rate
Definition: number of deaths among children under 1 year old.
Often expressed as a unit of per 1000 live births in the same period.
Example: In Australia, the infant death rate decreased from a peak of 5.7 deaths per 1,000 babies in 1999 to 2.8 deaths per 1,000 live births in 2022.
Morbidity Rate
Definition: pattern of illness, disease, or injury that does not result in death.
Ill health in an individual to levels of ill health ina population group (ATSI).
Almost 1.2 million (4.6%) / 1 in 20 people were living with diabetes in Australia in 2022.
Mortality Rate
Definition: refers to the number of deaths per year per 100,000.
Example: The leading cause of death among males is coronary heart disease in 2022 (11,303 deaths).
Life Expectancy
Definition: An indication of how long a person is expected to live.
Life expectancy has greatly increased over the past century.
We are expected to live 33 years longer than those born in 1890.
Example:
The average current life expectancy for non-indigenous Australians (2022) is 82.9 years old. For males, it is 81.2 years, and for females, it is 85.3 years. While for the ATSI population born in 2020-2022, males are expected to live to the age of 71.9 and females to the age of 75.6 years old.
Causing the difference between first nations people and non-indigenous Australia’s to be approx. 8 years; this is a result of social determinants (socioeconomic status) as well as environmental factors (as a generalization, the majority of First Nations people will live regionally, causing health care to be less accessible.
Use tables and graphs for health reports.
Leading Causes of Death
Identifying Priority Health Issues
Social justice system, priority population groups, prevalence of condition, potential for prevention and early intervention, and costs to the individual and community.
Social Justice System
Definition: Measures that aim to decrease or eliminate inequity, promoting inclusiveness of diversity and establishing environments that are supportive of all people.
Purpose: Recognize and address both health outcomes, such as incidence and prevalence of disease and death rates, as well as factors like SES, environment, and cultural factors.
Equity
Resources are allocated in accordance with the needs of individuals and populations with the desired goals of equality of outcomes. Results in particular groups within Australia receiving more funding and being identified as priority groups in Australia because of poorer health outcomes.
Example: indigenous scholarships, bursaries, special entry pathways in to uni, bulk-billed health care due to majority living rurally, having a lower life expectancy, alcohol abuse and mental health.
Diversity
The differences that exist between individuals and people groups.
Ensures that each group has access to health care and achieves good health outcomes.
Example: Providing brochures in multiple languages and having interpreters in hospitals.
Supportive Environment
Where people live, work, and play that protect people from threats and increase their ability to make health-promoting choices.
Example: Local government promotes health/wellbeing for all by designing/funding/maintaining playgrounds designed for children with all abilities (wheelchair-accessible swings), shared bike paths, and free-to-use outdoor fitness equipment.
Priority Population Groups
There are priority population groups that achieve significantly poorer health outcomes compared to the rest of Australia.
These can be cultural: ATSI people within Australia.
Environmental: rural and remote living causing people to have limited access to health care facilities and services.
Can also be age-based (elderly).
Economically: those with low SES (as they will not be reaching out for services due to cost – dental, physio).
How is epidemiology used?
Provide statistics on these population groups and allow the government, organizations, and researchers to identify priority groups that need extra resources to reduce the gap in good health outcomes.
Further advances our knowledge of sociocultural, socioeconomic, and environmental determinants of health.
Priority groups become the focus of health initiatives (receiving more funding and health programs being developed to meet the needs of the groups).
Example:
Males have higher rates of cancer than females.
People in remote areas have higher death rates than urban dwellers (due to them having higher risk jobs – famers).
Lower oral health is found in people of lower SES ($, public health care = long waits).
Environmental: the royal flying doctor service that functions in remote areas to provide better access to emergency medical care and primary health services.
Prevalence of Condition
Definition: prevalence – the number or proportion (of cases, instances, and so forth) in a population at a given time (with cancer, the prevalence refers to the number of people alive who have been diagnosed).
Used to determine the number of people affected by the health issue.
Higher prevalence = greater health issue (may cause it to be identified as a priority health issue in Australia).
It is important to measure population health, understand the demands on health services, and plan appropriately to inform health policy.
Current conditions with higher prevalence
Cardiovascular disease (has been a priority health issue for a long time in Australia and will continue to be long into our future.).
6.7% of adults (1.3 million) had one or more conditions related to heart, stroke, or vascular disease in 2022.
57,300 acute coronary events (heart attack or unstable angina) among people in 2021 – around 157 every day.
Coronary heart disease was the leading cause of disease burden for males in 2024 and seventh for females.
CVD was the underlying cause of 45,000 deaths (24% of all deaths) in 2022.
Cancer.
Dementia and Alzheimer’s disease.
Diabetes.
Cerebrovascular disease.
Incidence
Definition: the number of new cases diagnosed in a specific time period.
Helpful to understand the current trends in disease.
A decrease in new cases over a six-month period compared to the previous six months suggests a declining trend.
Example: As of March 31, 2025, Australia has reported 46,734 new COVID-19 cases for the year.
Potential for Prevention and Early Intervention
Potential prevent and early intervention will make treatment more successful.
In Australia, the more potential for prevention and early intervention, the more likely the health issue will be made a priority. Prevention:
The easier it is to prevent disease, the more likely it is that health promotion will impact the burden of disease and reduce its incidence. Lifestyle diseases are easily preventable as they are caused by inactivity and poor dietary choices (mostly – genetics can also be a factor).
Example: type II diabetes, hypertension, cardiovascular disease, and obesity.Preventative action has been taken to reduce smoking, like increasing the prices of cigarettes (pack of 20 in 2000 = 16 to pack of 20 in 2025 costing 35) to reduce diseases linked to smoking, such as chronic obstructive pulmonary disease (COPD), cerebrovascular disease (stroke), and lung cancer.
Early Intervention
Occurs if prevention couldn’t occur.
Higher rates of survival for those diagnosed and treated early for the condition.
Example: Stop smoking, early screening for at-risk individuals, reducing exposure to pollutants, vaccinations, improved diet, and physical activity.
Individuals genetically predisposed to a disease, e.g., breast cancer, should have biannual mammograms and regular self-checks.
Cost to the Individual and Community
When identifying health issues, the costs to the individual and community of the health issue must be considered.
Costs to the individual and community come in various forms, such as expenses, time, and connection with other issues, such as mental health.
Cost to the individual
Physical -> pain, discomfort, and immobilization.
Social -> loss of social contact, increased dependence on others, loss of confidence.
Emotional -> stress, depression, mental anguish.
Direct cost -> expensive treatments.
Indirect cost -> loss of potential earnings as they cannot work.
Cost to the community
Direct -> diagnostic testing, specialist care, education, health promotion to reduce incidence, funding to hospitals for treatment.
Indirect -> loss of productivity for companies, carers having to take time off work, company loses money as they pay for sick leave.
The community will pay through Medicare taxes (in 2022-23, health spending has returned to pre-pandemic trends. An estimated 252.5 billion was spent on health goods and services in Australia, which equates to $$9,597 per person and comprised 9.9% of overall economic activity.
CVD. (coronary heart disease) are a high-cost disease due to the need for large surgical procedures, lengthy recovery periods, keeping them out of work, loss of independence, and income, linked to lower self-esteem levels due to their loss of independence.
What are the priority issues for improving Australia’s health?
Groups experiencing health inequities: ATSI and people in rural and remote areas
ATSI
Overview
All interrelated
For first nation people, cultural identity, family, participation in cultural activities and access to traditional lands can also influence overall health and wellbeing.
Colonisation and the forcible removal of first nations children from their families and communities have had a fundamental impact on the disadvantages and poor physical and mental health of indigenous people worldwide.
Nature and extent of health inequalities
Largest gap in health outcomes in Aus
Life expectancy is 8 years lower than other Australians
Overall experience socioeconomical disadvantages and inequalities(however in recent years there numbers have been improving – 2022)
Cancer is the most common group of disease-causing deaths among ATSI people, overtook CVD in recent years.
Impact of disease and injuries can be understood is assessing the burden of disease by looking at years of health life lost due to living with ill health (non-fatal burden) and years of life lost due to dying prematurely (fatal burden).
ATSI people have higher death rates in each age group than non-indigenous Australians, though this is improving, and the gap is decreasing slowly.
Examples:
First nation males born in 2020-2022 could expect to live 71.9 years, and females 75.6 years compared to first nation people born in 2010-2012 where males could expect to live 69.1 years and females 73.7 at this time that was 10.6 and 9.5 years less than non- first nations Australians
Leading disease groups contributing to the total burden included mental and substance use disorders (depression, alcohol abuse, drug abuse, smoking) which caused 23% of total burden this can be linked to a lower SE status, less support, less access to tech and geographical isolation in rural and remote areas, injuries contributes to 12% of the total burden due to higher rates of motor vehicle accidents as a result of windy and poorly maintained rural roads, domestic violence and work such as farming related incidents. Cancers contribute 9.9% of the total burden as a result of smoking (lung.
cancer) due to lower sociocultural status and less education and melanomas (skin cancer) due to less education and working situations (farmer)for ATSI people living in rural and remote areas. Musculoskeletal conditions make up the final 8.0% of the total burden.
ATSI death rate at 35-44 years old is 4 times non ATSI people and the child death rate is twice that of non ATSI people though this is gape is slowly decreasing.
Overall ATSI people have an extensive gap in health outcomes compared with other Australians. This includes them having 7 times more kidney disease, 3 times more diabetes, 1.5 times more obesity and cancer rates as well as a youth suicide rate that’s 6 times more for females and 4 times more for males
Sociocultural Determinates: family, peers, religion, culture and media
Epidemiological data reveals ATSI families are less educated and have less income, which contributes to the family’s upbringing.
Higher rates of domestic violence, (child abuse and neglect is one of the most influential risk factors contributing to total burden in those between 5 and 44 years of age
More likely to be imprisoned
Brought up in communities and are greatly influenced by culture
Poorer access to health services due to language barriers existing in some instances and poor examples being set by adults.
Another major barrier is the disempowerment felt by ATSI people as a result of many years of oppression and discrimination
This oppression and discrimination include the invasion of the first fleet, the stolen generation and general caricature of ATSI people today.
Ongoing discrimination creates barriers to better outcomes and diminishes physical and mental health
Example:
Almost half ATSI families with dependent children are one parent families
42.2% of children in out of home care were ATSI children in 2021
Propitiation of ATSI people aged 15 and over who smoke every day has fallen substantially over the past decade. It has gone from 45% in 2008 to 37% as of most recently
Due to lack of understanding of nutrition ATSI people can have poorer diets as a result of a lack of important nutrients and high consumption of high processed food can contribute to obesity rates (rates are increasing in ATSI population as in 2019 71% were overweight or obesity compared to 66% in 2013) this can also contribute to an increase in other disease (CVD) in the ASTI population. Diet will be effected by the food that are affordable (SE) and readily available (envir). Such as fresh fruit and veg being difficult to access for ASTI people with low incomes and living in rural areas (with 1 in 7 ATSI people living in rural or remote areas)
Socioeconomic (SE) Determinates: education, employment and income
Education qualification can influence health status and health outcomes
Higher levels of education can directly impact a person’s health through a greater understanding and application of health information
Higher education leads to better prospects for employment and income which can aid access to good quality housing, healthy food and health care services
An adequate income is fundamental in living a health life as it provides greater access to nutritious foods, better housing, health and other services (physio, dental).
Example:
Nationally in 2021, 58.0% of ATSI people aged 15-24 were fully engaged in employment, education, or training. As the employment rate of first nation people has increased around 5% between 2016 and 2021. However, there is still a gap with non-indigenous Australians who have 78% in employed, education or training
Between 2011 and 2021, the proportion of first nation people aged 20-24 who had attained at least year 12 or equivalent qualification increase from 52% to 68%
ATSI households are nearly 2.5 time as likely to be in the lowest income bracket and are 4 times less likely to be in the top income bracket compared to non-indigenous households
Nearly half of all indigenous children live in jobless families, which makes up 3 times the proportion of all children
More than 1 in 3 (35%) first nation adults lived in households with equivalised gross household income in the bottom 20% of income nationally
Unemployment and poorer levels of education often leads to lower health literacy and, subsequently, poor/risky behaviour choices (unhealthy diet, illicit drug use, alcohol abuse) causing higher prevalence of risk taking and disease (injuries, diabetes, CVD, cancer). This can be attributed to an insufficient health awareness and a lower standard of education, both of which have led to a poorer understanding of the correlation between these behaviours and poor health
Household income, level of education, and employment status has very large impacts on health outcomes and contributes to the health gap between indigenous and non- indigenous.
Environmental Determinates: geographical location, access to health services and access to technology
Access to tech is poorer than other Australians, this contributes to the gap in health outcomes
ATSI people reported having difficulty accessing health services (dentists, physio, GP) due to long waits with public health care or the services being unavailable or not readily available
Significant interaction and overlap between social determinates and health risk factors
Example:
Higher rates of renting compared to owning a house
Higher rates of homelessness
More likely to live remote or rurally because of their culture
Around 1 in 5 ATSI people are living a house that is “rundown” or overcrowded
ATSI people living in rural or remote areas have a harder time accessing health care like the dentist and the physio as they have to physically go to the appointment, and this can.
be difficult due their geographical location or their job not allowing them time off or them not being able to get time off for another reason.
Around 1/3 of the health gap is due to social determinates (employment and hours worked, highest non-school qualification, level of schooling completed, housing adequacy and household income) Just under 1/5 of the gap is due to health risk factors (risky alcohol consumption, high blood pressure, overweight and obesity status, inadequate fruit and vegetable consumption, physical inactivity and smoking
In 2018-2019, the proportion of indigenous Australian adults who didn’t smoke differed by employment status and education attainment with those who finished year 12 having 71% not smoking while those who only reached year ten had 49% smoking. As well as 66% of those employed didn’t smoke while 48% of those who did smoke where unemployed.
The roles of individuals, communities and governments in addressing the health inequalities
Individuals, communities along with federal and state governments all have a role to play in improving access to health care and the quality of life for all ATSI groups
Are all interrelated
Individuals
Every ATSI individual needs to be and feel empowered (through knowledge and elders) to take responsibility for their health and make informed decisions that will improve their quality of life
Reduce risk behaviours including smoking, substance abuse
Increasing protective behaviours including healthy diets and adequate physical activity
Needs to be a motivation to increase education and awareness of good health practices in indigenous communities
Examples
Long term objects include increasing the quality of education, offering community support, recruiting elders to role model healthy behaviours and providing greater access to health services and facilities so that individuals have the opportunities and benefits afforded to other groups living in Aus.
Communities
To ensure that indigenous Australians are aware and involved in the design and implementation of cultural and reconciliation programs offered locally
They are more likely to use and support programs that they have an influence over.
Example:
Many community groups such as Aboriginal medical services are design and implemented by indigenous Australians and thus are more likely to be utilised by the ATSI communities.
Government
Is responsible for funding and overseeing the protection and implantation of indigenous health care on a national scale.
Responsible for creating health promotion initiatives
Aims to improve the way health care system prevents, treats and manages the chronic disease that affect many ATSI people (cancer)
The goal is to reduce key factors for chronic disease in the indigenous community ( such as smoking)
Improving chronic disease management and follow up
Example close the Gap
initiative is a statement of intent signed by the Aus government (state, territory and commonwealth.
Aims to achieve equality in health status by reducing infant mortality and increase life expectancy in ATSI people.
Also include closing the gap in education, and employment outcomes. Improve accessibility of health care to ATSI people living in rural and remote areas Include addressing the risk-taking behaviours of individuals include housing strategy to improve their environment determinate of health
People in Rural and Remote Areas
Nature and extent of the health inequities:
28% of Aus population live in rural and remote (R&R) areas (approx. 7 million people).
32% of people living in rural and remote areas are ATSI people
People living in rural and remote areas face unique challenges due to their geographical isolation and poorer health outcomes compared to people living in metropolitan area.
People living in R&R areas have higher rates of hospitalisation/deaths/Injuries ( because of more physically taxing jobs with higher chance of injury – farming), poorer access/use of primary health services due to their geographical isolation compared to those living in major cities
Inequities:
Higher rates of diabetes and related deaths
Higher rates of transport accidents (due to less developed roads and wildlife)
Higher rates of suicide (less access to therapist and stigmas created around mental health)
Higher death rates of liver cirrhosis (poor diet and higher rates of smoking and drinking (cultural – normalised by adults’ family being the biggest SC influence)because of a lack of education on the importance of a quality diet and the detrimental impact of smoking and excessive drinking)
Higher death rates for perinatal and congenital conditions. (babies with birth related issues can be a result of the mother drinking or smoking while pregnant due to a lack of education on the dangers)
Higher burden of stroke poorer oral health (less access to dentist as they have to physically go and that can effect employment because they will have to travel, and it will cost money to not only get there but then the services as well)Example:
In 2018, remote and very remote areas fatal burden rate (number of years lost to pre was 1.8 times that of people in major cities
In 2019-20 people rates of potentially preventable hospitalisations were 2.6 times higher for people in very remote areas and 1.8 time as high for those in remote areas
In 2020, rates of potentially avoidable deaths was 3.0 times as higher for females and 2.1 times as high in males that lived in very remote areas
In 2020-21, Medicare claims show numbers of non-hospital non-referred attendance person (GP visits) were lower in remote and very remote areas (4.7 and 3.4 per person), than outer regional areas (6.1 per person), inner regional areas and major cities (6.8 per person for each area)
Over 70% of adults living in R&R areas are overweight compared to 65.1% in major cities
Daily smoking rate in R&R areas are twice that of major cities
37.7% of people in R&R areas engage in risky single-occasion drinking compared to 24.4% in major cities
The rate of life time risky drinking is remote areas is 1.6 times that of major cities
Coronary heart disease is the leading cause of disease in all remote areas it is twice that for major cities
Suicide and self-inflicted injuries in R&R areas is 2.2 times of major cities
Chronic kidney disease results in 3.7 times the disease burden in R&R areas compared to major cities
Sociocultural Determinates:
Proportion of ATSI people is higher than in other areas and contributes to the poorer health outcomes for people living in rural and remote areas Poor indicators of health are also influenced by children being brought up in rural and remote areas where there are higher smoking rates, this causes higher rates of second- hand smoking and increase the likelihood of them becoming smokers Children with overweight or obese, participate in lower rates of activity and high-risk drinking parents are more likely to mimic the behaviour (parents are the most influential Due to the culture of people living in rural and remote areas they develop an attitude of avoiding complemental as well as adopting a “she’ll be right” mentality that can impact decision making causing many to fail to seek medical assistance when they become sick.
Examples:
Daily smoking rates increase with remoteness with 7% in major cities compared to 20.4% in remote and very remote areas
People living in rural areas are 24 times more likely to be hospitalised due to domestic violence than those in major cities
Rural areas have higher exposure to UV radiation
Socioeconomic Determinates
Disadvantaged in regard to education and employment opportunities, income and access to goods and services More likely to work in farms, in transportation or mines, which are all hazardous occupations that have higher rate of tobacco and alcohol use Have a lower average income and poorer level of education (lower health literacy – less aware of the impacts of risk behaviours like smoking and excessive substance abuse) have higher levels of social cohesiveness, community involvement and participation in volunteer work Examples:
higher levels of unemployment Lower incomes, as well as lower share of the population who are earners Lower completion rates of secondary and tertiary education, dropping with remoteness (due to them going to work at early age on farms or mines)
Environmental Determinates
Number of GP’s employed in R&R areas is rising, however it is still lower than in major cities thus limiting the access to general medical services
Poorer distribution of medical specialists and medical tech
Example:
Use of medical services is poorer than major cities, including cancer screening programs for cancers such as bowel cancer People with kidney disease are required to travel long distances on a regular basis to access dialysis.
18,405 people in remote and very remote Aus have no access to primary healthcare services within an hour’s drive of their home. This has significantly improved from 2022 where it was 44,930.
Utilise Medicare almost 50% less than those in major cities
Those is in outer regional, remote and very remote areas experience longer wait periods to see a GP than those in major cities
Those living outside of major cities face difficulties utilising disability and aged care services poorer access to internet and mobile phone reception
The role of individuals, communities and governments in addressing the health inequalities:
Individuals:
Good decision making and taking responsibility for their own health and the health of those around them
Improve their knowledge, employment opportunities and income levels and help individuals make informed choices about their health and health care used
Individuals can also help promote health in their family and friends by encouraging good health choices
Example: actions such as remaining in schools, seeking to attend university either online or at rural or remote-based units (Charles Sturt). Or not smoking and reducing alcohol intake
Communities:
Heath inequalities by providing relevant health care and support services Communities must communicate and collaborate closely with government agencies to encourage qualifications health professionals to serve and support rural areas
Includes the development of multipurpose services programs that often connect with the community services and the development of community health centres with services they offer Government Gov funds many rural and remotes programs to assist in the delivery if health care to rural and remote living people Must also design and implement initiatives to promote health education Programs includes the royal flying doctor services which provides health care clinics, medical evacuations, provides medical rest and remote consults Rural and remote general practice programs to help increase the number of GP’s available in these areas High levels of preventable chronic disease, injury and mental health problems: cardiovascular disease (CVD), cancer (skin, breast, lung) and diabetes Defn chronic disease (CD)– conditions that had lasted, or are expected to last, 6 months or more Overview: High levels of preventable chronic disease, injury and mental health problems are part of Australia’s health priorities and the target of many health promotions and campaigns CD is Aus’s most pressing health priority Most are caused by lifestyle choices and can be prevented or delayed by simple adjustments to people’s life choices CD have a very high disease burden, and their preventative nature and higher prevenance makes them a key priority issue in Australian’s health Other health priorities, such as injury also have the potential to be prevented, particularly in relation to transport and work-related injuries Mental health is also priority issue for Australia’s health with a growing burden of disease across the country Among all ages, approx. 15.4 million (61%) were living with at least one of the selected long term health conditions in 2022 This ranged from 28% of people aged 0-19 to 94% of people aged 85 or older Anxiety (19%) and back problems (16%) were the most common of the selected long-term health conditions among people of all people in 2022 Cardiovascular disease (CVD): Defn - all disease of the circulatory system (heart and blood vessels) Nature of the problem: The main cause in CVD is atherosclerosis, which refers to the build-up of fat and plaque inside the arteries, which can block the blood vessels Blockages can result in death of cells that were relying on the arteries for blood supply Examples: Coronary (ischaemic) heart disease: include heart attack and angina. Heart attack results from a momentary blockage of the artery to a section of heart muscle. While angina results from a partial blockage and produces chest pain, particularly on exertion Stroke (cerebrovascular disease: a temp blockage of the blood vessels to the brain, resulting in the death of some brain cells, or a vessel begins to bleed, reducing the delivery of O2 to part of the brain. Strokes can result in a range of debilitations including communication, mobility, cognitive function and can also be fatal Heart failure: where the heart is unable to maintain a strong enough blood flow. Resulting in chronic tiredness, reduced capacity for phys activity and shortness of breath. It is a life-threating condition and cannot be cured in most cases. Extent of the problem: Leading cause of death world wide (WHO, 2021) Second cause of death in Aus (24% of all deaths) behind cancer with coronary heart disease the leading single cause of death Number and rate of CVD deaths have declined substantially (declining by 23% between 1980 and 2021) due to an increase in education on changed to risk behaviour (physical inactivity and unhealthy diets – high in sugar and fats) and increase technology to increase early intervention Prevenance is higher among men than women Prevalence increased with age, over half (52%) of CVD deaths occurring in persons aged 85 years and over These was however a slight increase in the mortality rates due to CVD in 2020 due to Covid-19 affecting the respiratory system and impacting their O2 supply Risk and protective factors: Risk factors Protective factors Hypertension (high blood pressure), physical inactivity, obesity and smoking Eating high calorie and high fat diets contributes to obesity and can cause CVD Both obesity and phys inactivity also contribute to hypertension, as does smoking Smoking contributes to the plaque build-up and atherosclerosis, causing it to be the main underlying cause of CVD Family history, sex, age (unchangeable) Regular exercise Regular health checks Eating a balanced diet low in saturated fats Sociocultural determinates: family, peers, media, culture and religion In addition to the genetics inherited, growing up in a family that is overweight or obese, eats food high in sugar and saturated fats or lives a sedentary life will increase the likelihood of the child growing up to live a similar lifestyle and make similar choices concerning risk factors Peers can influence individuals to make poor health choices, pressure to smoke, drink or use drugs Socioeconomic determinates: employment, income and education Education, especially health literacy and knowledge influences lifestyle choices to help reduce the risk of CVD (physical active, healthy diet -less sugar and saturated fats in diets) Education enables employment CVD has higher rates in blue collar employment as employment choices link to lifestyle choices. for example, tradies due to normalised behaviour of smoking and unhealthy diets due to convenience (foods high in sugar and saturated fats) Lower income levels result in fewer health related choices like buying lean meat or joining a gym Environmental determinates: geographical location, and access to health services and technology People living in rural areas have higher death rates from CVD This could be because the speed of medical treatment for heart attack or a stroke greatly affects the results People who access medical treatment swiftly have less chance of disability or death resulting from their stroke or heart attack and if they are in rural and remote areas, they have less chance of doing that Access to technology also impacts survival rates, but also is used in medical checks to test for atherosclerosis, angina and other CVD’s Groups at risk: ATSI the death rate from CVD was 1.8 time as high among indigenous Australians compared to non-indigenous Australians Low socioeconomic hospitalisation rates were 1.2 times as high for people in low socioeconomic areas compared to those in the highest socioeconomic areas Rural and remote people 1.4 times more likely compared to major cities The elderly specifically those 85 years and older Smokers much higher rates of CVD Men more likely to have CVD than their female counterparts Cancer (breast, skin, lungs): ] Defn- cell that have become abnormal and begin to multiply rapidly and cannot be controlled by the body. Overview: Most of the time the body’s immune system controls abnormal cells and removes them though sometimes it can’t be controlled Cancer cells invade surrounding tissues and can be fatal Tumour often to help minimise the damage