HHD SAC 3

Public health and promotion:

Changes that have occurred in Aus Health status since 1900:

-          1900 infectious disease were leading cause of death

-          1950 infectious disease under control due to old public health and biomedical model (people living longer therefore increase in cardiovascular disease and cancers)

-          1975 Social Model of public health addresses lifestyle related diseases

 

Old public health:

Government actions focused on changing the physical environment to prevent the spread of disease.

Policies:

-          Housing quality

-          Sewage and sanitation

-          Mass immunization programs

Practices:

-          Clean drinking water

-          Campaigns

-          Birthing practices

 

Biomedical model:

Refers to physiological aspects of disease and is the use of technology to diagnose and cure disease and illness once symptoms are present.

-          Scans and testing

-          Medication

-          Surgery

Strengths:

-          Improves quality of life

-          Extends life expectancy

Limitations:

-          Expensive

-          Relies on professionals

-          Doesn’t promote good health and wellbeing

 

Social model of health:

Acknowledges that ssociocultural, political, and physical environments have a significant influence on health, emphasizing the importance of addressing the cause of health inequality to improve overall health and wellbeing.

Ottawa Charter:

Guides health promotion campaigns over the world, aims to build healthy public policies.

 

3 Stratergies:

Enable – working with those who experience poorer health

Medicate – helping people work together to produce the best outcomes for health and wellbeing

Advocate – actions designed to gain support from governments and society to improve health and wellbeing

 

Action areas:

Build healthy public policy:

Relates to decisions made by governments and organizations regarding laws and policies that affect health and wellbeing. (Removing tax on unprocessed foods banning smoking in public places)

Create supportive environments

Aims to promote a healthy physical and sociocultural environment by being safe, stimulating, satisfying and enjoyable. (Cycle paths, sun shades, breakfast programs in schools, providing services such as life line ect.)

Strengthen community action:

Relates to giving the community a sense of ownership over health and wellbeing stratergies. Individuals and groups working together to increase the likelihood of them being effective. (Immunization that involves media, doctors and schools.)

Reorient health services:

Changing the focus of the health system so that it promotes health and wellbeing rather than focusing on diagnosis and treatment. Doctors become educators, don't just fix they help eliminate. (Doctors discussing healthy eating, promoting anti smoking ect.)  

Develop personal skills:

Educating people by giving them the skills and knowledge to make informed decisions about their health and wellbeing. (Running cooking classes, slip slop slap ect.)

 

 

 

Programs to improve Aboriginal and Torres Strait Islander peoples health

 Evaluating Initiatives:

COINSSFFN

C - Culturally appropriate

O - Ottawa Charter

I - Improvements

N - number of participants

S - significance health issue

S - social justice

F -funding

F - feedback

N -   Needs

 

Social Justice:

Relates to fairness within society. It is the fair and equitable distribution of resources, opportunities and privileges in society.

Based on:

  • Human rights

  • Access

  • Participation

  • Equity

 

Healthy Eating:

Australian Dietary Guidelines:

Is a healthy eating promotion document aimed at general society to limit diet related diseases.

The five Guidelines:

Guideline 1 - to achive and maintain a healthy weights, be physically active and choose amounts of nutritious food and drink to meet your energy needs.

Guideline 2 - Enjoy  wide variety of nutritious foods from the five food groups every day and drink plenty of water.

Guideline 3 - Limit intake of foods and drinks containing saturated fat, added salt added sugars and alcohol.

Guideline 4 - Encourages support and promote breastfeeding

Guideline 5 -care for your food, prepare and store it safely

Strengths:

-          Free and easy only access

-          Inclusive through use of age groups and SES

Limitations:

-          Written document – hard for low literacy

-          Only English

Australian Guide to Healthy Eating:

Is a visual food selection tool designed to help consumers identify, select and consume appropriate portions of foods from the five groups.

Strengths:

-          Translated into more than 10 languages

-          Visual so low levels of literacy needed

Limitations:

-          No information about serving sizes

-          No specific advise for age groups

 

Challenges in bringing about nutritional change:

Personal Factors:

-          Willpower and taste preferences

-          Attitudes and beliefs

-          Health and wellbeing factors

Sociocultural Factors:

-          Education:

-          Income

-          Occupation

-          Employment status

-          Family and peer group

Commercial factors:

-          Distribution and affordability

-          Processing, packaging and labelling

-          Marketing and media

Environmental factors:

-          Geographical location

 

Australia’s Health System:
Medicare:

Australia's universal health insurance scheme that provides free or subsidized treatment for anything that is clinically necessary, such as GP visits, x-rays, pathology or urine tests, eye tests, public hospital, subsidized treatment in private hospital.

Schedule Fee: The part covered by the government

Bulk Billing: Nothing out of pocket.  

Patient co payment: When someone charged above the scheduling fee therefor you will have to pay amount above the schedule fee.  

Medicare Safety Net: Provides extra assistance for those who frequently use Medicare

Medicare Levy: 2% tax placed on most tax payers (except low income)

Medicare Levy Surcharge: Additional 1-1.5% tax placed on high income earners who don’t have private health insurance.

General Tax: Contributes to Medicare if the Levy and Surcharge do not raise enough funds. 

 

Advantages of Medicare:

  • Choice of doctor for out of hospital services

  • Available to all Australians citizens

  • Covers x-rays and eye tests

 

Disadvantages of Medicare:

  • No choice of doctor

  • Waiting lists

  • Often doesn’t cover the full amount

 

 

PBS:

Australia's subsidy scheme for essential medicines.

PBS Safety net: Those who spend lots of money on PBS meds or are low income earners will get mor money off.

 

NDIS (National Disability Insurance Scheme)

A national insurance scheme that provides services and support for people with permanent, significant disabilities and their families and careers.

 

Private Health Insurance (PHI)

Insurance that can be purchased in addition to Medicare, where members pay a fee to the insurance company in return for payment towards healthcare costs.

Advantages:

  • Choice of doctor

  • Own hospital room

  • Not as long waiting lists

 

Disadvantages:

  • Premiums can be expensive

  • 'gap' payments may be required as PHU doesn’t always cover

 

PHI Incentives: - to free public system

PHI rebate: The government pays a portion of the premiums for private health insurance, depending on income and age.

Lifetime health cover: People who take up PHI after the age of 31 pay an extra 2% on their premiums for each year they are over the age of 30.

Medicare Levy Surcharge: People who earn more than 90 000 a year and don’t have PHI will pay extra tax (1-1.5%)

Age based discount: Young people aged (18-29) can receive a discount of between 2% and 10% when they take out an insurance policy.

 

Promoting Health Status:

Funding:

Medicare: funds most fees associated wit health services consultations, tests and treatments in public hospitals - reduces BOD

PBS: funds essential medicines - reducing illness

NDIS: funds recourses for those who require - reduces rate of injury and mental health disorders

PHI: Account for 40% of all hospital treatments funding for these comes from PHI - federal gov funds PHI rebate - more access to faster treatment.

Sustainability: 

Medicare: choosing which services should be subsidized and by how much, improves efficacy and increases sustainability  of the system

PBS: verifying the effectiveness of medicines reduces strain of the system, increasing sustainability

NDIS: individualized plans means individuals only receive necessary funds increases efficiency meaning more funds are available for the system.

PHI: incentives encourages more people into PHI reducing strain of public system ensuring people are treated effectively.

 

Access:

Medicare: access to GP consultations and public hospitals is provided to people of all socioeconomic backgrounds. Eg telehealth improves access for these in rural areas.

PBS: access for low income earners is improved with the concessional co-payment amount

NDIS: access for people with significant and permanent disabilities.

PHI: the federal government's PHI rebate increases access to PHI for those on lower incomes, therfor increasing access to health services.

 

Equity:

Medicare: the safety net takes into account people who require more frequent services, and provides additional support for them

PBS: the concessional co-payment allows people with low incomes to access medicines at a lower cost.

NDIS: individualized plans means that participants receive their required assistance

PHI: people aged 65+ receive greater PHI rebate from the government.