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DETAILED EXPLANATION - Role of Epidemiology Epidemiology is the study of disease in groups or populations through the collection of data and information, to identify patterns & causes. Epidemiology considers the patterns of disease in terms of: 1. Prevalence the number of cases of disease that exists in a defined population at a point in time. 2. Incidence the no. of new cases of disease occurring in a defined population over a period of time. Epidemiology is used by govt. & health-related organisations to obtain a picture of the health status of a population, to identify the patterns of health & disease, & analyse how health services & facilities are being used. Limitations of epidemiology: dont always show the significant differences in health status amongst certain groups cant provide the whole health picture fail to explain WHY health inequities persist Do not account for health determinants that shape health.

3 SPECIFIC EXAMPLES Epidemiology commonly uses statistics on: births, deaths, disease incidence, disease prevalence, hospital use, injury incidence, work days lost, money spent on health care Examples of collection bodies include: Aust Bureau of statistics; govt. departments; national heart foundation; roads & traffic authority


Measuring Health Status

critique the use of epidemiology to describe health status by considering questions such as: What can epidemiology tell us? Who uses these measures? Do they measure everything about health status?

Measuring Health Status Continued

- Measures of Epidemiology Mortality the number of deaths in a given population from a particular cause &/or over a period of time. The main causes of death in Australia are CVD, cancers & respiratory diseases. Infant Mortality the number of infant deaths in the first year of life, per 1000 live births. It can be divided into 1. Neo-natal (deaths in the first 28 days of life) or 2. Post-neonatal (deaths in the remainder of the first year of life). Infant mortality has declined steadily in recent decades and is the best indicator of a nations health (medical diagnosis & treatment; sanitation, health

use tables and graphs from health reports to analyse current trends in life expectancy and major causes of morbidity and mortality for the general population and comparing males and females

education, improved support services) Morbidity is the incidence or level of illness, disease or injury in a given population. Life expectancy is the length of time a person can expect to live. It is the avg. number of years of life remaining to a person at a particular age. Life expectancy has risen due to lower infant mortality; declining death rates for CVD; declining overall death rates for cancer; decline in deaths from traffic accidents. Identifying priority health issues Government and health organisation prioritise health issues based on contribution to burden of illness potential for reducing burden health inequities social justice principles Relate to eliminating inequities in health. Promote diversity selected priority issues must reflect social justice principles priority population groups Population has different subgroups that have different levels of health status. Priority issues therefore reflect inequities in subgroups. Prevalence of a condition Epidemiology reveals prevalence of a disease and helps identify risk factors. High prevalence rates indicate high economic burden and therefore large potential for reducing burden Potential for prevention and early intervention Majority of illness and disease result from poor lifestyle behaviours. For burden to reduce individual and environments determinates must be addressed. Most chronic diseases and mental health problems have social and individuals determinants that can be altered. Costs to individual and community Disease and illness place economic burden on individual which is measured by finance losses decreased productivity and decline in quality of life the cost of treatment medicine rehabilitation o Direct costs Treatment and caring

Hospital use, doctors visits, Medicare statistics, health surveys.

CVD as high prevalence therefore great poteintail to reduce burden Lung cancers can be targeted br prevention and early intervention Indirect cost include how much productivity is lost when a person takes days off work

argue the case for why decisions principles are made about health priorities by considering questions such as: how do we identify priority issues For Australias health? what role do the principles of Social justice play? Why is it important to prioritise?

money spent diagnosing money spent on prevention indirect costs value of output lost (retraining employees, lost of productivity)

Groups experiencing health inequities

There are differences in the level of health within particular groups in society. Health inequities are unfair differences in levels of health status between groups in society. Socio-cultural family, peers, media, culture, religion Socio-economic income, employment, education Environmental geographical location, access to technology and health services - Aboriginal and Torres straight islanders o Nature and extent Lower life expectancy 17 years Increase mortality in all ages Increase death rate from CVD Infant mortality 3x higher - Socioeconomically disadvantaged people Measured by ones income education employment and housing. Socioeconomic disadvantages are a health risk. Higher SES = lower infant mortality Low SES= higher BP - People in rural and remote area More likely to Smoke Drink in hazardous amounts Lower education Less access to health services

ATSI live 17 years less SES disadvantaged are more likely to have higher infant mortality Rural and remote are more likely to smoke

research and analyse

Aboriginal and Torres Strait Islander peoples and ONE other group experiencing health inequities by investigating: the nature and extent of the health inequities the sociocultural, socioeconomic and environmental determinants the roles of individuals, communities and governments in addressing the health inequities

High levels of preventable chronic disease

research and analyse

CVD, cancer and ONE other condition listed by

investigating: the nature of the problem extent of the problem (trends) risk factors and protective factors the sociocultural, socioeconomic and environmental determinants groups at risk A growing and aging population Population is increasing. 50%from increase birth rates the other half from net migration. Between 30.9-42.5 million by 2056 13% will be over 70 in 2021 - Healthy aging Government encourages people to plan for financial security. If people are unhealthy later in life then theyre working years are shortened. Resulting in reduction in economic growth. Ambassador for aging promotes positive and active aging and community and government programs - Increased population with chronic disease disease and disability Aging population resosbonsible for increasing chronic disease. Chronic disease accounts for 80% of burden. Predicated from 75% of deaths by 2020 future levels of chronic disease could be reduced by controlling risk factors - Demand for health services and workforce shortages Increased chronic disease means higher demand for health and aged care services. Inittives purposed by the government include More nurse Expansion of the role of nurses Increased community care Improvements in retirement income include Means tested pension Employers required to pay super annuasion Net migration accounts for 50% of population growth Chronic disease accounts for 80% of burden Initives by the government is to expand the role of nurses

assess the impact of

a growing and ageing population on: the health system and services health service workforce carers of the elderly Volunteer organisations.

Voluntary super annuation Availability of cancers and volunteers Carers and volunteers count towards workforce. Older Australians contribute by being paid workers carers volunteers. Over 55 contribute approx 75 billion unpaid caring. There is likely to be a shortage of unpaid carers in the future. Responsibility for health care facilities and services o Commonwealth government Set national health policies collect tax to finance health system and fund research. o State government Primarily responsible for providing health and community serives (hospitals, promotion ect) o Local government Environmental concerns, control monitor o Private sector Wide range of services including hospitals and dentistry e.g. cancer council o Community groups Formed on local needs basis e.g. cancer support groups. Equity of access to health facilities and services Is about the health systems ability to provide affordable and appropriate health services also refers to equal distribution. An individuals access can reflect SES Knowledge of services Geographical location Cultural and religious beliefs Health insurance doesnt cover dentistry and therefore some cannot afford Knowledge gaps can result from literacy difficentcies or language barriers Health care expenditure early intervention vs. prevention Health care expenditure is the allocation of funding and other economic resources for the provision and consumption of health services. 87.3 billion It costs more to cure a disease then to prevent illness or death Prevention methods include

Health care in Australia

Evaluate health care

in Australia by investigating issues of access and adequacy in relation to social justice principles. Questions to explore include: How equitable is the access and support for all sections of the community? How much responsibility should the community assume for individual health problems?

describe the
advantages and disadvantages of Medicare and private health insurance, e.g. costs, choice, ancillary benefits

Educating school children about protective behaviours Better government coordination Advertising restriction The strong argument for increasing preventative funding include Cost effective Improvement on quality of life Contain increasing cost Maintenance on social equity Use existing structures Reinforce that individuals are responsible for health Impact of immerging new treatments and technologies Examples of improved technology Advances in image tech Eye conditions treated with drugs not lasers Materials and construction of body parts HIV drugs Preventable technologies can save people money in the future Health insurance: Medicare and private Funds to operate Medicare come from taxes 1.5% of taxable income Medicare provide Free treatment in public hospital Free or subsidised treatment of medical fractionates (GPs and specialists) 85% is subsidized by government or bulkbilling occurs Private health insurance includes Shorter waiting times Choice of hospital Choice of doctor Ancillary benefits Private room 3the government encourage people to get private insurance by 30% rebate Avoid levy surcharge

Life time health care incentive

Complementary CAM refers to healing practices that do not fall within conventional medicine and alternative - Reasons for growth health care WHO increase support approaches Migration Ineffectiveness of modern medicine on some Holistic nature of treatment and health Strength of traditional believes of many - Range of products Acupuncture Chiropractor Hebraism Massage Mediation - How to make informed decision 5 questions to ask are What is treatment and benefits Experience and training Qualifications Cost Can be combined with modern medicine Health promotion based on owatta charter action areas

critically analyse
complementary and alternative health care approaches by exploring questions such as: How do you know who to believe? What do you need to help you make informed decisions?

argue the benefits of

health promotion based on: individuals, communities and governments working in partnership the five action areas of the

Ottawa Charter

investigate the
principles of social justice and the responsibilities of individuals, communities and governments under the action areas of the Ottawa Charter

critically analyse the

importance of the five action areas of the Ottawa Charter through a study of TWO health promotion initiatives related to Australias health priorities