Professional Documents
Culture Documents
The study of epidemiology is the study of why a country is sick. The rate of illness in a
population.
Limitations of epidemiology
● It does not show the health variations in sub groups.
● Does not explain why these inequities exist
● Does not account for the health determines
● Does Not provide the whole picture people with mental illness or disabilities.
What does it tell us? Epidemiology tells us the basic health status of Australia in terms of
quantifiable measures of ill health. This data is gathered and used to provide trends in disease
incidence and prevalence along with information about ethnic, socioeconomic and gender
groups. Epidemiology uses data on death rates, birth rates, illnesses, injuries, treatments
provided, work days lost, Hospital usage, and money spent by both consumers and the
government
Prevalence - the diseases that are occurring and causing problems now.
Distribution - the extent of the disease
Incidence - The number of new cases that are found
Who uses it ? Researchers, health department officials, the government, and health or medical
practitioners use epidemiology. This data is used to help identify priority health issues and
possible causes of disease or illness.
Money must be put into different resources that will result in the greatest changes.
Problems cannot all be fixed at one.
By applying the principles of social justice we can determine the impact these principles have on
reducing health inequities and improving the health of a nation.
We must have knowledge and be able to understand information about sub groups in society.
We must be able to
● Determine the health disadvantages of groups within a population.
● Better understand the social determinants
● Identify the prevalence of the disease
Furthermore, there are many chronic diseases that can be prevented and have potential for
early intervention. These diseases cost Australia millions in healthcare and include diseases
such as diabetes, cardiovascular disease and other conditions such as cancer.
Some subgroups can be indigenous people, people who have a low SES people, people living
in rural locations, the elderly, people living with a disability and sometimes men who are at much
greater risk of developing certain diseases
Groups that show unusually high incidence to illness and diseases require strategic action.
Epidemiology tells us that some population groups are significantly disadvantaged compared to
others.
Some strategies that are already utilised are
● Funding to the RFDS for aeromedical emergency health care and community health
clinics in remote areas.
● Incentive programs for medical practitioners
● 17% more funding to Indigenous health services
These disadvantages cann all be linked to either low SES, sociocultural or environmental
determines.
It helps to identify risk factors, that can call forward action in a particular health area.
High prevalence rates of a disease indicate that the health and economic burden that the
disease or condition places on the community.
Potential for early intervention means ability to avoid the condition from occurring.
People who have poor levels of education, low income, poor housing, unskilled work or long
levels of unemployment,
● Have a higher mortality rate and a lower life expectancy rate
● Higher rates of smoking
● Are less informed about health, make less health promoting choices
● Make less use of preventative health services and don't know what all the services do
and the benefits of modifiable health promoting choices.
● People living in low SES areas were 1.6 times as likely to have at least two chronic
health conditions.
● Lower education leads to limited employment options. That will result in working
high risk jobs or being unemployed. This can have a negative effect on your
mental health.
● Live in low SES areas, and they have more blue collar jobs, as these jobs don't
require high levels of education. These jobs are often more dangerous and have
negatives effects on your health.
● Often live rurally where there is less access to health promotion and prevention
services.
● Lower life expectancy rates by 2.1 years.
● Higher burden of stroke and cancer. (x6 the incidence of lung cancer)
● 40% higher rates of CVD.
● Sociocultural - are exposed to greater risk factors, that negatively impact their
health. Substance abuse, discrimination, violence and conflict are common.
● Socioeconomic - Have a lower health literacy which limits which reduces there
employment options and also results in higher levels of unemployment.
● Environmental - may have poorer living conditions
● Governments are responsible for funding healthcare services, PBS scheme,
medicare, School immunisation programmes.
https://www.aihw.gov.au/
http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/
0/367D3800605DB064CA2578B60013445C/$File/1244055001_2011.pdf
Identify 5 findings that you would believe would have the greatest impact on ATSI
health ? P32
10% of people live more than 100km from a hospital
Just 1 in 5 were studying for educational qualifications
8% had educational involvement
41% still smoke compared to just 18%
By not valuing and knowing how important education can be and that it is a flow on cycle it will
continue to stay at a steady rate. Can be seen in the overall life expectancy 10 year gap.
Will reduce their ability to get a good job and reduce their overall immunity and access to
health care as they wont have the money and knowledge of what these diseases are and how
they can be stopped.
By increasing there educational involvement, it will give them more opportunities after school
allow them to get a better paying job that will will be positive for there socioeconomic status, it
will allow them to live productive lives. It will allow them to make better personal decisions that
will continue to improve their health and allow greater access to health support services.
Atherosclerosis
Is the buildup of fatty material on the interior walls of arteries.
This build up hinders the flow of blood to the body's tissues and also increases blood pressure.
The build up occurs in patches known as atheroma or plaque and is characterised by the
presence of chelostrole. It may occur in any artery of the body, but it is the greatest threat to an
individuals health when it is present in the arteries leading to the brain, the eyes, legs or the
heart.
Arteriosclerosis
Is the hardening of arteries. It often begins in childhood. It develops as the fatty of fibrous
deposits build up and the arteries become less aesthetic and harder.
Heart attack
Generally caused by the complete closure of a coronary artery by atherosclerosis, it may also
occur when a blood clot forms and blocks a narrowed artery.
The efficient functioning of the heart relies on regular oxygenated blood flow, so the cessation of
flow to any part of the heart results in tissue death.This is a heart attack.
During the healing process following a heart attack nearby arteries grow new branches to
supply the damage tissue.
Angina Pectoris
Is a medical term used to describe the chest pain that occurs when the heart has an insufficient
supply of oxygenated blood.
This may be experienced by heart attack sufferers.
It is usually caused by coronary atherosclerosis. The narrowed arteries allow enough
oxygenated blood to flow to the heart to enable everyday activity, but chest pain or tightness
occurs when the heart becomes overloaded by exertion, excitement or overeating.
Heart failure
Heart failure is a reflection of the heart's inability to cater for the demands placed on it during
everyday life. It may mean that the heart cannot contract sufficient to supply the body with its
oxygen requirements. Heart failure doesn't mean that the heart has failed, rather one part of the
heart has stopped beating or working and that the other parts have to compensate.
Atherosclerosis = Blocked occurs when blood vessels become blocked by fat or cholesterol,
reducing or completely preventing blood flow.
Atherisclerosis = Hard when blood vessels lose their elasticity and harden.
Mortality
CVD accounted for almost 30% of all deaths among Australians in 2015.
Ischemic heart disease / Coronary heart disease is the leading cause of death in the population
overall, Accounted for 12% of deaths in 2015. Stroke is the next leading cause of CVD.
Morbidity
CVD is the leading cause of disability in Aus, with around 1.4 million Australians estimated to
have a disability associated with CVD.
Cancer
Cancer refers to a diverse group of several hundred diseases with a common feature - the
uncontrollable growth and spread of abnormal body cells. It involves a mutation and is believed
to originate from a single cell whose genetic material has been influenced or damaged by some
foreign agent. It divides and multiplies uncontrollably transferring is damaged genetic material to
its offspring.
The prevalence of cancer is growing. It is estimated that one on two males and females will
develop cancer before the age of 85. It contributes to 19%of the total disease burden in
Australia.
At the end of 2012, there were 994,605 people in Australia who were diagnosed with cancer in
the previous 31 years (4.3% of the Australian population), including 410,530 diagnosed in the
previous 5 years.9
Incidence
Cancer is the only major cause of death in Australia that is increasing in both sexes. The most
common have been : breaks cancer, skin cancer, melanoma and prostate cancer.
Mortality account for 27% of all deaths in 2017. It is currently the leading cause of death in
Australia, behind CVD.
In 2017, the risk of dying from cancer before the age of 85 is estimated to be 1 in 4 for men and
1 in 6 for women. 7
In 2012, the leading cause of cancer death was lung cancer (8,137), followed by bowel cancer
(3,980), prostate cancer (3,079), breast cancer (2,819) and pancreatic cancer (2,524)
Lung Cancer
It is currently the leading cause of cancer deaths in Australia for men and women, yet it is
largely preventable.
Cigarette smoking is the major preventable risk factor. The risk of developing lung cancer is 10
times higher among smokers than among non smokers.
Less than 10% of all cases of lung cancer occur in non smokers, as a result of occupational
hazards, air pollution and other environmental factors are linked to the incidence of lung cancer.
Breast cancer
Is the second most common cause of cancer related death in Australia. It affects 1 in 8
women in Australia and as you age the risk and the incidence of cancer rises.
There is no known cause yet but there are a number of factors that contribute such as
increasing age, family history, a diet high in fat, obesity, menstruation starting at an
early age and late first pregnancy or not having children.
Skin cancer
Are the most common type of diseases affecting Australians. This type of cancer occurs as a
result of prolonged exposure to ultraviolet radiation. A significant number of deaths from
malignant melanoma skin cancers could be avoided through skin protection and early detection.
Breast cancer ; Obese Women, who haven't given birth, aged over 50, who have a relative
who has cancer, who do not practice self examination.
Skin cancer ; people in lower latitudes, who have fairer skin, who have outdoor occupations
and people who do not choose to use protection methods.
Stats
Prevention
Australians aren't wearing wide brim hats and not applying sunscreen as much today as they
were in the past. This can be seen through the different facts and figures.
These measures are not protecting them from the sun.
GPs Therapists
Nurses Psychiatrists
Midwives Physiotherapists
Health workers
Dentists
Focus includes prevention, promotion and
clinical care
Hospitals
Public hospital = don't pick time or doctor
Private hospitals = are owned and operated by individuals and community groups.
It costs more but private health insurance and medicare will rebate most of the cost,
Get to pick your own time, place and doctor. They provide same day short stay
surgeries.
Equity
Is the allocation of resources according to the need of individuals and populations.
There are three types of nursing homes = private charitable, private for profit and state
government. But the Australian government assumes responsibility for most of the
financial costs of running nursing homes.
Psychiatrist hospitals
Treatment has changed for severe mental illness over the years, moving away from
institutional care to a system of care that integrates both hospital services and
continuing care with the community settings.
Medical services
The most extensively used service is that of the GP who diagnose and treat minor
illnesses. GPs usually refer their patients to a specialist, who have better skills in a
particular field.
Pharmaceuticals
Pharmaceticules are provided through hospitals and doctors by private prescription and
over the counter in shops.
Community supports
Community supports are a significant factor in the provision of an environment that is
conducive to positive health. They support health but they are not apart of the
healthcare system, eg implementations in food policies o ensure the production and
delivery meets the safe standards. Another example is town planners and engineers
have a role in providing infrastructure that is safe and promotes positive health.
Community groups there are many different community groups that promote health.
These are formed largely on a local needs basis and are established to address
problems specific to an area or region. Eg Cancer Council Australia. RFDS,
Local government Are mainly focused with environmental control and a range of
personal, preventative and home care services. The state gov are responsible for
controlling these services while the local govs implement them.
Private sector - this sector provides a wide range of services such as private hospitals,
dentists and alternative health services. These services are approved by the
commonwealth department of health. Many religious organisations, charity groups and
private practitioners run such services.
State and territory governments They have the prime responsibility of providing
health and community services.
Hospital services, mental health programmes, community care, youth and family
services, health promotion, rehab programmes, regulation inspection licensing and
monitoring premises, institutions and personnel.
One example has been the federal government greater funding the RFDS to provide
better rural health care services and access, they have also providing better incentives
for doctors to work rurally.
Access to doctors in remote areas is a challenge.
GPs are not paid by medicare for teleconference consultations.
There must be a greater focus on prevention rather than curative when it's too late.
There must be a significant boost in GP numbers in all areas.
It takes many years for results/benefits and trends to start occuring once a preventative
programmes has been implemented. Some preventative programmes for CVD, cancer
and traffic accidents have been visible over the years. QUIT, Sunsmart, Girls make your
move, stop revive and survive and drink driving campaigns.
Curative measures are more costly and contribute continuously more to health
expenditure.
Many may feel that prevention is undervalued and under recoursed even though
funding for health promotion and illness prevention has increased in recent years.
Some strategies that can be used to prevent illness and death include :
Educating children in schools about positive health behaviours.
Restrictions on advertising, Higher taxes on poor health products, Legislation.
The provision of support programmes
There are strong arguments for increasing funding and resources to preventative health
strategies.
1. Cost effectiveness - will save funds and resources that go into the curative
approach.
2. Improvement to quality of life - are many positive health outcomes for individuals
that will result in improvements in morbidity and mortality.
3. Containment of increasing costs - prevention is the best way to keep costs down.
4. Maintenance of social equity - A policy of prevention helps to provide greater
equity.
5. Use of existing structures - prevention uses existing structures rather than relying
on special services and technological procedures.
6. Reinforcement of individual responsibility for health - These prevention strategies
empower individuals to take control of their own personal health.
Impact of emerging new treatments and technologies on health care
There are constantly new treatments and technology being developed that help our
health.
MRIs are more commonly used with X-rays.
In Australia
Unfortunately, these new technologies take a lot of time and money to develop.
Some of these new technologies are also unaffordable uness funded by the government
or privately donated.
Much research is currently being done on early detection, because of the benefits both
personal and financial far outweigh surgery and other curative techniques.
Lower levels of private health insurance are found the young, elderly, and other groups
that have less available income.
The fall in the number of people with private health insurance creates pressure on the
public health system. The strain on the health care system was mainly caused by the
increasing demands for service from an ageing population and an increase in the
number of free medicare patients.
Snapshot
Health insurance isn't right for everyone there has been an increase in charges, costs
and taxes in relation to private health care which has seen less people taking out private
health insurance.
Diversity
= Involving all community groups in the planning and decision making process. It also
recognises cultural and social diversity, as well as beliefs and attitudes. Eg, Translation
services at Medicare offices is a culturally sensitive way to enable overseas born citizens the
opportunity of taking advantage of the services available.
Supportive environments =
We all have the right to be healthy and to receive adequate health care.
Environments must be structurally supportive, (ie) affordable, accessible and able to overcome
disabilities and language barriers. The action to create a supportive environment needs to be
physical, social, spiritual, economic and political
The Medicare system is one such example of providing a supportive environment. It is the
cornerstone of the public health care system in Australia. Its philosophy, that all Australians,
regardless of their personal circumstances, should have access to adequate health care at an
affordable or no cost.
Medicare provides;
- Essential medical care at affordable or no cost
- PBS (Pharmaceutical Benefits Scheme) which provides government subsidised (or
reduced) cost of selected drug treatments. In 2016, max cost of a prescription drug was
$38.30 (Pensioners
- $6.20 for those on a concession card). 80% of all ‘scripts’ are subsidised by the PBS
Medicare Safety Net: Establishes a threshold (In 2016, $1475.70) over which basic medical
costs will be further subsidised by up to 80% for the rest of the year. Useful for socio-
economically disadvantaged people or those who require frequent and ongoing treatment
What role do healthcare facilities and services play in achieving better health for
all Australians
Complementary and alternative health care approaches 108
Complementary and alternative medicine refers to healing practices that do not fall
within the area of conventional medicine.
Recent studies show that two thirds of Australians are using CAM treatment with an
expenditure of $4 billion. This trend has a lot to do with social change. Many people see
CAM as an opportunity to exercise choice, exerting greater choice over their health
through empowerment.
Some of the ranging products and services available are
Acupuncture - is based off ancient Chinese beliefs, widely used for pain relief, asthma
and arthritis.
Aromatherapy - is the use of pure essential oils to influence or modify the mind, body or
spirit.
The Bowen - Therapeutic technique
Chiropractic - is used to relieve pain and improve health through spinal manipulation.
Herbalism - uses plants and herbs exclusively.
Meditation - is the state of inner illness.
Homeopathy - based on the notion that substances promoting illness in a healthy
person can be sures for a sick person.
Iridology - is the analysis of the human eye to detect signs of the the individuals
physical, emotional and spiritual well being.
Federal government : are responsible for building healthy public policy, developing
infrastructure and funding for health promotion in order to create an environment that
supports the improvement of the health of all Australians.
State government : are responsible for implementing these strategies and delivering
adequate health services throughout their states and territories. They license private
hospitals and use legislation for to operate public hospitals. They regulate the sale of
drugs, tobacco, alcohol, the use of paracetamols, blood products and private health
insurers.
Private sector : Are responsible for monitoring health promotion and ensuring that it is
creating a healthy environment that supports the community's well being. They should
also ensure that the community has adequate access to health services and goods.
Communities : are responsible for the implementation of these initiatives and ensure
that members are actively participating. It is most effective when there is strong
community engagement. Examples are meals on wheels and programmes developed
by Cancer Council. The standing council of health, the Australian health ministers, The
running of each individual system falls to the realant health ministers.
Individuals : Are responsible for developing personal skills by implementing what they
learn through the health promotion in their own lives. Example is that they can adopt a
healthy lifestyle by staying fit and active and also having a nutritious diet.
How health promotion based on the ottawa charter promotes Social Justice.
WHO state that health promotion should advocate, mediate and enable.
The ottawa charter utilises the principles of social justice in its implementation. It
promotes equity, so that societies most disadvantaged have access to information and
health care. Thus, they become more knowledgeable and empowered, and have more
atomonity over their health. This is done by reducing social, economic and personal
barriers that may limit their access to health services and facilities.
Road safety
DPS - Road safety introduced school education programmes ad safer driver courses to
improve the knowledge and driving ability of young drivers.
BHPP - introducing legislation, having fixed speed cameras around Sydney and an
urban speed limit of 50Km/H
SCA - Road safety works with community based organisations to provide “Driver reviver
stops” to combat fatigue related accidents.
CSE - Has sought to make speeding socially unacceptable through the “speeding - no
one thinks big of you” campaign. Road have been upgraded to have higher safety
standards and cycle anes have been introduced to keep them safe on roads and
encourage this way of transport.
RHS - The many campaigns increase road safety awareness and promote a
preventative approach to road safety issues. It has been successful in reducing road
fatalities.