Summary Notes- Unit 3, Area of Study 2

Promoting health and wellbeing This area of study looks at different approaches to public health
over time, with an emphasis on changes and strategies that have succeeded in improving health and
wellbeing. Students examine the progression of public health in Australia since 1900, noting global
changes and influences such as the Ottawa Charter for Health Promotion and the general transition
of focus from the health and wellbeing of individuals to that of populations. Students investigate the
Australian health system and its role in promoting health and wellbeing. They conduct a detailed
study on a successful health promotion campaign or program, and inquire into priorities for health
improvements in Australia.

On completion of this unit the student should be able to explain changes to public health
approaches, analyse improvements in population health over time and evaluate health promotion
strategies. To achieve this outcome the student will draw on key knowledge and key skills outlined in
Area of Study 2.

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AUSTRALIA’S HEALTHCARE SYSTEM
Australia’s health system
- plays a significant role in promoting health status
Description Medicare
Australia’s universal health
insurance scheme, established
in 1984, gives all Australians,
permanent residents and
people from countries with
reciprocal agreements (NZ, UK,
..) access to healthcare that is
subsidized by the government
Advantages Available to all Australian
(what is citizens
covered) Choice of GP
Covers schedule fees for GPs,
eye tests, X rays, blood tests …
Some dental for children
Medicare safety net assists
families with high needs
75% of treatment in a private
hospital
PBS
Federal government’s program
to provide subsidized medicines
to Australian citizens of $38.80
or $6.30 for concession,
adjusted each year
Around 5000 medicines are
listed
NDIS
National insurance scheme that
provides services and support
for people with permanent,
significant disabilities
(substantially reduces ability to
participate effectively in daily
life tasks or activities without
support), and their families and
carers, established in 2013 to
improve the health and
wellbeing of people with
disabilites
Covers people under 65 who
are Australian citizens or have
special visas, and live in
Australia
Assists people with severe
disabilities to access services
and support to be able to
participate in society
Support can be federal,
community or informal
Provides funding to assist
support services – carers,
transport, accessories
Private Health Insurance
Type of health insurance where
members pay a premium in return
for payment towards health-
related costs not covered by
Medicare. It is optional.
Enables access to private hospitals
so waiting times for some
procedures may be shorter
Choice of doctor in private or
public hospital
May cover dental, physio …
Helps to reduce govt costs of
Medicare
Incentives to have PHI – rebate,
Lifetime cover, Medicare Levy
Surcharge
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Disadvantages No choice of doctor in hospital
(what is not treatment
covered) Waiting lists may be long
Doesn’t cover alternative
treatments
Often doesn’t cover the full
amount
Accommodation in private
hospital,
most dental,
home nursing care, ambulance
services, glasses/ hearing aids,
drugs,
Funding - Medicare levy – 2% of most tax
payers
- Medicare Levy Surcharge –
additional 1 – 1.5% for higher
income earners without PHI
- general taxation
Promoting Allows all Australian citizens to
Health and access health care to treat
wellbeing / illnesses / receive hospital
health status treatment so reduce mortality
rates
Provides access to tests for
diagnosis so early treatment –
reduce morbidity rates
Some medicines (usually rare
treatments) are not listed and
can be very expensive
Federal Government and
patient contributions
Allows all Australian citizens to
access common antibiotics to
treat infections so reduce
morbidity
Cancer drugs can reduce
mortality rates
Lifetime approach
Less severe disabilities (may be
some people who miss out)
Can be lengthy process to
access support
Federal (through an increase in
Medicare Levy) and State /
Territory Governments
Provides people with disabilities
improved access to services to
improve mental health, social
health by increasing social
connectedness
Provides support to carers to
improve their mental health
Access to support equipment
can reduce pain so decrease
levels of morbidity
Costly – premiums
Sometimes there is a “gap”
between PHI contribution and fee
Some qualifying periods
Policies can be confusing
May pay for procedures that are
not used
Individual premiums
Provides people with faster access
to elective surgery so can reduce
morbidity
If extras, can provide access to
alternative treatments to reduce
morbidity
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NATIONAL DISABILITY INSURANCE SCHEME

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AUSTRALIA’S HEALTHCARE SYSTEM- PROMOTING HEALTH
The role of the Australian healthcare system in promoting health in relation to

• Funding
• Sustainability
• Access
• Equity

FUNDING

Australia’s health system operates with the combined funding from the federal and state/territory governments, private health insurance, other forms of
insurance funds and individuals.

The Australian healthcare system is funded by the State and Federal Governments via

• The Medicare Levy

• The Medicare Levy Surcharge

• General taxation

• Individuals purchasing private health insurance

• Businesses purchasing insurance (TAC, Workcover etc)

• Individuals paying for services not covered by Medicare

The cost of the health system in Australia has increased over time

• Increasing health costs have occurred over time, largely due to:

• an ageing population — the average age is increasing in Australia, resulting in a higher proportion of chronic conditions requiring care.

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• increasing incomes, a growing economy and rising expectations — rising incomes and a growing economy mean that there is more money
available to spend on healthcare. As more money becomes available, the population expects that more can be done to improve their health
and wellbeing when required.

• more expensive technologies and services — as research and development progress, there are more medical technologies and services
available and these contribute to increased expenditure.

Providing
hospitals &
medical
technology

Advances in
Highly trained
knowledge and
medical
technology
professionals
through research

Funding
Australia’s health
system promotes
Programs that health status
work to promote through… Subsidised health
health such as services and
QUIT and medications
LiveLighter

Improved access
Support and
to private health
aides through
insurance
the NDIS
through rebates

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Sustainability
Sustainability refers to meeting the needs of the current generation without
compromising the ability of future generations to meet their own needs

Access
An accessible health system is one that can provide all people with timely access to quality health
services based on their needs, not ability to pay, regardless of where they live in the country.

This means that access must be available to people from all socioeconomic groups and those living
within and outside of Australia’s major cities.

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Equity
• Equity relates to fairness.
• It is about providing every person with the resources they need to lead a
good life and experience a high level of health and wellbeing.
• Equity involves taking unfair circumstances into account, so that those
who are disadvantaged are given the opportunity to participate in life on
a level playing field.
• Providing equal access to healthcare doesn’t mean the system is fair to
everyone, so particular people may get additional services

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EXAM QUESTION UNPACKED
How does Australia’s healthcare system promote health?
• You could discuss health and wellbeing (dimensions) OR health status indicators to
answer a question like this
• You need to show understanding of the concept being asked about (eg funding,
sustainability, equity, access) as well as how this leads to an improvement in health.
For example:
Access:
• Subsidised GP visits means that all Australians can receive treatment at an
early stage, reducing the physical symptoms of disease and improving the
functioning of the body.
• Subsidised medication (PBS) allows individuals to receive treatment for
illness, reducing the symptoms and improving life expectancy.
• Private health insurance takes pressure off the public health system. This
reduces waiting lists for those relying on the public system, improving access
and allowing morbidity and mortality rates to be decreased
Equity:
• the Medicare safety net means that people with high healthcare costs can
receive greater subsidies on their healthcare, reducing the stress and anxiety
that individuals may feel when they or a family member gets sick.
• Providing a higher private health insurance rebate to those on lower incomes
means services such as shorter waiting lists for non-essential surgery are
available to more people. This allows people to receive a knee replacement
sooner, improving their physical health and wellbeing and reducing their pain
and suffering
Funding:
• Funding of individual programs and supports through the NDIS allows
permanently disabled people to attend school and work, increasing the
meaningful connections that they make with other people.
• Early diagnosis of cancer due to the funding of Breastscreen means that
breast lumps are more likely to be detected early, improving survival rates
and reducing mortality.

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 Sustainability:
• Only providing subsidies for a limited range of services saves the government
money, allowing the healthcare system to continue operate, reducing
morbidity and mortality for individuals today as well as into the future.
• Providing health promotion programs such as QUIT, reduces the prevalence
of long term illness such as lung cancer, saving the government money and
allowing the healthcare system to survive into the future.

CHANGES IN AUSTRALIAN’S HEALTH STATUS

Improvements in Australia’s health status since 1900 and reasons for these
improvements, focusing on policy and practice relating to:
• ‘old’ public health
• the biomedical approach to health and improvements in medical
technology
• development of ‘new’ public health including the social model of health
and Ottawa Charter for Health Promotion
• the relationship between biomedical and social models of health

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PUBLIC HEALTH

Public health is the organised response by society to protect and promote health, and to prevent
illness, injury and disability. It involves identifying public health issues, problems and priorities, and
designing and implementing interventions targeted at whole population or sub-groups.

Old Public Health

Diseases that were common in Australia during the first half of the twentieth century are in many
ways different from those that Australians face now

They can be grouped together into 5 broad categories, however. Together these diseases accounted
for 60% of deaths at the start of the century and 83% at the end.

These broad categories are

• Infectious and parasitic diseases

• Cancers (neoplasms)
• Cardiovascular disease
• Injury and poisoning
• Respiratory diseases

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 The Biomedical Approach to Health Care
➢ Treats individuals once symptoms of ill health are present
➢ It relies heavily on doctors, hospitals, pharmaceuticals and medical technology
➢ The reasons for illness are not the focus and treatments are considered the solution
➢ Focuses on biological determinants of health not education about behavioural and social
determinants of health
➢ This approach to health care has been dominant years
➢ Has played a large role in prolonging life expectancy in Australia.
➢ It receives the majority of health care funding (over 90 per cent).

Advantages of the Biomedical Approach

➢ It creates advances in technology and research
⚫ There would diagnosis and treatment of illness, x-rays, antibiotics or anaesthetics.
➢ Many common problems can be effectively treated
⚫ Some treatable diseases cause considerable ill health/death
➢ Extends life expectancy
⚫ some infectious diseases can now be treated/cured
➢ Improves quality of life
⚫ Many chronic conditions can be managed with medication, therapy or surgery

Disadvantages of the Biomedical Approach

➢ It relies on professional health workers and technology and is therefore costly
$$$$$$$$$$$$
⚫ Millions of dollars may only treat a small number of patients
➢ It doesn’t always promote good health
⚫ The focus is the condition rather than the determinants that caused it
⚫ Does not encourage responsibility for own health
➢ Not every condition can be treated
⚫ Cancer has treatments available but no cure
⚫ Focusing on the determinants may prevent cancer
➢ Affordability
⚫ Not all individuals can afford the medical technologies

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HEALTH PROMOTION PROGRAMS
The role of health promotion in improving population health, focusing on one
of: smoking, road safety, or skin cancer, including:
 why it was/is targeted
 effectiveness of the health promotion in improving population
health
 how the health promotion reflects the action areas of the Ottawa
Charter for Health Promotion

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Initiatives introduced to bring about improvements in Indigenous health and
wellbeing in Australia, and how these reflect the Ottawa Charter Action
Areas for health promotion.

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Initiatives to promote Healthy Eating in Australia- including the Australian
Dietary Guidelines, the Australian Guide to Healthy Eating and Nutrition
Australia.

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The work of Nutrition Australia includes:
▪ Health and wellbeing program
▪ Services offered in workplaces including cooking demonstrations,
nutrition education seminars, one-on-one consultations and
vending machine assessments
▪ Seasonal long day care menu packs
▪ A menu pack with simple seasonal recipes suitable for children
and based on the Australian Dietary Guidelines.
▪ Healthy lunchbox week
▪ An annual initiative that promotes healthy eating amongst
children through aiming to inspire parents to create healthy
lunchboxes that their children will enjoy. Quick online recipes are
provided and fact sheets and videos also work to increase
knowledge
▪ The Healthy Eating Advisory Service
▪ offering menu assessments, information and support on food and
nutrition and the provision of healthy food and drinks in early
childhood services, schools, hospitals and workplaces across
Victoria.
▪ National Nutrition Week
▪ National Nutrition Week coincides with the 16 October (World
Food Day) each year.
▪ A National Nutrition Week kit (containing media reports and
interviews, games and competitions, and information on stalls and

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food tastings) can be downloaded from the Nutrition Australia
website to guide activities in schools, health centres, community
fairs and shopping centres.

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Challenges in bringing about dietary change

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EXAMPLE QUESTION RESPONSE MARKING GUIDE

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