Year 12 (HSC) PDHPE Core 1 Study Notes

Year 12 (HSC) PDHPE Study Booklet

Core 1: Health Priorities in Australia

1 How are priority issues for Australia’s health identified?

Measuring health status:

Role of epidemiology Measures of epidemiology

Identifying priority health issues:

Social justice principles Priority population groups prevalence of condition Potential for prevention and early intervention Costs to the individual and community

Measuring Health Status:

Role of epidemiology

Statistics help researchers to: Compare patterns of health in

population Identify health causes Identify strategies to prevent

diseases Promote health

Epidemiology is used by: Gov. Health org. Doctors

Epidemiology considers patterns of diseases in terms of:

Prevalence Incidence Distribution (extent) Apparent causes

(determinants & indicators)

Focuses on negative health rather than positive health

Focuses on: Births Deaths Disease incidence Disease prevalence Hospital use Injury incidence Work days lost Money spent on health care

Identifying Priority Health Issues:

Measures of epidemiology

Morbidity: the level of illness, disease or injury in given population

Morbidity measures & indicators:

Hospital use: provides statistics of rates of illness/ accidents

Doctor visits & medicare statistics: indicate reasons for visits and no. Of visits

Health survey and reports

Disability & handicap: the incidence of disease/accidents can lead to impairment, disability & handicap

Mortality: number of deaths in given population from particular cause over a period of time.

Infant mortality: Infant mortality is amongst

indigenous infants(2* the rate)

Decline can be attributed to: Improved medical

diagnosis Improved public

sanitation Improved health

education

Life expectancy: length of time a person can expect to live, based on current death rates.

Life expectancy at birth= common indicator

Life expectancy at 65 years old

Life expectancy is greater now

Improvements: Lower infant mortality Decline death rates (CVD &

cancer) Fall in deaths (traffic

accidents) Living longer= medical

knowledge Life expectancy increase=

ageing population (need for nursing homes, care for dependent people)

Recognising and eliminating health inequities, the promotion of equity, diversity and supportive environments for all people.

Equity:The fair allocation of funding and resources. E.g. GPs who bulk bill people with health care card.

Diversity:Australia has a diverse population (multicultural) and the needs of these populations need to be met. There needs to be sufficient health care services & facilities for everyone.

Supportive environments:Australians have a right to have safe & healthy environments. This can be achieved through cost, availability and ease of access.

Epidemiology identifies population groups suffering. It supports social justice too. Greater attention is directed to people experiencing inequities.

Social Justice Principles

Priority population groups

ABTSI, elderly, disabled people, people born overseas, low SES people, people living in rural/remote areas

It allows health authorities to:

Determine health disadvantages

Better understand social determinants of health

Identify prevalence of disease & injury

Determine needs of groups – social justice principles

Epidemiology data provides a guiding path to identify priority areas to prevent disease and injury and it helps us to identify risk factors.

Prevalence of condition

E.g. the decrease in deaths from CVD can be attributed to effective health promotion strategies. However increasing rates of type 2 diabetes indicate a need for a particular focus on the related determinants and risk factors.

Cancer, CVD and type 2 Diabetes: majority of disease burden in Australia

Prevalence of condition

Potential for preventative and early

intervention

The diseases depend on lifestyle and health related behaviours (smoking, diet, alcohol and physical activity levels)

Healthy problems that are preventable, as well as those that respond well to intervening in early stages, deserve increased attention.

Diseases place a great economic and health burden on the individual, which can be measured in terms of financial loss, diminished quality of life and emotional stress. Unable to work, due to disease.

Cost of treatment, medication, rehabilitation.

Direct individual costs: financial burden that is associated with illness and disability such as medical costs and loss of employment.

Indirect individual costs: persistent pain and loss of quality of life, increased pressure on family to provide support, emotional toll of chronic illness

Direct community costs: funding of the Australian health care system. Supports primary health care and pharmaceuticals

Indirect community costs: premature loss of contributing as valuable members of society and the cost for employers in absenteeism decreased retraining.

Costs to the individual and community

2 what are the priority issues for improving Australia’s health?

Groups experiencing health inequities look in PE folder for information on groups experiencing health inequities

ABTSI Socio economically disadvantaged people People in rural and remote areas Overseas born people Elderly

Costs to the individual and community

People with disabilities

High levels of preventable chronic disease, injury and mental health problems

CVD Cancer Injury Mental health problems and illness Diabetes Respiratory disease

A growing and ageing population

Healthy ageing Increased population living with chronic disease and disability Demand for health services and workforce shortages Availability of carers and volunteers

High levels of preventable chronic disease, injury and mental health problems

The nature of CVD:

CVD: refers to damage to, or disease of the heart and blood vessels.

Extent of the problem (trends) Mortality: CVD accounted for 32% of all deaths among Australians in 2010.

Mortality: CVD accounted for 6% of hospital use in 2007-08

Risk factors and protective factors for CVD:

Non-modifiable risk factors :

Modifiable risk factors: Protective factors:

Gender –CVD higher in men, 50years old

Smoking – when smoking stops, risk of heart attack & strokes reduce

Obesity &overweight – increases risk of

Regular physical activity

Eat a diet low in saturated fat and cholesterol

coronary

heart diseas

e

poor supply of blood to muscular walls of heartstroke

interruption of blood supply to brain

peripheral

vascular

disease

diseases of the arteries, arterioles and capillaries that affect the limbs.

SmokersFamily history of CVD

heart disease Advancing age –

CVD increases with age

raised blood fat levels – diets high in saturated fat can rise blood cholesterol levels

diet low in salt maintaining healthy

weight managing stress

Family history Physical inactivity – high blood pressure and fat levels

Diabetes – damages blood vessels ad arteries

Avoid exposure to tobacco smoke

Determinants of CVD:

Socio cultural determinants:

Socio economic determinants:

Environmental determinants:

ABTSI peoples are more at risk as they are associated with having a low SES and education levels

People with low SES or who are unemployed have higher death rates because income can limit health choices

People living in rural and remote areas are more at risk, as they tend to have less access to health info., health services and technology, such as electrocardiogram monitors.

Media exposure of effects of smoking on health have led to a reduction in smoking rates and therefore a declining trend for CVD rates

People with low education levels are more at risk as poor education is linked to poor health choices and less knowledge about access and use of health services

Groups at risk of CVD:

People with high blood pressure levels (hypertension)

People who consume high fat diet

People aged over 65 years

The nature of cancer:

Cancer: large group of diseases, characterised by the uncontrollable growth and spread of abnormal cells.

Tumor: swelling caused by a clump of abnormal cells

Extent of cancer (trends):

Incidence:

Cancer = major causes of death in Australia,

increasing in incidence in males & females.

Benign tumors – non cancerous, cure=surgery

Malignant tumors – cancerous, spreadable, invade healthy tissues

Main reasons for increases in incidence:

Mortality:

Cancer accounted for 30% of all deaths in Australia in 2010. 33.1% male deaths 26.5% female deaths 2010 major types of cancer= lung, bowel, prostate, breast and pancreatic

cancers.

Risk factors and protective factors for cancer:

Non-modifiable risk factors:


Family history Late menopause Early onset of

menstruation

Tobacco smoking Occupational

exposure (asbestos)

Avoid tobacco smoke

Avoid asbestos

Air pollution Number and types

of moles on skin

High fat diet Exposure to sun

Practise self examination

Protective equipment to reduce exposure to sun.

Determinants of cancer:




ageing population better detection

new technology and screeing programs

Family history=higher risk

Low SES or unemployment = higher death % because income limits health choices

People living in rural/remote areas have less access to health services such as pap smears, technology – breast cancer screenings

Incidence of lung cancer & cervical cancer higher in ABTSI peoples – higher % of smoking, less access to health services

People working outdoors such as lifeguards = prone to get skin cancer

Groups at risk of cancer:

The nature of diabetes:

Diabetes (mellitus): condition affecting the body’s ability to take glucose from the blood stream to use it for energy.

Type 1 diabetes:

Body produces minimal amounts of

Insulin or none at all

Extent of diabetes (trends):

Incidence:

Smokers Obese women

Men & women aged 50 years

Type 2 diabetes: Pancreas is able to produce insulin but amount is less effective

Risen significantly over past 20 years. In 2007-08 4.1% of Australians reported that they had medically diagnosed

diabetes, due to increase obesity.

Prevalence:

Prevalence of diabetes increases with age ABTSI have highest prevalence % of type 2 diabetes in the world

Risk factors and protective factors of diabetes:



Being over 45 and having high blood pressure

Family history

Over weight Having had heart

disease

Nutritious foods Eat plenty of breads

and cereals and vegetables

Being over 35 and an ABTSI

Having had diabetes during pregnancy

Having high blood pressure

Eat low saturated fat and low in salt

Maintain physical activity

Determinants of diabetes:

Socio cultural factors: Socio economic factors: Environmental factors: ABTSI high risk due

to low education and less access to health services

Low SES and less education more at risk because more likely to consume high levels of alcohol, physically inactive and consume poor diet

Access to technology led to higher levels of physical inactivity and greater risk of diabetes.

Australians incidence of type 1 diabetes among those aged 0-14 high among other OECD countries, due to consumption of high saturated fat and sugar

Groups at risk of diabetes:

Woman who had diabetes during pregnancy People aged over 45 Family history Overweight ABSTI

Nature of mental health:

Mental health: problems include

Schizophrenia affects the normal functioning of the brain. Drug abuse, physical neglect and early pregnancy = poor health choices.

Extent of mental health (trends):

According to the 2007 National Survey of Mental Health in Australia; estimated 20% of Australian adults experienced symptoms of a mental disorder in the 12 months prior to survey.

Women more likely than men to have symptoms of anxiety.

Risk factors and protective factors of mental health:



Mental illness (schizophrenia)

depression prescribed anti-depressants or psychological therapy

Chemical changes with brain

Drug and alcohol abuse

Organisations such as Youth Beyond Blue

Depression

schizophrenia

Personality disorders

Major depression

Post traumatic stress disorder

Determinants of mental health:




ABTSI peoples more at risk of suicide & depression due to high levels of drugs & alcohol abuse

People with low SES or who are unemployed have higher % because they to engage more in substance abuse.

Rural, young males are at higher risk of suicide due to less access to support services and fewer job prospects.

People who have had a falling out with peers, or who have been exposed to bullying, are more at risk.

Groups at risk of mental health:

Nature of respiratory disease:

People suffering chronic depression Elderly people

Alcoholics

Young gay and lesbian people

People who have suicide attempts

Respiratory disease: a group of diseases that affect the respiratory system (lungs, lower & upper airways, nose and throat).

E.g. asthma, hay fever, chronic bronchitis Chronic obstructive pulmonary disease COPD – lung tissue becomes

damaged and the air passage becomes narrow – obstructs oxygen intake. This is due to inhaling gases & particles such as tobacco.

Extent of the respiratory disease (trends): The prevalence of some conditions in the respiratory disease group is

decreasing – attributed to decline in smoking (males). The National Health Survey 2007-08 estimated that 5% of Australians

who were 55 & older had some form of COPD. More males than females die from COPD.

Risk factors and protective factors of respiratory disease:



inhaled allergens such as pollens, animals hair, dust mites

colds and flu visit doctor to find how to prevent and manage asthma attacks.

cold air or changes in temperature

Food preservatives

Determinants of respiratory disease:




ABTSI more at risk due to high % of smoking

People with less income more likely to smoke and have less money to spend on treatment

People living in rural and remote areas have less access to emergency services - Higher death rates from asthma.

Family history of allergies – more prone to asthma

People repeatedly exposed to hazardous chemicals at work

Nature and extent of injuries:

Injuries: major cause of preventable mortality & morbidity in Australia

Transport injuries

Suicide attempts Residential injuries (falls, drowinings, poisonings, burns & scalds Industry injuries Consumer product injuries

Extent of injuries (trends):

In 2010, deaths from injuries accounted for 6.2% The male mortality % from injury is more than twice the female %.

Risk factors and protective factors of injuries:


Modifiable risk factors; Protective factors:

Lack of judgment Carrying more passengers than the no. Of seat belts

Adhering to road safety rules

The road is complicated

Peer pressure Not driving when fatigue or under influence of alcohol or dugs

Determinants:




Injury & hospitalisation % high for ABTSI because of low levels of education

Males aged 25-64 from disadvantaged areas are 2.2times more likely to die in traffic accidents and 1.6 times likely to die from suicide. Females are 2.2 times more for traffic injuries and 1.3 times more from suicide.

People working in rural/remote areas because they are more exposed to dangerous machinery

Media exposure of laws relating to road use and consequences of

Unemployed people or low income earners may not be able to afford safety

People in rural/remote areas more likey to commit suicide

road trauma helps reduce traffic injuries

devices in homes because they have high level of unemployment and less access to support services.

A growing and ageing population:

Healthy ageing:

ageing people unhealthy due to

sickness or injury

work years likely to be shortened

reduction in economic growth

more access to health services

Responsibility of Ambassador for ageing:

Prompt positive + active ageing Encourage contributions made by elderly Prompt initiatives Assist elderly to access programs

Increased population living with chronic disease & disability:

Improvements in number of people surviving heart attacks, strokes & cancers, however – increase of chronic disease or disability.

Demands for health services and workforce shortages:

Government initiatives to meet needs of older population: More funding for dementia care

Government initiatives to improve Australia’s retirement income system – shortages in labour from illnesses:

Compulsory superannuation These initiatives encourage planning for financial security for elderly and

economic burden on gov.

Availability of carers and volunteers:

Older Australians can contribute to caring and voluntary work

Statistics= caring + volunteering is beneficial to economy

2010 2.9 billion Aus over 65 volunteered Caring society= quality of life

Prediction for future= shortage of carers.

Roles of Health-care facilities and services in achieving better health

Health care in Australia:

CWLTH STATE LOCAL GOV.

Note: maintaining & achieving good health leads to less access to health services.

Health insurance funds Public and private services Institutions Other org.

diagnoses treatment

rehabilitation care for people with long-term

illness.

CWLTH GOV.

(Policies, finance, health programs)

Health insurance:

Private:

HCF NIB BUPA Medibank Grand

United Aus. Unity

Health Fund

Public:

Medicare.

Health care providers:

Institutional care:

Hospitals: Repatriation Public Private Psychiatric

STATE GOV.

Non-institutional care:

Community health services

Medical services Health Promotion

agencies Pharmaceutical

services.

LOCAL GOV.

Nursing homes: provides care for:

Those unable to look after themselves

Health care providers:

Institutional care:

Hospitals: Repatriation Public Private Psychiatric

Non-institutional care:


Medical services Health Promotion

agencies Pharmaceutical

services.

Public

Provides same day surgery

Provides highly specialised & complex services (heart &lung transplants)

Operated & financed by state & CWLTH GOV.

Serves greater proportion of elderly and young patients

Private

Operations not emergency

Performs short stay surgery

Owned & operated by individual & community groups

Less complex surgery & less expensive equipment (eye, nose mouth operations).Same day surgery

Aged/ dementia Disabilities

Types of nursing homes:

Private charitable Private for profit STATE

GOV

Psychiatric hospitals:

Reduction in hospitalisation for mental illness, no. Of public psychiatric hospitals

Service providers: GP’s Private psychiatrists Community based public mental health services Specialised residential mental health care facilities

Medical services:

Medicare – all Australians eligible to

claim refunds for payments for medical services outside hospitals (& services as private patients in hospitals). Whole/part of cost of GP consultation is reimbursed by Medicare.

Consultation - improved access to doctor & increased health promotion & awareness of prevention: e.g. pap smears

Doctors

GPs Specialists Health

Professionals

Health Related Services

Ambulance (private health insurance )

Nursing (Medicare)

Physiotherapy (private health insurance)

Dentistry (private health insurance)

Health inspection

Pharmacy (Medicare)

Occupational and speech therapy (private health insurance)

Optometry (Medicare)

Counselling

Pharmaceuticals:

Pharmaceutical Benefits Scheme (PBS): funded by CWLTH Gov & non Gov. CWLTH Gov program, that provides subsidised (pay part of cost of producing to keep selling price low) prescription drugs to Aus residents, ensuring affordable access.

PBS Safety Net: to ensure no one is excluded for financial reasons from access to medicine needed. People with no Gov concession card – eligible.

Health care roles:

Prevention Promotion Rehabilitation Care Diagnosis Treatment

Health Providers:

Doctors Nurses Physiotherapists Dentists

Organisations:


Charities Support groups

Governments:

CWLTH Local State

Institutions:

Hospitals Clinics Nursing

homes

Responsibility for health-care facilities and services:

5 levels of responsibility: CWLTH Sate & Territory Local Private sector Community Groups

CWLTH Gov:

Provides funds to State & Territory Gov for health, and influences health policy & delivery.

Responsible for special community services – health programs/ services for veterans & Aboriginals

Contributes major funds to: high levels residential care (care given away from home) e.g.

treatments for sufferers of anorexia medical services health research public hospitals public health activities

Sate &Territory Gov:

responsibilities: hospital services metal health programs dental health services home and community care women’s health programs rehabilitation programs child, adolescent & family health services

contributes major funds to: community health services public hospitals public health activities

Private sector:

services – private hospitals, dentists & alternative health services (e.g. chiropractors)

Approved by CWLTH Department of Health and Ageing Private Org. – National Heart Foundation & Cancer Council funded

by State & CWLTH

Local Gov:

Monitoring of sanitation & hygiene standards in food outlets; waste disposal; monitoring of building standards; immunisation; Meals on Wheels

State controls immunisation, but local implements them.

Community groups:

E.g. Cancer Council, cancer support groups, carers Australia/ NSW, Dads in Distress, Sexual Health Services & Diabetes Aus.

Promotes health to empower individuals & community

Equity of access to health facilities and services

SES

Knowledge of available services

Geographic location

Culture & religious beliefs

Access affects issues like:

Shortages of qualified staff Lack of funding/equipment Patient waiting list for surgery Waiting times in emergency departments

Health care expenditure VS early intervention and prevention expenditure:

It costs more to ‘cure’ a disease once it has developed than it does to fund measures to ‘prevent’ the illness

More than 90% of Aus health expenditure is allocated to treating & curing illnesses

Preventative programs:

Knowledge gap= lack of education, poor literacy, migrants, indigenous groups, language barrier

Early intervention focuses on:

Education

Healthy eating practices

Weight control Active lifestyle

Strategies to prevent illness and death: Educating children about

positive health behaviours Restrictions on advertising Higher taxes on alcohol

and tobacco Preventative Health strategies:

1. Cost effectiveness – preventing = huge savings 2. Improvement to quality of life – prevention= improvements in

morbidity rates and longevity3. Maintenance of social equity – policy of prevention= helps

provide greater equity

Impact of emerging new treatments and technologies on health care:

E.g. of developments in emerging treatments & technologies: progress advancing in treatment of eye conditions with drugs

instead of lasers quit smoking by

developing tablets genetic testing, which

finds diseases earlier and prevents death

E.g. of early intervention programs= pap smears, vaccines to prevent HPV infections, tests for prostate cancer.

Health insurance: Medicare and private:

Medicare

Provides access to – free treatment as public patient in public hospital

Provides access to – free/subsidised treatment by medical practitioners

All Aus covered 85%

Doctors Bulk Bill patients= patient pays nothing and doctor receives 100% (85% for specialists) of scheduled fee from Medicare

Medicare Private health insurance Who pays? CWLTH Gov

Tax payers CWLTH Gov Private

contributors How paid for? Levy/tax linked to

salary Monthly premiums for

various forms of cover What benefits? Basic medical services

Choice of GP Basic hospital services Specialist health care

Some special benefits – e.g. sports equipment

The rest is listed above in the mind map.

Complementary and Alternative Health-Care Approaches:

Short wait times

Able to stay in hospital of own choice

Have doctor of own choice

Ancillary benefits – dental cover

Security, protection, peace of mind

Private rooms

Insurance covers while overseas

Reasons for the growth of complementary and alternative health products and services:

1. WHO recognition – support of a list of medicinal plants for use in preparation for herbal medicines

2. Alternative medicine – traditional method 3. Effectiveness of treatment4. Herbal medicine= desire, rather than synthetically produced medicine.

Range of products and services available:

Alternative health care approach Description Acupuncture Involves inserting needles into skin.

Healing= stimulates body and mind’s own healing response

Aromatherapy Use of pure essential oils to influence, mind, body/ spirit. Used in treatment of depression, sleeping disorders, anxiety

Chiropractic Based on relationship between spine and functioning of nervous and musculoskeletal system

Herbalism Uses plants and herbs. Used to restore & support body’s own defence mechanisms.

How to make informed consumer choices:

A client needs to ask the following ques: What is the treatment you offer? How does it benefit me? What experience and training do you have? What are your qualifications? How much will the treatment cost? Can this treatment be combined with conventional medication?

Private health insurance:

CWLTH Gov implemented schemes to encourage people to take out private health insurance:

30% tax rebate (discount) – for people with private health insurance 1% Medicare levy surcharge (extra) Lifetime health care incentive with lower premiums (payments) to those

who join before age 30.

Disadvantages of Medicare:

Some services not covered. E.g. dental services Waiting lists

Limitations to level of choices available. No choice of doctor

Disadvantages of private health insurance:

Costly Premiums must be paid regardless of levels of use.

Chapter 4 Actions required to address Australia’s health priorities

Ottawa Charter:

Five Action Areas:

1. Developing Personal Skills D ( acronym= DRBSC)2. Re-orientating Health Services R3. Building Healthy Public Policy Biggie4. Strengthening Community Action Smalls5. Creating Supportive Environments Cat

How health promotion based on the Ottawa Charter promotes social justice:

Social justice principles = Equity, Diversity, Supportive Environments.

Five action areas Equity Diversity Supportive environments

Developing personal skills

Mandatory PDHPE K-10

Access to Medicare community based support

Media campaigns

Re-orientating health services

Health services for ABTSI

Language assistance

Partnerships with the community

Building healthy public policy

Bulk billing (pharmaceutical Benefits Scheme)

AbStudy health care cards

Health campaigns

Strengthening community action

Lobby groups Lobby groups Lobby Groups

Creating Provision of health Destigmating Legislative

Developed in 1986 by UN

Established by WHO

supportive environments

enhancing items (labelling health conditions to cover areas of health promotion) health conditions

bans Provision of

health enhancing items

E.g. of health promotions that are based on the Ottawa Charter to an extent include:

Closing The Gap Fresh Tastes @ School National Tobacco Strategy National Action Plan on Mental Health

Explanation of each action area:

1. Developing personal skills: aimed at improving knowledge and skills of individuals so they:

Are able to make informed health decisions Have the capacity to be a positive influence on those around them

Equity – education to improve all people’s levels of health literacy is central in ensuring they have information and skills required to make decisions about their health to ensure positive outcomes.

Diversity – is about ensuring that information is relevant to all people regardless of their age, gender, culture, geographic location, sexuality or socio-economic status. Programs must be able to be personalised in order to target all individuals

Supportive environments – empowering individuals by giving them knowledge and skills, which they can pass on to others within their environment. If a parent is educated about healthy food habits they will provide nutritious foods for their children, which will reduce the chance of them developing a diet related illness such as diabetes.

2. Re-orientating health services: the process of re-orientating health services encourages the health sector to move beyond its traditional role of providing curative services.

This is also about change in professional education & training.

Equity – all individuals, regardless of educational backgrounds, should have equal opportunities to train in the promotion of health as well as the provision of health services to increase the health outcomes of their own community and that of others.

3. Building healthy public policy – laws can ensure that all people are treated fairly, regardless of their social makers. E.g.:

All workplaces have government enforced smoking bans that protect both blue-collar & white-collar workers.

PBS is an e.g. of equity because the government provides affordable and equal access to prescription drugs, as the government subsidises the cost of medication to assist people from low SES.

The ‘no hat no play’ policy in primary schools promotes a supportive environment for children, as wearing a hat during play is compulsory. This protects children from UV exposure.

4. Strengthening community action – valuing diversity is essential when aiming to strengthen community action. Each community is unique & different so must be consulted about the development of health promotion strategies intended to improve their health.

Developing equity between communities is also important. Resources whether financial, structural or human – must be equally available to all communities in order to optimise potential for health promotion success.

5. Creating supportive environments – the place they live and the people around them can either create barriers to good health or in optimal conditions help to break down barriers

Supportive environments – local council improves the lighting & security of the local bicycle track it will increase the chance of it being used by people either early hour of the morning or later in the evening. This increased level of availability may encourage member of the community to use the track and therefore improve their physical fitness.

Year 12 (HSC) PDHPE Core 1 Study Notes

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