Unit 3 AOS 2 SAC 1

Question 1

Leading causes of disease in the 1900s and why

Answer 1

Infectious diseases
Cardiovascular disease
Cancer
Respiratory diseases
Injury and poisoning

Improvements in sanitation, public health (vaccination development and delivery), and medical treatments, such as antibiotics, led to dramatic declines in deaths from infectious diseases during the 20th century.

Question 2

How has public health changed since 1900 and why

Answer 2

Improvements in sanitation, public health (vaccination development and delivery), and medical treatments, such as antibiotics, led to dramatic declines in deaths from infectious diseases during the 20th century.

• Control of infectious disease
• Better hygiene
• Improved nutrition
• Improved sanitation
• Better understanding of dehydration

Question 3

What is public health

Answer 3

The organised response by society (governments) to protect and promote health and wellbeing, and to prevent illness and injury.

Question 4

What is “old” public health

Answer 4

Government actions that focussed on changing the physical environment to prevent the spread of disease, such as providing safe water, sanitation and sewerage disposal, improved nutrition, improved housing conditions and better work conditions.

Question 5

Biomedical model and examples

Answer 5

The biomedical model of health focuses on the physical or biological aspects of disease and illness. It is a medical model of care practiced by doctors and health professionals and is associated with the diagnosis, cure and treatment of disease.

E.g. x-rays, scans, blood tests, surgery, ultrasound etc.

• ‘Bandaid’ or quick fix approach
• aims to return the patient to pre-illness health
• relies on medical practitioners and technology
• focuses on the individual

Question 6

Improvements in technology as a result of the biomedical model of health

Answer 6

• Stethoscope in 1910 (measure blood pressure)
• New X-ray techniques.
• Heart-lung bypass machine
• Hypertension medication
• Coronary angioplasty and stent
• Cholesterol medication
• Pacemaker

Question 7

Social model of health

Answer 7

An approach that recognises improvements in health and wellbeing can only be achieved by directing effort towards addressing the physical, sociocultural and political environments of health that have an impact on individuals and population groups

Question 8

AREAS

Answer 8

Addresses the broader determinants/factors of health:

• focus on more than the behavioural factors
• social, economic, and environmental determinants

Involves intersectoral collaboration:
- government and non-government groups working together to address barriers and improve health outcomes for all

Acts to reduce social inequity:

• reduce the barriers that may prevent people from experiencing good health such as income, race, gender
• aim to ‘level the playing field’

Acts to enable access to healthcare:
- address the social and environmental barriers that may restrict someone’s ability to access healthcare, such as location, income.

Empowers individuals and communities:
- give people the knowledge and skills needed to allow them to participate in the decisions that positively impact their health

Question 9

Difference in the old and new (social model) models of health

Answer 9

Biomedical model:
Individual focus
Focus on cure
Not all conditions can be treated

Social model:
Population focus
Focus on prevention
Not all conditions can be prevented

Question 10

Health promotion

Answer 10

The process of enabling people to increase control over, and to improve, their health

Question 11

Ottawa Charter

Answer 11

An approach to health developed by the World Health Organisation that aims to reduce inequalities in health. It reflects the social model of health and provides five action areas that can be used as a basis for improving health status, all of which are centred around three strategies for health promotion which are enabling, mediating and advocacy.

Question 12

Bad Cats Smell Dead Rats

B

Answer 12

Build healthy public policy:
Refers to decisions (laws, policies) made by government and organisations that affect health
Laws and policies that make it easier to practice good health
E.g. removing the goods and services tax (GST) on unprocessed foods (which are healthier options than processed foods) and increasing the tax on certain alcoholic drinks.

Question 13

Bad Cats Smell Dead Rats

C

Answer 13

Create supportive environments: about making it easier for people to make healthy choices by providing a physical and social environment that promotes health rather than detracts from it.

E.g.

• councils installing shade cloths over playgrounds
• bike paths and walking tracks
• the Quitline online service
• Kids Help Line counselling
• Red Frogs at Schoolies

Question 14

Bad Cats Smell Dead Rats

S

Answer 14

Strengthen community action: refers to involving many different groups within the community to work towards a common goal of improving health.
This works to build links between individuals and communities to encourage communities to be involved in the development of health promotion campaigns and feel a sense of ownership

E.g. Local Men’s Shed programs

Question 15

Bad Cats Smell Dead Rats

D

Answer 15

Develop personal skills: is about providing people with the skills they need to be able to take control of their health and make healthy choices.
This priority area is about education, specifically the development of health-related knowledge.

E.g. The big issue

Question 16

Bad Cats Smell Dead Rats

R

Answer 16

Reorienting health services: is about shifting the health system the health system towards prevention, as opposed to focusing on cure.

A doctor’s waiting room often has preventative messages on their wall, such as reducing tobacco smoking or preventative measures for type 2 diabetes

Question 17

Social model of health strengths and limitations

Answer 17

Strengths:

• Aimed at a population level; therefore, more cost-effective
• Encourages good health through disease-prevention
• Health messages can be passed down to future generations
• Can be targeted to vulnerable population groups

Limitations:

• Health messages may be ignored
• Not all conditions can be prevented (for example, genetic conditions)
• Doesn’t assist those who are already sick

Question 18

The biomedical model of health strength and limitations

Answer 18

Strengths:

• Life expectancy extended and quality of life improved
• Leads to significant advances in medical technology and research
• Most people and conditions can be treated and ‘cured’.

Limitations:

• The ‘fix-it’ approach doesn’t promote good health
• Relies on costly medical technology and practitioners
• Not all conditions can be treated or cured

Question 19

Relationship between biomedical model and social models of health

Answer 19

The social model of health considers preventative measures, whereas the biomedical model considers only diagnosis, cure and treatment of disease. This results in the social model of health placing less of a burden on the Australian healthcare system

Question 20

Social model of health principles - obesity prevention

Answer 20

Addresses the broader health determinants:

• make affordable access to culturally appropriate healthy foods
• ensuring affordable access to recreational facilities to encourage physical activity, such as well-lit walking tracks

Acts to reduce social inequities:
- health-promotion campaigns such as LiveLighter free access to resources, such as the 12 week meal and activity planner, to allow all members of the community to be able to access these resource, and can be downloaded in different languages

Empowers individuals and communities:

• workplaces running health cooking demonstrations to develop employee skills on preparing healthy lunches
• nutrition education programs in primary and secondary schools

Acts to enable access to healthcare:
- provision of bariatric services e.g. lap-band surgery, in public hospitals via Medicare

Involves intersectorial collaboration:
- Federal government working alongside Heart Foundation and Cancer Council to implement the LiveLighter program

Question 21

Examples of medical technologies in treating cardiovascular disease

Answer 21

Pharmaceuticals:

• blood pressure medication
• blood thinners
• cholesterol lowering medication

Surgeries:

• bypass surgeries
• pacemaker
• stenting

Other medical interventions:
- defibrillator

Question 22

Medicare

Answer 22

A universal health insurance scheme as it is available to all Australian residents, regardless of income, location and culture.

Question 23

PBS (Pharmaceutical Benefits Scheme)

Answer 23

A federal government initiative that aims to make essential medicines available through subsidising a range of prescription medications at affordable prices for Australian citizens

Question 24

PBS advantages

Answer 24

• They subsidise the prices of medications to make it affordable for Australians
• Available for over 5000 medications
• Providing access to essential medication
• Enables access to medications from local pharmacies
• Includes PBS Safety Net and the RPBS to further protect people from the high cost of medication
• Available to all citizens despite age
• Provides additional support to those with concession cards by having lower co-payments.

Question 25

PBS disadvantages

Answer 25

- Doesn't subsidise every medication - Available for over 5000 medications - Dispensing fees - Providing access to essential medication - Significant financial burden it places on the Australian Government - Enables access to medications from local pharmacies - The co-payment of $38.80 that still needs to be paid by most Australians

Question 26

PBS | Equity, Sustainability, Access

Answer 26

Funding - Essential medicines; including those subsidised through the PBS Sustainability - Only certain medications are subsidised, otherwise, it’s too costly Access - Subsided medication; through the PBS, including further concessions for low-income earners, removes the income barrier Equity - PBS Safety Net, the government is trying to ensure financial costs areas ‘fair’ as possible Full price [$38.80] or concession rate [$6.30] - those low income, pensioners or seniors - The PBS Safety Net is in place to assist those people who have a reliance on prescription medication and protect them from significant financial costs

Question 27

Medicare | Who can access it and what it covers

Answer 27

Who can access it: - all Australian permanent residents What's covered: - GP visits - Treatment and accommodations as a public patient in a public hospital - Eyes tests - X-rays - Pathology tests (blood tests)

Question 28

How is Medicare funded

Answer 28

Medicare funding: - General taxation: additional costs - Medicare levy: additional 2% of their tax - Medicare levy surcharge: additional 1-1.5% tax on top for high income earners

Question 29

Advantages and Disadvantages of Medicare

Answer 29

Advantages: - available to all Australian citizens - basic health tests and treatments are provided at little or no cost - reciprocal arrangements with other countries allow Australian citizens to access subsidised/free health care in other countries - allows patients to choose their own doctor for out-of-hospital services Disadvantages: - waiting lists for many non-emergency treatments - doesn't cover many common alternative treatments such as massage - may not cover all costs of doctors and specialist fees if charged more than the scheduled fee - does not allow patients to choose their doctor for in-hospital treatments

Question 30

Medicare | Sustainability, Access, Equity

Answer 30

Sustainability: - The Medicare levy increased from 1.5 to 2 per cent in July 2014 to assist in providing the necessary funds to maintain Australia’s health system and introduce the National Disability Insurance Scheme. Access: - It covers the cost of healthcare in public hospitals, making it more accessible for Australians Equity: - Medicare promotes equity by providing hospital care to all Australians, regardless of their ability to pay. - The Medicare funding also reflects equity as it is based on a percentage of an individual’s income, so those who earn more, pay more - Safety net and concession pricing schedules make financial costs as fair as possible

Question 31

How does medicare promote Australia's health

Answer 31

Medicare pays rebates for medical services and procedures provided by private practitioners in the community such as GPs and other medical practitioners, and Medicare ensures Australians have access to free hospital services for public patients in public hospitals and a range of prescription pharmaceuticals subsidised

Question 32

How does PBS promote Australia's health

Answer 32

The PBS provides timely, reliable and affordable access to necessary medicines for Australians Under the PBS, the government subsidises the cost of medicine for most medical conditions. Most of the listed medicines are dispensed by pharmacists, and used by patients at home.

Question 33

NDIS

Answer 33

The NDIS will provide all Australians under the age of 65 who have a permanent and significant disability with the reasonable and necessary supports they need to enjoy an ordinary life. The NDIS will help people with disability achieve their goals. This may include greater independence, community involvement, employment and improved wellbeing.

Question 34

NDIS | advantages and disadvantages

Answer 34

Advantages: - Allows individuals with a disability to tailor the NDIS funding to their specific needs. - It enables individuals to have access to specialised services to assist with their disability. - NDIS allocates a caseworker to assist the person with the disability and their family. Disadvantages: - Individuals have to meet the criteria to qualify for NDIS, therefore not all Australians with disabilities are catered for. - There have been examples of some services actually charging more when they know an individual is on NDIS.

Question 35

Who is eligible for the NDIS

Answer 35

- Be under 65 years of age - Be an Australian citizen - Live in Australia where NDIS is available - Have an permanent and significant impairment that impacts social and economic participation

Question 36

NDIS | access, equity, sustainability

Answer 36

Access: - The NDIS aims to provide the necessary financial support to access the required services to achieve their goals and promote health for all Australians with a significant and permanent disability. - The NDIS has been rolled out in every region in Australia, improving access to those living in major cities. Equity: - The NDIS is equitable as it ensures people with a disability and their carers are able to access more resources in a sector that needs help the most. - The NDIS individualised plan ensures those with more significant needs, receive more assistance. Sustainability: - The roll out of the NDIS over 3 years ensures that it is sustainable. - The support and individualised plan provided by the NDIS is for the lifetime of the person with the disability. The distribution of funds is allocated on a needs basis which results an efficient health system improving health outcomes.

Question 37

How does NDIS promote Australia's health

Answer 37

Provides services and support for people with permanent, significant disabilities, and their families and carers

Question 38

PHI (Private Health Insurance)

Answer 38

An optional additional health insurance which provides people with coverage for health services not covered by Medicare. Private health insurance requires consumers to pay a fee, also known as an insurance premium.

Question 39

PHI | advantages and disadvantages

Answer 39

Advantages: - Enables access to private hospital care - Choice of doctor while in public or private hospital - Shorter waiting times for some medical procedures - Depending on level of cover, some dental, chiropractic, physiotherapy services can be paid for Disadvantages: - Costly in terms of the premiums that have to be paid - Sometimes have a ‘gap’ which means the insurance doesn’t cover the whole fee and the individual must pay the difference - Policies can be complex to understand and create confusion

Question 40

PHI | Sustainability, Access, Equity

Answer 40

Sustianability - The PBS aims to be economically sustainable by subsidising the cost of a wide range of essential medications to treat chronic conditions to make them more affordable to all Australians so they can meet their needs. - Subsidised medications may reduce the cost to the wider health system by preventing development of chronic conditions and therefore reduce the demand for hospital stays and demands on healthcare. - Constant reviewing of medicines available means only reliable medications are added to the PBS that would meet the needs of current generations and improve the health of people in the future. Access: - All Australian citizens and permanent residents are entitled to access subsidised medicines through the PBS. - Low income earners have increased access to essential medicines with the lower concessional cost. - The PBS provides timely access to medication at local pharmacies at a reduced cost. This quick access to medication will also lead to a reduction in the time spent in ill health. The low cost medication increases affordability and therefore more financially accessible. Equity: - The concessional cost provides greater assistance to low income earners and unemployed. - The introduction of close the gap PBS co-payment for indigenous Australians with chronic disease promotes equity by providing additional support for this disadvantaged population group in Australia. - The PBS also has a safety net for people with chronic illness or concession card holders therefore reducing the cost for PBS medications and providing support to those who need it. - As the PBS is available to all Australians it does not discriminate on the basis of age, race, gender, income location or health status.

Question 41

PHI promoting health in Australia

Answer 41

The PBS plays an important role in promoting health in Australia by making medications more readily available to all Australians in the aim to reduce the impact of health conditions therefore reducing illness, improving life expectancy and health status.

Question 42

PHI funding

Answer 42

Essential medicines are subsidised through the PBS, providing treatment for many conditions, promoting health outcomes.

Question 43

Smoking | Why is it targetted

Answer 43

Smoking is a preventable risk factor, so all smoking-related diseases and impacts are considered to be avoidable. Smoking affects vulnerable population groups disproportionately, with people living outside major cities and people from Indigenous and low socioeconomic backgrounds being more likely to smoke tobacco, contributing to the lower levels of health and wellbeing experienced by these groups.