What are the priority issues for improving Australia's health?

Question 1

Groups experiencing health inequities

Answer 1

• Aboriginal and Torres Strait Islander Peoples
• The elderly
• The disabled
• Rural and remote communities
• Overseas born
• Socioeconomically disadvantaged

Question 2

Nature and extent of health inequalities for Aboriginal and Torres Strait Islander People

Answer 2

• Lower life expectancy
• Higher mortality rates at all ages
• Higher death rates from cancer, CVD, Respiratory disease + diabetes
• infant mortality is twice that for ATSI people

Question 3

Trends for ATSI

Answer 3

• A decline in death rates from all causes for indigenous males and similar for females

Question 4

Sociocultural, economic and environmental determinants of ATSI health

Answer 4

• Cultural: high rates of smoking, lack of role models, alcohol abuse
• economic: higher rates of youth unemployment due to lower levels of education, resulting in poorer life choices, lower literacy levels, lower income levels
• environmental: over 50% of ATSI population live in geographical isolation (rural and remote areas), poor access to health services + care

Question 5

What are the role individuals, communities and governments play in addressing health inequities?

Answer 5

• Individuals: access health support, make positive and healthy choices
• communities: organisations aim to provide primary health care services such as Aboriginal controlled health services (ACCHS) and Aboriginal medical services (AMS). These organisations partner up with ATSI communities to identify priority issues and provide an extensive range of indigenous focused services.
• Governments: $805 million Indigenous Chronic Disease package, close the gap campaign

Question 6

Nature and extent of health inequalities for the socioeconomically disadvantaged

Answer 6

• measured by income, housing, education, employment
• men and women from lower socioeconomic backgrounds have higher rates of mortality and illness

Question 7

Sociocultural, socioeconomic and environmental determinants of socioeconomically disadvantaged

Answer 7

• Cultural: family structures, prominent smoking culture due to lack of income, increased likelihood of discrimination, inactive lifestyle with lack of nutrition and proper diet
• economic: lower levels of education leading to lower employment opportunities
• environmental: limited or reduced access to health resources, less safe working conditions

Question 8

The role of individuals, communities and governments in addressing socioeconomic health inequities

Answer 8

• Individuals: increased access to information e.g. brochures, participation in health promotion activities and enhancing health literacy
• communities: education and encourage members of the community, provide relevant health care services, initiatives e.g. “youth off the streets”
• governments: free or reduced course of health through medicare, free or subsidised treatments from health professionals, income support through centrelink

Question 9

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

Answer 9

• protective behaviours: likely to enhance a person’s level of health e.g. healthy eating
• Risk behaviours: behaviours that contribute to the development of health problems or poorer levels of health e.g. smoking

Question 10

Cardiovascular Disease (CVD)

Answer 10

• Refers to damage to, or disease of, the heart, arteries, veins and/or smaller blood vessels
• Identifies as health priority area
• One of leading cause of death and sickness
• more likely in males and indigenous people

Question 11

Nature of CVD

Answer 11

3 forms of CVD:
- coronary heart disease - (poor supply of blood to the muscular walls of the heart by its own
blood supply vessels, the coronary arteries)
- Stroke - (interruption of supply of blood to the brain)
- Peripheral Vascular disease - (disease of the arteries, arterioles and capillaries that affect the
limbs, usually reducing blood supply to the legs)

Question 12

Atherosclerosis

Answer 12

• Build up of fatty and/or fibrous material on the interior walls of the arteries hindering the flow of blood to the body’s tissues + increases blood pressure
• degenerative disease

Question 13

CVD

Answer 13

Manifests as a heart attack or angina
- Heart Attack: is caused by a complete closure of a coronary artery or when a clot blocks a narrow artery
- Heart relies on a regular oxygenated blood flow - without this causes tissue damage therefore a heart attack.
- can result in sudden death

Question 14

CVD

Answer 14

• Angina pectoris: is chest pain that occurs when there is an insufficient supply of oxygenated blood
• may be experienced by a heart attack sufferer
• Stroke: results from a blockage of blood to the brain
• can affect the body from functioning severely
• Heart failure: the heart’s inability to cater to the tasks of everyday life
• Peripheral vascular disease: reduced blood flow to the legs and the feet usually due to atherosclerosis or arteriosclerosis.

Question 15

The extent of CVD in Australia

Answer 15

• 1 in 6 Australian’s affected by CVD = 4.2 million Australians
• steady decline in CVD death rates
• accounted for 29% of deaths among all Australians in 2015
• CHD leading cause of death in Australia overall
• Cerebrovascular disease/stroke is the second leading cause of cvd
• Declining prevalence of CVD is due to reduction in the levels of risk factors and, improved medical care + treatment

Question 16

CVD and morbidity

Answer 16

• leading cause of disability - 1.4 million
• CVD accounted for 6% of hospitalisation in 2013/14

Question 17

Risk, protective and modifiable factors of CVD

Answer 17

Risk:
- Genetics
- Gender
- Advancing age
Protective factors:
- Regular physical activity
- Eating a diet low in saturated fat and cholesterol
- low consumption of alcohol
- consuming a diet low in salt
- maintaining healthy weight
- managing stress
- avoiding exposure to tobacco smoke
Modifiable risk factors:
- smoking
- raising blood fat levels
- high blood pressure
- obesity and overweight conditions
- abdominal obesity
- physical inactivity
non-modifiable factors:
- genetics
- old age
- gender

Question 18

sociocultural determinants of CVD

Answer 18

• family history
• asian people less prone to getting CVD due to generally low fat diet
• Aboriginal and Torres Strait islanders more at risk
• media exposure of the effects of smoking have influenced a decline in CVD rates

Question 19

socioeconomic determinants of CVD

Answer 19

• have higher death rates
• poor education leads to poorer health choices and less knowledge of how to access health services

Question 20

environmental determinants of CVD

Answer 20

• people living in rural and remote areas are more at risk as they tend to have less accessibility to health information, health services and technology

Question 21

Groups at risk of developing CVD

Answer 21

• Tobacco smokers
• people with family history of CVD
• people with high blood pressure levels
• people who consume a high fat diet
• aged 65+ males
• blue collared workers

Question 22

Nature of cancer

Answer 22

• uncontrolled growth and spread of abnormal body cells
• benign tumour (not cancerous)
• Malignant tumour (cancerous)
• tumour (groups or lumps of abnormal cells)
• Neoplasm (an abnormal mass of tissue that forms when cells grow and divide more than they should)
• Metastases (the development of secondary malignant growths at a distance from a primary site of cancer)

Question 23

Extent of cancer

Answer 23

• Prevalence of cancer is increasing
• Increase in incidence due to ageing population, better detection of cancer, new diagnostic technology and screening programs and better reporting of cancer
• more frequent in males than females

Question 24

Lung Cancer

Answer 24

• Most common occurring type of cancer
• 10x higher in smokers than non-smokers
  risk factors:
• tobacco smoking
• occupational exposure to cancer-causing agents
• air pollution
  protective factors:
• avoid exposure to tobacco smoke
• avoid exposure to hazardous material
  groups at risk:
• smokers
• people exposed to occupational hazards
• people working in blue collar occupations
• men/women aged 50+

Question 25

Breast Cancer

Answer 25

• second most common cause of cancer for women
• affects 1 in 8 women
• incidence + risk increases with age
  risk factors:
• genetics
• age
• poor diet
• early menstruation
• late menopause
• no children
  protective factors:
• consume a diet in high fruits + vegetables
• practice self examination
• have regular mammograms
  groups at risk:
• women who have given birth
• obese women
• women 50+
• direct relative
• do not practice self examination
• women with early menstruation or late menopause

Question 26

Skin Cancer

Answer 26

• most common skin disease
• highest skin cancer rates in the world
• Basal cell carcinoma + squamous cell carcinoma&raquo_space; most common
  risk factors:
• prolonged exposure to ultraviolet radiation
• fair skin, red hair and blue eyes
• number of moles on skin
  protective factors:
• avoid excess exposure to strong sunlight
• wearing hat, sunscreen, appropriate and protective clothing
  groups at risk:
• people in lower latitudes
• people with fair skin
• people in outdoor occupations

Question 27

Cancer health determinants

Answer 27

• cultural: genetics more at risk, lung cervical cancer higher risk for ATSI (higher rates of smoking)
• economic: occupational hazards, SES and income restrictions limit health choices
• environmental: rural and remote are more at risk, as they tend to have less access to health information

Question 28

nature of Diabetes

Answer 28

Type 1:
- body produces minimum amounts of insulin or none at all
- controlled by injecting an artificial supply on insulin
- developed in children/ young adults
Type 2:
- The pancreas has the ability to produce oxygen but the amount is insufficient or less effective
- treatment: healthy eating, regular exercise and medication
- most commonly occurring in 50+
- excessive weight plays vital role
Gestational diabetes:
- during pregnancy
- insulin resistance

Question 29

Extent of diabetes

Answer 29

• increasing in prevalence
• prevalence increases with age
• higher for males
• ATSI have one of the highest prevalence rates for type 2 in the world
• experience lower life expectancy
• 85% are type 2

Question 30

Risk factors of diabetes

Answer 30

• physical inactivity
• high consumption of alcohol
• diet high in fat and sugar
• family history
• are over 45 with high blood pressure
• over 35 ATSI

Question 31

Protective factors of diabetes

Answer 31

• nutritious food
• diet low in fat
• healthy body weight
• limit alcohol intake
• breast feeding

Question 32

Groups at risk of diabetes

Answer 32

cultural:
- ATSI
- family history
economic:
- Low SES
environmental:
- greater access to technology

Question 33

A growing and ageing population

Answer 33

• Consequence of sustained low fertility levels and increasing life expectancy at birth
• Last 1/2 of 20th century showed:
  o Decline in fertility
  o Decline in mortality
  o In 2012, 13% of the population was 65y+

Question 34

Healthy ageing

Answer 34

• Government has responded by urging people to financially plan for their later years in life
• People who maintain good health are less likely to access health aged care services later in life
• increase population living with chronic disease and disability = impact on health care services

Question 35

increased population living with chronic disease and disability

Answer 35

• Ageing population has led to an increase in the no. of Australians with a chronic disease/disability
• Chronic, non-communicable diseases account for approx. 80% of the total burden of disease

Question 36

Demand for health services and workforce shortages

Answer 36

• demand for health services + aged care has risen
  o Increased residential aged care places
  o More funding for dementia care in aged care
  o Incentives for people to remain in their homes
  o Attracting, retaining, and training aged care workers
• Improving Aus retirement income system: o Means-tested age pension
  o Superannuation cover
  o Voluntary, private superannuation contributions and other forms of private savings
• Such initiatives encourage people to plan for financial security and independence for their late years of life to
  reduce the economic burden on the government as Australia’s population ages.

Question 37

Availability of carers and volunteers

Answer 37

• carers (continual care e.g family members) and volunteers (members of community who are unpaid) are ageing with the rest of the population
• Australians over the age of 55, for example, contribute approximately $75 billion per annum in unpaid caring
  and volunteering activities.
• Predicted shortage of carers in the future

Question 38

The impact of a growing and ageing population

Answer 38

The health care system and services
- concern that there will be an unsustainable pressure on public spending and rising health costs
Health service workers
- increase in demand for home and community care services such as meals on wheels
- increase spending on primary health care, health promotion and health, safety and security
Carers of elderly
- Carers NSW provide support, training and services to carers and represent the needs of carers publicly politically.
volunteer organisations
- largely understaffed
- suffered increased costs