1
Q
What is the role of epidemiology?
A
The study of the patterns and causes of health & diseases in populations. This study is applied to improve health
2
Q
What can epidemiology tell us?
A
The basic health status of Australia and the trends in mortality/morbidity over a period of time. It:
- Monitors major causes of illness and death (emerging issues and inequalities)
- Identifies and targets areas in need of prevention, treatment and funding
- Monitors use of health care services
3
Q
Who uses the measures of epidemiology?
A
- Policymakers (three levels of government i.e. local, state, federal)
- Manufacturers of health products (drug) and providers of health services (gym/helplines)
- Governments to compare our health with other countries
4
Q
Identify the limitations of epidemiology?
A
- Doesn’t show variations between health status among subgroups E.G. ATSI & non – AB people
- Doesn’t accurately indicate the quality of life in terms of people’s health
- Can’t provide whole picture health E.G. mental health is non-existent in data
- Imprecise methods, source and reliability of data collections E.G. R/R areas
5
Q
Identify the 4 measures of epidemiology?
A
- Morbidity
- Mortality
- Infant mortality
- Life expectancy
6
Q
- Morbidity + examples
A
= refers to ill health in an individual and to levels of ill health in a population
E.G. the number of cases of obesity is increasing, whereas CHD is declining in both females and males in AUS
= Has two indicators
- Prevalence: the number of cases of disease at a specific time
- Incidence: the number of new cases occurring
7
Q
- Mortality + examples
A
= measures the number of deaths from a particular cause over a given period of time
- E.G. lung cancer (the leading cause of death) is decreasing for males and increasing for females
- 2nd leading cause = dementia & Alzheimer
8
Q
- Infant mortality + examples
A
= measures the number of deaths among children aged under 1 year in a given period per 1000 live births
- predicts adult life expectancy
- E.G. infant mortality is decreasing & relatively low
- Indicates better health education & improved medical diagnosis
9
Q
- Life expectancy + examples
A
= the average number of years a person will live
E.G. females = 84.4 yrs,
E.G. males = 80.3 yrs
- Death rates continue to fall due to better healthcare, immunisation, the decline in CVD and cancer deaths, reduced traffic accidents, etc
10
Q
Identify the priority health issues
A
- Social justice principles
- Priority population groups
- Prevalence of conditions
- Potential for prevention and early intervention
- Cost to individuals and communities
11
Q
- Social justice principles
A
SJ = the elimination of inequity, the promotion of inclusiveness and the establishment of supportive environments for all
- Equity = everyone has fair access to health services, support & resources
E.G. Centrelink (financial aid) - Diversity = recognises social, cultural factors that impact an individual’s health/wellbeing
E.G. brochures in multiple languages within hospitals - Supportive environments = physical and social aspects of where people live, play & work + access to resources & opportunities
E.G. National Road Safety Strategy i.e. additional speed cameras
12
Q
- Priority population groups
A
PPG = groups in society with significantly different health statuses, disadvantages & inequalities:
- ATSI people = higher death rate (10.6% male, 9.5% female), smoking rates, rates of disability
- Low SES = higher rates of smoking & diabetes levels, death from avoidable causes, less likely to seek dental check-ups to cost
- R & R Area = higher levels of smoking, rates of obesity, levels of risky drinking, blood pressure and lack of activity
13
Q
- Prevalence of conditions
A
- Prevalence of a condition assists in the identification of risk factors = indicates the potential for change for the health issue
- High prevalence of specific diseases places a significant economic & health burden on the community
- E.G. CVD is the leading cause of preventable death in AUS
14
Q
- Potential for prevention and early intervention
A
- Intervention should be aimed at modifying the environment which can change people’s lifestyle behaviours
- Educating people & making them aware of the risk factors
- Sociocultural: E.G. men with a high tendency to part-take in high-risk activities i.e. drugs
- Physical: E.G. affect a person’s ability to attain work/socialise
- Environmental: E.G. . R & R areas have less access to health services/treatment
- Economic: E.G. $$ treatment & health services impacts their health literacy
15
Q
- Costs to individuals and communities
A
INDIVIDUAL = cost/burden measure in terms of:
- Direct effect = the cost of medication and treatment, loss of income
- Indirect effect = the cost of emotional stress, depression, the burden on others, reduced quality of life
COMMUNITIES = economic burden of illness, disease & death
- Direct effect = the cost of hospitalisation, Medicare, prevention programs, pharmaceuticals, education and screening
- Indirect effect = the cost of foregone earning, retraining replacement workers and absenteeism
16
Q
Difference between health inequity vs. health inequality
A
- Inequity refers to unfair/unjust differences in health
- Inequality refers to the differences in the health of individuals and groups
17
Q
Nature & extent of health inequities within ATSI populations?
A
- Significantly poorer outcomes than the rest of the Australian population
- Lower life expectancy (17 years less than other Australians)
- Higher levels of cancer (1.5x more likely), higher prevalence of cancer & higher levels of diabetes/CVD (5x more likely)
- This is due to lower levels of education, employment & income
18
Q
3 Health determinants within the ATSI population
A
SOCIOCULTURAL:
- Long history of racism & discrimination
- ATSI is intergenerational & impacts physical health
- More likely to participate in high-risk activities i.e. drugs
- Low self-esteem and poor mental health
SOCIOECONOMIC:
- Low levels of education can significantly limit employment opportunities
- Earn a lower gross income which can affect lifestyle behaviours (physical activity & diet)
ENVIRONMENTAL:
- Large proportion live in rural areas which have limited access to health care services and facilities
- Employment opportunities are labour intensive this increased risk of injury
19
Q
Role of communities, individuals & governments within ATSI population
A
INDIVIDUALS: access information & health services
- encourage choices promoting good health
- E.G. ATSI should pursue careers in health care
COMMUNITIES: responsibility to address inequities
- provide support, educate the community, create awareness E.G. QUIT smoking groups
GOVERNMENTS: creating health policies
- health initiatives specifically designed to improve the health of ATSI E.G. Closing the Gap
20
Q
Nature & extent of health inequities within R/R areas
A
- Death rates 1.5 x more prevalent
- High rates of cancer, high levels of disability and suicide, high death rates of liver cirrhosis
- Poor oral health
- Links to the access of health facilities
21
Q
3 Health determinants within R/R areas
A
SOCIOCULTURAL:
- children growing up around smokers are subject to 2nd hand smoking & more likely to smoke when they are older
- Obese families influence their children’s diets & lifestyle
- lower levels of P.A. & higher levels of risky drinking
SOCIOECONOMIC:
- Education: lack of education opportunities leads to lower health literacy
- Employment: more likely to work on farms, in transportation or mines which is hazardous with higher rates of tobacco and alcohol use
- Income: lower average income
ENVIRONMENTAL:
- Poor distribution of medical specialists and medical technology E.G. GPs & cancer services in R/R areas
- Number of GP’s is rising but still lower than in major cities
22
Q
Role of communities, individuals & governments within R/R areas
A
INDIVIDUALS: good decision making and taking responsibility for their own health
- remaining in school or going to uni E.G. Charles Stewart
- improves knowledge, employment opportunities and income levels
- promotes good health choices in R/R families
COMMUNITIES: provides relevant health care and support services
- Developing of multi-purpose service programs
- Community health centres with the health services
GOVERNMENTS: funds programs to assist the health care of R/R living people
- E.G. Royal Flying Doctor Service provides health care, clinics, medical evacuations, provides medical check-ups and remote consultations
23
Q
What are chronic diseases + examples
A
Chronic diseases are long term and persistent conditions that can lead to a gradual deterioration of health & are responsible for 80% of the total disease burden
- Cardiovascular disease
- Cancer (skin, lung, breast)
- Diabetes
24
Q
Nature & Extent of CVD
A
CVD = Condition affecting the blood vessels and heart (poor supply of blood to muscular walls of the heart)
- Atherosclerosis is the main cause of CHD, stroke due to the build-up of fatty tissues in vessels causing narrowing and decrease in blood
- 1 in 6 Australians affected & cause 27% of deaths
- Decreasing mortality rate for both males/females
25
Risk & Protective Factors of CVD
Non-Modifiable Risk Factors:
- Age (older) and gender (males ignore warnings)
- Family history E.G. genetic heart conditions
Modifiable Risk Factors:
- Smoking = increases risk x2
- Raised blood fats, blood pressure (cholesterol, heart overload)
- Obesity, no PA = type 2 diabetes damage blood vessels & arteries
Protective Factors
- 30 mins physical activity per day – manage stress and provides a positive mindset
- Healthy diet = low salt and fat intake, safe alcohol consumption
- Medical check-ups for cholesterol and BP
26
3 Determinants linked to CVD
- Sociocultural = family history E.G. diet, Asians less prone, ATSI more at risk, media exposure of smoking reduces rates
- Socioeconomic = less money limits food choices, lower education decreases knowledge about risk behaviours
- Environmental = rural and remote less access to info, services and technology E.G. ECG (heart monitors), mass media campaigns of less fatty foods to improve nutrition
27
Groups at Risk for CVD
- ATSI = 2.6 x more likely to have a heart attack & 1.7x more likely to have a stroke over the age of 25 compared to other Australians
- Smokers = higher rates of CVD
- Socioeconomic disadvantaged = 40% death rate of CVD
- Overweight
28
Nature & extent of diabetes
- Relates to the body’s ability to control blood sugar levels using insulin and can be either hereditary or developmental
- Caused by improper functioning of pancreas, little insulin and high blood glucose levels
- Type 1 (juvenile) – no insulin produced to control blood sugar levels: genetics
- Type 2 (non-insulin) – characterised by a breakdown in the efficiency of insulin controlled by tablets, exercise and diet
- More than 1 in 20 Australians have diabetes (1.2 million)
- Men (6.8%), females (5.4%)
- E.G. ATSI = highest prevalence in the world of type 2
29
Breast cancer
* Highest incidence in women, death rates have fallen
Risk factors:
- Modifiable = high fat diet, physical inactivity, last first pregnancy
- Non-modifiable age, gender, family history, early menstruation
Protective factors: self-breast examination and mammograms every 2 years after 50, known family history, early detection
- Sociocultural: family history and modern lifestyle, pregnant after 40
- Socioeconomic: less education and knowledge, unhealthy diet
- Environmental: free breast screening
- Groups at risk: women who haven't given birth, obesity, over 50, no self-check, late menopause
30
Lung cancer
* The leading cause of cancer death, but preventable
* Decreased in males, increased in females
Risk factors:
- Modifiable = Tobacco smoking, being exposed 2nd hand to smoke
- Non-modifiable = gender, age, family history
Protective factors: Avoid or quit smoking, moderate alcohol consumption, healthy balanced diet
- Sociocultural: family history of cancer, less tolerance to smoking in culture E.G. ATSI, low SES and some stressed females more likely to smoke
- Socioeconomic: more likely to smoke
- Environmental: no smoking laws
- Groups at risk: smokers, blue-collar, men and women over 50
31
Skin cancer
* Most common incidence and AUs rates are highest in the world
* Types include basal cell carcinoma, squamous cell carcinoma & malignant melanoma
Risk factors:
- Modifiable = Unprotected exposure to the sun
- Non – modifiable = Having fair skin, large amounts of moles/freckles
Protective factors: sun protection, sunscreen, wearing sunglasses and hats
- Sociocultural: teens sunbake due to culture and media reports of tan, etc
- Socioeconomic: lifeguards/ outdoor workers, low education linked to poor health choices and less knowledge about how to access and use health services
- Environmental: school rules ‘no hat no play’ and Gov. laws outdoor workers provided with sunscreen
- Groups at risk: fair skin, no hat or sunscreen for outdoor workers
32
3 Determinants linked to diabetes
- Sociocultural – poor diets and sedentary lifestyles 4x more likely to be hospitalised and die from diabetes
- Socioeconomic – ATSI due to smoking, alcohol consumption, imbalanced diet
- Environmental – less access to health services, info, pollution, 2 x more likely to be hospitalised
33
Groups at Risk for diabetes
- ATSI, low SES, R & R, 55+, overweight, poor diet, frequent alcohol users, inactive populations
34
Growing and Ageing Population
- Australia’s growing and ageing population is a product of increased life expectancy and decreased birth rates
- 15% over 65 yrs. (2017)
- This is because families are having fewer children (fertility issues) and the population is living longer (education, PA and healthy lifestyle)
- The proportion of older Australians is growing at a faster rate than younger Australians
35
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
36
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
- AIM = to enhance an individual’s physical, mental and emotional health and reduce the risk of the early onset of disabilities and diseases
- Able to contribute to the workplace for a longer period of time, resulting in a greater economic growth
E.G. Superannuation significantly reduces the dependence that retirees have on pensions
- Healthy lifestyle saves money, prevents functional decline and enhances quality of life
37
Healthy Ageing
Refers to the participation in a healthy lifestyle that promotes health and increases the quality of life as one ages
- AIM = to enhance an individual’s physical, mental and emotional health and reduce the risk of the early onset of disabilities and diseases
- Able to contribute to the workplace for a longer period of time, resulting in a greater economic growth
E.G. Superannuation significantly reduces the dependence that retirees have on pensions
- Healthy lifestyle saves money, prevents functional decline and enhances the quality of life
38
Increased population living with chronic disease and disability
AGEING POPULATION:
- increase in the number of aged people = increase of chronic diseases and disabilities
- survival rates from many chronic diseases increases = quality of living and independence decreases
E.G. cancer, dementia, etc
PEOPLE'S LIFESTYLE:
- Technology makes people more sedentary
- People are more engaged in phones than doing physical exercise and sport
DEVELOPMENT OF MEDICAL TECHNOLOGY:
- Increased awareness encourages people to be screened for diseases E.G. signs, symptoms & risk factors of cancer
- Allows early diagnosis = appropriate treatment = mortality rates decrease
E.G. elderly: 53% have disabilities, 1 in 5 have CVD, 38% have high BP
39
Demand for health services & workforce shortages
- As people age, they become more susceptible to developing chronic diseases and other illnesses thus a greater need for health professionals, aged care workers & facilities and services is created
E.G. in the last 10 years, the number of people living in aged care facilities has risen by 20%
- Creates a strain on the public health system, Medicare and the PBS as more people will be utilising health services and require medication
40
Availability of carers and volunteers
CARERS
- the increase in chronic disease and disability = increase in carers and volunteers
- family members/friends may be responsible for caring for the elderly (dressing, feeding, giving medication)
- either part-time or full time
VOLUNTEER ORGANISATIONS
- Members of the community that offers their services to others for free - heavily rely on charity and donations
- - Volunteer/carers will face increased workload & decreasing rates of people volunteering
E.G. Meals on Wheels - meals for the elderly who are unable to cook a nutritious meal
E.G. Red cross – checks on people’s overall wellbeing and helps support isolated people
41
Healthcare in Australia
- Health care facilities and services provide treatment and management options for injuries and illness and better health for all
- Promotes early intervention and prevention of death
- Health system encompasses diagnoses, treatment, rehabilitation, care for the ill and improvement of health
42
Range & types of health facilities & services:
- Institutional services
INSTITUTIONAL SERVICES - mental health facilities, hospitals, aged care homes, ambulance services
* Hospitals are either private or public:
- - PUBLIC = operated by state and fed government, everyone has access to Medicare, no choice of Dr.
- - PRIVATE = covered by private health insurance, the user pays, choice of Dr, E.G. SAN Hospital, patients have their own room
43
Range & types of health facilities & services:
- Non-institutional services
NON-INSTITUTIONAL SERVICES - surgeons, midwives, health workers and specialists
(non institutional = Facilities and services that do not involve and overnight stay.)
* Medical services – GPs
-- GPs are most used and increasing due to better access and more awareness of prevention (pap smear, immunisation)
-- If bulk billed, Medicare covers all costs
-- Medicare allows Aus., to claim refunds in payments
44
Who is responsible for health services and facilities
1. Federal government
2. State government
3. Private sector
4. Communities
5. Individuals
45
State government's responsibility:
- Oversees the provision of public hospitals and other health care services e.g. dentist, optometry, etc
- Develops health promotion activities and initiatives E.G. vaccinations for high schools
- Regulate products that impact health i.e. alcohol and drugs
- Delivers community-based preventative services i.e. cancer screening
46
Federal government's responsibility:
- Provide national health programs E.G. Medicare and the PBS aimed to increase equity by providing all Australians with subsidised health care and medication
- Funding = $104 billion on health expenditure(2019-20)
- Create national health legislation = aims to protect schools, workplaces, places of leisure
E.G. Workplace Health and Safety Act
47
Communities responsibility:
- Promoting and providing health promotion initiatives and programs E.G St Vincent de Paul’s Night Patrol
- Organise activities that encourage P.A. ( e.g. free soccer competition)
48
Individual's responsibility:
- Access to health services & information to ensure they maintain their health & aware of risk factors
- Change their lifestyles to reduce their chances of developing conditions
49
Equity of access to health services and facilities
- Socio-economic status is often the greatest determinant related to access to health facilities and services
E.G. Low SES areas may not be able to access specialist doctors, due to affordability
E.G. levels of education may lead to being unaware of the health care services and facilities that are available to them = Limits their options of health care
E.G. People that speak very little English may experience great difficulty in accessing and utilising health care services and facilities if they do not have access to a translator
50
Health care expenditure versus expenditure on early intervention and prevention
Health care expenditure = is the allocation of funding and other economic resources for the provision and consumption of health services
- Health care expenditure is increasing $140.2 billion in 2011-12
- Focus on curing rather than preventing, as it costs more to cure rather than prevent E.G. surgery/treatment cost more than education and campaigns
- Lifestyle behaviours could be easily adopted by Australians through health promotion at the local, state and national levels = cause 75% of all premature deaths
- PROBLEM: It takes years for preventive measures to translate into less death and incidence or lifestyle disease
51
Strategies to focus on curing using health care expenditure
* Strategies:
- School education emphasises the importance of healthy behaviours and lifestyles
- Restrictions on advertising junk food & alcohol to kids
- Higher taxes on alcohol and smoking
- Legislation E.G. No smoking in public areas
- Support programs to help people give up addictive behaviours E.G. Alcohol Anonymous
52
Identify the emerging new treatments and technologies on healthcare
- Keyhole surgery
- Genetic testing
- MRI (Magnetic Resonance imaging)
- Early cancer detection
53
Explain the emerging new treatments and technologies on healthcare
- Keyhole surgery = only requires a small incision rather than a large one and a camera device is used to view the inside of the body
- Genetic Testing = Allows a person to become aware of particular diseases that may be susceptible to tell (early diagnosis and treatment = chance of survival)
- MRI = generates images of the internal structure of the body without using ionising radiation
- Early Cancer Detection = tests for prostate cancer and mammograms for breast cancer
54
What is public health insurance: Medicare
MEDICARE HEALTH INSURANCE
- A nationwide, public health insurance system and can be accessed by all Australian residents
- All AUS residents have access to treatment public hospitals = allows for low SES
- Doesn’t cover all health costs or ancillary services i.e. dental, chiro OR ambulance services
- Long wait lists for specific operations and surgeries
- - Medicare Benefits Scheme (MBS) = list of medical services for which the AUS gov. will pay a Medicare rebate to provide patients with financial assistance
- - Bulk Billing = patient pays nothing & doctor receives up to 100% (85% - specialists) from Medicare (no out-of-pocket expenses) - ensures equity of access
55
What is private health insurance?
PRIVATE HEALTH INSURANCE
- Covers some or all of hospital treatment, doctor fee, ambulance and other health costs (chiro, dental)
E.G. Bupa, HCF, Medibank
DIS = usually expensive and therefore cannot be accessed by all Australians = higher the premium, more extensive benefits (doesn't support SJ and equality)
- ADV = choice of doctors, reduces the burden on the public health systems, shorter waiting lists for surgery, immediate access
56
Definition: complementary & alternative health approaches
, they are different, complimentary compliments traditional medicine, e.g a person going through chemotherapy will do acupuncture to relieve side effects of their treatment for cancer. alternative is alternate to traditional medicine, for example someone with cancer will avoid chemotherapy and try acupuncture instead to treat the cancer, does this make sense? Cancer is always a good example to use.
57
What are syllabus points - complementary & alternative health alternatives
- Reasons for growth of complementary and alternative health products and services
- Range of products and services available
- Making informed consumer choices
58
What are the reasons for complementary & alternative health and product services
healing practices that don’t fall within the area of conventional medicine E.G. hypnosis, naturopathy, meditation, etc
- Gov surveys, results show 2/3 or 42% of AUS use CAM
- Increase in CAM (last 10 years) success stories, education, word of mouth, WHO recognition & endorsement, ease of access & strength of traditional beliefs for specific cultures
59
CAM -
| Identify a range of products & services available
- Acupuncture
- Chiropractor
- Herbalism
- Massage
- Naturopathy
60
Describe method: acupuncture
- Involves fine needles asserted into the body for 20-30 minutes to relieve pain by stimulating mind & body’s own healing process
- Traditional medicine of Eastern countries
61
Describe method: chiropractor
- Relationship with spine and functioning of the nervous and musculoskeletal system
- Adjust sine through rapid thrusts to correct subluxations, removing interference to the nervous system and promote healing
62
Describe method: herbalism
- Plants & herbs restore & support the body’s self-defence system
- Primary source for over 75% of world
- Believe in innate ability to heal ourselves with whole part rather than chemical extracts from plants
63
Describe method: massage
- Manipulation of soft body tissues to improve the flow of blood to reduce muscular tension (enhances tissue healing)
- Includes relaxation, reduces blood pressure, stress and anxiety levels and overall beneficial immune system
64
Describe method: naturopathy
- Holistic treatment that recognises the important individual's taking responsibility for positive life changes
- Seeks to address symptoms & resolve underlying causes of illness
65
Explain why consumers make informed choices
- To make sure the service is credible and provides valid and reliable services
- A client MUST research the product and ask the following questions:
* What does the treatment offer and how much?
* What experience, training and qualification?
* Are you a member of professional organisations?
* Side effects and benefits of treatment
* Ask friends, family for recommendations or success stories
- Obtaining feedback & references may help
- Evaluate the use of products & services
- Research should be conducted prior to selecting the product or service
66
Definition: What is health promotion
HEALTH PROMOTION: the process of improving health and preventing ill health
- aims to advance the health of individuals & communities through intervention
- helps to empower by providing support to increase control & improve health
67
Definition: What is the Ottawa Charter in relation to health promotion
The Ottawa Charter provided a positive definition for health
- encourages the collaborative approach to health promotion that aims to promote health through changing the social determinants of health
- ensures promotion is done in intersectoral collaboration with different levels/sectors:
68
Identify the ACTION AREAS of the Ottawa Charter
- Building Healthy Public Policies = policy development at all levels seeks to promote health
- Developing Personal Skills = requires the provision of information, education and life skill development
- Reorienting Health Services = a system that promotes health, rather than curative services (individuals/gov’s/communities)
- Creating Supportive Environments = a link between people’s health and their environment, requiring a socioecological approach to health
- Strengthening Community Actions = to empower communities, which improves outcomes of health promotion
69
Level of Responsibilities for each health promotion sector include:
- Governments
- Communities
- Individuals
70
BHPP (Building Healthy Public Policies)
| How can it apply at gov, com and indiv levels
Governments
- All levels of gov responsible for the creation & maintenance of policies aiming to improve health (E.G. Close the Gap statement of intent)
Communities
- Contribute towards the development of health policies
- Involved in carrying policies out (E.G. ATSI community involvement in development/implementation of ‘Close the Gap’)
Individuals
- Act in accordance with policies delivered (E.G. not smoking in public areas)
71
Developing Personal Skills (DPS)
Governments:
- Develop policies & provide funding towards developing personal skills (E.G. K-10 compulsory PDHPE and educating on road safety)
Communities:
- Run education & training programs to develop personal skills in relation to health (E.G. community health centre education prenatal classes, brochures, etc, school education systems, Quit helpline, etc.)
Individuals:
- Seek to develop own skills in relation to health
- Enabled to take charge of own health (E.G. research behavioural choices from health, act on advice & enrol in community programs, etc.)
72
Reorientating Health Services (RHS)
Governments:
- Fund, research & create policies around prevention & health promotion
- Look at all determinants of health & not just curative services (E.G. TV advertisements, training of primary health sector to promote health as well as cure)
Communities:
- Conduct research
- Be involved in the promotion of health (E.G. Cancer Council conducts research around cancer but also promotes better health choices in relation to the prevention of cancer)
Individuals:
- Seek to make healthy life choices & help others to do the same, including participation in health promotion (E.g. participating in Jump-Rope-For-Heart or consulting a GP about quitting smoking)
73
Creating Supportive Environments (CSE)
Governments:
- Plan, implement & manage infrastructure (E.G. location of hospitals, parks, community centres + councils approve developments
Communities:
- Help maintain healthy environments
- Promote healthy behaviours (E.G. Clean Up Australia Day, fun runs, maintain parks, fields & ovals, YMCA gyms, etc.)
Individuals:
- Make better health choices using & maintaining environment (E.G. putting rubbish in bins provided)
74
Strengthening Community Actions (SCA)
Governments:
- Engage with community groups in creation of policies (E.G. allowing communities to provide feedback on policies before signing them)
Communities:
- Contribute to & take ownership of policies being empowered to act & implement them (E.G. Aboriginal community-controlled health services)
Individuals:
- Promote community activities that promote health
- Be involved in community actions (E.G. promote fun runs, engage in community discussions around health)
75
Definition: Benefits of partnership
BENEFITS OF PARTNERSHIP = in health promotion allow for an efficient and effective system in which various members of the community are able to participate in improving the health status of the nation
76
Why use
| partnership in health promotion
- Addresses the needs of individuals and communities = more efficient
- More comprehensive health promotion = better results in health promotion goals
- Discussion between all groups on planning, delivery & evaluation = empowers individuals to take action
- Increasing recognition of individuals participating in decisions on their health = enables people to take action and control over their health
- Different sectors work together to join their resources – intersectoral collaboration
77
Definition: Social Justice in relation to health promotion
SOCIAL JUSTICE refers to the framework to ensure and promote equity so that societies most disadvantaged have access to quality health care and information
- Results in them becoming more knowledgeable and an empowered ability to take control over their health
- Thus, reducing social, economic and personal barriers that may limit their access to health services and facilities
- Improves holistic/physical health AND mental/social health increased self-esteem
78
Social Justice in terms of developing personal skills
Equity - Access to education for all individuals. Access can be restricted by money, geo area or lack of exposure E.G. offering free online health courses for students
Diversity - Provision of info relevant to all people and personalised through Medicare brochures in different languages E.G. pamphlets in various languages to address ALL
Supportive environments - Media campaigns to raise awareness and increase knowledge E.G. Stop It… Or Cop It = refers to all laws i.e. drinking, drugs, speeding, phone
79
Social Justice in terms of building healthy public policies
Equity - All people need access to the same legislation and policies E.G. Medicare, PBS
Diversity - Different policies are implemented into specific areas where they have different needs E.G. help support ATSI with education
Supportive environments - Workplaces and schools have policies to improve health E.G. no smoking at work and no-hat-no-play at school
80
Social Justice in terms of creating supportive environments
Equity - Method of prevention rather than curing E.G Providing sunscreen and hats to prevent cost as a barrier
Diversity - Media campaigns show different environments E.G. mental health in men
Supportive environments - Encourages healthy choices E.G. Laws banning smoking in public places and schools shaded areas
81
Social Justice in terms of strengthing community actions
Equity - Strong community voice to address health inequalities – resources for all
Diversity - Strong voice in promoting the need for diversity E.G. lobbying for more GPs to rural and remote areas
Supportive environments - When communities are united, it creates a sense of support, which means individuals can rely on others to improve their health
82
Social Justice in terms of reorientating health skills
Equity - Allocation of funding of education and training to ATSI = reduce inequality E.G. Aware of cultural background and offer P.E. at all schools
Diversity - Health services must be culturally sensitive and respect the needs of all people E.G. doctors should be aware of how a patient’s culture influences health
Supportive environments - Adopting preventative rather than cure approach E.G. school funding of breakfast programs for nutrition
83
What does the Ottawa Charter represent?
- Ottawa Charter in action
* If Ottawa Charter is represented through strategies:
- The risk of people or populations adopting poor health behaviour is reduced
- Those already engaged in poor health behaviours are encouraged to reduce these actions, which results in improvements in their health and decreased burden on the health system
* The benefits of this approach include:
- Better results of health promotion
- Health promotion that addresses all the determinants of health
- Greater empowerment of individuals and groups
- Health promotion that is based on the principles of social justice
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What is the aim of the health promotion initiative: Towards Zero
AIM = Governments, individuals and communities need to work together to achieve a zero road toll by 2056
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Towards Zero - DPS
- Education regarding vehicle safety must be escalated through public information campaigns and support for consumer rating initiatives i.e. cars having an ANCAP star rating.
- Increase education on measures to curb high-risk behaviour = speeding, seat belts, fatigue, illicit drug use.
- E.G. Current campaigns: ‘Plan B’, ‘Don’t trust your tired self’
- Safety programs have a crucial role to play in Australian Road safety = must be maintained and refreshed to ensure they are effective
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Towards Zero - DPS linked to social justice
- Health education is multilingual (paper, internet, TV, pamphlets, radio) and culturally appropriate = equity, diversity and supportive environments
- Educating students at an early age in schools = free & compulsory = EQUITY
E.G. PDH lessons will focus on road safety
- Social media = targets younger groups in strive to influence them to make the right decisions
- Access to everyone = accounts for blind people (dictation feature)
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Towards Zero - RHS
- Intro of new 40km/h speed limits in high pedestrian areas and school zones
- Survey new strategies to ensure they are successful in decreasing statistics E.G. success of urban speed cameras and country fatalities
- Target country areas with education campaigns aimed at changing behaviour
- Increase the number of mobile drug testing units & ensure they are able to test for all illicit drugs
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Towards Zero - RHS linked to social justice
- Need to look after the most disadvantaged group = the group with the highest fatalities is 17-21 = hence the focus on ‘L’ and ‘P’ Plate drivers
- Focus on rural and remotes areas due to high fatality rates.
- Increase number of mobile drug testing units – CSE: Supportive environments
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Towards Zero - CSE
- Increase use of technological aids aimed at behavioural changes E.G. auto seatbelt reminders
- Graduated License Scheme re-evaluated – increased supervised driving requirement, create support for beginner drivers in order to decrease fatalities in 17-22 age group - very successful as fatalities of young drivers have 1/2 since 2000
- Target black spot programs in order to decrease fatalities by 30% especially in Rural and remote areas
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Towards Zero - CSE linked to social justice
- Focus and support on pedestrians / heavy vehicle drivers and cyclists – equity to all road users.
- Diversity – different initiatives will run in different areas – E.G. collab with ATSI in order to ensure they are culturally appropriate
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Towards Zero - SCA
- Speed cameras in the urban high-risk areas = the community has a big involvement in the decision of high-risk areas and speed camera placement E.G. Warringah road speed camera
- Sharing information between jurisdictions helps to improve safety and the effectiveness of initiatives = esp. important in country areas
- Country communities and local councils are heavily involved in the identification of blackspots and planning of education campaigns
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Towards Zero - SCA linked to social justice
- Community control leads to empowerment
- Caters to individuals and communities issues through the use of initiatives E.G. Work with heavy vehicle communities to come up with an effective strategy to improve safety
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Towards Zero - BHPP
- Overall increase enforcement on the roads i.e. R/R areas
- Combined laws of seatbelts, RBT, Intensive Speed cameras, roadside drug testing all have had a major influence on the decrease in road fatalities
- Ensure all new and second-hand vehicles have an ANCAP safety rating
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Towards Zero - BHPP linked to social justice
- Laws are there to create SUPPORT
| - Laws ensure equity amongst all drivers E.G. Increase penalties for drink driving esp. repeat offenders
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What is the aim of the health promotion initiative: Healthy School Canteens
AIM = to increase student access to healthy food and drink options, to reduce intake of unhealthy foods and to encourage children to drink water
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Healthy School Canteens - DPS
- The strategy is based on the Australian dietary guidelines
- GOAL: link the healthy school canteen strategy to curriculum areas and the student well-being approaches
- Integrate the topic of a healthy lifestyle into the curriculum with the explicit teaching of healthy lifestyle choices in PDHPE, Food Tech, etc
- Use websites such as the Healthy Food Finder as a resource for learning about healthy food and drinks across a number of curriculum areas
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Healthy School Canteens - DPS linked to social justice
- Education ensures EQUITY, which would help achieve the goal of reducing childhood obesity
- Cross curricular education ensures students will access information on good food choices and ensure equity
- Schools are responsible for their own menu which takes into account our diverse country = supportive environments
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Healthy School Canteens - RHS
- School canteens are well placed to help reduce childhood obesity and the goal is to reduce obesity by 5% over the next 10 years
- GOAL: increase access to healthy foods and drink options, reduce intake of unhealthy foods and encourage water as a drink
- Provide healthy, tasty food and drink options at the canteen which will support the physical domain of the Wellbeing Framework for Schools and Crunch & Sip program for Year K-6
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Healthy School Canteens - RHS linked to social justice
- Canteens are a supportive environment to help students make the correct choices regarding nutrition and could help decrease obesity rates amongst children to a large extent.
- Increase ACCESS to healthy foods for ALL students in ALL areas
- Information is multilingual to cater for diversity
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Healthy School Canteens - CSE
- School leaders play a vital role in engaging their community and promoting a shared responsibility for healthy choices.
- Goal is to involve students and to increase their voice as to what is on offer in the canteen
- Try to engage volunteers to help implement the strategy and help prepare the food
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Healthy School Canteens - CSE linked to social justice
- Involvement of students and the whole school approach, ensures social justice, as students should have a voice as to what is available at the canteen – ensures EQUITY
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Healthy School Canteens - SCA
- The strategy will apply to all public schools in NSW, they have from 2017 – 2019 to move to the new strategy
- Freshly prepared foods need to meet an overall health star rating of 3.5 stars and above and portion sizes should not be exceeded
- Schools develop their own canteen policy tailored to their individual needs
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Healthy School Canteens - SCA linked to social justice
- Ensuring schools have a few years to move to the new strategy ensures equity, as schools in rural and remote areas will need to access the star rated foods, ensure EQUITY
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Healthy School Canteens - BHPP
- The revised strategy will ensure the goals of the program are met and that canteens have a set criterion to follow, health star rating and portion size control.
- Reduce the costs of healthy foods, partnerships in the community with farmers or bulk buy in order to reduce the cost of healthy foods
- Funding from NGOs to help schools implement the strategy
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Healthy School Canteens - BHPP
- Reducing the cost of healthy foods ensures people from low socioeconomic areas have access to canteen foods
- Sccording to statistics people from lower SES areas are more likely to buy food from the canteen V higher SES areas
- Ensures EQUITY and SUPPORTIVE ENVIRONMENTS – everyone should have a RIGHT to ACCESS healthy foods at a reasonable price.
