FOCUS QUESTION 1: HOW ARE PRIORITY ISSUES FOR AUSTRALIA’S HEALTH IDENTIFIED? MEASURING HEALTH STATUS

• The pattern of health of the population in general over a period of time

ROLE OF EPIDEMIOLOGY • Provides information on the patterns and causes of disease, illness, and injury in a population

• Monitors major causes of illness and death to identify emerging issues and inequalities between groups

• Identifies areas of need so prevention and treatment targeted

• Areas need most funding

• Use of health care services

• Looks at disease in terms of

• Prevalence: number of cases at a specific time

• Incidence: number of new cases

Who uses it? • Policy makers at all levels of government

• Manufactures of health products

• Providers of health services

• Government for comparison

• Example: Motor Vehicle Accidents. Epidemiology shows young makes between 17-25 years have an increased risk of death or injury from motor vehicle accidents

• Education and prevention strategies can be directed towards this group

• Does Epidemiology measure everything about health? No fails to explain the sociocultural factors contribute to negative health behaviours

Limitations of epidemiology: • Doesn’t show variations in health status between population sub groups

• Fails to explain why

• Does not account for health determinants

• Might not accurately indicate QOL

• Can’t provide whole picture of health

• Imprecise methods of data collection

• Source of collection

• Survey itself

MEASURES OF EPIDEMIOLOGY • Major measures used to determine the health of populations:

LIFE EXPECTANCY: • The length of time a person can expect to live

• Males: 79.9, Females: 84.3

• Based on current death rate

• Increasing

• Improvements due to: better medical care, eradication of diseases, lower infant mortality, decreasing CVD and cancer deaths, reduced deaths in traffic accidents.

MORTALITY RATE: • Number of deaths in a given population

• Leading cause of death = CVD for males and females

• 2nd cause is stroke

• dementia deaths increasing prominently

INFANT MORTALITY RATE: • Number of infant deaths in the first year of life, per 1000 live births

• Most important indicator of health predict life expectancy

• Australia = 3.3/1000 decreasing

• 2 types: neonatal (28 days), post neonatal (rest of year)

• decreased due to: better medicine, better sanitation, better education for mothers and babies, better support

• ATSI = 3x as high 7.8/1000

MORBIDITY RATES • Incidence or level of illness, injury, or disease in a given population

Measures include: • Hospital use (show areas of worst health/ funding allocations, etc)

• Doctor visits and medicare stats: gives reasons for and number of dr visits. Shows referral to specialists, reasons, sick days

• Health reports and surveys: AIHW report every 2 years

• Disability and handicap payments

IDENTIFYING PRIORITY HEALTH ISSUES SOCIAL JUSTICE PRINCIPLES

- Favours reduction or elimination of inequity, promotion of inclusiveness, and the establishment of environments that support all people.

- Preventable chronic diseases for Australia must relflect the principles of SJ - Address inequities that cause groups to have poorer levels of health - E.g. ATSI life exp. 12 years younger not socially just. - Good overall health status, but improvement is needed in some areas

EQUITY DIVERSITY SUPPORTIVE ENVIRONMENTS

• Makes sure resources and funding are distributed fairly and without discrimination. All people have access to health services and support at the same time that they need it.

• E.g. medicare → all Australians in theory have access to doctors and hospitals at an affordable or no cost.

Ways that equity is implemented within Australia:

• Medicare: providing at a reasonable or no cost. SES status should not preent persons’ capacity to get treatment

• Pharmaceutical Benefits Scheme (PBS): reduces cost of certain drugs. List of “live saving” or “QOL improving”. Patients can buy at a reduced cost. Concession < $6.20

• Medicare Safety Net: Threshold over which basic medical costs are subsidized by the gvt by up to 80%. 2016 threshold is $1475 per family/ individual. Normally get back 40% without Concession.

• Recognizes and involves community groups in planning and making decisions about health issues.

• Australia has a diverse population with diverse health

needs → health services need to adapt to cater for everyone

• E.g. consulting ATSI about how best to achieve better eating habits through traditional values etc.

• all Australians have the right to be healthy and to have adequate services

• environments need to be supportive in order for this to happen

• e.g. school in NT → ‘no school, no swim’

→ aimed to increase attendance rates

• Where people work/ live/ play must be supportive of healthy decisions e.g. bike path

PRIORITY POPULATION GROUPS

ATSI LOW SES RURAL AND REMOTE • higher death rates from:

heart disease, respiratory disease, diabetes

• higher suicide rates

• higher blood pressure

• higher cholesterol

• higher smoking rates

• lower use of preventative health services

• higher rates of heart disease and injury

• lower access to health care services

• Strategies designed to raise the health status of these people:

• Royal Flying Doctor Service

• Incentives for doctor and dentists to practice in rural and remote areas

• 17% more funding for ATSI people

• Purple house

PREVALENCE OF CONDITION

- Prevalence of a disease or death within the population i.e. how many deaths are attributed to breast cancer

- Helps to indentify risk factors help identify potential for change - Areas that will be an economic burden on society - 80% of australias disease burden comes from: cance, CVD, mental health, injury, respiratory disease,

diabetes, musculoskeletal conditions, neurological disorders, oral health problems, infectious disease, asthma. most are easily preventable.

POTENTIAL FOR PREVENTION AND EARLY INTERVENTION • Majority of illnesses and diseases come from poor lifestyle behaviours

• Almost 75% deaths of people under 75 are considered easily preventable

• For change to be effective we must target and address the individual and environmental determinants that cause health inequities: SES, Employment, Access to info and health services, Housing, Support networks, Environmental infrastructure

• For a disease to be a priority it must be preventable

COSTS TO THE INDIVIDUAL AND THE COMMUNITY • Cost/ burden on the individual can be measured in terms of:

• Financial loss: can be more than can afford

• Loss of productivity: may have to stop work

• Diminished quality of life: lack of money = less social time = stay at home = depression

• Emotional stress

• Illness, disease, and death place an economic burden on community

DIRECT COSTS: money spent on diagnosing, treating and caring for the sick, as well as money spent on prevention. Estimated from money spent on hospital admissions and medical services, drug prescriptions INDIRECT COSTS: value of the output lost when people become too ill to work

FOCUS QUESTION 2: WHAT ARE THE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH?

GROUPS EXPERIENCING HEALTH INEQUITIES

ATSI LOW SES

NATURE AND EXTENT • 2.3% population but account for 3.5% disease burden

• 12 years younger LE

• 81% die younger than 65

• Higher rates diabetes, infant mortality, hospitalization

• Half as likely complete yr 12

• 1/3 eyesight problems

• Lower LE

• More likely to die from preventable diseases e.g. CVD

• higher infant mortality

• More likely to smoke

• Less health knowledge

• Less use of preventative health strategies

SOCIOCULTURAL • Dealing with wide ranging effects of European colonization and past practices e.g. white Australia policy

• Strong reliance on ATSI family and culture for support means many ATSI distrust gvt

• 12% ATSI children 4-17 years being cared by someone who is removed from natural family

• Family or peer influences

• E.g. parents smoke → more likely to smoke as a child

accept it as the ‘norm’

• Contribute to attitude

• Lifestyle disease

SOCIOECONOMIC • Often cant afford to make healthy lifestyle choices

• Lower education can contribute to poor post natal care and recognizing and reducing risk factors associated with CVD, diabetes, infant mortality

• Money → lack of = Poor food habits, little health care, more risk behaviours

→ more chance morbidity/ mortality

• Lower education levels →

less health knowledge →

risk behaviours → lower health status

• Youth unemployment 2x

national average → despair

→ social problems →

mental issues → drug use,

crime, risk behaviours → poor health status

ENVIRONMENTAL • 24% ATSI people live in remote and rural areas reducing access to health care, Dr, fruit and veg.

• Disadvantages in housing, education, employment

• Poor physical environment

• High density/ over crowded

housing: increase stress → violence, family breakdown

→ chronic disease e.g. CVD and mental health issues

• Lower levels of sanitation → preventable diseases e.g. lung cancer, asthma.

INDIVIDUAL • Behavior risk factors present e.g. smoking, binge drinking, drug use, physical inactivity, lower rates of fruit and veg consumption

• Can be changed through social justice principles

• Degree of responsibility

• Ability to make healthy decisions, but attitudes and behaviours need to be changed to do so

• Reduced financial capacity makes healthy decisions harder

COMMUNITY • Significant role in addressing health inequities

• ATSI community work with health organisations to improve health of community

• E.g. no school no swim

• For change to occur ATSI community must be involved in consultation and decision making

• Has responsibility

• Programs suitable for needs their communities face

• E.g. before school breakfast program, nutrition classes for parents

GOVERNMENT • Working with ATSI groups to develop culturally appropriate snd effective ways to address health issues

• Close the gap: o Statement of intent aims to reduce health

inequities experienced by ATSI people o Equality in health status, life expectancy,

and infant mortality rates o Aims to close the gap in literacy and

numeracy, educational achievement, employment.

• Commitment to ensuring ATSI people have full participation in addressing health needs

• Large responsibility to health inequities

• Medicare and PBS ensure free or low cost health care

• Promote health education through schools and campaigns

• Specific mandatory information in PDHPE classes

HIGH LEVELS OF PREVENTABLE CHRONIC DISEASE, INJURY, AND MENTAL HEALTH PROBLEMS

CARDIOVASCULAR DISEASE LOW SES

NATURE • Disease involving the heart, blood, and blood vessels

• CHD: poor supply of blood to the muscular walls of the heart

• Atherosclerosis is the main cause of CHD. Build up of fatty tissue causing narrowing and decreased blood flow

• Peripheral vascular: disease of arteries and capillaries affect blood supply to legs

• Cerebrovascular (stroke): restriction blood flow to brain

• Heart failure: heart cannot cater for every day demands weak.

• Angina- lack of blood supply to the heart (another word for heart attack)

• Group of disease that results when the process of cell division becomes uncontrolled

• Cells multiply in random manner and form tumours

• Benign tumours remain localized and do not spread

• Malignant tumours affect surrounding cells and can travel throughout the bloodstream, can cause new cancers to grow.

• Types:

• Carcinoma: cancer of epithelial cells (skin, mouth, throat, breasts, lungs)

• Sarcoma: cancer of the bone, muscle, or connective tissue

• Leukemia: cancer of the blood forming organs of the body

Disease/ injury/ problem Mortality trend Morbidity trend

CVD Decreasing Decreasing

Cancer Decreasing Unchanged

Diabetes Unchanged Increasing

Respiratory disease Decreasing Unchanged

Injury Decreasing Decreasing

Mental health Decreasing Increasing

• Lymphoma: cancer of the infection fighting organs of the body

EXTENT • Most common cause of death in aus

• 2012 22% population had LT disease of circulatory system

• deaths have decreased since 1968 by 78% due to reduction in level of risk factors and improved medical care and treatment

• males higher than females

• ATSI 2x population

• CHD leading cause of death in CVD

• 16% overall disease burden

• 11% hospitalization in 2014

• most expensive disease

• Second highest cause of death

• Highest in 45-54 age group

• Increased in incidence over last 20 years

• Males more likely to die than females

• Prostate, bowel, lung, melanoma most common in males

• Breast, colorectal, melanoma, lung most common in females

RISK/ PROTECTIVE

Non modifiable: • Age

• Family history

• Gender

Modifiable: • Smoking

• Blood fats

• Blood pressure

• Obesity

• Inactivity

• Type 2 diabetes

• Contraceptive pill

Protective factors: • Being physically active

• Healthy diet

• Safe alcohol consumption

• Medical check ups

• Managing stress

• Maintaining healthy weight.

• Risk Factors:

• Lung: smoking, asbestos exposure, air pollution

• Breast: family history, high fat diet, early menstruation, obesity

• Skin: fair skin, living in high sun exposed areas, long hours in the sun, moles

• Protective factors:

• Lung: not smoking, avoid smoking environment, chemicals

• Breast: self breast check examination, know signs and symptoms, family history, mammogram and screening services

• Skin: slip slop slap, use shaded areas, no sun baking.

SOCIO-CULTURAL

• Family history e.g. diet of high salt and high fat more likely

• Asians less prone low fat diet

• ATSI more at risk

• Media exposure of risk of smoking led to reduction in smoking rates and decline trend in CVD

• Family has healthy practices so will you Decreased risk

• Higher chance in ATSI more likely to smoke earlier

• Higher chance n low ses

• Females at risk

• Family history increases risk i.e. breast cancer

• Sunbaking culture increases risk of skin cancer

SOCIO-ECONOMIC

• Low ses/ unemployed more at risk. Less money = limits ability to make healthy choices

• Low education more at risk less knowledge on protective behaviours

• Low SES higher death rates more likely to smoke, unhealthy diet

• Occupation with chemicals lung cancer, lifeguard skin cancer

• Low education Higher risk more poor health choices and less knowledge of how to access health services

ENVIRON-MENTAL

• Rural and remote at more risk = less access to information services and technology

• Rural and remote more at risk less access to info and preventative services

• No smoking laws can reduce risks

• No hat no play

• Law that outdoor workers need to be provided with sunscreen

GROUPS AT RISK

• ATSI

• Low SES

• Smokers

• Family history of disease

• High blood pressure

• Overweight

• Blue collar workers

• People over 65

• Lung: smokers, blue collar, over 50

• Breast: woman who have not given birth, obesity, 50+, no self check, late menopause

• Colorectal: obese males and females, high fat, low fibre diet, males 50+

• Skin: fair skin, work outdoors

• Prostate: make 50+, family history

• Cervical: 50+, early intercourse, neglect pap smear, smokers.

A GROWING AND AGEING POPULATION HEALTHY AGEING

• Aim is to ensure the elderly maintain health into old age, stay in the workforce for longer, and engage in society

• Concerned with quality of life, independence, and increasing the number of healthy years, not just the years of life enjoyed by the individual.

• Reduce risk of illness and disease, and improve all dimensions of health

• Simple lifestyle changes

• Gvt very supportive contribute to WF as long as possible

• Increase economic growth and decrease the use of services

• Working years are shortened if sick = reduced economic growth

• Younger generation making lifestyle choices

• If the population is healthier wealth of skills and knowledge that can benefit society skills can be utilised for longer

Benefits: • Prevent disease save money

• Prevents functional decline

• Enhanced quality of life

• The healthier the individual, the less demand placed on health + aged care services

Services: • Seniors.gov.au website that acts as a source of information on preventative care, managing common health

conditions, accessing services, emotional health.

• Gvt appointed ambassador for healthy ageing nolene brown responsible for:

• Promoting positive ageing

• Encouraging contributions of elderly

INCREASED POPULATION LIVING WITH CHRONIC DISEASE AND SIABILITY • Chronic disease = 80% disease burden

• Responsible for 75% of all deaths by 2020

• 2011 75% population had LT condition

• implications enormous on health care

• long term conditions increased with age

• many common chronic diseases not high in mortality but impact on QOL burden

DEMAND FOR HEALTH SERVICES AND WORKFORCE SHORTAGES • Risen

• High use hospitals elderly more time

• Elderly use GPs more often (25% patients)

• Older people use health facilities at a higher rate

• Gvt steps to meet demand:

o Expansion of role of nurses o Increased residential aged care o More funding o Aged care workers o Increase community care o More gps, nurses.

• Government attempted to improve retirement: o Means tested pension o Superannuation o Extra contributions to super also encouraged

• Examples: o rapid response team 2008 help elderly waiting for assessment in gvt funding o $250000 pilot program cut assessment times assess a person’s needs and help them access

correct services

• State Issues: o NSW gvt trouble paying suppliers due to limited budget o Workforce shortages o Improve staff rations funding o All can’t treat growing and ageing population

AVAILABILITY OF CARERS AND VOLUNTEERS • Carer: person who looks after an older person or someone with a disability or chronic illness

• Volunteer: person who offers to perform a service for the community

• $75 million per year in unpaid caring and volunteer activities

• older Australians make huge contribution as carers and volunteers

• minimal growth in the number of carers rise in home needed support

• shortage of carers in future

• Meals on wheels: o Volunteer service provides meals to elderly people unable to cook for themselves o Cooked lunch and dinner help maintain nutritious diet apply

• The red cross: o Volunteer service “a call a day to check you are ok” o Checks on person’s overall wellbeing and supports isolated people with social health o Alerts medical service if they do not respond

• Seniors.gov.au o Gvt provides community aged care packages send carers into homes to help with daily tasks.

ASSESS THE IMPACT OF A GROWING AND AGEING POPULATION ON:

Health system and services • Hospital waiting lists and emergency departments will be busier

• Drs and Gps harder to see

• Administrators will struggle with budget

• Services will be aunable to cope with demand

• Care assessment teams overworked

• Access becomes harder

Health service workforce • Dr more pressure increase workload mental health

• Nurses role expanded unpaid and overworked

• Patient care is reduced

• Decrease in quality care

Carers of the elderly • Will struggle not enough

Volunteer organisations • Volunteers carers struggle increase in workload

• Volunteer organisations less people to complete services

• May need to spend money to recruit people

• Rates declining

FOCUS QUESTION 3: WHAT ROLE DO HEALTH CARE FACILITIES AND SERVICES PLAY IN ACHIEVING BETTER HEALTH FOR ALL AUSTRALIANS? HEALTH CARE IN AUSTRALIA RANGE AND TYPE OF HEALTH FACILITIES AND SERVICES

Health Facilities/ Services

Information Examples

Public Health Service • Prevention, promotion, protection

• Target broad populations

• Educate and provide awareness programs

• Promote laws

• Gvt and NGO drive these activities

• Nothing healthy about a tan, free breast checks, large scale immunization for all babies

• School – nutrition programs, teeth brushing, cervical canver injection

• Workplace – healthy foods, OH&S

• Media – campaigns on television

Primary care and community health services

• First health service visited

• Use increasing

• 85% reported using GP at least one

• GPs usually first point of contact

• Community health to target specific groups (r+r, women, men)

• Rural and remote: mental health and suicide prevention

• Women’s health needs: before and after birth care, mothers groups, parent support services for infant health

• Mens health: mental health counseling groups

Hospitals • Accounted for 40.4% health expenditure (58.8 billion)

• 1310 public and private hospitals

• public hospitals = 240000 fulltime staff

• most hospital resources allocated to providing care of admitted patients

• only get into private with private health care much better care, smaller waiting times

• public hospitals = overcrowded, long waiting times

• private hospitals if waiting for surgery can have it done very quickly, get to choose doctor, more comfortable

Specialised health services

• target specific health conditions

• use of services increasing

• IVF available since 1979 is increasing

• Mental health and diabetes increasing use of services increasing

Goods • Medicines + pharmaceuticals • Over the counter and prescription

•

RESPONSIBILITY FOR HEALTH FACILITIES AND SERVICES

Commonwealth government

• national policies

• funds state and territory governments

• influences state policy and delivery of service

• controls community services

• 2 national subsidy chemes: PBS and medicare

• $52.9 billion health expenditure 2011

• major money residential care, medical services, health research, hospitals

State and territory government

• Prime responsibility

• hospitals

• 3/3 state/ territory funding for public hospitals

• responsible for mental health, dental, home and community care, DOCS, health promotion, rehab, regulation prudential, hospitals and community services

• campaigns: o anxiety awareness campaign o dark side of tanning

Private sector • Non gvt funding $36.6 billion/ 30.1%

• Privately owned but approved by fed gvt e.g. heart foundation

• Charities and religious groups

Local government

• Sanitation and hygiene monitoring

• Rubbish collection

• Meals on wheels

• Immunization, various clinics

Community groups

• Formed on a local needs basis e.g. counseling low ses areas or area with high suicide rates

EQUITY OF ACCESS TO HEALTH FACILITIES AND SERVICES

Purpose: make sure no one experiences poor health because of unfair and avoidable disadvantage • Groups that experience lower levels of health: ATSI, R+R, low SES, OSBP, elderly, disabled increased health

risks affected by inequities because of daily living conditions

• Biggest action by the government of equity of access was medicare and PBS

EQUITABLE APPROACH WILL…

Prioritise high risk groups

Focus health promotion on social determinants

Initiatives to strengthen commmunity

Reduce social inequities to ensure everyone benefits from healthy supportive environment

Range of measures put in place to address access issues:

R+R: Royal flying doctors service, Incentives encouraging professionals to work in rural areas

Low SES Bulk billing through medicare

NESB/ born overseas: Translation services designed to remove language and cultural barriers

Is access equitable?

• Majority of Australians have (technically) equal access to fundamental medical treatment through medicare

What can impact an individuals access to

health care

SES status Knowledge of available

services

Cultural and religious beliefs

Geographic locationShortage

of staff

Lack of funding and equipment

Waiting lists for elective

surgery

Waiting times in

outpatient clinics or

emergency

Definition: health equity is about everyone in a population having the necessary knowledge, skills and resources to achieve and maintain good health and wellbeing

• Does not cover all areas of health e.g. physio

• Private health care increases access and therefore not everyone has equitable access

HEALTH CARE EXPENDITURE VERSUS EXPENDITURE ON EARLY INTERVENTION AND PREVENTION

• Health expenditure $121.4 billion 2011 large amount still not enough

• Only 2% spent on prevention balancing act between=n prevention and cure

• Problem is the now public health care system is pushed already need more funding

• Trends: o Health care expenditure increasing (even though increasing still getting worse due to ageing

population) o Will continue to increase while focus on cure not prevention o Problem costs more to cure a disease than to prevent it

• Expenditure on health care much more on illness prevention due to emphasis on medical treatments to cure common disease and illness in society (i.e. gvt can’t win!)

• New public health model focuses on social factors

• Places emphasis on health promotion as the most cost effective way

• When people are prevented from getting sick = savings made in treatment costs and workplace productivity o Governments, individuals and communities are being made more accountable for their expenditures o Many people resent paying tases to support those who choose unhealthy lifestyles o Insurance companies recognize the problem and charge higher premiums for smokers incentives

to make healthy choices

• Lifestyle factors could cause up to 75% of all premature deaths yet more than 90% funding allocated to cure

• Gps more aware of importance of promoting healthy behaviours

• Strategies used to prevent illness and death in community: o School education o Communication between different levels of government e.g. local hospitals network o Restrictions on advertising o Legislation

o Higher taxes on alcohol and tobacco o Support programs to help people give up addictive habits

Early intervention

• Large improvements = survival rates improved

• Needed to decrease mortality

• Strategies for the future:

• Ageing population inreases need for funding for actual health care

• Funding is finite, other groups need to work together to improve health e.g. schools

Arguments for increasing funding and support for preventative health strategies:

Cost effective • Huge long term savings

• Health care may become too expensive for all Australians to access

Improved quality of life • More enjoyable life

Maintenance of social equity •

Use of existing structures • Better than having to spend money on special services

Reinforcement for individual responsibility

• Empowers people to take control of personal health

Benefits overall • Reduced mortality and death rates

• Increased life expectancy

• Better QOL

• Reduced impact on family and carers

Health care expenditure definition: allocation of funding and other economic resources for the provision and consumption of health services

• E.g. healthy canteen strategy, free health checks or flu shots, no smoking laws, bike paths.

IMPACT OF EMERGING NEW TREATMENTS AND TECHNOLOGIES ON HEALTH CARE

• Many new technologies and technologies that have improved and will continue to improve health care

• Examples: o Key hole surgery less invasive less trauma to the body faster recovery time less pain

shorter stay in hospital o Better materials for operations e.g. heart valves, replacement joints, eye lenses o Administering chemo through wafers in the brain o Improved and synthesized HIV drugs o Prosthetic limbs o Melafind scan skin using infared imaging to scan moles increase early intervention o 3D ultrasounds

• Does not embody principles of social justice not everyone can access

• Lots of emphasis and research on early detection – personal and financial benefits outweigh alternatives

HEALTH INSURANCE: MEDICARE AND PRIVATE 1. Medicare: Australia’s system of health care that provides services to all Australians. Est. 1984 2. Funded by income taxes and medicare levy (2% persons taxable income) 3. Less than $20k don’t have to pay levy, 20-26K subsidized cost 4. Provides free treatment in public hospitals, subsidized treatment from GPs and other certain services 5. Every person covered 85% amount of fee 6. Bulk billing dr receives money from medicare 7. People who choose to take out private health insurance also remain in public health care system

COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPROACHES

REASONS FOR GROWTH OF COMPLEMENTARY AND ALTERNATIVE HEALTH PRODUCTS AND SERVICES

1. Social change improved information more accepted 2. WHO recognised importance 3. WHO produced lis of medicinal plants 4. Recognition alternative medicibes traditional medicine for majority of worlds population 5. Recognition by health funds 6. Effective when conventional medicine is ineffective 7. Natural/ herbal medicine rather than synthetically produced 8. Holistic nature benefits whole body, health as a whole 9. Formal qualifications and courses

RANGE OF PRODUCTS AND SERVICES AVAILABLE

Acupuncture • Fine needles into skin

• Ancienct system of healing

Chiropractic • Spine and nervous/ musculoskeletal system

• Adjust spine

• Correcting subluxations, maintaining control over bodily function

BENEFITS Less waiting time Less invasive Tech like skype Early detection

LIMITATIONS Costs, research and equipment expensive so not available to all therefore inequitable.

Healing practices that do not fall within conventional medicine

Herbalism • Plants and herbs exclusively

• Whole plant form

• Restore and support defence mechanisms.

Massage • Inducing relaxation

• Reduce blood pressure, stress, anxiety, immune system

The Bowen Technique • Muscle and connective tissue movement that gently realigns the body and balances and stimulates energy flow

• Effective in treating soft tissue injuries, musculoskeletal problems, migraines, asthma, sinusitis, bronchial symptoms, menstrual irregularities.

Naturopathy • Address symptoms of illness as well as resolving underlying proble,s

• Lifestyle changes

Aromatherapy • Pure essential oils

• Inhaled/ applied

• Depression, sleep disorders, anxiety

Iridology • Analysis of human eye to detect signs of physical, emotional, spiritual wellbeing

• Range of naturopathic treatments

Meditation • State of inner stillness

• Focusing on an object/ word/ breathing

• Strengthens immune system, sleep, lower blood pressure, increased motivation

HOW TO MAKE INFORMED CONSUMER CHOICES

• Make sure credible, reliable, valid

• Investigate service

• Research

• Ask questions o What treatment and how much does it cost? o What experience, training, qualifications? o Member of professional organization?

• Side effects and benefits

• Training courses to collect info

• Ask friends, family for recommendations

• After always reassess service: o Achieving what you believed it would? o Meeting expectations? o Health improving? o Need it? o Afford it? o Better service?

FOCUS QUESTION 4: WHAT ACTIONS ARE NEEDED TO ADDRESS AUSTRALIA’S HEALTH PRIORITIES? HEALTH PROMOTION BASED ON THE OTTAWA CHARTER

LEVELS OF RESPONSIBILITY OF HEALTH PROMOTION Aus Government • Develops policy and funds HP

• Collect epidemiology

• Monitor social justice

• Promoted health through development of dietary guidelines and physical activity guidelines

State Government • Specific campaigns for the state

• E.g. fresh tastes healthy canteen strategy

Non-government and corporate strategies

• Specific areas of responsibility e.g. heart foundation

• Corporate strategy: banana boat giving out free sunscreen

Individuals • Have a level of responsibility

• Making aware of potentially harmful effects of certain lifestyle behaviours

• Seek help as early as possible

• Some barriers that make healthy decisions hard.

Schools • Make children and young people aware of healthy behaviours and strategies to avoid them

• E.g. PDHPE curriculum

• Linked to individuals.

BENEFITS OF PARTNERSHIPS IN HEALTH PROMOTION

• Ottawa charter used as a checklist for health promotion

• Success = inter-sectoral collaboration

• Ensuring individuals work in partnerships with community groups and governments, HP campaigns have greater chance of success.

BENEFITS

NEEDS ARE MET • Individuals AND COMMUNITIES

• E.g. asking schools what they need

ENABLING • Done by and with people encourages participation

• E.g. making school logo

EMPOWERMENT • Giving people the support needed to achieve a goal

• Empowers to identify problems and work together aand identify solutions

• E.g. solving problem of bike paths will empower ppl to ride to work

DEVELOPMENT OF NETWORKS

• Pooling of resources and knowledge campaign greater chance of success.

SHARING RESPONSIBILITY • Using expertise and resources of each partner

COST EFFECTIVENESS • Organisations will be able to offer skills/ services at a reduced cost

HOW HEALTH PROMOTION BASED ON OTTAWA CHARTER PROMOTES SOCIAL JUSTICE

Developing personal skills:

Health promotion: the process of enabling people to improve their health.

Social justice: a value that favours the reduction or elimination in inequity and the promotion of inclusiveness, diversity, and the establishment of environments that are supportive to all people.

• Refers to the provision of information and education to help people make informed decisions and choices

• Improves individuals knowledge and skills to achieve good personal health (skills include decision making, communicating/ problem solving)

• Aim is to empower individual

• Diversity e.g. pamphlets in different languages.

Creating supportive environments

• Make the environments where people work/live/play more supportive of health

• Increasing people’s ability within these environments to make healthy choices

• Supportive environments e.g. banning smoking in public places

Strengthening community action

• Focuses on the action that communities can take to improve their own health

• Specific to community needs

• Diversity e.g. lobbying for more dr in rural and remote areas

Reorienting Health services

• Health services has moved away from more traditional approach of DR and medicine

• Emphasis is now places on different groups working together to achieve good health

• Equity e.g. allocation of funding to ATSI programs e.g. no school no swim

Building healthy public policy

• This relates to decisions made at all levels of government and by organisations that work towards health promotion

• Supportive environments e.g. drink driving laws

9.1.1. THE OTTAWA CHARTER IN ACTION