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CORE 1: What are the priority issues for improving Australia’s health? -…

- - - - Sociocultural
        
        Oppression and exploitation, racism and discrimination, higher rates of domestic violence, language barriers, lower self esteem, poor mental health. Higher rates of smoking and inactivity, kis exposed to risk factors and parents not setting a healthy example.
      - Environmental
        
        Poor access to health services, large health outcomes gap, higher number of ATSI renting homes, higher number of ATSI homeless, more likely to live rural/remote due to culture/traditions.
      - Socioeconomic
        
        Lower education/employment rates, poor education and poor health literacy: poor decision making.
    - - Individual
        
        Individuals are empowered by a number of initiatives to make informed choices about behaviour and to make health promoting decisions.
      - Community
        
        ATSI community leaders were involved in the design and implementing of "close the gap" interventions. Includes many groups like ATSI community controlled health organisation and aboriginal medical services.
      - Government
        
        Larger health promotion and funding ($805mil) indigenous chronic disease package, aims to improve healthcare system management of ATSI chronic diseases, goal to reduce key risk factors ie. smoking
    - - (10yrs less life expectancy, 7x end stage kidney disease, 3.3x diabetes, 1.5x obesity, 1.5x cancer) Ages 35-44: 4x death rate, ages 1-12 : 2x death rate
    - - "close the gap" Aims to achieve equality in health status by reducing infant mortality rate and increasing life expectancy in ATSI peoples. Also closing the gap in education, income to address risk taking behaviours of individuals. Includes housing strategy.
  - - - (40% higher CVD deaths, 6x lung cancer, 33% higher obesity in women, 33% higher asthma, poorer 5yr survival rate, 2X COPD rate, higher burden stroke, diabetes, higher mortality rate for all cancers, lower life expectancy, lower oral health, higher kidney disease rate)
    - - Socioeconomic
        
        low employment and income, lower health literacy, poor eating tendencies, unemployment and resultant poor mental health.
      - Environmental
        
        Homeless/sheltering and resultant poor mental health, social stigma of homelessness, inability to access centre-link: no address, rural access to health services.
      - Sociocultural
        
        Risky behaviours common, higher rates of drinking, smoking, obesity, low physical activity, children raised around 2nd hand smoke, therefore higher cancer rates.
    - - Community
        
        Community provide relevant health care and support services e.g. "PCYC", "youth on the streets". Programs provide welfare support for use and aim to improve health outcomes for low SES.
      - Government
        
        Government providing funding for free/reduced cost healthcare. Medicare (1984). Medicare funds hospitals, medical services and pharmaceuticals, free public patient care in hospitals
      - Individuals
        
        Individuals focus on good decision making and taking ability for their own health, and those around. Can promote health in others by encouraging not smoking/drinking, reducing risk factors and addressing inequities.
    - - Aims to provide free or subsidised treatment from a range of health professionals including doctors, optometrists, physiotherapist, and medical specialists and provide subsidised medicine through the pharmaceutical benefits scheme (PBS). The goal is to provide all Australians adequate and affordable healthcare, regardless of SES.
- - - - "A disease in which the body's ability to produce or respond to the hormone insulin is impaired, resulting in abnormal carbohydrate metabolism." Type 1 (early onset), type 2 (adult onset) and Gestational (pregnancy)
      - 1 million people in Australia diagnosed, 1/4 people undiagnosed. 85% type 2, 12% type 1. Diabetes rate doubled in the last 20 yrs, 4.2%. 6th leading cause of death in Australia, contributing to 10% deaths.
    - - MODIFIABLE obesity, poor diet, physical inactivity, high BP, management of blood sugar (type 1)
      - NON MODIFIABLE Family history, PCOS, gestational diabetes.
    - - SOCIOECONOMIC Low SES status people have higher drinking, smoking and obesity rates.
      - ENVIRONMENTAL people outside major cities are more likely to be diagnosed with type 2 diabetes.
      - SOCIOCULTURAL ATSI, chinese, Indian, Islander families are more at risk for type two diabetes due to their diets.
    - - ATSI peoples, people with a family history, Islanders, Indian, Chinese background, males, low SES, people living outside major cities, elderly
  - - - Skin cancer can include: malignant melanomas, basal cell carcinoma, squamous cell carcinoma. The most aggressive form of skin cancer is malignant melanoma which spreads aggressively throughout the entire body and damages all cells.
      - Incidence of melanoma has almost halved in the last 30yrs due to positive choices around sun safety and sunscreen.
    - - MODIFIABLE occupational exposure, sunbeds, sun safety, regular GP checks, avoid excess UV exposure
      - NON MODIFIABLE family history, genetics (ie. red hair, fair skin, freckles.)
    - - SOCIOECONOMIC low education limits employment. people working outside with non-skilled labour at risk for sun exposure and melanoma.
      - ENVIRONMENTAL people who liv on a beach are more likely to be our in the sun more often and placed at higher risk for cancer.
      - SOCIOCULTURAL Australian culture revolving around the heat of summer, beaches and tanning, recent media advertisement educated Australia on melanoma risk.
    - - Males, people working outside, fair skin, red hair or freckles, no sunscreen.
  - - - MODIFIABLE smoking, obesity, high blood fat percentage, physical inactivity
      - NON MODIFIABLE Family history, gender, ethnicity, advancing age
    - - SOCIOECONOMIC low SES/ unemployed have higher death rates: lower income can limit healthy choices, ie. fuit and veg can be expensive, exercise facilities are expensive. Poor education leads to poor health literacy and access/use of health services
      - SOCIOCULTURAL Family history, ATSI more @ risk (low SES + education), Asians less susceptible (low fat diet), media exposure of smoking effects, subsequent lower smoking rates and declining trend in CVD.
      - ENVIRONMENTAL Rural and remote areas more at risk due to less access to health services and technology (eg. electrocardiogram monitors)
    - - Tobacco smokers, family history of CVD, high BP (hypertension), high fat diets (raised cholesterol), people over age 65, males.
    - - "Any disease which affects the circulatory system" eg. Coronary heart disease, stroke, peripheral vascular disease, heart failure, myocardial arrhythmia.
      - No.1 leading cause of death in Australia (29%), 1 in 6 Australians affected, overall decreasing trend of incidents: reduced risk factors and improved treatment. Males are more likely to die than females, ATSI 2x rate of deaths than other Australians. Mortality: 99.1 to 62.4 deaths per 100,000 people (2017-16) decrease. Morbidity: leading cause of disability, (1.4 mil) 2013-14. Hospitalisation rates 6% CVD, 31% CHD
  - - - MODIFIABLE Tobacco smoking (active or passive), workplace or other carcinogen exposure (asbestos and air pollution),
      - NON MODIFIABLE family history, hereditary or genetic predisposition.
    - - SOCIOCULTURAL ATSI peoples commonly smoke, and raise children around the 2nd hand smoke, putting them at risk for lung cancer too.
      - SOCIOECONOMIC Low SES people with lower education, income and employment are more likely to smoke, and also less likely to seek medical assistance
      - ENVIRONMENTAL Living in rural and remote areas, lots of people smoke, and pollution in urban areas can affect breathing and increase development of lung cancer.
    - - Lung cancer can include: lung nodules, non small cell lung cancer, small cell lunch cancer, mesothelioma. Small cell lung cancer is the most aggressive form of lung cancer
      - Currently No.1 leading cause of cancer deaths in Australia, males have a higher risk than females but both increasing. 10x higher risk if smoker. Less than 10% lung cancers are in non-smokers.
    - - Smokers, people living with smokers, people working in asbestos environments, ATSI populations
  - - - MODIFIABLE occupational radiation exposure, hormonal birth control, obesity, regular GP checks and breast-screens,
      - NON MODIFIABLE family history, women who don't/can't breastfeed.
    - - SOCIOECONOMIC lower education limits health literacy and less aware risk/protective factors. Jobs which expose workers to radiation, low SES have higher cancer rates.
      - ENVIRONMENTAL Rural and remote people have less access to specialists in cancer and less technology available for treatment. Often travel is required for treatment.
      - SOCIOCULTURAL Family history, heredity or genetic predisposition
    - - Breast cancer can include: ductal carcinoma in situ, ductal carcinoma, metastatic breast cancer. Although breast cancer rates are particularly high for women, it can also affect men in some rare cases.
      - No.1 cause of death for women in Australia, 1 in 15 women get it. New cases doubled since 1982 and expected to rise with ageing population.
    - - Women who have never given birth, women on hormonal birth control, women 50 years and older, obese women, people with family history, women who don't self-examination, women who start menstruating at an early age, women who have late menopause
  - - - MODIFIABLE lifestyle choices, behaviours, carcinogen exposure.
      - NON MODIFIABLE age, gender, family history/genetics
    - - SOCIOECONOMIC Low level of education and low income: unemployment, higher risk taking behaviours ie. smoking, drinking, no sunscreen, physical inactivity, obese, poor diet, less access to health products.
      - ENVIRONMENTAL Low SES and rural and remote may experience lower education facilities and limited access to health care facilities
      - SOCIOCULTURAL ATSI people have a higher incidence of cancer and lower survival rates. Low SES and environmental location: smoking: lung cancer and cervical cancer: access issue
    - - 'The existence of abnormal cells that have an uncontrolled growth and spread within the body. classified by cell type"
      - No.2 leading cause of death (28%), 1 in 2 men, 1 in 3 women will develop a major cancer <85yrs. Death rates dropped since 1980s but increase in new cases identified. Cancer mortality rate increases as people get older. Most common cancer in men is prostate cancer. Most common cancer in women is breast cancer. Decreased trend in cervical cancer due to new vaccine.
    - - Low SES, ATSI population, elderly