1. Priority issues for Australia’s health
Core 1
Priority issues for Australia’s health

2. Health of indigenous people
The most obvious contrast in health status is found between Aboriginal
and Torres Strait Islander peoples, and non-indigenous people.
Indigenous people are reported to have :
Lower life expectancy
Higher mortality
Higher infant mortality
Higher rates of diabetes
Higher rates of elevated blood pressure
Higher rates of injuries
Higher rates of respiratory diseases
Higher rates of cancer, endocrine and digestive disorders
Higher hospitalisation rate

3. Health of indigenous people
Life expectancy at birth, indigenous Australians, 1991 – 96
Persons
Years
Males
Females
Indigenous western Australia ¹
53.7
58.9
Indigenous eastern Australia ²
59.2
63.6
Indigenous total
56.9
61.7
Total Australia
75.2
81.1
1 Western Australia, South Australia, Northern Territory
2 New South Wales, Queensland, Victoria, Tasmania, the Australian Capital Territory
Source : Australian Institute of Health and Welfare 1998, Australia’s Health 1998, Canberra p.29

4. Socio-economically disadvantaged people
Higher infant mortality
Higher mortality rates
Poor living conditions
Unemployment
Low levels of education
High substance abuse

5. Australians born overseas
Lower mortality rates
Lower morbidity rates (except for mental health)
Unemployment
Racism
Low wages /crime /exploitation
Higher level of health: migration criteria, poor people find it difficult to migrate, less lifestyle disease risk factors
Problem areas: migrant women, elderly, occupational health and safety, racism and cultural differences

6. People living in rural and isolated locations
Higher mortality rates
Lower life expectancy
Low wages
Poor access to health services
Unemployment
Major increase in suicide
Disadvantages: life expectancy is less, death rates are 69% higher
Greater: diabetes, homicide･Inequities/causes include: low socio-economic status, access to resources, occupational hazards

7. People with disabilities
Disability: lack of ability to perform everyday functions/ activities
18% of people have one
Higher rates in males than females
Higher rates in rural areas
Handicap: disadvantage resulting from impairment/disability that limits/prevents and everyday role. More severe.
Inequities: social stigma and financial constraints

8. 6 years greater life expectancy
Gender specific conditions: breast and cervical cancer
Lower rates in most diseases than men
More vulnerable to domestic violence

9. Men 25% higher death rate Higher infant mortality rates
Gender specific conditions: testicular and prostate cancer
Causes: more risk taking behaviour, less use of medical services
Youth: more suicide, drug dependency and MVA

10. Older people We have an aging population
Medical problems: arthritis, hypertension
Social problems: poor education and socio-economic status
Have a greater demand for health services
Higher mortality rates
Higher morbidity rates

11. Cancer Why is cancer control a National Health Priority Area?
Nature
A group of diseases characterised by the uncontrolled growth and spread of abnormal cells
Believed to be caused by damage to the genetic structure of a single cell
Extent
Causes 27% of all deaths in Australia
Major types – lung, breast, colon, prostate, melanoma
Risk factors
Vary according to the cancer type. Some factors include family history, smoking, high-fat diet, exposure to cancer-causing agents
Social determinants
Lower socioeconomic status
Lack of education
Groups at risk
Vary according to cancer type
Most common groups include cigarette smokers, those exposed to health hazards, obese women, those over 50 years, family history

12. Cancer Glossary
Cancer – a large group of diseases that are characterised by the uncontrolled growth and spread of abnormal cells.
Tumour – is a swelling or enlargement caused by a clump of abnormal cells.
Neoplasm – an abnormal mass of cells that force their way among healthy cells and interfere with their normal functioning.

13. Metastases – are secondary or new tumours that may begin some distance from the original malignant tumour.
Carcinogens – cancer causing agents such as chemicals, pollutants, radiation, cigarette smoke, and alcohol
Breast Cancer
Breast Self Examination – (BSE) – a preventative action which detects changes or abnormalities in the breast.
Mammographic Screening – is a process of using a special x-ray of glands, fat and blood vessels under the skin of the breast to identify any variations from the normal or healthy tissue.

14. Skin Cancer
Basal Cell Carcinoma – a surface skin cancer that originates from the basal cells, which underlie the surface cells. It is the most common type of skin cancer.
Squamous Cell Carcinoma – surface skin cancer that originates in the squamous or surface cells. It is the fastest growing form of skin cancer.

15. Injury Why is injury prevention and control a National Health Priority Area?
Nature
Major categories include transport-related accidents, suicide, falls, burns, scalds, industry-related injuries and interpersonal violence
Extent
Causes 6% of all deaths in Australia
Leading cause of death in 1 – 44 age group
Risk Factors
road accidents : alcohol, lack of judgement, power, speeding, complacency
childhood injuries : unsafe behaviours, lack of supervision
Social determinants
alcohol abuse
susceptibility to risky behaviour
Groups at risk
varies according to injury type
most common groups include children (burns and scalds), those who operate machinery in workplaces and older people (falls)

16. Injury Glossary
Suicide – is an intended self-inflicted injury which is fatal.
Parasuicide – is an attempted suicide that is not fatal and is often impulsive.

17. Mental Health Why is mental health a National Health Priority Area?
Nature
Ranges in severity from mental complaints and symptoms (eg depression) to mental illness (eg schizophrenia)
Extent
Estimated that 18% of Australians have experienced symptoms of mental disorder
Mental disorder – highest among 18 – 24 age group
Suicide is the leading cause of death in 15 – 24 age group
Risk factors
Depression, mental illness, drug abuse, stress, negative experiences
For suicide : depression, mental and physical illness, social isolation
Social determinants
Unemployment and low income
Lack of access to health care
Groups at risk
Those who suffer depression, disadvantaged groups

18. Diabetes Why is diabetes mellitus a National Health Priority Area?
Nature
A condition affecting the body’s ability to take glucose from the bloodstream and use for energy
Two types – insulin dependent (type 1) and non-insulin dependent (type 2)
Extent
Approximately 700,000 Australians affected
85% of diabetics have type 2 diabetes
Risk factors
Type 2 diabetes – obesity, high blood pressure, age over 50, family history, inactivity, smoking, increasing age
Social determinants
Lack of sound nutritional practices
Lack of access to health care
Groups at risk
Indigenous Australians
Australians born overseas
Elderly

19. Diabetes Glossary
Diabetes Mellitus – a condition affecting the body’s ability to take glucose from the bloodstream to use it for energy.
Insulin – is a hormone produced by the pancreas that helps glucose to enter the body cells and be used for energy.

20. Asthma Why is asthma a National Health Priority Area?
Nature
A chronic respiratory condition in which the narrowing of the airways causes difficulties in maintaining sufficient airflow in and out of the lungs.
Unpredictable condition that can occur at any time.
Extent
Major cause of morbidity in Australia, and highest incidence in the world.
Decrease in mortality.
Risk factors
Triggered by large number of factors
Social determinants
Socio-economic factors.
Exposure to environmental pollutants
Groups at risk
Young children (Parents who smoke)
People with allergies
Hereditary

21. Nature Extent Risk Factors Social determinants Groups at Risk
Why is arthritis and musculoskeletal conditions a National Health Priority Area?
Nature
Arthritis is a group of musculoskeletal conditions in which there is inflammation of the joints, causing pain, stiffness, disability and deformity
Osteoarthritis - Osteoarthritis is one of the most common forms of arthritis.
Rheumatoid arthritis - Rheumatoid arthritis is a chronic inflammatory disease that mainly affects the joints and is characterised by joint swelling and destruction.
Osteoporosis - Osteoporosis meaning "porous bones" is a musculoskeletal disorder where the bone density thins and weakens, resulting in an increased risk of fracture.
Extent
Osteoarthritis was the seventh most frequently managed problem by general practioners in Australia in
In the 2001 National Health Survey, 2.7% of females respondents reported having rheumatoid arthritis compared with 2.0% of males. The prevalence of rheumatoid arthritis increases sharply with age but is higher in females at nearly all ages.
In the 2001 National Health Survey, 1.6% of respondents reported osteoporosis. The prevalence was 10.5% among females aged 65-74, increasing to 12.3% among female respondents aged 75 and above. In comparison, the prevalence of osteoporosis in males was much lower, at 1.2% and 1.5% in the two age groups respectively
Risk Factors
Hereditary
Social determinants
Gender
Age
Groups at Risk

22. Social determinants
Social factors contribute to health inequities among
population groups. The most important social
determinants include :
social and economic factors
education
employment
ethnicity
gender
age
location

23. Key Concepts Health Promotion
Involves activities that are aimed at improving health and preventing illness
Public Health
A combination of science, medicine, practical skills and beliefs aimed at maintaining and improving the health of all people
New Public Health
All activities organised by society to protect people from disease and to promote good health
Ottawa Charter
A framework for health promotion

24. Trends in public health over the past decade
Trends in Health
Trends in public health over the past decade
Improvements
Mixed changes
No change
Worsening areas
Overall mortality
Stroke
Heart disease
Road safety
Dental health
Congenital abnormalities
HIV/AIDS
Diseases controlled by immunisation
Colorectal cancer
Level of
improvements in
lower socio-
economic groups
Lung cancer
Cervical cancer
Increased physical activity
Indigenous health
Breast cancer
Premature
deaths
Social disparity
Alcohol consumption
Senile dementia
Illicit drug use
Prostate cancer
Skin cancer
Diabetes
Youth suicide
Obesity
Sroiuce : G. Egger, R.Spark, J.Lawson and R.Donovan 1999, Health Promotion Strategies and Methods, Revised Edition, McGraw-Hill, Roseville NSW P.3