HSC Core 1: Health Priorities in Australia

How are priority issues for Australia’s health identified? Identifying priority health issues “At the National Health Summit held in 1993 the health ministers agreed that national goals and targets should be stated and form the basis of a national health policy. From this summit there is continued acknowledgement of the need to reorientate policies and programs towards health prevention and improvement, rather than simply curative measures and health care services. The priority areas were identified as: Cardiovascular health * Diabetes mellitus Cancer control * Mental Health Injury prevention and control * Asthma Arthritis and musculoskeletal conditions” PDHPE Application and Inquiry: Oxford Press

Principles of social justice Priority population groups “When the Australian Government makes decisions about how it will address the health problems confronted by the nation, it uses a set criteria, based on ‘evidence’, to identify the most important priorities. The question of how best to spend money and distribute resources is answered by applying these criteria: Principles of social justice Priority population groups Prevalence of condition Potential for prevention and early intervention Costs to individuals and the community. A health issue that meets most of these criteria will be made a priority, ensuring it will be the target of greater spending and resource allocation from the health sector”. PDHPE in focus: McGraw Hill

Identifying priority health issues - Social Justice Principles “Social justice is a set of values that recognises the impact of discrimination, past disadvantage, structural barriers to equality, as well as other social factors. It is concerned with reducing inequality by supporting the most disadvantaged people in society. The principles of social justice apply differently in different contexts, so in practice social justice may look different in health or law or education. In health the principles of social justice include: Participation Equity Access Rights

Social Justice Principles: “Social justice principles provide a framework or process to guide the equal division and distribution of policies and practices so all groups have equal opportunity to benefit depending upon their needs.” Participation: “The importance of communities and individuals being fully involved in the planning and decision making associated with improving their own health” Access: “Removing barriers to make sure that all people, regardless of their circumstances, are provided with satisfactory health services and information”

Rights: Supportive Environments: Diversity: The laws that protect human rights should protect good health as one of the most fundamental rights of all. Supportive Environments: Social, environmental and political conditions all have a profound effect on health and need to be included in the processes of decision making and planning if population health is to be improved. Diversity: When cultural, religious and other differences are accepted, the needs of all members of society are acknowledged. In this way a wider range of solutions to health problems becomes credible and available.

Identifying priority health issues - Priority Population Groups “One of the criteria for selection as a priority issue was the potential to reduce inequalities in health status. To achieve social justice for each issue, specific priority population groups were identified. These priority population groups are those that are shown by research to experience an unnecessarily high incidence of the condition. Some of the priority groups identified include: Socio-economically disadvantaged A.T.S.I peoples People living in rural and remote areas The elderly People with disabilities People who were born overseas. PDHPE Application and Inquiry: Oxford Press

“The criterion for how best to spend money and distribute resources for health based on priority population groups should be considered by asking questions, such as: Does a specific group within the population suffer higher prevalence of this condition? Can this health issue be improved by targeting a specific population group?

Identifying priority health issues - Prevalence of Condition “The criterion for how best to spend money and distribute resources for health based on prevalence of condition should be considered by asking questions, such as: Does this health problem affect a large number of people within the population? Is there evidence that the extent of this health problem is increasing? “Australian governments have established well-organised systems for reporting, collecting, measuring and monitoring the prevalence of health conditions throughout the country and the changes that are occuring in characteristics and structure of the population.”

Identifying priority health issues - Potential for prevention and early intervention “The identification of priority issues is based on the potential for prevention and early prevention. The incidence of lifestyle-related conditions (such as CVD, some forms of cancer and type 2 diabetes) can be reduced through behavioural change and environmental modifications. For health problems that are not lifestyle related the potential for change is extremely limited and progress is more reliant on research and medical advances.” “Health problems are social issues that are directly related to the society in which people live. Prevention for many people is limited and, in some cases, non existent. To blame individuals for their behaviour ignores the social, economic, cultural and political forces at work in society” PDHPE in Focus

Identifying priority health issues - Cost to the individual and community Does this condition impose high or inequitable costs on its sufferers and their communities? The costs imposed on individuals by poor health can be extensive and varied. These might include the: The financial cost of treatment or lost employment and medications Physical cost of lost mobility or functionality Emotional suffering caused by chronic pain or depression Social cost resulting from damaged relationships and family suffering PDHPE in Focus

The combination of premature death and time spent with a disability is referred to as ‘burden of disease’. The costs imposed on the community may include ‘direct’ costs that are borne by the healthcare system or ‘indirect’ costs that may be borne by the family or other sectors of the community”. “Direct costs might include the financial cost of providing hospital and medical services or the cost of subsidising pharmaceuticals or funding medical research”.” “Indirect costs might include the cost of premature death, lost productivity, insurance costs, support services or retraining programs” PDHPE in Focus

References: Boyd, A., Eussen, A., Lumley, D., O’Halloran, M., Sculley, L. (2010). PDHPE in Focus. The McGraw Hill: Sydney. Browne, S., Clarke, D., Henson, P., Hristofski, F., Jeffereys, V., Kovacs, P., Lambert, K., Simpson, D. (2010). PDHE: Application and inquiry Ruskin, R., Proctor, K., Neeves, D. (2010). Outcomes: Personal development, health and physical education, HSC Course 4th edition. John Wiley & Sons: Sydney