1. National Health Priority Areas (NHPAs)

2. NHPAs Cancer control Cardiovascular disease
Injury prevention and control
Mental health
Arthritis and musculoskeletal conditions
Asthma
Diabetes
Obesity
Dementia

3. Arthritis and musculoskeletal conditions
Arthritis is a term used to describe a disorder of one or more joints. Arthritis disorders are part of a broader group of disorders of the muscles and bones called musculoskeletal disorders.
This NHPA is focussed on:
osteoarthritis
rheumatoid arthritis
osteoporosis.

4. Osteoarthritis
A degenerative joint condition affecting the weight-bearing joints such as the hips, knees and ankles as well as the hands and spine. In the initial stages pain occurs in the joints during and after activity, but as the condition progresses pain may be experienced from minimal movement or during rest.

5. Rheumatoid arthritis
An auto-immune disease causing chronic inflammation of the joints. It most commonly affects the hand joints and can lead to deformities
of the hands.

6. Osteoporosis
A condition whereby there is a progressive loss of bone density and decrease in the strength of the skeleton with a resultant risk of fracture.

7. Strategy Waves Warm Water Wellness Program
Arthritis Victoria’s Waves program provides gentle warm water exercise classes in hydrotherapy pools and offers a general workout for the whole body. Exercising in warm water is one way to help people with arthritis remain physically active

8. Arthritis and musculoskeletal conditions
Reason why NHPA
Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Affects 31% of Australians – more than 6 million people
Obesity
Osteoporosis: Physical inactivity and joint trauma
Arthritis: Environmental link, perhaps virus or bacterial infection
Self management courses
Exercise programs for elderly
Healthy Bones Week
$24 billion in health care, lost work time, shortened lives and years spent with disability
Family members need to act as carers
Isolation, lack of self esteem and depression due to chronic pain

9. Asthma
A chronic condition that affects the small air passages of the lungs. When exposed to certain triggers, the airways of people with asthma will narrow, making it difficult to breathe.

10. Asthma Friendly Schools Program
The Asthma Friendly Schools Program is a national program that targets school students, staff and parents and was developed to help schools provide a safer environment for children with asthma. The aim of this program is to achieve improved quality of life, health outcomes and wellbeing for school children with asthma. Schools are required to meet a number of essential criteria in order to become an Asthma Friendly School.

11. Asthma Reason why NHPA Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Affects more than 2 million Australians
Often coexists with other chronic respiratory diseases
Leading cause of disability
Age
Higher prevalence for females
Viral infections
Exercise
Air pollutants
tobacco smoke
Allergens (dust mites, pollen and animal danders)
Self-management programs
Asthma friendly schools
in , $615 million in direct costs
Individual costs include preventative medicine and inhalers
Time off work, therefore loss of productivity and cost to employer

12. Cancer control
Cancer control is about attempting to control or stop the growth of a group of diseases in which the cells become defective and behave abnormally.
Eight priority cancers have been identified;
Lung cancer melanoma,
non-melanocytic skin cancer
colorectal cancer prostate cancer
non-hodgkins lymphoma, cervical and breast cancer

13. Which cancers were the most common in 2007?
In 2007, the most commonly reported cancers were:
Prostate cancer (19,403 cases)
Bowel cancer (14,234 cases)
Breast cancer (12,670 cases)
Melanoma of the skin (10,342 cases)
Lung cancer (9,703 cases).

15. How many people died from cancer in 2007?
A total of 39,884 people died from cancer in 2007 (22,562 males and 17,322 females), this equates to an average of 109 people dying from cancer every day.
Cancer was the second most common cause of death in 2007, accounting for approximately three of every ten deaths (29%).

17. Why was it selected?
1.Because it is the leading cause of disease burden in Australia
2.Because of the potential for the prevention of many cases of cancer
3.Due to the large economic burden it places on the health care system

18. National Bowel Cancer Screening Program
Medicare Australia and the Department of Health and Ageing are working together to implement this program. Currently fewer than 40% of bowel cancers in Australia are detected early. Bowel cancer screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. Screening involves a test called a Faecal Occult Blood Test (FOBT), which involves an individual sending a sample to a laboratory for analysis. The goals for this program are to reduce the incidence and mortality rate of bowel cancer through screening to detect abnormalities early.

20. Cancer control Reason why NHPA Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Leading cause of death
Leading cause of total burden of disease
More than 39,000 deaths each year
Genetics
Age
Smoking (lung cancer)
UV radiation (skin cancer)
Screening and vaccination programs
SunSmart
In , direct costs of $2.8 billion
Cost to individuals – medication, treatment and surgery
Personal suffering
Feeling of loss
Time off work

21. Cardiovascular Health
Cardiovascular health is about maintaining a healthy heart and circulatory system. Cardiovascular diseases include all diseases and conditions of the heart and blood vessels including coronary heart disease, stroke and peripheral vascular disease. It is caused mainly due to damage to the blood supply to the heart, brain and legs.

23. The main types of CVD in Australia are:
coronary heart disease
stroke
heart failure and cardiomyopathy
acute rheumatic fever and rheumatic heart disease
peripheral vascular disease
congenital heart disease.
The main cause of most CVDs in Australia is atherosclerosis, which is an abnormal build-up of fat and other substances which form plaque inside the arteries.
Atherosclerosis is most serious when it leads to reduced or blocked blood supply to the heart (causing angina or heart attack) or to the brain (causing a stroke).

24. The major preventable risk factors for cardiovascular disease are:
Tobacco smoking
Poor diet and nutrition
Physical inactivity
Overweight and obesity
High blood pressure
High blood cholesterol
Diabetes

25. Why was it selected
1. To improve the cardiovascular health of Australians by reducing coronary heart disease and the impact that it has on the population
2. Because it is the largest cause of premature death and the second leading cause of disease burden in Australia
3.Because of the potential for the prevention of many cases of cardiovascular disease
4.Due to the large economic burden on the health care system as the most expensive disease group

26. Cardiovascular health
Cardiovascular disease is the largest cause of premature death in Australia

27. Strategies
The Tick Program The Tick Food Approval Program is a public health nutrition program that was established in 1989 as part of the Heart Foundation’s long term strategy to improve the eating patterns of all Australians. It is a guide to help people make healthy food choices quickly and easily. Its also encourages food manufacturers to develop products that support the Heart Foundations guidelines. To earn the Tick, foods need to meet a standards in relation to fat levels, trans fats, kilojoules, salt, fibre and calcium. To earn the Tick products need to be lower in fats and salt and higher in other nutrients such as fibre than other foods in the same defined food category.

28. Cardiovascular disease
Reason why NHPA
Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Leading cause of premature death (18% of all deaths in 2005)
Leading causes of disability
Second leading cause of disease burden
Overweight and obesity
Diabetes
Genetics
Tobacco smoking
Poor diet and nutrition
Physical inactivity
Heart Foundation Tick
Jump Rope for Heart
Go Red for Women
FAST (Stroke Foundation)
In , $5.9 billion in direct costs (11.2% of total health care spend)
Impact on lifestyle
May affect capacity to work and participate in activities

29. Diabetes Mellitus
Diabetes is a long-term (chronic) condition in which the body loses its ability to control the level of glucose (sugar) in the blood. Insulin is a hormone produced by special cells in the pancreas that helps the body to convert glucose from food into energy. People with diabetes either don’t have enough insulin or their body cannot use insulin effectively

30. Type 2 Diabetes Mellitus
Type 2 diabetes is the most common form of diabetes.
It occurs mostly in people aged 50 years and over and,
People with type 2 diabetes produce insulin, but cannot use it effectively or may not produce enough.
Type 2 diabetes may initially be managed with changes to diet and exercise, and/or oral glucose-lowering drugs.
People with type 2 diabetes may progress to needing insulin or a combination of these therapies if their condition cannot be managed through lifestyle changes and/or oral drugs.
Type 2 diabetes accounts for 87% of all people with diabetes, according to self-reported data from the 2007–08 National Health Survey.

31. Risk factors

34. Diabetes mellitus Reason why NHPA Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
More than 1 million Australians have diabetes
Genetics
Age
Physical inactivity
National diabetes action program
In , $836 million in direct costs
Ongoing costs for daily medication for type 1 diabetes
Impact on daily lifestyle for people with type 1 diabetes

35. injury prevention and control
This NHPA aims to reducing the incidence of injuries such as intentional harm including suicide and unintentional injuries such as falls, poisoning and transport accidents

36. Injury contributes substantially to the burden of disease
Injury contributes substantially to the burden of disease. In 2010, injury was estimated to account for 6.5% of the total burden of disease in Australia.
Each year about 400,000 people suffer an injury severe enough to be admitted to a hospital.
Older people, particularly women, have higher rates of injury as a result of falls.

37. Why was it selected?
1.Because it is a significant cause of disease burden in Australia 2.Because of the potential for the prevention of many injuries 3.Due to the large economic burden it places on the health care system

38. Arrive Alive
Arrive Alive is the Victorian Government’s new 10-year road safety strategy to help combat road trauma, deliver further major improvements to our road transport system and improve safety for all Victorian road users. The strategy incorporates the Safe System approach to road safety –safer roads and roadsides; safer vehicles; safer road users. It also incorporates initiatives in the key areas of: road improvements; drug driving; young drivers; strategic enforcement; safe vehicles. Arrive Alive’s target is by the end of 2017, a reduction in deaths and serious injuries by 30% and save an extra 100 lives a year, prevent over 2000 serious injuries and reduce the severity of serious injuries.

39. Injury prevention and control
Reason why NHPA
Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Major cause of death for people under 45
Leading cause of death for children
Can result in permanent disability
Age
Excess weight increases risk of falls in older people
Unsafe environment (e.g. Pools with open gates)
Drink driving
National Prevention Plans
National Kidsafe Day
TAC: “If you drink and drive, you’re a bloody idiot”
In , $4061 million in direct costs
Cost to individual families e.g. modifying home for disabled family member
High costs for health care for people living with disability
Pain and suffering

40. Mental Health
Mental health is about promoting a state of wellbeing in which the individual realizes his or her own abilities, can cope with the stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

41. 3.2 million Australians (20% of the population aged between 16 and 85) had a mental disorder in the twelve months prior to the survey.

42. Why was it selected?
1.Because it is the leading cause of non-fatal disease burden in Australia 2.Due to the large economic burden it places on the health care system

43. MindMatters
MindMatters is a national mental health initiative for secondary schools funded by the Australian Government Department of Health and Ageing and is implemented by Principals Australia. MindMatters uses a whole school approach to mental health promotion and with this focus, embeds promotion, prevention and early intervention; enhances the development of school environments; develops social and emotional skills; helps school communities; develops strategies; and working with families all with the aim of raising awareness and providing coping strategies for all individuals.

44. Mental health Reason why NHPA Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Leading cause of burden of disease
More than 20% of Australians will experience mental illness
Genetics
Physical (chemical imbalance)
Unhealthy family environment
Stress
beyondblue
National Suicide Prevention Strategy
KidsMatter
MindMatters
High number of hospitalisations, therefore high costs for individuals and families
Personal suffering
Stigma

45. obesity

55. Obesity Reason why NHPA Biological risk factors
Behavioural risk factors
Health promotion strategies
Direct costs
Indirect and intangible costs
Global epidemic
Increases risk of other diseases
Weight
Poor diet and overconsumption
National Obesity Strategy
Measure Up
Estimated $11 billion per year
Stigma
Discomfort

56. Dementia
Dementia is not a single specific condition. Rather, it is an umbrella term that describes a syndrome associated with more than 100 different conditions which are characterised by the impairment of brain functions, including language, memory, perception, personality and cognitive skills.

57. Alzheimer disease is the most common type of dementia, accounting for about 50% to 75% of dementia cases worldwide. It is characterised by short-term memory loss, apathy and depression in the early stages. Onset is gradual and decline is progressive. This form is most common among older people with dementia, particularly among women.
Vascular dementia is generally considered to be the second most common type of dementia, with about 20% to 30% of dementia cases thought to be this type. It is caused by cerebrovascular conditions (for example, stroke). Symptoms in the early stages are similar to Alzheimer disease, but memory loss is not as great and mood fluctuations are more prominent. Physical frailty is also evident. Onset can be sudden.

58. An overview of the stages of dementia
Mild or early
Deficits are evident in a number of areas (such as memory and personal care) but the person can still function with minimal assistance.
Symptoms include: moderate memory loss especially for recent events, some disorientation in time, moderate difficulties with problem solving, reduced interest in hobbies, and the need for prompting regarding personal care tasks.
Moderate or middle
Deficits become more obvious and severe, and increasing levels of assistance are required to help the person maintain their functioning in the home and community.
Symptoms include: severe memory loss, considerable difficulty orienting to time and place, obvious difficulties in finding words, severe impairment of judgement and problem solving, need for assistance with personal care tasks, and emergence of behavioural difficulties (for example, wandering, aggression, sleep disturbance and disinhibited behaviour).
Severe or late
Characterised by almost total dependence on the care and supervision by others.
Symptoms include: very severe memory loss, very limited language skills, unable to make judgements or solve problems, regularly not recognising familiar people, frequent incontinence, requires substantial assistance with personal care, and increased behavioural difficulties.
By this stage the majority of people with dementia are in residential care.

59. Sunday night last week on the relationship between head trauma and dementia:
factsheet from the WHO:
(two from Alzheimer’s Australia about Dementia becoming an NHPA): Alzheimer’s Australia:  (1.57)
Alzheimer’s Australia: (2.47)
What is dementia?:

60. Dementia Reason why NHPA Biological risk factors
Behavioral risk factors
Health promotion strategies
Direct and indirect cost
Ageing population
298,000 Australians had dementia in 2011,
3rd leading cause of death accounting for 6% of all deaths
Twice as many women as
men died from dementia (6,083 and 2,920 respectively)
Ageing
Family history
hypertension
vascular risk factors (such as smoking, sedentary lifestyle, obesity,
head trauma, depression
Alzheimer’s Australia provides a range of free
support services to people living with dementia, their families, carers and health
there were at least 200,000 informal carers of people with dementia
health and aged care system expenditure$4.9 billion in 2009–10,

61. Summary
NHPAs are a collaborative effort involving Commonwealth, State and Territory Governments
Eight current NHPAs collectively account for almost 80% of total burden of disease and injury in Australia
Obesity is the most recently added NHPA – announced in April 2008