1. How are priority issues for Australia's health identified? IDENTIFYING PRIORITY HEALTH ISSUES

2. Identifying priority health issues Australia is one of the healthiest countries in the world; however, Australia's population still experiences a range of health problems. The challenge for the Australian government is to allocate a limited amount of resources to address these health problems. This means that priorities need to be established. The Australian government has chosen to use a framework of priority health issues to achieve this. Epidemiology plays an important role, however issues such as social justice, potential for prevention and costs are also important.

3. Identifying priority health issues The determination of priorities for health, spending can be very challenging. Different people in the community will take different perspectives. The Australian government has determined that along with epidemiology, the following considerations are important: ◦Social Justice Principles ◦Costs to the individual and the community ◦Priority population groups ◦Prevalence of the condition ◦Potential for prevention and early intervention 1S, 2C’s, 3P’s

4. Social Justice Principles Social justice means that the rights of all people in our community are considered in a fair and equitable manner. It involves the establishing of supportive environments and the promotion of diversity. For example: a homeless youth, an aged person and a person from a non-English speaking background should have the same opportunity to achieve and maintain optimal health.

5. Social Justice Principles The four principles of social justice include: PEAR P articipation: the empowerment of individuals and communities to be involved in planning and decision making for good health. E quity: fair allocation of resources and entitlements without discrimination. A ccess: The availability of health services, information and education. R ights: Equitable opportunities for all individuals to achieve good health

6. Application Outlined below are scenarios that involve social justice issues. Identify the social justice issue in each scenario and propose examples of health actions that can be taken to support social justice principles. 1. A local hospital notices that women from a non-English speaking background are not taking advantage of free breast screening programs in their community. Currently, all advertising about the program is in English. 2. A local high school does not have wheelchair access to the art classrooms that are upstairs. As a result, disabled students cannot participate in art classes. 3. Small rural communities are experiencing significant difficulty in employing doctors and nurses. The local residents are concerned about the impact on health services.

7. Costs to the individual and the community III health impacts across all aspects of a person's life. Loss of life, quality of life and the financial burden to a family, are examples of the detrimental effect of developing a chronic health condition. Many people, who suffer from serious illness, may need to be hospitalised for lengthy periods of time. This may prevent them from maintaining employment status and consequently place a financial strain on their families. Also includes the indirect financial, physical, social, emotional and mental costs as well. According to the Australian Institute of Health and Welfare (AIHW), the average health expenditure per person more than doubled between the years 1995-96 and 2005-06. In 1995-96, the average health expenditure per person was $2146 compared to $4874 in 2005-06.

8. Application Read the article Cardiovascular diseases top Australian health care spending (link on my Weebly) then answer the following questions: 1. What was the estimated health-care expenditure on cardiovascular diseases in 2008-09? 2. Was the cost of treating and managing cardiovascular diseases higher in males or in females? 3. On which age group in the population is health-care spending highest?

9. Priority Population Groups High levels of preventable chronic disease, injury and mental health problems have been identified as one of the priority health issues for Australians. Within each of these health areas, certain groups in our population have been identified as at increased risk of developing these diseases or health conditions. By identifying at risk population groups, government health care expenditure and health promotion initiatives can be directed towards these groups to attempt to reduce the prevalence of the disease.

10. Application Using information presented in the section of Australia’s Health 2014 – In Brief (on my Weebly), identify two priority population groups that are represented. 1. Outline some of the inequities each group experiences with regards to health status. 2. What impact do the principles of social justice have on identifying priority population groups?

11. Prevalence of the condition Analysing statistics allows us to interpret the prevalence of a condition or disease. Prevalence means how common a condition is in the community. Morbidity statistics are reliable indicators of the prevalence of a condition. They can often highlight points of difference for the same condition, e.g. the mortality (death) rate for a disease/condition may be low but the morbidity rate quite high. Governments can then look at the reasons why (e.g. improved technology for detection and treatment) and further allocate resources. Hospital admissions and health surveys are two examples of how statistics are accumulated to give us a picture of the health status of a population.

12. Application Using the AIHW health report Australia's Health 2014 (located on my Weebly), outline the prevalence of the following chronic health conditions; Prevalence means how common a condition is in the community/the number of cases of disease that exists in a defined population. Cardiovascular disease – p. 125 Cancer – p. 105 Diabetes – p. 141 Respiratory disease – p. 138 Injury – p. 148 Mental health problems and illnesses – p. 131

13. Application Prioritising Conditions 1. Based on prevalence statistics, how would you prioritise each of these conditions? 2. Which should get the most funding? Why?

14. Potential for prevention and early intervention There are many behaviours that can influence the incidence and prevalence of diseases and conditions. These are often related to lifestyle behaviours, e.g. smoking, lack of physical activity and a diet high in fat and salt increase a person's risk of cardiovascular disease. By making lifestyle changes such as eating a healthy diet, regularly exercising, limiting alcohol intake and refraining from smoking, many lifestyle related conditions can be prevented. For many Australians, behaviour change is difficult to achieve. There are many social and environmental factors that influence behaviour. Making decisions about the allocation of resources for health issues is a complex one. Changing behavioural, social and environmental determinants provides great potential for decreasing the burden of poor health on the individual and society. It is through prevention and early intervention where some diseases and conditions, if detected in the early stages, can be treated successfully.

15. Application Preventing Cancer Copy and complete the table below describing how the specific cancers can be prevented and/or treated and the potential for change in incidence and prevalence over time. ConditionPrevention, detection and potential for change Lung Cancer Breast Cancer Melanoma

16. Application Students learn to: Argue the case for why decisions are made about health priorities by considering questions such as: ◦how do we identify priority issues for Australia’s health? ◦what role do the principles of social justice play? ◦why is it important to prioritise? 1)Why is it important to prioritise issues for health? 2)How do we identify health priority issues? 3)The link below on my Weebly page will help you answer the following question: AIHW National Health Priority Areas Explain what the National Health Priority Areas initiative is and what it hopes to achieve?

17. Practise Question 2013 HSC Question: Why is it important to prioritise particular health issues in Australia? Include examples in your answer. (5 Marks) 1.8 minutes (1 min and 48 secs) per mark 1.8 x 5 = 9 minutes - GO! Refer to the marking criteria/sample answer and peer mark once you have finished.