health unit 3 sac 2 - topics 5

• Old public health


  When bacteria were the major causes of diseases, poor living conditions resulted in pressure on governments to address high rates of infectious diseases
• Old public health actions

  1. Government funded sewage systems, so people had clean water and sanitation

  2. Improved nutrition

  3. Improved housing conditions

  4. Improved work conditions
• Old public health contributed to reduction in influenza and pneumonia, better immune systems- increased LE and IMR's
• Biomedical model of health


  • Focuses on the physical or biological aspects of disease and illness
  • Involves doctors and health professionals diagnosing, treating and curing diseases
  • Individuals are the focus
• Diseases targeted by old public health

  • Tuberculosis
  • Smallpox
  • Cholera
  • Typhoid
  • Polio
  • Bubonic plague
• Strict quarantine laws in the early 1900's prevented the arrival and transmission of diseases from other countries, reducing mortality from infectious and parasitic diseases
• Housing standards required houses to have adequate ventilation while also implementing laws to remove slums and prevent overcrowding, reducing mortality from respiratory diseases
• One action of old public health was provision of clean drinking water


  This ensured that people were less likely to drink water contaminated with pathogens, therefore less people dying from infectious or parasitic diseases e.g. cholera, decreasing mortality rates in Australia
• Life expectancy for both sexes has increased over time in Australia. For example, in 1900, life expectancy was approx. 55 years, whereas in 2010, life expectancy was approx. 83 years
• One action of old public health is improved workplace safety regulations


  This could ensure that less people are dying from unsafe work environments causing falls or head injuries, increasing life expectancy over time in Australia
• Biomedical model of health


  • Advances in medical technology enables common problems to be effectively treated
  • Extends Life Expectancy
  • Improves quality of life
  • Relies on health professionals & technology & is costly/affordability
  • It does not always promote good health and wellbeing
  • Not every condition can be treated
• Advancements in medical technology such as the introduction of the stethoscope, sphygmomanometer, x-ray, heart-lung bypass machine, and antihypertensive drugs have resulted in a decline in cardiovascular death rates
• The biomedical model of health has been effective in improving Australia's health


  • It includes advancements in medical technology e.g. a heart lung bypass machine, and has assisted in improving life expectancy in Australia over time
  • However, it can be costly and not affordable for everyone, and not every condition can be treated with medication or surgery
• One advancement in medical technology is x-rays


  This can assists in detecting tumours early, therefore operating and removing them, preventing Australians from dying prematurely from diseases such as lung cancer
• One advancement in medical technology is a heart lung bypass machine


  This can assists in open heart surgery to unclog blocked arteries, preventing Australians from dying prematurely from diseases such as cardiovascular disease
• New public health - Social model of health

  • An approach to health that expands the traditional focus on individual behavior change to one that considers the ways in which physical, sociocultural and political environments impact on health
  • Incorporates education as a method for behavior change
  • Recognises that factors beyond individual control are responsible for poor health & wellbeing
  • Policies, education & health promotion activities are key
• Principles of the social model of health - 'I-DEAR'


  • Addresses broader determinants of health
  • Considers the wider reasons for health inequalities
  • Emphasises the role of the community
  • Involves people in decision making
  • Recognises the need for intersectoral action
• This can assists in detecting tumours early, therefore operating and removing them, preventing Australians from dying prematurely from diseases such as lung cancer
• Heart lung bypass machine


  An advancement in medical technology that can assist in open heart surgery to unclog blocked arteries, preventing Australians from dying prematurely from diseases such as cardiovascular disease
• New public health - Social model of health


  An approach to health that expands the traditional focus on individual behavior change to one that considers the ways in which physical, sociocultural and political environments impact on health. Also referred to as the social model of health.
• Social model of health


  • Incorporates education as a method for behavior change
  • Recognises that factors beyond individual control are responsible for poor health & wellbeing
  • Policies, education & health promotion activities are key to the social model
• Principles of the social model of health - 'I-DEAR'


  • Addresses broader determinants of health
  • Involves intersectoral collaboration
  • Acts to reduce social inequities
  • Acts to enable access to healthcare
  • Empowers individuals and communities
• Addresses broader determinants of health

  Considers the wider reasons why people behave & make choices the way they do - eg gender, culture, race or ethnicity, socioeconomic status, geographic location and physical environment
• Involves intersectoral collaboration


  Involves interested and concerned groups coming together to work on projects which address social and environmental determinants of health - eg government departments, education system, local groups & the private sector.
• Acts to reduce social inequities


  Seeks to address factors which contribute to inequities in health amongst different population groups such as gender, culture, race, SES etc
• Acts to enable access to healthcare


  Addresses the barriers people face in accessing healthcare including cultural & language barriers, economic and geographical factors and education levels
• Empowers individuals and communities


  Gives people an opportunity to participate in decision making about their health & wellbeing & gives them the health knowledge and skills to be able to make informed choices
• The Health Star Rating reflects the principles of the social model of health
• Advantages & disadvantages of the social model

  • Promotes good health & wellbeing
  • Assists in preventing some diseases
  • Relatively inexpensive
  • Focuses on vulnerable groups
  • Education can be passed on
  • Responsibility for health is shared
  • Not all conditions can be treated
  • Doesn't promote technology and medical knowledge
  • Doesn't address individual health issues
  • Health promotion messages may be ignored
• This project worked with a group of 54 older residents (aged 55-93) in a public housing estate in the City of Whitehorse. A Whitehorse Community Health Service (WCHS) physiotherapist and dietitian worked in partnership with community members and other key stakeholders.
• Key engagement strategies


  • Weekly outreach on the estate, a community newsletter, monthly resident and partnership luncheon meetings, health education workshops and a number of community wide events and celebrations. Residents also formed small working groups to work on their priorities together.
• Whitehorse Community Health Service and partner agencies worked within a participatory action research framework so that community concerns were identified and addressed along the way.
• The process of residents working in small groups together meant solutions were generated, owned and where possible implemented by them.
• The program was successful in bringing about neighbourhood environment & safety improvements: footpath repairs, parkland access path redevelopment, park bench installation, ramp installation at the community hall, housing safety upgrades, improved estate signage and road intersection improvements.
• A weekly exercise program in the local hall was provided by Council's Leisure Centre staff and the Community Health and fitness instructor.
• Improved access to public transport (such as a new Sunday bus service and improvements to bus stops at Mitcham station) was implemented and residents became much more empowered and more able to advocate to agencies and departments on their own behalf.
• This resulted in the development of a ten-year Council plan for the neighbourhood and upgrading of local amenities.
• Principles of the Social Model - Examples from the case study

  • Involves Intersectoral collaboration - Physiotherapist, dietitian, community members and key stakeholders working together to improve physical activity
  • Addresses the broader Determinants of health - Aiming to change physical environment –footpath repairs, park benches etc.
  • Empowers individuals and the community - 54 older residents worked together, newsletters community wide events, health education workshops, working in small groups to make decisions, bus stop to empower communication with agencies.
  • Acts to enable access to healthcare - Installation of new bus service
  • Acts to Reduce social inequities - Health education workshops, ramp installation.
• Improving health status using the social and biomedical approaches to health - Lung Cancer


  • SOCIAL - Anti Smoking Campaigns, Graphic smoking ads air on TV, Smoking education, Plain packaging, Banning of smoking in cars with children
  • BIOMEDICAL - Chest x-rays, Heart-lung bypass machine, CT scans, PET scans, Chemotherapy, Oxygen machine, Stethoscope
• Improving health status using the social and biomedical approaches to health - Examples

  • Infectious and parasitic - Health education on vaccines
  • Cancers - Use health promotion campaigns such as Quit and SunSmart to encourage people to undertake behaviours that will prevent the development of cancer, Make changes to the environment in which people live and work to reduce exposure of people to cancer-causing substances
  • CVD - Use health promotion campaigns designed to encourage people to consume a healthy diet, to not smoke and to exercise more, Make changes to environment to encourage physical activity
  • Respiratory - Make changes to the environment in which people live and work to reduce exposure of people to air contaminants, Health promotion campaigns such as Quit
  • Injury and poisoning - Improve the safety of the roads to prevent road crashes, Health promotion campaigns such as KidSafe