organising hhd

• Old Public Health


  Government actions that focused on changing the physical environment to prevent the spread of disease, such as providing safe water, sanitation and sewage disposal, improved nutrition, improved housing conditions and better work conditionsion, and environmental health as a result of the range of different infectious disease causing illness and mortality at the time.
• New Public Health


  Identifies that there are a number of physical, environmental and sociocultural factors that can impact health. The aim of New Public Health is to prevent illness, disease and injury by modifying the risk factors. It is about health promotion and is focused on the population level opposed to individuals.
• Social Model of Health


  Recognises the improvement in health and wellbeing can only be achieved by directing efforts towards addressing the physical, sociocultural, and environmental factors of health that have an impact on individuals and population groups
• Advantages of the Social Model of Health

  > Aimed at a population level; therefore, more cost effective

  > Encourages good health through disease prevention

  > Can be targeted to vulnerable population groups

  > Education can be passed on from generation to generation.
• Disadvantages of the Social Model of Health

  > Health messages may be ignored

  > Not all conditions can be prevented (genetic)

  > Doesn’t assist those who are already sick

  > It does not promote the development of technology and medical knowledge.
• Strengths - Biomedical Approach to Health


  > Technological advancements which are beneficial for other cases with that disease

  > Common problems have effective treatments

  > Extends life expectancy

  > Improves quality of life, reduces pain and suffering for people living with chronic disease
• Limitations - Biomedical Approach to health


  > Expensive as it relies on professional health workers to carry out the treatment. Treatment (medicine, surgeries, etc.) and training of these professionals can take a long time.

  > Doesn’t necessarily promote healthy behaviours (treats disease instead of focusing on prevention).

  > Not every condition can be treated

  > Some people believe most diseases can be prevented through lifestyle choices so it's considered waste of healthcare resources
• What is the biomedical approach to health?


  Biomedical approach to health focuses on the physical or biological aspects of disease and illness. It is a medical model practised by doctors and health professionals and is associated with the diagnosis, treatment and cure of disease.
• Build healthy public policy

  This action area relates directly to the decisions made by government and organisations regarding laws and policies that make it more difficult for people to undertake unhealthy behaviours and seek to make healthier choices the easier choices.
• Create supportive environments

  This action area recognises the impact that the broader determinants have on health and wellbeing and health status and aims to promote a healthy physical and sociocultural environment for all members of the community. A supportive environment is one that promotes health and wellbeing by being safe, stimulating, satisfying and enjoyable.
• Strengthen community action

  An action area that focuses on building links between individuals and the community, and centres around people working together to achieve a common goal. Giving the community a sense of ownership of a health and wellbeing strategy and working together increases the likelihood that it will be effective.
• Develop personal skills

  > Education is the main aspect of this action area

  > Acquiring health knowledge and skills that allow people to make informed decisions that may indirectly affect health and wellbeing -> Solve conflict -> prevent violence OR learning how to cook a healthy meal.

  > Can occur in many places, including school and work settings, families, and government and non-government organisations.
• Reorient health services

  This action area refers to changing the health system so that it promotes health and wellbeing too.

  • Addressing all factors that influence health and wellbeing, not just diseases. This requires a shift towards health promotion, which includes doctors taking on the role of educator.
• PHI Incentive - PHI Rebate


  In 1999, the government introduced the 30 per cent rebate incentive. Under this scheme, policyholders received a 30 per cent rebate (or refund) on their premiums for private health insurance.
• PHI Incentive - Lifetime Health Cover


  People who take up private insurance after the age of 31 pay an extra 2 percent on their premiums for every year they are over the age of 30. This encourages younger people to take up private health insurance and keep it for life. Having more young people with private health insurance helps offset the cost of providing healthcare for older Australians, who are more likely to need it.
• PHI Incentive - Medicare LevySurchage


  People earning more than $90 000 a year ($180 000 for families) pay an extra tax as a Medicare levy surcharge if they do not purchase private health insurance. The Medicare levy surcharge is calculated according to income and ranges from 1 per cent to 1.5 per cent.
• PHI Incentive - Age-based discount 


  In 2019, the Australian government introduced a fourth incentive. Under this initiative, insurers have the option of offering young people aged 18–29 a discount of up to 10 per cent for hospital cover. The discount allows for a two per cent reduction in premiums for each year that the person is aged under 30, to a maximum of 10 per cent.
• Health Services Usually Covered by Medicare


  • General practitioner consultation fees
  • Treatment and accommodation as a public patient in a public hospital
  • Eye tests performed by an optometrist
  • Pathology tests
  • X-rays
• Health Services Usually Not Covered by Medicare


  • Most dental examinations and treatments
  • Accommodation costs in a private hospital
  • Alternative therapies including chiropractic services, physiotherapy, naturopathy, and remedial massage
  • Health aids including hearing aids, glasses, and contact lenses
  • Ambulance services
• Advantages of PHI

  > Allows patients to choose their doctor in hospital (public or private)

  > Allows choice of hospital

  > Can reduce waiting times for non-emergency treatments

  > May allow access to private rooms in hospital

  > May provide financial cover for a wider range of services than Medicare

  > Reduces the pressure on the public system
• Disadvantages of PHI

  > Premiums can be costly

  > Depending on type of cover, service clamed and treating doctor, there may still be out-of-pocket costs

  > Waiting periods may apply for some services

  > May be paying for services not being claimed
• Why smoking was targeted

  Smoking kills around 15,000 Australians per year and has significant social and economic costs (around $31.5 billion dollars annually).

  > Every single case that is caused by smoking is preventable.
• Challenges in bringing about dietary change - Personal preference


  o Foods high in fat are flavour enhancers that stimulate the brains reward system by releasing dopamine. This cycle can create cravings for foods containing these substances, making dietary changes challenging for some
• Challenges in bringing about dietary change - Attitudes and beliefs 


  o If an individual has not tried a variety of healthy food options they may believe they are bland or tasteless o Beliefs such as veganism or only consuming organic products or Australian made products can restrict certain foods in the diet and can make achieving a balanced food intake difficult.
• Challenges in bringing about dietary change - Willpower 


  o The ability to resist short term temptations to meet long term goals o Changing food intake requires commitment which can be difficult with temptations at places such as parties and social gatherings, work functions, restaurants and school canteens
• Challenges in bringing about dietary change - Food security


  o When all people at all times have access to sufficient, safe and nutritious food to meet their dietary needs for an active and healthy life.

  o This includes having enough money and the means to access them including geographical location and transport o Those with a high socioeconomic status have more choice in relation to the foods they consume

  o Those living outside Australia’s major cities also experience higher rates of food insecurity due to the cost of basic nutritious foods being 30% higher in rural and remote areas
• Challenges in bringing about dietary change - Time constraints and convenience


  o When more time is spent working and less time is spent preparing food, convenience foods are often consumed.

  o Certain occupations such as truck drivers and those working in the trades, may rely on the foods that are offered from outlets near their place of employment, accessing fast food may be more convenient for these people.
• Challenges in bringing about dietary change - Education, nutrition, knowledge and cooking skills 


  o Lack of nutritional knowledge and cooking skills often predisposes people to consume unhealthy meals o Lack of education can lead to consumers believing that are consuming healthy foods as they do not have the skills to accurately assess their current food intake
• Challenges in bringing about dietary change - Families, culture, society and religion

  o The earliest food experiences most people have is shaped by family o The cultural and religious background of the family may include ties to traditional foods that have been consumed through generations

  o Childhood in particular is seen as a stage when many personal preferences in relation to food are established

  o The people with whom an individual consumes food can influence the foods they consume
• Challenges in bringing about dietary change - Food marketing and media 


  o Advertisements, newspapers, magazines, television, radio, internet, supermarket, sponsorships, the use of celebrities.
• Ottawa Charter


  Developed from the social model of health by the World Health Organisation (WHO) that attempts to reduce inequalities in health.
• Enable

  > This Ottawa Charter Strategy for health promotion aims to ensure equal resources (education, employment) and opportunities are available to all people to achieve equal health. For example; dietary guidelines can assist people in choosing a nutritious diet and accessible health care in rural and remote communities can also create increased opportunities for population groups to increase their health.
• Mediate

  > This Ottawa Charter Strategy for health promotion aims to resolve conflict to produce outcomes that promote health through coordinated action from the government, non-government, health sectors, food, sport industries, media and community organisations.

  • e.g a community organisation may form a walking group initiative and doctors may promote this by informing their patients of the benefits of regular physical activity
• Advocate

  > This Ottawa Charter Strategy for health promotion aims to demonstrate active support and initiative for health promotion to make changes to improve health determinants for everyone. For example; Advocating that all population groups should receive vaccinations.
• Access Sustainability and Equity


  Access: Ability of people to be able to obtain healthcare at the right place and right time, irrespective of income, culture or location.

  Sustainability: Meeting the needs of the present without compromising the ability of future generations to meet their own needs.

  Equity: The quality of being fair and impartial.
• Medicare 


  Australia’s Universal health insurance scheme that provides all Australian citizens, permanent residents and people from other countries with a reciprocal agreement (New Zealand, Unite Kingdom, Sweden, Belgium etc.) access to healthcare at no out-of-pocket cost regardless of their age, income, ethnic background etc.
• Medicare Advantages/ Strengths


  o Available to all Australian citizens

  o Basic health tests and treatments are provided at little or no cost

  o Reciprocal arrangements with other countries allows Australian citizens to access subsidised/free health care in other countries

  o Allows patients to choose their own doctor for out-of-hospital services
• Medicare Disadvantages / Limitations


  o Waiting lists for many non-emergency treatments

  o Doesn’t cover many common alternative treatments

  o May not cover all costs of doctors and specialist fees if charged more than the scheduled fee

  o Does not allow patients to choose their doctor for in-hospital treatments
• Medicare Safety Net


  Aims to protect those who have a heavy reliance on medical services from high ‘out-of-pocket’ expenses. Once an individual or family’s out-of-pocket expenses have reached the threshold amount, the Medicare services for that individual or family are charged at a cheaper rate for the rest of the year.
• Medicare Funding


  Medicare Levy: Most tax payers in Australia pay an additional 2% of their taxable income towards the costs of Medicare.

  Medicare Levy Surcharge: High income earners without private health insurance pay an additional 1-1.5% tax on top of the Medicare Levy. General Taxation: When costs for Medicare are not met by the Medicare levy and Medicare levy surcharge the additional costs are covered by general income tax revenue.