Memorisation

• Public health


  The ways in which governments monitor, regulate and promote health status and prevent disease
• Old public health


  Government actions that are focused on changing the physical environment to prevent the spread of disease
• Health promotion


  The process of enabling people to increase control over, and to improve, their 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
• New public health


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

  An approach that recognises improvements in health and wellbeing can only be achieved by directing effort towards addressing the physical, sociocultural and political environments of health that have an impact on individuals and population groups
• Ottawa Charter for Health Promotion


  An approach to health developed by the World Health Organization that aims to reduce inequalities in health
• Health system


  All the activities whose primary purpose is to promote, restore and/or maintain health
• Schedule fee


  The amount that Medicare contributes towards certain consultations and treatments
• Patient co-payments


  The payment made by the consumer for health products or services in addition to the amount paid by the government
• Bulk billing


  When the doctor charges only the schedule fee and the payment is claimed directly from Medicare so there are no out-of-pocket expenses for the patient
• Premium


  The amount paid for insurance
• Sustainability


  Meeting the needs of the present without compromising the ability of future generations to meet their own needs
• Access


  Individuals are able to use a service without barriers such as location, knowledge, time or cost
• Equity


  Ensures we are all on an even playing field by providing extra support for people in need so they can have the same basic/essential opportunities as everyone else
• Categories of disease


  • Infections and parasitic diseases
  • Cancers (neoplasms)
  • Cardiovascular diseases
  • Respiratory diseases
  • Injury and poisoning
• Changes in health status since 1900

  1. Life expectancy increased - plateaued from 1961 to 1972 due to cardiovascular diseases

  2. Mortality rates have decreased

  3. Infectious diseases have decreased

  4. Cancer mortality rates increased and peaked in the mid-1980s (due to lung cancer from smoking) and then fell gradually

  5. Death rates from cardiovascular diseases increased and peaked in the mid-1960s

  6. Death rates from respiratory diseases fell dramatically across the 20th century - peaked in 1919 due to the Spanish influenza pandemic

  7. Death rates for injury and poisoning more than halved - rapidly declined from the 1970s due to the compulsory wearing of seatbelts
• Old public health policies

  • Establishment of government-funded water and sewage systems and better sanitation
  • Quarantine laws
  • Elimination of housing slums and introduction of better-quality housing
  • Improved food and nutrition
  • Improved working conditions
  • Establishment of public health campaigns
  • More hygienic birthing practices
  • Provision of antenatal and infant welfare services
• Biomedical approach


  • Focuses on individuals who are ill
  • Concerned with disease, illness and disability
  • Relies on services provided by doctors, specialists and hospitals
  • Quick fix approach
  • Relies on technology to diagnose, treat and cure
• Advantages of biomedical approach

  • Funding brings about improvements in technology and research
  • It enables many illnesses and conditions to be effectively treated
  • It extends life expectancy
  • It improves quality of life and health adjusted life expectancy
• Disadvantages of biomedical approach

  • It relies on professional health workers and technology and is therefore costly
  • It doesn't always promote good health and wellbeing
  • Not every condition can be treated
  • Not affordable for all
• Principles of the social model of health

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

  • Promotes good health and wellbeing and assists in preventing diseases
  • Takes a more holistic approach to health and wellbeing
  • Relatively less expensive than the biomedical approach
  • Focuses on vulnerable population groups
  • Education can be passed on from generation to generation
  • Responsibility for health and wellbeing is shared
• Disadvantages of social model of health


  • Not every illness or condition can be prevented
  • Does not promote the development of technology and medical knowledge
  • Does not address the health and wellbeing concerns of individuals
  • Health promotion messages may be ignored
• Five action areas of the Ottawa Charter

  • Build healthy public policy
  • Create supportive environments
  • Strengthen community action
  • Develop personal skills
  • Reorient health services
• Medicare


  • Choice of doctor for out-of-hospital services
  • Available to all Australian citizens
  • Reciprocal agreement between Australia and other countries allows Australian citizens to access free healthcare in selected countries
  • Covers tests and examinations, doctors' and specialists' fees (schedule fee only), and some procedures
  • The Medicare Safety Net provides extra financial contributions for medical services once an individual's or family's co-payments reach a certain level
• Disadvantages of Medicare


  • No choice of doctor for in-hospital treatments
  • Waiting lists for many treatments
  • Does not cover alternative therapies
  • Often does not cover the full amount of a doctor's visit
• Private health insurance incentives

  • Private health insurance rebate
  • Lifetime health cover
  • Medicare Levy Surcharge
  • Age-based discount
• Advantages of private health insurance

  • Enables access to private hospital care
  • Choice of doctor while in public or private hospital
  • Shorter waiting times for some medical procedures such as elective surgery
  • Depending on the level of cover purchased, services such as dental, chiropractic, physiotherapy, optometry and dietetics could be paid for
  • Helps to keep the costs of operating Medicare under control
  • High income earners with private health insurance do not have to pay the Medicare levy surcharge
  • Private health insurance rebate
  • Lifetime Health Cover incentive
  • The age-based discount may provide cheaper private cover for those aged 18–29
• Disadvantages of private health insurance

  • Costly in terms of the premiums that have to be paid
  • Sometimes have a 'gap' - the insurance doesn't cover the whole fee and the individual must pay the difference
  • Qualifying periods apply for some conditions (such as pregnancy)
  • Policies can be complex to understand and so create confusion for the average person
• Evaluating Indigenous Initiatives


  1. Actual improvements to health and wellbeing

  2. Number of participants taking part in the initiative

  3. Feedback provided by participants

  4. Action areas of the Ottawa Charter that are evident

  5. Whether the initiative is culturally appropriate

  6. Whether the program has taken the needs of the target group into account

  7. Funding that has been provided to implement the initiative

  8. Whether the program addresses a significant health issue for Indigenous Australians
• Australian dietary guidelines


  • To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs
  • Enjoy a wide variety of nutritious foods from these five food groups every day: Vegetables and legumes/beans, Fruits, Lean meats and poultry, Grain (mostly cereal) foods, Milk, yoghurt and cheese
  • Limit intake of foods containing saturated fat, added salt, added sugars and alcohol
  • Encourage, support and promote breastfeeding
  • Care for your food; prepare and store it safely
• Challenges for dietary change

  • Personal preference
  • Attitudes and belief
  • Willpower
  • Food security
  • Time constraints and convenience
  • Education, nutrition knowledge and cooking skills
  • Family, culture, society and religion
  • Food marketing and media
  • Health and wellbeing factors
• Medicare - Sustainability


  Determining which services will be subsidised through Medicare can preserve funds for the most necessary services, yielding the greatest gains in health
• PBS - Sustainability


  Continually reviewing the medicines available through the PBS means those that will have the greatest benefits are prioritised, which assists in keeping the scheme sustainable
• Therapeutic Goods Administration


  A federal government body that verifies the effectiveness of all PBS medicines, contributing to improved treatment and less reliance on the health system
• NDIS - Sustainability


  Each participant in the NDIS receives an individualised plan, which means that only necessary funds are spent on each person. As a result, more people can access the NDIS and experience improved health outcomes
• Medicare levy


  Increased from 1.5 to 2% in July 2014 to assist in providing the necessary funds to maintain Australia's health system and introduce the National Disability Insurance Scheme
• PHI - Sustainability


  Incentives such as the private health insurance rebate, Lifetime Health Cover and the age-based discount assist in maximising the funding gained through the private system. This means more people are treated through the private system, which reduces the strain on the public system, improving health outcomes for more people
• Medicare - Access


  Provides access to people of all socioeconomic backgrounds to services such as doctors' consultations and treatment in public hospitals