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Disease Control and Prevention in Australia

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A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, at the Public Health Association Conference 2011 - Canberra

A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, at the Public Health Association Conference 2011 - Canberra


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  • 1. DISEASE CONTROL andPREVENTION IN AUSTRALIAPublic Health Association Conference 2011 CANBERRA – 4 April 2011 Professor Jim Bishop AO Chief Medical OfficerAustralian Government Department of Health and Ageing
  • 2. UNITED STATES GOVERNMENT Centres for Disease Control and Prevention OBJECTIVES• Monitor health• Detect and investigate health problems• Conduct research on prevention• Develop sound public health policies• Implement prevention strategies• Promote healthy behaviours• Foster safe environment
  • 3. OECD HEALTH DATA 2010 How Does AUSTRALIA Compare Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)8,000 75387,0006,000 50045,000 4627 4210 4079 4063 39704,000 3793 3737 3696 3677 3540 3470 3359 3353 3129 3060 3008 2902 28703,000 2729 2687 2683 21512,000 1801 1781 1737 1437 1213 999 8521,000 767 0 1 Refers to insured po pulatio n rather than resident po pulatio n. 2. Current expenditure. 3. 2006. 4. 2007. So urce: OECD, OECD Health Data, June 201 . 0 Public expenditure on health Private expenditure on health
  • 4. COMMONWEALTH GOVERNMENTHEALTH & HOSPITAL EXPENDITURE UNDER THE NHHN Source: Commonwealth Budget Papers, DOHA and PMC Analysis
  • 5. MAJOR DISEASE BURDEN in AUSTRALIA
  • 6. PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010Source: AIHW Australia’s Health 2010
  • 7. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  • 8. BROAD CAUSE MORTALITY TRENDS IN AUSTRALIA Source: AIHW
  • 9. AGED ADJUSTED DEATH RATES From CVD, 1907 - 2006 Source: AIHW Australia’s Health 2010
  • 10. CHANGES IN DEATH RATES IN MALES - using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  • 11. Mortality-to-incidence ratio 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Ke ny a NiSource: IARC 2010. ge ria Eg yp Vi t et Na m Tu rk ey In di a Ch in a Ru So ss ut ia h Af ric a G re ec e Br az il Cz Ja ec pa h n Re pu bl ic Un ite Ita d ly Ki ng do m Ca na da G er m an Sw y Ne ed w en Ze al an d US Au A st ratios for selected countries - 2008 ra lia Males Females ALL CANCER – MORTALITY/INCIDENCE
  • 12. DEATH RATES FROM INFECTIOUS DISEASES, 1922-2007Source: AIHW Australia’s Health 2010
  • 13. TRENDS IN LEADING CAUSESOF DISEASE BURDEN 2003-2023 Source: AIHW Australia’s Health 2010
  • 14. TOTAL CANCER CASES & DEATHS per year (1972 to 2036) Source: Cancer Institute NSW
  • 15. AUSTRALIAN GOVERNMENTS OCCUPATIONAL HEALTH and SAFETY• Safework Australia• National Centre for Injury Prevention and Control• Jurisdictional responsibilities in State and Territory Departments of Health• Quality and Safety in Health Care - Australian Commission on Quality and Safety in Health Care - Jurisdictional Quality and Safety initiatives eg: Clinical Excellence Commission (NSW)
  • 16. AUSTRALIAN GOVERNMENTS PUBLIC HEALTH PREPAREDNESS• Office of Health Protection (OHP)• National Incidence Room (NIR)• Australian Health Protection Committee (AHPC) - Jurisdictional, CDNA, enHealth, ADF, PHLN• Links to: - Emergency Management Australia (A/G) - ADF - Other Commonwealth Portfolios (DFAT, AusAID)
  • 17. CENTRES FOR DISEASE CONTROL & PREVENTION US GOVERNMENT NON – COMMUNICABLE DISEASES• National Centre for Birth Defects• National Centre for Chronic Disease Prevention• National Centre for Environmental Health• National Centre for Injury Prevention Research component within the National Institutes of Health funding
  • 18. AUSTRALIAN GOVERNMENTS NON-COMMUNICABLE DISEASES• Australian National Preventative Health Agency• Australian and Jurisdictional Government Population Health programs• Australian Population Health Development Principal Committee (AHMAC Committee) – Screening Sub-committee• Jurisdictional enHealth programs and enHealth sub-committee of AHPC• National screening programs in breast, cervix and bowel: Australian and Jurisdictional programs• Specific Commonwealth, Jurisdictional programs on Chronic Diseases Research components within the NHMRC Funding
  • 19. CENTRES FOR DISEASE CONTROL & PREVENTION SURVEILLANCE and REPORTING• Health Statistics• Laboratory Policy• Public Health information• Public Health Surveillance• Epidemiology and analyses• Scientific education and professional development
  • 20. AUSTRALIAN GOVERNMENTS* SURVEILLANCE AND REPORTING• Australian Bureau of Statistics• Australian Institute of Health and Welfare• National Notifiable Disease Surveillance System• Sentinel Surveillance System• TGA adverse event reporting• DFAT Travellers Advisory• Cancer registries in each State and Territory• Screening and pap test registers• FSANZ and OZFoodNet * National Health Security Act and agreement
  • 21. AUSTRALIAN GOVERNMENTS INFRASTRUCTURE• AHPC (enHealth, PHLN and CDNA)• OHP Epidemiology Branch• State and Territory Epidemiology Programs• National Immunization Program (NIP)• Australian Technical Advisory Group on Immunization (ATAGI)
  • 22. AUSTRALIAN GOVERNMENTS GOVERNMENT SUPPORTED or ACADEMIC PROGRAMS• Cancer Australia (NBOCC)• National Centre for Injury Prevention and Control• National Centre for Asthma monitoring• National Centre for HIV Epidemiology and Research• National Centre for Immunization Research and Surveillance• National Centre for Asbestos related diseases
  • 23. THE KEYS TO PREVENTION Tobacco Blood pressure Overweight/obesity Physical inactivity Blood cholesterol Alcohol Fruit/vegetables Illicit drugs Air pollution Total of 32% Unsafe sex 0.0 2.0 4.0 6.0 8.0 % DALYsSource: Table 4.1 AIHW Australia’s Health 2008
  • 24. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  • 25. AUSTRALIAN HEALTH SURVEY Four components run by ABS 2011-13 - Health Survey - ATSI Health Survey - Nutrition and Physical Activity Survey - Health measurement Survey Around 50,000 participants De-identified data available as summary statistics, tables
  • 26. Budget 2010-11Anti-smoking campaigns ($27.8m)COAG agreed• Increased tobacco excise• Plain packaging• Restricting internet advertising of tobacco products• Further funding for National Binge Drinking Strategy ($50m)• Survey of Australia’s Health ($54m) National Preventative Health Agency
  • 27. CONCLUSIONS• Australia’s health outcomes are good by International standards• Prevention programs have some success and remaining challenges• Well Supported health emergency responses occupational health, food and medicines safety• Chronic diseases are the major burden of disease in Australia supported with substantial infrastructure• Australian Governments have invested in academic centres to lead research and training in similar areas to the US CDC rather than bureaucratic structures