IMPACT OF RESEARCH ON
AUSTRALIA’S HEALTH
Clinical Research Excellence Conference
MELBOURNE – 5 August 2010
Professor Jim B...
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
7538
5004
4627
4210
4079 406...
Health Expenditure as a share ofGDP, OECD Countries
16.0
11.2
10.7 10.5 10.5 10.4 10.2 9.9 9.9 9.8 9.7 9.7 9.4
9.1 9.1 9.0...
AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
SELF-ASSESSED PHYSICAL &
MENTAL HEALTH, 2007
Source: AIHW Australia’s Health 2010
BROAD CAUSE MORTALITY
TRENDS AUSTRALIA
Source: AIHW
Source: AIHW Australia’s Health 2010
AGED ADJUSTED DEATH RATES
From CVD, 1907 - 2006
All Cancer- Mortality/Incidence
ratios for selected countries - 2008
Source: IARC 2010.
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0....
Changes in Deaths rates in
Males using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
Changes in Deaths Rates in
Females Using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
Cancers with reducing death
rates 1997 to 2006 – all ages
Lung, -18.5
Colon, -19.6 Prostate, -19.7
Leukaemia, -23.7
Stomac...
5 YEAR SURVIVAL RATES 2004
NSW SEER
Non small cell lung 13% 14%
Colon 65% 67%
Rectum 66% 69%
Breast Cancer 89% 90%
Lymphom...
CANCER
Milestones in Survival Improvement
Prevention – Tobacco control
Early detection
•Screening
•Interventions
Better...
PROJECTED BURDEN of
MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010
TRENDS IN LEADING CAUSES
OF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010
Changes in Incidence Rates for all Cancer in
Males using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
Changes in Incidence Rates in
Females using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW
THE KEYS TO PREVENTION
0.0 2.0 4.0 6.0 8.0
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol...
AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
SMOKING IN AUSTRALIA
SMOKING
STATUS
NSW VIC QLD WA SA TAS ACT NT AUS
Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6
We...
AUSTRALIA’S INITIATIVES IN
TOBACCO CONTROL
 Advertising Bans
 Under the counter at retail sites
 Banning smoking in res...
OBESTITY INCREASING
FOR ALL
Source: AIHW: Australia’s Health 2008
Increased Risk Body Fatness Oesophagus
Pancreas
Colorectal
Breast (PM)
Endometrum
Abnormal Fatness Colorectal
Reduced Risk...
Source: AIHW Australia’s Health 2010
PROPORTION OF ADULTS WITH
HIGH BLOOD PRESSURE
1980 to 1999-2000
Source: AIHW Australia’s Health 2010
CHRONIC PULMONARY DISEASE
MORTALITY 1980 to 2007
Source: AIHW Australia’s Health 2010
DEATH RATES FROM
INFECTIOUS DISEASES, 1922-2007
Source: AIHW Australia’s Health 2010
PREVALENCE OF CURRENT
ASTHMA 2007-08
Source: AIHW Australia’s Health 2010
PREVALENCE OF TREATED END
STAGE KIDNEY DISEASE 2000-2007
NSW Population Age Distributions,
Males (1977-2036)
Source: Cancer Institute NSW
Total Cancer Cases and Deaths
per year (1972 to 2036)
Source: Cancer Institute NSW
Milestones in
Cancer Control
 Public health measures in smoking reduction,
screening breast, cervix, bowel, health litera...
BREAST CANCER
MORTALITY
NEJM 2005
Source: New Engl.Journ. Med: 353:17
Projected YLLs – Three scenarios,
Australia – 1980 to 2016
Source: Bishop et al – Cancer Institute NSW
NON-COMMERCIAL CANCER
RESEARCH EXPENDITURE, 2004
(A$ per CAPITAL)
Source: Eckhouse et al (2007), ABS
PRIORITY HEALTH AREAS
SOURCE: NHMRC Research funding 2010 facts book
CANCER PUBLICATIONS
Australia Growth* World Australian
Share
2000 1,881 5.6% 88,604 2.0%
2002 2,000 3.5% 97,035 2.1%
2004 ...
CLINICAL GUIDELINES
Supports for Clinical Decision Making
 Evidence Base
 Highest Impact
 Range of best practice tools
...
AUSTRALIAN HEALTH SURVEY
 Four components run by ABS 2011-13
- Health Survey
- ATSI Health Survey
- Nutrition and Physica...
 Focus on the major burden of disease and
their risk factors provides a basis for
improving the health of our community.
...
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Impact of Research on Australia's Health

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A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, at the Clinical Research Excellence Conference - Melbourne 5 Aug 2010

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Impact of Research on Australia's Health

  1. 1. IMPACT OF RESEARCH ON AUSTRALIA’S HEALTH Clinical Research Excellence Conference MELBOURNE – 5 August 2010 Professor Jim Bishop AO Chief Medical Officer Australian Government Department of Health and Ageing
  2. 2. Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP) 7538 5004 4627 4210 4079 4063 3970 3793 3737 3696 3677 3540 3470 3359 3353 3129 3060 3008 2902 2870 2729 2687 2683 2151 1801 1781 1737 1437 1213 999 852 767 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 1. Refers to insured population rather than resident population. 2. Current expenditure. 3. 2006. 4. 2007. Source: OECD, OECD Health Data, June 2010 Public expenditure on health Private expenditure on health OECD HEALTH DATA 2010 How Does AUSTRALIA Compare
  3. 3. Health Expenditure as a share ofGDP, OECD Countries 16.0 11.2 10.7 10.5 10.5 10.4 10.2 9.9 9.9 9.8 9.7 9.7 9.4 9.1 9.1 9.0 9.0 8.7 8.7 8.5 8.5 8.4 8.1 7.8 7.3 7.2 7.1 7.0 6.9 6.5 6.1 6.0 5.9 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 1. Current expenditure 2. 2006 3. 2007 Source: OECD Health Data 2010 June 2010 % GDP Health Expenditure as a share of GDP, OECD Countries
  4. 4. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  5. 5. SELF-ASSESSED PHYSICAL & MENTAL HEALTH, 2007 Source: AIHW Australia’s Health 2010
  6. 6. BROAD CAUSE MORTALITY TRENDS AUSTRALIA Source: AIHW
  7. 7. Source: AIHW Australia’s Health 2010 AGED ADJUSTED DEATH RATES From CVD, 1907 - 2006
  8. 8. All Cancer- Mortality/Incidence ratios for selected countries - 2008 Source: IARC 2010. 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 Kenya Nigeria EgyptVietNam Turkey India China Russia South Africa G reece Brazil Japan Czech Republic Italy United Kingdom CanadaG erm anySweden New Zealand USAAustralia Mortality-to-incidenceratio Males Females
  9. 9. Changes in Deaths rates in Males using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  10. 10. Changes in Deaths Rates in Females Using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  11. 11. Cancers with reducing death rates 1997 to 2006 – all ages Lung, -18.5 Colon, -19.6 Prostate, -19.7 Leukaemia, -23.7 Stomach, -29.4 Head and Neck, -23.7 Bladder, -18.5 Testicular, -42.2 Breast, -13.8 Cervix, -38.3 NHL, -25.1 Unknown, -24.8 Rectum , -19.9 Bowel , -19.7 All cancers, -13.8 , -24.3 -18.5 Kidney , -24.1 , -15.2 -31.9 , -21.1 -19.0 -19.0 , -18.9 -7.9 -45 -40 -35 -30 -25 -20 -15 -10 -5 0 Male Female Source: Tracey et al, Cancer Institute NSW
  12. 12. 5 YEAR SURVIVAL RATES 2004 NSW SEER Non small cell lung 13% 14% Colon 65% 67% Rectum 66% 69% Breast Cancer 89% 90% Lymphoma (DL) 53% 53% Source: Tracey et al – Cancer Institute NSW
  13. 13. CANCER Milestones in Survival Improvement Prevention – Tobacco control Early detection •Screening •Interventions Better treatments – medical research Clinical trials of better approaches Evidence based standard practice
  14. 14. PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010 Source: AIHW Australia’s Health 2010
  15. 15. TRENDS IN LEADING CAUSES OF DISEASE BURDEN 2003-2023 Source: AIHW Australia’s Health 2010
  16. 16. Changes in Incidence Rates for all Cancer in Males using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  17. 17. Changes in Incidence Rates in Females using Joinpoint Analysis Source: Tracey et al – Cancer Institute NSW
  18. 18. THE KEYS TO PREVENTION 0.0 2.0 4.0 6.0 8.0 Tobacco Blood pressure Overweight/obesity Physical inactivity Blood cholesterol Alcohol Fruit/vegetables Illicit drugs Air pollution Unsafe sex % DALYs Total of 32% Source: Table 4.1 AIHW Australia’s Health 2008
  19. 19. AUSTRALIA’S RANKING AMONG OECD COUNTRIES 1987-2006 Source: AIHW Australia’s Health 2010
  20. 20. SMOKING IN AUSTRALIA SMOKING STATUS NSW VIC QLD WA SA TAS ACT NT AUS Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6 Weekly 1.2 1.5 1.4 1.2 1.5 0.6 0.9 1.2 1.3 Less than Weekly 1.4 1.7 1.3 1.4 1.8 1.6 1.6 1.3 1.5 Ex-smoker 24.7 24.4 25.7 28.3 24.1 26.5 24.8 22.4 25.1 Never smoked 56.3 55.9 54.5 54.3 56.2 48.6 57.9 49.8 55.4 National Drug Strategy Household Survey 2007Source: 2007 Household Survey, Australian Government
  21. 21. AUSTRALIA’S INITIATIVES IN TOBACCO CONTROL  Advertising Bans  Under the counter at retail sites  Banning smoking in restaurants, pubs and cars  Graphic warnings on cigarette packets  Anti-tobacco campaigns  Increase in tobacco excise  Plain packaging
  22. 22. OBESTITY INCREASING FOR ALL Source: AIHW: Australia’s Health 2008
  23. 23. Increased Risk Body Fatness Oesophagus Pancreas Colorectal Breast (PM) Endometrum Abnormal Fatness Colorectal Reduced Risk Physical exercise Colon Source:World Cancer Research Fund: Food, nutrition, physical activity and prevention of cancer, 2007 OBESITY and CANCER
  24. 24. Source: AIHW Australia’s Health 2010 PROPORTION OF ADULTS WITH HIGH BLOOD PRESSURE 1980 to 1999-2000
  25. 25. Source: AIHW Australia’s Health 2010 CHRONIC PULMONARY DISEASE MORTALITY 1980 to 2007
  26. 26. Source: AIHW Australia’s Health 2010 DEATH RATES FROM INFECTIOUS DISEASES, 1922-2007
  27. 27. Source: AIHW Australia’s Health 2010 PREVALENCE OF CURRENT ASTHMA 2007-08
  28. 28. Source: AIHW Australia’s Health 2010 PREVALENCE OF TREATED END STAGE KIDNEY DISEASE 2000-2007
  29. 29. NSW Population Age Distributions, Males (1977-2036) Source: Cancer Institute NSW
  30. 30. Total Cancer Cases and Deaths per year (1972 to 2036) Source: Cancer Institute NSW
  31. 31. Milestones in Cancer Control  Public health measures in smoking reduction, screening breast, cervix, bowel, health literacy  Adjuvant treatment of breast, lung and bowel cancer  New anti-cancer drugs and symptom control drugs  Cancer research translated into practice  Cancer registries, data linkage and analysis
  32. 32. BREAST CANCER MORTALITY NEJM 2005 Source: New Engl.Journ. Med: 353:17
  33. 33. Projected YLLs – Three scenarios, Australia – 1980 to 2016 Source: Bishop et al – Cancer Institute NSW
  34. 34. NON-COMMERCIAL CANCER RESEARCH EXPENDITURE, 2004 (A$ per CAPITAL) Source: Eckhouse et al (2007), ABS
  35. 35. PRIORITY HEALTH AREAS SOURCE: NHMRC Research funding 2010 facts book
  36. 36. CANCER PUBLICATIONS Australia Growth* World Australian Share 2000 1,881 5.6% 88,604 2.0% 2002 2,000 3.5% 97,035 2.1% 2004 2,514 19.0% 110.390 2.3% 2006 3,035 14.1% 125,934 2.4% _______________________________________________________________________ 8 year period 17,917 70.4% 822,768 2.2% _______________________________________________________________________ * From pervious year Source: Cancer Institute NSW 2008
  37. 37. CLINICAL GUIDELINES Supports for Clinical Decision Making  Evidence Base  Highest Impact  Range of best practice tools  Successful implementation methods  Monitor and report
  38. 38. 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
  39. 39.  Focus on the major burden of disease and their risk factors provides a basis for improving the health of our community.  Manipulation of the determinants of disease show some successes but some challenges  Application of new research to the high priority disease burden provides new opportunities to further improve outcomes for our population CONCLUSIONS
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