Core 1 Presentation CQ1

1. Core 1: Health Priorities in Australia
CQ1: How are priority issues for Australia’s health identified

2. The stuff
you need
to know….
The
context in
which we
apply it...

3. BOOKMARK THIS WEBSITE AND DOWNLOAD
THE PDF
Australia’s health 2020: in brief (Full
publication;23July2020Edition)(AIHW)

4. Measuring Health Status
Role of
epidemiology
Measures of
epidemiology
(mortality, infant
mortality,morbidity,
life expectancy)

5. Role of Epidemiology
EPIDEMIOLOGY: The study of disease in groups or populations through the collection of data and
information, to identify patterns and cause.
PREVALENCE: The number of cases of disease that exists in a defined population at a point in time
INCIDENCE: The number of new cases of disease occurring in a defined population over a period of
time.
Epidemiology is used by Governments and health-related organisations to obtain a picture of the health
status of a population.

6. What does it epidemiology do?
WHAT CAN IT TELLS
US?
Considers patterns to
determine:
WHO USES THESE MEASURES….
Helps researchers and health authorities:
SOME OF THE MEASURES...
Looks at data such as
Prevalence
Incidence
Distribution (the extent
of the issue)
The apparent causes
(either determinants or
indicators for disease)
Describe and compare the patterns of health of
groups, communities and populations
Identify health needs and allocate health
resources
Evaluate health behaviours and strategies to
control and prevent disease
Identify and promote behaviours to improve
health (e.g. lower sugar intake)
Governments, NGOs, health department,
medical practitioners etc...
-Births
-Deaths
-Disease incidence
-Disease prevalence
-Contact with health-care
providers
-Hospital use
-Injury incidence
-Work days lost
-Money spent on health care

7. Limitations
Whilst epidemiology has been a proven method of measuring health status, there are limitations. These
include;
- Largely objective data, therefore some subjective measures can be difficult to gauge e.g. life
expectancy provides valuable statistical information, but quality of life measures, however, are
far more subjective and often rely on self reporting tools which can be less reliable.
- Does not explain the why for health inequities.
- Numerous sources of information
- Varying levels of reliability
- Imprecise methods of data collection
- No standardisation of instruments, defintions and classifications

8. MEASURES OF EPIDEMIOLOGY
(mortality, infant mortality, morbidity, life expectancy)
MORTALITY: A measure of the number of deaths in a given population over a period of time (most
commonly a year). Usually represented per 100,000 of the population. Decreasing
INFANT MORTALITY: A measure of infant deaths in the first year of life (0-1yrs old), per 1000 live
births. Decreasing
MORBIDITY: The incidence or level of illness, disease or injury in a given population. Decreasing for
most major health conditions (or at least occurring later in people’s lives) - Survival rates increasing
unfortunately so is the incidence of diabetes and mental health problems.
LIFE EXPECTANCY: The average number of years a person can expect to live if the existing mortality
patterns continue. Increasing

9. Mortality
In 2020, there were 161,300 deaths
in Australia (52.4%M, 47.6% F).
These deaths had a wide range of
causes but some were more
common than others.
The leading causes of death in Australia (according
to ‘Australia’s Health in Brief remember the link at
the start of the unit that you bookmarked and
downloaded the PDF) are:
Although Coronary Heart Disease is number 1, in
2016 Cancer (all types combined) took over as the
leading cause of death. Coronary Heart Disease
remains, however, the leading single cause.
Potentially avoidable death rate fell by 41%
between 199 and 2019
What is the order?
Make sure the order is
correct in your notes

10. Important to understand Tables & Graphs
Based on the table
● What is the combined leading cause of
death?
● What is the leading cause death for
males?
● What is the leading cause of death for
females?
● What is responsible for more deaths –
lung cancer or Cerebrovascular
disease?
● Which is responsible for more deaths in
the given area:
Males – COPD or Females – Lung
cancer

12. Mortality
In 2020:
● The leading cause of death was ischaemic heart diseases (IHD).
● Dementia, including Alzheimer's disease was the second leading cause of death. People who died from dementia
had a high median age at death of 89.1.
● Cerebrovascular diseases, lung cancer and chronic lower respiratory diseases rounded out the top five leading
causes.
● Deaths from the five leading causes all decreased from 2019.
● There were 55 deaths due to influenza. Influenza and pneumonia dropped to the 17th leading cause of death
(down from the 9th leading cause in 2019). The ranking of influenza and pneumonia is influenced by the severity of
the flu season.
● Suicide was the 15th leading cause of death. People who died from suicide had median age at death of 43.5.
● COVID-19 was the 38th leading cause of death, with 898 deaths recorded through the civil registration system.
● From 2011 to 2020:
● Deaths due to Ischaemic heart diseases and Cerebrovascular diseases decreased by 22.9% and 15.8% respectively.
● Deaths due to Dementia, including Alzheimer's disease increased by 47.8% (4,711 deaths).

13. MORTALITY TREND = DECREASING

15. Males

16. Females

17. Summary
The 10 leading causes of death in 2018 were generally the same as in 2008, albeit with different
rankings (Figure 3).
• For males, coronary heart disease was the leading cause of death in both these years,
accounting for 17% of deaths in 2008 and 13% in 2018. However, the death rate from
coronary heart disease has decreased over the decade. The largest change in leading
causes of death for males from 2008 to 2018 was the rise of dementia including Alzheimer’s
disease, from seventh to third place.
• For females, coronary heart disease, cerebrovascular disease, breast cancer and colorectal
cancer fell in rank from 2008 to 2018. On the other hand, there were notable increases—for
dementia including Alzheimer’s disease (from third to first place) and for COPD (from
seventh to fifth place).

18. Infant Mortality
This measure is considered to be the most
important indicator of the health status of a
nation and can also predict life expectancy.
It is divided into;
- neonatal (deaths in first 28 days of life) =
influenced by maternal and neonatal care
- post-neonatal (day 29-1 yr)
Infant mortality rate was 3.3 deaths per
1000 live births in 2017

19. INFANT MORTALITY
TREND =
DECREASING
Regional and remote areas
accounted for 38% of
premature deaths
Mortality rates are between 1.2
and 3.8 times as high in
regional and remote areas than
in major cities
More premature deaths are
males (62% vs 38%)
Has improved due to:
- Improved medical diagnosis
- Improved public sanitation
- Health education
- Improved support services

20. Morbidity
Illness, disease and injury are all
conditions that reduce our quality
of life. Information about the
prevalence and incidence of these
conditions gives us a better
perspective of the Nations health.

21. MORBIDITY TREND = DECREASING WITH SURVIVAL RATES
INCREASING. DIABETES AND MENTAL HEALTH ISSUES INCREASING
Morbidity measures:
- Hospital Use
- Doctor visits and Medicare
statistics - Medicare is
Australia’s public-funded
universal health care
system. Providing free or
low cost medical,
optometric and hospital
care. Federal Government
funding.
- Health surveys and reports
- Disability and handicap
statistics
*DALY - Disability-adjusted life years
(think of 1 DALY as 1 year of healthy life lost)

22. Life Expectancy = INCREASING
Life expectancy is continually
increasing. A child born between
2016-18 can expect to live to 84.9
(females – ½ a year more than
previous report) or 80.7 (males – a
1/3 a year more than previous report).
This is attributed to:
- Lower infant mortality
- Declining death rates from CVD
- Declining overall death rates
from cancer
- Fall in deaths from traffic
accidents

25. The burden of
illness and the
potential to
reduce this
burden is the
greatest
significant
consideration of
the Government
when prioritising
health funding.

30. Identifying priority health
issues
Principles of Social Justice
Priority Populations Groups
Prevalence of condition
Potential for prevention and
early intervention
Costs to the individual and
community

31. Identifying Priority Health Issues
P - Principles of Social Justice (Remember
SEED??)
P - Priority Populations Groups
P - Prevalence of Condition
P - Potential for Prevention and Early
Intervention
C - Cost to the Individual and Community
Priority groups are identified on;
- Their contribution to the burden
of illness in the community
- The potential for the reduction
of this burden
Priority groups include;
- ATSI
- Low SES
- Rural and Remote
- People born overseas
- Elderly
- People with disabilities

32. SEED - The Social Justice Principles
Supportive Environments:
All Australians have the right to be healthy. Environments need to be structured
so that they are supportive of this. Examples include: Provision of health
services/products at affordable or no cost, products/services are located in
metropolitan, rural and remote locations and providing products/services that
help people overcome difficulties associated with disabilities. Give 2 examples
Equity:
Ensuring that resources are allocated fairly so that all Australians have the
opportunity to be healthy. This may mean resources are allocated to some
groups/communities in greater amounts. Give 2 examples
Diversity:
Australia has a diverse population with diverse health needs. Each group’s issues
must be met. E.g. Greater volume of services and facilities for our aging
population, Medicare demonstrate diversity with translation services, community
initiatives making citizens born overseas aware of the available health services.
Give 2 examples

33. Some Examples
Medicare: provides essential medical care at an
affordable cost, or at no cost, so that socioeconomic
factors should not restrict a person’s capacity to
receive the treatment they need. Federally Funded
Pharmaceutical Benefits Scheme (PBS): Subsidises
(reduces) the cost of selected drug treatments deemed
to be life-saving or adding significantly to quality of
life. Several costly drug therapies for cardiovascular
disease, cancer and other chronic diseases are
included on the subsidised list under the PBS.
Federally Funded
Medicare Safety Net: Identifies a threshold over
which basic medical costs incurred in any one year are
further subsidised by the government. -------------------

34. Priority Population Groups
If a specific population group is experiencing health disadvantages, it could be argued that their right to
be healthy is being impinged. Epidemiology has informed us that some population groups do
experience health inequalities and that these disadvantages need to be addressed.
This identification helps authorities:
- determine the disadvantages of certain groups
- better understand social determinants
- prevalence of disease and injury in specific groups
- determine the needs of groups in relation to the SJP
Examples include:
- Royal Flying Doctors Service (RDFS), providing aeromedical emergency health services and clinics in
remote sites
- Incentive programs for medical practitioners and dentists to practice in rural or remote areas
- Allocating more funding to Indigenous health services than non-Indigenous
- Developing NSW Multicultural Health Communication Service (supporting culturally and linguistically
diverse communities)

35. Prevalence of Condition
Refers to how common the condition is within
the community. We obtain this through
epidemiological data. It relates primarily to high
levels of preventable chronic disease, injury
and mental health problems.
High prevalence rates indicate the health and
economic burden that the disease or condition
places on the community.
Looks to reduce the burden of disease
(remember the table 5 slides ago?)

36. Potential for Prevention and Early Intervention
The majority of disease and illnesses suffered by Australians result from poor lifestyle behaviours.
Unfortunately simply changing people’s behaviours is easier said than done. Many people’s choices are
a reflection on their environment.
SES, access to info and health services, employment, housing, support networks and environmental
infrastructure (water, roads, power grids etc..) are increasingly being viewed as determinants of health
inequities.
Individual and environmental determinants must both be met. Support in addressing the modifiable risk
factors is important.
E.g. Quitting smoking, breast screening etc...

37. Cost to the Individual and Community
INDIVIDUAL:
Refers to the economic and health burden placed onto an
individual. Measured in terms of financial loss, loss of
productivity, diminished quality of life and emotional stress.
Financial and productivity costs = costs associated with
treatment or impaired ability e.g. hospital charges,
rehabilitation, medical fees, drugs therapies, travel costs and
loss of income.
Non-financial = pain and suffering experienced and the
reduction in quality of life. E.g. not being able to participate in
activities they once did and enjoyed, lifestyle changes for
carers of injured or disabled. Emotional trauma is also a non-
financial cost to an individual.
COMMUNITY:
These can be DIRECT or INDIRECT costs.
DIRECT:
Money spent on diagnosing, treating and caring for
the sick, plus the money for prevention. E.g.
Research, screenings, hospital admissions,
pharmaceutical prescriptions and education.
INDIRECT:
The value of output lost when people become too ill
to work or die prematurely. E.g. forgone earnings,
absenteeism and the retaining of replacement
workers.

38. Just to put it in
perspective…..

39. Questions - HSC Past Questions