Professional Documents
Culture Documents
IN AUSTRALIA
Critical Question 1 - How are priority issues for Australias health
identified?
Measuring Health Status
Role of Epidemiology
The collection and analysis of the data used to make this assessment is known as
Epidemiology.
Measures of Epidemiology
Morbidity: The rates, distribution and trends of illness, disease and injury in a given
population.
Mortality: The number of deaths for a given cause in a given population, over a set timeperiod.
Infant Mortality: The number of deaths in the first year of life per 1000 live births.
Life Expectancy: An estimate of the number of years a person can expect to live at any
particular age.
High levels of preventable chronic disease, injury and mental health problems
Cardiovascular Disease
Nature
Cardiovascular Disease (CVD) refers to all diseases of the heart and blood vessels,
caused by a build up of fatty tissue inside the blood vessels (i.e. atherosclerosis) and the
hardening of the blood vessels (i.e. arteriosclerosis)
3 types of CVD include Coronary heart Disease, Cerebrovascular Disease, Peripheral
Vascular Disease
Extent
The leading cause of death and sickness
Both mortality and morbidity is decreasing for males and females
Risk Factors and Protective Factors
Non-Modifiable Risk
Modifiable Risk Factors
Factors
- Age: rates increase sharply - Smoking and alcohol abuse
over 65 years of age
- Diet high in fat, salt and
- Being male
sugar
- Family history
- Low physical activity levels
- High blood pressure and
cholesterol levels
- Being overweight
Determinants
Sociocultural
Determinants
- Family history
- Indigenous: higher rates of
all risk factors
- Males: less likely to engage
in preventative health
measures
Socioeconomic
Determinants
- Low levels of disposable
income
- Unemployed
- Low level of education
Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Elderly
Protective Factors
- Nutritious and balanced diet
- Daily physical activity
- Responsible use of alcohol
- No smoking
- Maintain healthy weight
- Control stress levels
Environmental
Determinants
- People who live in rural and
remote communities
Cancer
Nature
A group of diseases leading to the uncontrolled growth of abnormal body cells.
Skin, Breast and Lung cancers are of most concern to health authorities
Extent
Mortality and morbidity rates are both increasing.
The most commonly occurring cancer is non-melanoma skin cancer (which is mostly nonlife threatening). The most common life threatening cancers include: Men: prostate,
colorectal, lung and melanoma and Women: breast, colorectal, lung and melanoma
Risk Factors and Protective Factors
Non-Modifiable Risk
Modifiable Risk Factors
Factors
- Gender: specific cancers
- Exposure to carcinogens
- Age: leads to increased risk (cancer causing agents),
- Family history
such as smoke, asbestos,
- Genetic makeup e.g. being UV radiation from the sun
fair skinned
- Lifestyle behaviours, such
as smoking, alcohol misuse
and poor dietary habits
Determinants
Sociocultural
Determinants
- Smoking amongst young
females
- Tanning habits, such as
excessive sun exposure
Socioeconomic
Determinants
- Unemployed: higher rates
of smoking
- Low levels of education e.g.
awareness of warning signs
and personal testing
Protective Factors
- Avoid carcinogen e.g. Slip,
Slop, Slap, Wrap
- Personal screening habits
e.g. breast and testicular
- Public screening e.g. breast
mammograms and prostate
blood test
- Seeking early medical
intervention
Environmental
Determinants
- People who work outdoors
- People who live in rural and
remote communities
- Exposure to chemicals in
the workplace
Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Males and Females
Other minor groups include smokers, outdoor workers, young adults and people with fair
skin
Diabetes
Nature
A disease that affects the bodys ability to take glucose from the bloodstream to use it for
energy
Caused by a malfunctioning of the pancreas leading to insufficient insulin levels, the
hormone responsible for regulation of blood glucose levels (BGL)
3 types:
1. Insulin Dependent Diabetes (IDDM) Known as Type 1 usually presents early in life
and patients require insulin injections and must monitor diet and physical activity to
maintain a safe BGL
2. Non-Insulin Dependent Diabetes (NIDDM) Known as Type 2 usually presents later in
life, as a result of long-term poor health behaviours related to diet and exercise. Requires
medication and lifestyle modifications
3. Gestational Diabetes (GD) occurs during pregnancy
The long-term effect s of each type include vision problems, kidney disease, circulatory
issues in arms and legs and a strong link to CVD (similar risk factors)
Extent
Worlds fastest growing disease similar issues are evident in Australia
Prevalence increases with age, especially NIDDM Type 2
The age of onset is decreasing which is a growing concern, especially for young people.
Due to unhealthy lifestyles
3.5% of all Australians have Diabetes
Risk Factors and Protective Factors
Modifiable Risk Factors
Non-Modifiable Risk
Factors
- High blood pressure
- Over 55 years of age
- Having CVD or its risk
- Family History
factors
- Over 45 years with CVD
- Having diabetes in
risk factors
pregnancy
- Over 35 and being of
- Being overweight
Aboriginal, Chinese, India or
Pacific Islander descent
Determinants
Sociocultural
Determinants
- Indigenous 10-30% may
have diabetes much is
undiagnosed
- Being Chinese, Indian or
Pacific Islander
- Social acceptance of binge
drinking
- Ageing population
- Being time poor leads to
increased reliance on
convenient food
Socioeconomic
Determinants
- Low SES more likely to
have poor diet, drink
excessive alcohol, be
physically inactive and be
overweight
- Low education less
awareness of prevention
strategies and health lifestyle
behaviours
Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
Mental Health Problems
Nature
Protective Factors
- Maintaining a healthy
weight
- A balanced and nutritious
diet, full of Low GI foods.
Eating 5-6 smaller meals per
day
- Healthy use of alcohol
- Daily physical activity
Environmental
Determinants
- Technology has lead to a
more passive society e.g.
popularity of video games
- People from rural and
remote and Indigenous
have difficulty in accessing
medical services
- Junk food advertising to
children
Any illness that negatively affects a persons emotional stability, perceptions, behaviour
and social well-being, such as depression, anxiety, addictions, obsessive compulsive
disorder, bipolar disorder, eating disorders and dementia
Extent
20% of people suffer form a mental health problem at some stage of life
Prevalence is increasing and much is unreported
18-24 years olds have the highest rates, especially substance abuse and depression
Risk Factors and Protective Factors
Modifiable Risk Factors
Non-Modifiable Risk
Factors
- Drug use
- Age increased risk of
- Chronic disease e.g.
dementia
arthritis
- Males suffer mostly
- Perceived self-worth and
depression and addictions
sense of identity
(substance abuse)
- Coping skills
- Females suffer mostly
Stressful situations e.g.
depression and anxiety
family breakdown and
- Uncontrolled life changes
occupational stress
e.g. death or abuse
- Grief
- Family history
Determinants
Sociocultural
Determinants
- Family breakdown lack of
support
- Difficult life circumstances
e.g. abuse
- ABTSI Increased alcohol
and drug abuse, and difficult
life circumstances
- Elderly people increased
social isolation and grief
Socioeconomic
Determinants
- Unemployed higher rates
of depression
- Low education risk factors
- People in financial distress
e.g. farmers during a drought
Protective Factors
- Social acceptance as
legitimate health concerns
- Awareness of social support
structures e.g. GP, online
help, telephone counseling
- Strong sense of
connectedness with family,
friends, work mates and
neighbours
- Personal resiliency skills
Environmental
Determinants
- Living in remote regions
lack of support and medical
services
- Stigma amongst males as
well as common stoical
attitudes
- Lack of emotional support
e.g. family breakdown
Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
People born overseas, especially refugees
People with a disability
Respiratory Diseases
Nature
Common diseases that affect the respiratory system include: Asthma, Chronic Obstructive
Pulmonary Diseases, Hay fever
Extent
6 million Australians have a long-term respiratory disease
Socioeconomic
Determinants
- Increased smoking amongst
low SES
- Low income less money
for preventative medication
- Low SES more likely to be
exposed to occupational
hazards
Protective Factors
- Awareness of personal
asthma triggers e.g. exercise
- Education about personal
prevention strategies and
plans for asthma attacks
- No smoking
Environmental
Determinants
- Higher rates of pollution in
cities
- People who live in remote
region are further from
emergency services
- Childrens exposure to
passive smoke
Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
Smokers
Injury
Nature
There are many types of injuries, which affect all stages of life. They often result in lingterm harm of ones physical, emotional and social well being. Examples include:
1. Road injuries and Motor Vehicle Accidents (MVAs)
2. Suicide and self-harm
3. Injuries around the home e.g. poisonings, falls, drowning, cuts, fires
4. Workplace accidents
5. Acts of violence
6. Sports and recreational injuries
Extent
Leading cause of death in 1-44 years age group (particularly MVAs and suicide amongst
males)
Greatest cause of potential life lost under 65 years
Major cause of hospitalisation
Deaths from injuries are decreasing in frequency, especially MVAs
The elderly are prone to injuries such as falls, which has a significant impact on their
quality of life
Socioeconomic
Determinants
- Low SES higher rates of
hospitalisation from injuries
- Low education less
awareness of dangers
around the home
- Low income makes it
harder to purchase safety
equipment
- MVAs are highest amongst
low SES populations
Protective Factors
- Minimising driving
distractions e.g. Mobile
phones and GPS
- Effective driver education
- Positive attitude towards
road and OHS rules and
regulations
- Home modifications for the
elderly
- Strong social support to
prevent suicide
Environmental
Determinants
- Workplace injuries are most
common in agricultural
settings
- Suicide is highest amongst
males from rural and remote
regions
- Unsafe home environment
of elderly people and children
can lead to increased risk of
injury
Groups at Risk
Elderly (Falls)
Indigenous Australians (MVAs and self-harm)
People from rural and remote regions (occupational injuries)
Children (poisoning and drowning)
Young Adults (MVAs, sport and recreational injuries and self-harm)
Males (Suicide and MVAs)
State/Territory Government
Local Government
Private organisations
Community groups
Health care in Australia is provided by the public sector (Medicare) or through private health
insurance. Medicare is the health-care system for all Australians. Its aim is to provide equity
in terms of cost and access for health care services.
Funding for Medicare comes from income tax (1.5% of taxable income) and the Medicare
levy surcharge (1% for high income earners).
Every Australian is covered for 85% of the scheduled fee.
Bulk Billing allows patients to pay nothing and the doctor receives the scheduled fee from
Medicare.
People have the option of increasing the health insurance they have by taking out private
health insurance. The extra insurance covers private hospital and ancillary or extras (dental,
physiotherapy, naturopathy, etc).
Reasons for choosing private health insurance include:
- Shorter waiting times
- Hospital choice
- Own doctor of choice
- Ancillary benefits such as physiotherapy
- Peace of mind
- Private rooms in hospital
- Health cover while overseas
- Avoiding increase tax
To combat falling private health insurance numbers the Commonwealth Government has
implemented several schemes.
- 30% tax rebate for people with private health insurance
- 1% Medicare levy surcharge
- Lifetime health-care incentive with lower premiums to those who join before age 30
Medicare
Private health insurance
Payment
Commonwealth Government Commonwealth Government
Taxpayers
Individuals and families
Payment type
Income tax
Annual, monthly, fortnightly
Levy surcharge
premiums
Benefits
Basic public hospital services Hospital cover
Basic medical services
- Hospital services
Some specialist services
- Choice of doctor
85% of scheduled fee
- Choice of hospital
Availability of bulk billing
- Private or public hospital
Ambulance cover
Ancillary cover
- Physiotherapy
- Chiropractor
- Naturopathy, etc
Some special benefits such
as gym membership
Overseas cover
Description
Involves inserting needles into skin
Use of pure essential oils to influence the
mind, body or spirit
System of muscle and connective tissue
movements that realigns the body and
balances energy flow
Adjustments are made to the spine to realign
correct body function
Uses plants and herbs
System that recognises the symptoms are
unique to an individual
Analysis of the human eye to detect signs of
wellbeing or otherwise
Includes remedial, Swedish, sports
State of inner stillness
Holistic treatment aiming to treat the
underlying cause as well as the symptoms of
the illness
The chance of successful health promotion is greatly increased when all levels of
government, non-government organisations, communities and individuals work together
towards one common goal.
How health promotion based on the Ottawa Charter promotes social justice
Health promotion to be effective needs to address the social justice principles (equity,
diversity and supportive environments).
Equity
Diversity
Supportive
environment
Developing personal skills
Mandatory PDHPE Access to Medicare Media campaigns
K - 10
Community based
support
Creating supportive
Provision of health Destigmatising
Legislative bans
environments
enhancing items
health conditions
Provision of health
enhancing items
Strengthening community
Lobby groups
Lobby groups
Lobby groups
action
Reorienting health services Health services for Language
Partnerships with
ATSI
assistance
the community
Building healthy public
Bulk billing
Abstudy
Health campaigns
policy
PBS
Health care card
The Ottawa Charter in action
Application of the Ottawa Charter requires critical analysis of the 5 areas of the Ottawa
Charter: developing personal skills, strengthening community action, creating supportive
environments, reorienting health services, building healthy public policy.
Examples of health promotions that are based on the Ottawa Charter to an extent include:
Closing the Gap, Fresh Tastes @ School, National Tobacco Strategy, National Action Plan
on Mental Health, Measure Up and Swap It Dont Stop It.
Source of fuel
Alactacid system
(ATP/PC)
Creatine phosphate
Lactic Acid
system
Carbohydrate
Glycogen
Efficiency of ATP
production
Approximately 2
ATP molecules
Duration
5 - 10 seconds
30 - 45 seconds
Cause of fatigue
Depletion of PC
By-products
None
Increased
accumulation of
hydrogen ions
Lactic acid
PC replenishment
in
2 5 minutes
Removal of lactic
acid with active
recovery in 15 30
mins
Aerobic system
Carbohydrate
Fat
Protein
Glucose 36 ATP
molecules
Fatty acid 130
ATP molecule
Unlimited
depending upon
intensity
Depletion of fuel
sources
Carbon dioxide
water
Restoration of
glycogen up to 48
hours
Fartlek training or speed play involves continuous exercise with sprints or a higher
intensity effort (e.g. Hill climb) interspersed throughout the session.
Aerobic interval training involves alternating repetitions of an exercise and a period of rest
or recovery.
Circuit training involves a series of exercises that are performed one after the other with
little or no rest in between each exercise.
Anaerobic
Anaerobic training involves exercise of high intensity and therefore short duration.
Interval training is a very common form of anaerobic training usually requiring maximal
effort. Generally the recovery rate ratio will determine the type of training and aims of the
sessions.
Speed, acceleration and agility are components that can be developed through anaerobic
training.
Plyometrics is a very common training style to develop anaerobic power. Plyometrics
involves exercises that produce an explosive muscular contraction.
Flexibility
Flexibility is the ability to move a muscle through its full range of motion. Good flexibility will
assist:
- Prevention of injury
- Improved coordination
- Muscular relaxation
- Decreasing muscle soreness
Static stretching the muscle is slowly and smoothly taken to the end of its range of motion
and held for approximately 30 seconds. This method is useful for rehabilitation, warm up and
cool down.
Dynamic stretching involves a series of movements that replicate game movements and
take the muscle through its full range of motion. It is popular for warm-ups.
Ballistic stretching involves a bouncing action at the end of the range of motion. This form
of stretching activates the stretch reflex. The force of the movement takes the muscle
beyond its preferred length. Therefore, this type of stretching has risks and is only
recommended for elite athletes.
PNF stretching proprioceptive neuromuscular facilitation involves lengthening a muscle
against a resistance. Generally it involves a static stretch, followed by an isometric
contraction then a period of rest before being repeated. Used often during rehabilitation.
Strength training
Strength is the maximal force generated by a single muscular contraction.
Hypertrophy an increase in the size of the muscle fibres and connective tissues
Isotonic involves exercises where the muscle shortens and lengthens
Isometric involves exercises where the muscle does not change length
Isokinetic involves exercises where the load remains constant throughout
Machine weights very popular method allowing for isotonic contractions and are very
simple to use. It is very easy to isolate muscle groups using this method of training.
Free weights include dumbbells, barbells, medicine balls and kettlebells. Allow a wide
range of exercises, muscle groups and types of contractions to be catered for. Good
techniques are needed to avoid injury.
Resistance bands are often used in rehabilitation but have become a popular form of
training lately due to their convenience. They allow for a range of contractions and a wide
range of muscle groups.
Stability balls have become popular of late. Their focus is to develop the core muscles and
majority of free weight exercises can be adapted to be performed incorporating the stability
ball.
Principles of training
Progressive overload
To continue to have training improvements, progressive overload needs to occur. The body
adapts to the training it undergoes. When this adaptation occurs the training needs to be
increased to stress the body beyond its current capabilities to achieve further training gains.
It also needs to be progressive so that the stress placed on the athlete does not cause injury
or fatigue. Overload can be achieved by increasing intensity, resistance, repetitions,
duration, frequency, etc.
Specificity
Exercise needs to be specific for the energy systems, muscles, movement patterns, etc
required for the athletes sport.
Reversibility
Training adaptations are lost once training ceases or lowers below the current capacity of
the athlete. A detraining effect results in the physiological adaptations gained through
training being reversed.
Variety
Completing the same or similar activities can lead to boredom which in turn may result in a
reduced training effort. Therefore it is important for training sessions to incorporate a range
of training types, settings, activities and drills.
Training thresholds
Training thresholds are the upper limits of a training zone and when passed take the athlete
to a new level.
The aerobic threshold (Lactate transition 1) is approx 70% of MHR. This level is sufficient to
cause a training effect.
The aerobic training zone is when athlete is working above the aerobic threshold and below
the anaerobic threshold.
The anaerobic threshold (Lactate transition 2 or Onset Blood Lactate Accumulation OBLA) is
approx 85% of MHR. Exercise beyond this point will see a marked increase of lactic acid
build up and therefore fatigue and the cessation of exercise.
Warm up and cool down
For most sports a warm up will last approximately 20 minutes. This will incorporate a general
warm up followed by a more specific warm up. The aim of the warm up is to prepare the
body both physically and mentally for optimal performance.
The general warm up will contain some running or aerobic activities and dynamic stretching.
The specific component of the warm up will contain activities relating to the sport.
The cool down is recommended to form part of the active recovery for the athlete. Generally
this will involve low intensity exercise. The aim of the cool down is to decrease blood lactate
levels and to minimise muscle soreness.
Adaptation
Decreased resting heart rate due to more
efficient stroke volume
Increased at rest and throughout exercise
Cardiac output
Oxygen uptake
Lung capacity
Haemoglobin level
Muscle hypertrophy
Effect on slow-twitch muscle fibres
stressed. There are many sources of stress and these include: financial concerns, selection
concerns, injury concerns, contract concerns, crowds, preparation and expectations.
Optimal arousal
Optimal arousal is the physical and emotional response related to a specific moment or
event. Arousal is important for successful sporting performance, however, not all athletes or
sports require the same level of arousal. An archer requires a different level of arousal (calm
and quiet) compared to a weightlifter (pumped up).
Optimal arousal is generally described utilising the inverted u hypothesis. As arousal
increases so does performance until optimal arousal and this performance is reached. If
arousal continues past this point (over arousal) then performance declines.
High
Performance
Low
Low
High
Level of arousal
Relaxation techniques
Over-aroused and anxious athletes benefit greatly from having a range of relaxation
strategies available to them. Relaxation will lower breathing rates, heart rate, blood pressure
and muscle tension leading to greater control and focus.
Examples of relaxation include listening to music, massage, watching TV or a movie,
controlled breathing exercises, yoga, Pilates, meditation and hypnosis.
Goal-setting
Setting long term and short term goals can assist an athlete greatly to remain focused. The
goals of an athlete can be about the outcome of their performance (e.g. winning gold at the
Olympics) or the process (e.g. swimming a personal best at the Olympics).Short term goals
should contribute to achieving the long term goal.
Supplementation
Supplementation is the process of eating additional nutrients to account for a deficiency in
an athletes diet. In most cases, sports nutritionists generally prefer to make regular dietary
modifications.
Vitamins and Minerals
Vitamins are chemical compounds, which can only be sourced through dietary intake. They
enable the normal functioning of the body and promote growth and development. Vitamins
are available in a wide range of foods, which is why a diverse range of food is needed to
meet the RDIs of each one.
Minerals are also chemical compounds, which play a similar role in the body. They are also
normally sourced through the food eaten in a regular diet, but can be supplemented if
needed. Deficiencies of some minerals can have a direct and adverse effect on the health
and performance of certain athletes. Minerals of significance include:
Iron
Calcium
Protein
Protein is required for the growth, repair and maintenance of muscle tissue. Athletes must
ensure they eat sufficient amounts of protein to aid recovery and promote growth of muscle
tissue. This is especially important for athletes who are undertaking strength training or highintensity interval training. Good food sources of protein include lean meat, dairy products,
nuts and eggs.
Caffeine
Caffeine is a stimulant, which speeds up the Central Nervous System. It is normally
consumed through chocolate, coffee, cola drinks and advertised energy drinks. It is also
available in the form a caffeine tablets. The supposed benefits of caffeine for athletes include
increased alertness, decreased perception of fatigue and the mobilisation of fat cells leading
to glycogen-sparing. Possible negative side effects include an elevated heart rate, overarousal and uncontrolled muscle twitches leading to decreased fine-motor control. In highdoses, it also acts as a diuretic, leading to dehydration.
Creatine
Creatine is a fuel source, which is stored in skeletal muscles. It is produced partly in the
body cells, but regular intake of protein, especially from meat sources, ensures the RDI for
Creatine is achieved. Its role is to assist in the production of Creatine Phosphate, which is
the fuel source for the replenishment of ADP back into ATP. This is commonly known as the
ATP-CP Energy System, which provides for ATP regeneration during short bouts of powerful,
high-intensity exercise, such as 100m sprints or shot-put. Athletes who either train for these
types of sports or undertake a heavy resistance-training program, may achieve training
benefits such as increased lean muscle mass and improved performance levels.
Recovery Strategies
Physiological Strategies
Both active recovery exercises and appropriate nutrition are important factors in restoring the
body to a pre-event condition, allowing the athlete to prepare for the next training session or
game as quickly as possible. Examples include:
Hydration
Nutrition
Cool Down
Stretching
Neural Strategies
Intense physical activity is very taxing on the muscular system, but also the Central and
Peripheral Nervous System. These neural strategies are aimed at relaxing the body and
muscles, reducing the perception of localised muscle fatigue as well as decreasing general
mental fatigue.
Hydrotherapy
Massage
Tissue Damage Strategies
Following intense physical activity and competition, it is common for athletes to suffer from a
variety of levels of tissue damage. This can range from microscopic muscle tears as a result
of heavy resistance training, to bruises and minor sprains and strains, right through to more
significant soft-tissue injuries.
Cryotherapy
Psychological Strategies
The pressure involved in participating in elite sport can be immense, and this can come from
both internal and external sources. For an athlete to maintain good mental and emotional
health, as well as manage their levels of motivation and anxiety, a range of personal
strategies can be employed to achieve this
Relaxation
Sleep
Certain genetic features can provide a varying degree of advantage with regard to the
potential for success. Specific inherited factors, which may be influential, include:
Muscle Fibre Type
Body Shape
Gender
Confidence
Whilst this is a personality trait, it stands alone as making a significant contribution to
sporting success at the elite level
Prior Experience
Certain sports have common characteristics, which can enable a person to transfer their
ability from one sport, and quickly adapt and learn the specific skills and tactics in another
sport. Some factors that can be transferred from one sport to another include:
Motor patterns
Ability
Some people seem to have a natural ability at sport, which is most evident in the rate that
they move through the stages of skill acquisition. They almost seem to be dominant in any
game they play. Some of the factors that may underpin this phenomenon include spatial
awareness (awareness of who and what is around them), kinaesthetic sense (awareness of
the bodys position in space), tactical awareness (awareness of what equipment should feel
like as it makes contact with the body), coordination (ability to move multiple limbs with
timing and precision e.g. hand-eye or foot-eye coordination), fast reaction time and
perceptive senses (enhanced sensitivity of the senses, especially during fast-paced sports)
Serial Skills are a combination of a range of discrete skills into one whole movement.
Team sports are require serial skills as an athlete is constantly using a variety of skills in
competition
Continuous Skills have no clear beginning or end, and the point at which they start or
end is at the discretion of the athlete, such as going for a run or swim