Mariam

El-Masry

Health Priorities in Australia

How are priority issues for Australias health identified?

Measuring health status; role of epidemiology, measures of epidemiology (mortality,

infant mortality, morbidity, life expectancy)

Role of Epidemiology
- refers to the study of health and disease in a population and its sub-groups over a
period of time
- the study of patterns of illness & disease in a population
- provides vital information for governments and health organisation by showing the
patterns of health and disease as well as the use of health services by the population in
which they operate
- Epidemiology aims to:
o Identify the risk factors of a disease
o Determine the extent of the disease within a population group
o Evaluate prevention strategies
o Provide suggestions for public policy
Measures of epidemiology
Mortality
- mortality rate means the number of deaths from a specific cause or in a specific
population over a period of time (usually a year)
- straightforward measure that can be used to determine the major cause of death in a
given population
- can determine trends in causes of death across age, gender, years and other population
sub-groups
- stats from 2010 ABS and Australian Institute of Health and Welfare reports indicate:
o majority of these deaths were people aged 75+ = 65%
o deaths rates for males were 1.4 times higher than for females
o leading death for both males and females was coronary heart disease followed by
lung cancer for males and strokes for females
Infant mortality
- the number of deaths in the first year of life per 1000 live births
- high infant mortality rate lowers life expectancy, low infant mortality rate contributes
to increased life expectancy
- rate is continuing to decline infant mortality rates among Indigenous Australians are
also declining however remain significantly higher than the general popularion
- global infant mortality has declined, this can be attributed to:
o improved education about natal care
o improved support services for newborns and births
o improved sanitation and technology
o improved diagnosis and treatment
o immunisation programs
Morbidity
- the incidence of illness, injury and diseases that do not result in death in specific
population
- prevalence and incidence data gives a much broader picture of Australias health than
mortality rates
Life Expectancy
- measure of how long, on average, a person is expected to live
- has increased dramatically over the last century, continues to increase

Mariam El-Masry

boy born in 2008-10 can expect to live for 79.5 years, girl 84 years
ATSI life expectancy is much lower than non-indigenous Australians
o 12 years for males, 10 for females
- Improvements in life expectancy can be attributed to:
o Improvements in medical knowledge and treatments
o Reduced smoking rates
o Improved working conditions and better health education

Limitations
- Providing accurate representation of health inequalities within population sub-groups
- Providing reasons why these inequalities exist
- Providing a measure of the impact a disease or injury can have on quality of life
- Measuring socio-cultural, environmental, socio-economic and individual impact on
health
Limitations in data collection include:
- Insufficient sample size
- Unreliable data e.g. self-reporting
- Unstandardized measures being used
- Multiple sources of information

Identifying priority health issues: social justice principles, priority population groups,

prevalence of condition, potential for prevention and early intervention, costs to the

individual and community


- Despite considerable improvements in Australias overall health over the years, there
are still certain groups that experience higher rates of ill-health
- Governments + health authorities need to identify and prioritise health issues based on:
o Which specific groups are experiencing higher rates of ill health / health
inequality
o What constitutes the burden of the disease on individuals and the community
o What exists reduce this burden
Social Justice Principles
- involves identifying areas where health inequalities exist + providing resources &
support to eliminate these inequalities
- health promotion is successful when inequalities are addressed using principles of
social justice
- health inequalities are identified by comparing prevalence + incidence + morbidity +
mortality rates among specific population groups
o recognising these differences ensures these groups are provided with the
opportunities to achieve optimum health
- also consider culture + religion + age + gender + sexuality + SES + history + language
o this helps direct development of health promotion to cater for the needs of
population groups
Priority population groups
- modern Australian society is very diverse, has many sub-groups with differing health
statuses
- identifying population groups that are experiencing ill-health enables governments to:
o gain a better understanding of the impact of socio-cultural, socio-economic and
environmental factors on health
o identify and guide further epidemiological research
o plan and implement specific interventions

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epidemiology highlights there are multiple sub-groups that are experiencing higher
rates of ill-health for specific health problems:
o Indigenous people
o People in rural and remote areas
o Socio-economically disadvantaged people
o Veterans
o Prisoners
o Overseas-born people
Prevalence of condition
- refers to the current number of cases of an illness or condition
- identifying mortality and morbidity rates as well as causes + trends can help to
determine the urgency with which conditions need to be addressed
- Cardiovascular disease (CVD): although its incidence is declining, its still the leading
cause of death in Australia
- Cancer is the second most common cause of death, incidence of certain cancer is
increasing
- Injury is the leading cause of death for people aged 1-44, injury mortality is decreasing
- Mental health problems prevalence has only been recently noted
- Asthma: despite increase in incidence and severity, increased awareness and
management has lead to decrease in number of deaths related to asthma
Potential for prevention and early intervention
- a significant proportion of the morbidity and mortality associated with chronic diseases
could be reduced through behavioural change + supportive environments
- this is difficult due to environmental factors such as employment status, housing &
access to health services and information
- in order to reduce major causes of mortality and morbidity supportive environments
must be established to encourage and support individual behaviour change
o e.g. risk factors for CVD (hypertension, smoking, overweight, high cholesterol,
sedentary lifestyle) are able to be modified mortality + morbidity associated
with CVD could be reduced significantly
- early intervention can also decrease the burden of disease by maximising opportunities
for effective treatment and full recovery
o e.g. cervical cancer is one of the most preventable and curable cancers
o National Cervical Screening Program rose awareness + increase number of
women having regular pap smears = great success in prevention and survival
rates
Cost to the individual and community
- there are many factors to consider when looking at the cost of ill-health to individuals
and the community
- financial cost can be split into direct and indirect costs
Direct Costs
- those that can be measured
- includes money spent on prevention, diagnosis and treatment
- hospital admissions, length of stay in hospital, prevention strategies, cost of medical
services/treatment and pharmaceutical prescriptions can be used to estimate direct
costs
Indirect costs
- difficult to measure quantitatively and accurately
- incl. reduced quality of life and relationship breakdowns associated with ill-health
- emotional well-being is often significant affected > reduced self-esteem, social isolation
and depression
- partial loss of independence also a significant indirect cost

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cost to the community of loss of productivity from work due to ill-health + costs
associated with training replacement workers

What are the priority issues for improving Australias health?
Groups experiencing health inequalities: Aboriginal and Torres Strait Islanders (1)
-

ATSI make up 2.5% per cent of the population yet experience significantly ill-health &
higher rates of premature death than other Australians
- current data, although more comprehensive and accurate than ever, is limited
o this is because only 33% of ATSI peoples live in capital cities = difficulties in
gathering data, analysing information
Nature & Extent of the health inequalities
- with significantly lower life expectancy and higher hospitalisation rates, rates of suicide
and many other diseases and illness the GAP between Indigenous and non-Indigenous
health is a major cause for concern
- overall, Indigenous population is much younger than non-Indigenous population =
median age of 21 compared to 36
o this is reflective of higher death rates, 1.9x higher than non-Indigenous
populations
o subsequent lower life expectancy
Causes of death
- ATSI have rate of avoidable death 3x higher than the rest of the population
- 2010: leading cause of death for ATSI males and females were coronary heart disease
- followed by suicide for males and cerebrovascular disease for females
- compared with non-Indigenous Australians, ATSI peoples experience higher death rates
from all causes
o almost 2x as likely to die from heart disease
o 6.4x more likely to die from diabetes
o 2.7x more likely to die from suicide
o almost 5x more likely to die from cirrhosis or other live-related diseases
o 3x more likely to die from respiratory disease
o 2.9x more likely to die from infections and parasitic disease
o 2.8x more likely to die in land transport accident
- infant mortality has decreased in the past 12 years, but is still significantly higher than
non-Indigenous population
Other health conditions
According to National ATSI Health Survey 2004-05, ATSI were:
- Twice as likely to report their health as fair or poor
- 5x higher rates of hospitalisation
- 1.3x to suffer heart or circulatory disease
- 10x more likely to suffer from kidney disease
Between 2001-05:
- rates of asthma decrease
- back and hearing problem incidence decrease
- 71% ATSI reported being happy, or calm and peaceful most or all of the time
Sociocultural, socioeconomic and environmental determinants
Most critical challenges for ATSI peoples include the following:
Lower Incomes

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nearly half of Indigenous households were in the lowest income quintile

<5% were in top income quintile
median household income for indigenous families is just over half the median
household income of non-Indigenous families
Higher rates of unemployment
unemployment rate (as of 2011) was 3x higher than non-Indigenous

Lower educational attainment
lower rates of school retention across all grades
o this is improving: gap of 50% between Indigenous and non-Indigenous Year 12
retention rates has decreased to 30%
lower rates if achievement in minimum standards of literacy and numeracy
ATSI who did attain higher level of schooling rated their health as higher
Lower rates of home ownership
proportion of ATSI families who owned their home was half that of other Australians
rate of homelessness among ATSI 4x higher
Less access to transport
51% have access to motor vehicle compared with 85% non-Indigenous population
Family Structure
ATSI children twice as likely to live in 1 parent households
Being a child in a 1 parent family has been linked to low SES, low educational
attainment and lack of support
Remoteness of some communities
Lack of indigenous role models in communities

2008 AIHW Report on Aboriginal Health and Welfare emphasises that the social
determinants mentioned increase likelihood of exposure to the following health risk
factors:
- tobacco use
- alcohol consumption
- illicit drug use
- overweight and obesity
- poor nutrition
- physical inactivity
- poor housing conditions

Role of individuals, communities and governments in addressing the health inequalities
- most effective way to improve health of ATSI is through a collaborative and considerate
approach
Close the Gap
- implemented in 2008, aims to reduce Indigenous disadvantage in life expectancy, child
mortality, education and employment by 2030
- significant element was commitment to involve ATSI peoples and their representative
bodies in all aspects of the campaign
- the government at all levels would be partnering with ATSI communities to build on
their ideas, strengths and leadership = sustainable solutions to longstanding problems
- empower ATSI people + ensure delivery of culturally appropriate programs
Aboriginal Healthy Lifestyle Program
- aimed at improving the lifestyles and reducing risk factors for chronic conditions within
the local Aboriginal community through:
o organising education /awareness workshops and activities to highlight the risks
of chronic health diseases

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o promoting existing health services and linking clients to appropriate services

o attending the initial appointment at local health services
o providing ongoing support and assistance to Indigenous clients with chronic
health diseases
o ensuring clients are equipped with the tools to self manage their chronic health
disease
o assisting with education/training in use of medical equipment

Groups experiencing health inequalities: People in Rural and Remote Areas

(2)


Nature and Extent of Health Inequities
- 29% of Australian population lives in rural areas and a further 3% live in areas
classified as remote
- rural arrears are outside metropolitan areas that have lower populations and are
further from major cities
- remote areas are significantly removed from major service centres
- people living in rural and remotes areas experience a range of health inequities due to
their geographical isolation
- experience limited access to goods and services, fewer educational and employment
opportunities
Rural, Regional and Remote Health Report identified the following:
- death rates in inner/outer regional areas were about 10% higher than those in major
cities
- death rates in remote and very remote areas were between 20% & 70% higher than
those in major cities
Compared with city-dwellers, people in rural and remote areas:
- experience similar levels of diabetes, cerebrovascular diseases (stroke), coronary heart
disease, depression and anxiety
- experience slightly higher levels of cancer in rural areas, but lower levels of cancer in
remote areas
- are more likely to suffer acute or chronic injury
- experience lower life expectancy, increasing with remoteness
- are less likely to report very good or excellent health
- are more likely to show high levels of psychological distress among males
Socio-cultural, socio-economic and environmental determinants
- long distances between population centres and sparse population distribution can
result in problems in providing adequate health services and difficulty in accessing
them
- there are fewer educational and employment opportunities available
o contributes to low SES and income + feeling of loss of control
- many people in smaller isolated communities have lower levels of access to real jobs
and greater reliance on social security = less control over their lives = higher levels of
stress
Link between health status and income:
- incomes of rural families on average 20% lower than incomes of those in metropolitan
areas = limit aspects of life such as food choices + health care options
- those involved in farming rely heavily on the environment
o poor seasons can affect income and place great stress on families > could lead to
harmful behaviour such as drinking or suicide

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also suggested that limited social venues in rural areas are an underlying factor in
higher rates or risky drinking
o local pubs and sporting clubs are among few social venues = encourages
socialising to take place with alcohol
- significant parallel between ATSI health and health status of those living in rural and
remote areas as almost of those living in rural and remote areas are Indigenous
- people living in rural/remote areas have been reported to display higher levels of risk
behaviours that may contribute to lower levels of health
o more likely to smoke,
o drink alcohol in risky quantities in the short term
o be overweight or obese
o consume less fruit and vegetables than the recommended serves per day
o experience lower birth weights, particularly among teenage mothers
Roles of individuals, communities and governments in addressing health inequities
Rural communities experience great difficulty in sustaining adequate health and medical
services for their members.
- difficulties attracting and retaining staff = for this reason, many health-care facilities in
rural/remote areas are multi-purpose
o allows communities to target services to the specific needs of community,
integrate services, reduce running costs & staffing needs
- National Rural and Remote Health Program focuses on educating health practitioners
about the specific needs of rural communities + training remote health care workers to
be able to adequately provide those needs + financial incentive
- Focus on psychological support to those in the rural health workforce
- Funding to NGOs & community health services is provided through NSW Rural Health
plan
- Health Direct Australia: telephone advice line staffed by registered nurses to provide
health information and advice 24/7/365
- Patient-Assisted travel schemes: financial assistance available for transport and
accommodation costs for those who have to travel over 100km to access specialist
medical care
- Mental Health Services in Rural and Remote Areas (MHSRRA): provides funding to nongovt. health organisation such as Royal Flying Doctor Service and Aboriginal Medical
service to help in provision of mental health

High levels of preventable chronic disease & injury: CVD, cancer & injury


Cardiovascular Disease (CVD)
Nature of CVD
- term used to describe all conditions and diseases of the heart and blood vessels
- there are 3 types of CVD in Australia:
1. Coronary heart disease, takes 2 main forms:
- angina: temporary loss of blood supply to the heart, which results in periodic chest pain
- heart attack: results from a sudden blockage to the hearts blood supply, which causes
damage to the heart and its function
2. Stroke: occurs when theres a blockage in the vessels that supply blood to the brain or
those vessels rupture and begin to bleed
3. Peripheral vascular disease: occurs when there is poor blood supply to the limbs
(peripheries)
- majority of CVDs, the main underlying cause is atherosclerosis

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atherosclerosis is the build up of fatty and fibre-like deposits on the inside walls of the
arteries
o this makes the arteries hard and less elastic
o increase in plaque = increase in blood pressure
- these build-ups occur over a long period of time and are most dangerous when they are
located in the arteries that supply the heart, brain & legs
Extent and trends in CVD
- CVD has been the leading the cause of death for the past 10 years
- Causes ~30% of all deaths nationally
- 2011: leading underlying cause of death was coronary heart disease
- 2011: second leading underlying cause was cerebrovascular disease, decreased in the
last 10 years
- proportion of people with heart disease increased with age, with more than 25% of all
Australians over 75 suffering CVD
- highest rate is in men 85 over
- survival rates for heart attacks increasing for both males and females BUT males are
twice as likely to have a heart attack
- heart disease more common among men than women
- proportion of people with heart disease increase with level of disadvantage = people
living in areas of disadvantage more likely to have heart disease
Risk factors and Protective factors
Risk factors can be modifiable and non-modifiable:
Non-modifiable:
- Age: risk increases with age due to the aging of the heart muscle = reducing efficiency of
the heart may compound problems and decrease treatment effectiveness
- Family history: people with family history of CVD, especially 1st-degree blood relative
tend to be more likely to develop CVD
- Gender: men are more at risk of developing CVD than females (before menopause), this
is thought to be to protective nature of oestrogen hormone
Modifiable:
- high blood pressure: due to increased stress placed on the heart and blood vessels,
leading cause of CVD worldwide
- smoking: thought to be responsible for 10% of all CVDs, doubles the chance of a heart
attack or a stroke
- obesity and overweight: directly increases the risk of CVD + high blood pressure, high
blood cholesterol and diabetes
- physical inactivity is linked with other risk factors such as high weight & poor diet,
which are also risk factors
- high blood lipid levels: higher levels of blood cholesterol increase risk of heart disease
and stroke, due to increased risk of atherosclerosis
- nutrition: a diet in high saturated fat linked to high blood lipid levels and high in salts
linked to hypertension
- high alcohol intake: 2+ drinks a day weakens the heart muscle
Protective factors:
- regular physical activity
- avoiding smoking or exposure to tobacco smoke
- good nutrition that includes a die low in saturated fats and salt, and high in fruits and
vegetables
- managing a healthy weight
- managing stress in positive ways
- low consumption of alcohol
- regular check ups, incl. monitoring blood pressure and cholesterol

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Socio-cultural, socio-economic and environmental determinants of CVD

- recent statistics from ABS show that as the level of SES decreases, the rate of CVD
increases
o largely due to the increased risk behaviours (smoking, obesity, physical
inactivity)
o lower level of education linked to CVD, as less education is linked to poor health
choices and diminished knowledge about health services
- social and cultural environment can also influence likelihood of developing CVD
o ATSI have higher rates of CVD than the rest of the population due to lower SES
and lower levels of educations = involvement in high risk behaviours such as
smoking ad excessive drinking
o In contrast, Asian population have been shown to have lower levels of CVD
- Geographical location; people living in rural remote areas have higher rates of CVD
because less access to health services and info + higher rates of smoking and excessive
drinking

Groups at risk of developing CVD

tobacco smokers
people with a family history of CVD
people with hypertension
people with high blood lipids
males
people who are sedentary
ATSI people, low SES and those living in rural and remote areas

Cancer (skin, breast and lung)
The nature of cancer
- refers to a group of diseases that result from the uncontrolled growth of mutated body
cells
- benign tumour is not considered harmful as it remains local and can be surgically
removed
- malignant tumour is one that has spread, or has the ability to spread and is cancerous
- carcinomas cancers that develop in the skin or the cells that line/cover internal
organs
- sarcomas cancers that develop in connective + supportive tissue such as bone, muscle
and cartilage
- hematopoietic cancers that begin in blood forming tissue such as bone marrow, do
not form tumours
The extent of cancer in Australia
- prevalence of cancer in Australia is increasing = 120 000 new cases diagnosed each year
- There are a number of reasons for this trend, including:
o advancements in methods of detection for example, mammograms for breast
cancer, pap smears for cervical cancer
o increased awareness of warning signs and more widespread use of personal
detection for example, breast self-examination and skin checks
o ageing population the risk of developing cancer increases with age, so having a
larger population of older people means more cases of cancer
o increased exposure to risk factors for example, ultraviolet (UV) radiation and
higher rates of obesity
- different trends in prevalence of certain cancers:

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o From 1991, cervical cancer, lip cancer and stomach cancer have all shown
decreases in incidence
o Lung cancer incidence decreasing in males but increasing in females as smoking
rates in females peaked later than in males.
o Rates of breast cancer rose between 1991 and 1995 with the introduction of
national screening programs in women, but since stable
- While there have been overall increases in incidence, mortality rates are decreasing
o Mortality rates for lung cancer showed a decrease for men but an increase for
women > can be due to the changes in smoking habits for men and women
o Mortality from bowel cancer has decreased for both men and women
o Both prostate and breast cancer mortality rates have decreased
- can be attributed to advances in detection techniques, increased screening programs
and greater awareness, which has led to earlier detection and a better prognosis for
treatment and survival






Risk factors and protective factors
Skin Cancer:
- main cause of skin cancer is exposure to UV radiation
- other factors that have been associated with an increased risk of skin cancer include:
o exposure to sun during childhood
o having a fair complexion, light-coloured, blond or red hair and/or fair skin that
freckles or burns easily
o a family history of melanoma
o having several large or many small moles
- Protective factors for skin cancer include
o monitoring moles and freckles
o limiting exposure to the sun by wearing sunscreen, a hat, protective clothing and
sunglasses
Breast Cancer:
- major risk factor is gender + age with risk increasing from one in 250 at the age of 30 to
one in 30 for a woman over the age of 70
- women who have a close family relative with breast cancer are twice as likely to
develop breast cancer themselves as someone who does not
- some risk factors are related to lifestyle choices, and include being overweight or obese,
consuming over three alcoholic drinks per day and a later maternal age (over 40 years)
- Protective factors include practising regular self-examination and regular
mammograms when over the age of 50, as well as leading a healthy lifestyle physically
active, balanced diet and not drinking excessive amounts of alcohol

Lung Cancer:
- largest risk factor is smoking, the longer the person has been smoking the higher chance
of developing lung cancer
- factors that may contribute to a higher risk include occupational exposure to
carcinogens such as asbestos and lead, and exposure to pollution and second-hand
smoke.
- Protective behaviours against lung cancer include not smoking or quitting and avoiding
exposure to asbestos etc.

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Socio-cultural, socio-economic and environmental determinants of cancer
- family that has healthy eating habits, exercises regularly and practices safe behaviours
such as covering up in the sun reduces the risk of cancer
- family history of cancer especially a member of the immediate family increases the
risk of cancer
- Some cultural groups experience higher rates of cancer i.e. Aboriginal and Torres Strait
Islander peoples have higher rates of lung cancer, as they have higher rates of smoking
and less access to health services
- Jobs that involve exposure to harmful substances such as asbestos may increase the risk
of lung cancer
- working jobs that involve regular exposure to the sun are more prone to skin cancer
- decreased access to health services, limited options for food and physical activity, and
decreased awareness of risk and protective behaviours = higher death rates from cancer
- People living in rural and remote areas are more at risk due their geographical distance
from health services that limit their access to protective services such as pap smears,
breast screening and prostate tests

Groups at risk of cancer

Lung Cancer:
- smokers
- men and women over the age of 50
- people with occupational exposure to carcinogens such as asbestos or lead
Breast Cancer:
- women past menopause
- women who have never given birth or who first gave birth over the age of 40
- women who are obese
- women with a direct relative who has, or has had, breast cancer
- women who do not self-examine their breasts
Skin Cancer:
- people with fair skin who tend to freckle or burn easily and/or blond or red hair
- people who have an outdoor occupation and are frequently exposed to the sun
- people who have spent too much time in the sun without protection

A growing and ageing population

-

ageing population refers to the fact that the number + proportion of older people in the
population is increasing
- increase is driven by a declining birth rate beyond replacement + increased life
expectancy
Healthy ageing
- behaviours that reduce the risk of illness and disease in older people
- healthy ageing is concerned with quality of life, independence and lengthening the
number of healthy years enjoyed by an individual
- benefits: prevention of disease & functional decline, extended longevity and enhanced
quality of life
- healthier the person, less demand that person places on health and aged care facilities

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older people have a wealth of skills & experiences that benefit society healthy ageing
means these skills & experiences can be utilised for longer
Increased population living with chronic disease and disability
- challenge of an ageing population is the increasing pressure that will be placed on the
health care system as a result of higher number of people living with chronic
disease/disability
- improvements to health behaviours can prolong life and postpone the age of onset of
disability
- prevention and detection strategies, improved technology and pharmaceutical
advances, improved surgical strategies and better social, cultural and economic
environments e.g. income, education and working condition
- other diseases/disability e.g. dementia can not be cured/prevented & will place
significant pressure on health-care system
o it is expected that sufferers of dementia will increase significantly = pressure on
carers, health services and government funding
o a large proportion of these people will require full-time care & accommodation
Demand for health services and workforce shortages
- those aged 55+ are the heaviest consumers of medical services
- older population is reliant on workers and taxpayers for support BUT growth in number
of people in workforce is expected to plateau
- to meet the demands of the growing & ageing population, health services will need to
expand dramatically
o more specialist health professionals, GPs & emergency services such as
ambulances, public services + housing for people who require assistance
Availability of carers and volunteers
- as population ages he number of people requiring informal care, at home and in their
community, is expected to increase, while the number of available carers declines
- number of aged people needing care is projected to rise by 160 per cent
- shortfall of informal primary carers will increase 5x
- The degree to which a carer is needed will vary significantly depending on the
individuals level of mobility and their degree of disability
o With an ageing population + increasing chronic disease/disability more cares &
volunteers are needed
- There are many providers of aged care in our community, including aged care homes
and retirement villages, private organisations, charitable organisations and communitybased care facilities
What role do health care facilities and services play in achieving better health for all
Australians?

Range and types of health facilities and services

Hospitals
Public Hospitals
- operated and funded by state and Commonwealth governments & provide highly
specialised services
- emergency, inpatient and outpatient services are free under Medicare
- services provided commonly include allied health such as dietetics, oncology, dental
obstetrics, radiology & pharmacy
Private Hospitals
- Owned by individuals/community groups
- Same treatment as public hospital, provided they have private health insurance

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- Tend to perform more elective procedures (not emergencies) e.g. ENT

Primary Care and Community Health Services
GP
- General practice plays an integral role in primary health care
- GPs diagnose, treat and manage health complaints, provide preventive advice and care,
prescribe medicines, and refer patients to other health professionals, hospitals and aged
care
Other health professionals/services (specialists +)
- specialists provide services in private practice as well as medical services for private
patients in public and private health
o e.g. obstetrics, dermatology
- recent government initiative has been the establishment of HealthDirect Australia a
telephone advice service staffed by health professionals
o use of specialist software that provides advice and information +
recommendations if further help is required
- Community health-care services include those provided through local health services or
governments
o services like community nurses, womens health services, immunisation
program implementation, rehabilitation programs and preventative health
education
Public Health
- Public health services focus on prevention and health-promotion strategies rather than
treatment, and are aimed at populations not individuals
- strategies focus on addressing the behaviours and factors that cause ill- health, and
promoting behaviours associated with good health
- use a variety of methods: health education and advertising campaigns, , immunisation
programs > promote healthy lifestyle choices and behaviours
- Specific examples include cancer screening initiatives for breast, bowel and cervical
cancers

Responsibility for health facilities and services

Governments
Commonwealth Government
- focuses on generating and allocating funding to the health-care system and the
development of national health-care policy
-