impact of research on australia's health
DESCRIPTION
A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, at the Clinical Research Excellence Conference - Melbourne 5 Aug 2010TRANSCRIPT
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IMPACT OF RESEARCH ONAUSTRALIA’S HEALTH
Clinical Research Excellence ConferenceMELBOURNE –
5 August 2010
Professor Jim Bishop AOChief Medical Officer
Australian Government Department of Health and Ageing
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Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
7538
5004
4627
42104079 4063 3970
3793 3737 3696 36773540 3470
3359 33533129 3060 3008 2902 2870
2729 2687 2683
2151
1801 1781 1737
14371213
999852 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 2010How Does AUSTRALIA Compare
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Health Expenditure as a share of GDP, OECD Countries
16.0
11.210.7 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 6.96.5
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
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AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
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SELF-ASSESSED PHYSICAL &MENTAL HEALTH, 2007
Source: AIHW Australia’s Health 2010
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BROAD CAUSE MORTALITY TRENDS AUSTRALIA
Source: AIHW
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Source: AIHW Australia’s Health 2010
AGED ADJUSTED DEATH RATESFrom CVD, 1907 -
2006
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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
Egypt
Viet N
amTurk
eyInd
iaChinaRuss
iaSou
th Afric
aGreec
eBraz
ilJa
pan
Czech
Rep
ublic
Italy
United King
domCana
daGerm
any
Sweden
New Zealan
dUSA
Austra
liaM
orta
lity-
to-in
cide
nce
ratio
MalesFemales
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Changes in Deaths rates in Males using Joinpoint
Analysis
Source: Tracey et al –
Cancer Institute NSW
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Changes in Deaths Rates in Females Using Joinpoint
Analysis
Source: Tracey et al –
Cancer Institute NSW
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Cancers with reducing death rates 1997 to 2006 –
all ages
Lung, -18.5Colon, -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 FemaleSource: Tracey et al, Cancer Institute NSW
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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
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CANCER
Milestones in Survival Improvement
Prevention –
Tobacco control
Early detection •Screening•Interventions
Better treatments –
medical researchClinical trials of better approachesEvidence based standard practice
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PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010
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TRENDS IN LEADING CAUSESOF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010
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Changes in Incidence Rates for all Cancer in
Males using Joinpoint
Analysis
Source: Tracey et al –
Cancer Institute NSW
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Changes in Incidence Rates in Females using Joinpoint
Analysis
Source: Tracey et al –
Cancer Institute NSW
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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
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AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
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SMOKING IN AUSTRALIA
SMOKINGSTATUS
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
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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
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OBESTITY INCREASING FOR ALL
Source: AIHW: Australia’s Health 2008
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Increased Risk Body Fatness OesophagusPancreasColorectalBreast (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
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Source: AIHW Australia’s Health 2010
PROPORTION OF ADULTS WITH HIGH BLOOD PRESSURE
1980 to 1999-2000
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Source: AIHW Australia’s Health 2010
CHRONIC PULMONARY DISEASEMORTALITY 1980 to 2007
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Source: AIHW Australia’s Health 2010
DEATH RATES FROMINFECTIOUS DISEASES, 1922-2007
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Source: AIHW Australia’s Health 2010
PREVALENCE OF CURRENT ASTHMA 2007-08
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Source: AIHW Australia’s Health 2010
PREVALENCE OF TREATED ENDSTAGE KIDNEY DISEASE 2000-2007
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NSW Population Age Distributions,
Males (1977-2036)
Source: Cancer Institute NSW
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Total Cancer Cases and Deaths per year (1972 to 2036)
Source: Cancer Institute NSW
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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
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BREAST CANCER MORTALITY
NEJM 2005Source: New Engl.Journ. Med: 353:17
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Projected YLLs
–
Three scenarios, Australia –
1980 to 2016
Source: Bishop et al –
Cancer Institute NSW
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NON-COMMERCIAL CANCER RESEARCH EXPENDITURE, 2004
(A$ per CAPITAL)
Source: Eckhouse
et al (2007), ABS
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PRIORITY HEALTH AREAS
SOURCE: NHMRC Research funding 2010 facts book
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CANCER PUBLICATIONS
Australia
Growth* World
AustralianShare
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
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CLINICAL GUIDELINESSupports for Clinical Decision Making
Evidence Base
Highest Impact
Range of best practice tools
Successful implementation methods
Monitor and report
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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
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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