PDHPE

How are priority issues for Australia's health identified ?

The study of epidemiology is the study of why a country is sick. The rate of illness in a population.

The 4 main measures are Life expectancy = the average number of years someone is expected to live. Mortality = is the number of deaths in a group of people from a disease over a specific time period. Morbidity = the rate of disease in a population. Infant mortality = death rates of children before the age of one.

Limitations of epidemiology ● It does not show the health variations in sub groups. ● Does not explain why these inequities exist● Does not account for the health determines ● Does Not provide the whole picture people with mental illness or disabilities.

What does it tell us? Epidemiology tells us the basic health status of Australia in terms of quantifiable measures of ill health. This data is gathered and used to provide trends in disease incidence and prevalence along with information about ethnic, socioeconomic and gender groups. Epidemiology uses data on death rates, birth rates, illnesses, injuries, treatments provided, work days lost, Hospital usage, and money spent by both consumers and the government

Causes of death in Australia. Cancer 29.2Diseases of the heart and blood vessels 27.7Diseases of the respiratory 9.3External causes 6.8Mental and behavioural disorders 6.3

Prevalence - the diseases that are occurring and causing problems now. Distribution - the extent of the diseaseIncidence - The number of new cases that are found

Who uses it ? Researchers, health department officials, the government, and health or medical practitioners use epidemiology. This data is used to help identify priority health issues and possible causes of disease or illness.

Identifying priority health issues

Social justice principles - these principles relate to eliminating inequity in health, promoting inclusiveness of diversity and establishing supportive environments for all Australians.

Money must be put into different resources that will result in the greatest changes. Problems cannot all be fixed at one. By applying the principles of social justice we can determine the impact these principles have on reducing health inequities and improving the health of a nation.

Equity - The fair allocation of resources and entitlements without discrimination. Diversity - involvement of the community in making decisions about health, considering the context of the community. Supportive Environments - the physical and social aspects of an environment that affect where people work, live, and participate in leisure activities.

Priority population groups - Are the groups that experience highest levels or are at greatest risk of a particular disease, illness or injury.

We must have knowledge and be able to understand information about sub groups in society. We must be able to

● Determine the health disadvantages of groups within a population. ● Better understand the social determinants ● Identify the prevalence of the disease

Furthermore, there are many chronic diseases that can be prevented and have potential for early intervention. These diseases cost Australia millions in healthcare and include diseases such as diabetes, cardiovascular disease and other conditions such as cancer.

Some subgroups can be indigenous people, people who have a low SES people, people living in rural locations, the elderly, people living with a disability and sometimes men who are at much greater risk of developing certain diseases

Groups that show unusually high incidence to illness and diseases require strategic action. Epidemiology tells us that some population groups are significantly disadvantaged compared to others. Some strategies that are already utilised are

● Funding to the RFDS for aeromedical emergency health care and community health clinics in remote areas.

● Incentive programs for medical practitioners ● 17% more funding to Indigenous health services

These disadvantages cann all be linked to either low SES, sociocultural or environmental determines.

Prevalence of the condition - Is the current number cases of a disease or illness in a population at a particular given time. The higher the prevalence the higher the priority.

It helps to identify risk factors, that can call forward action in a particular health area. High prevalence rates of a disease indicate that the health and economic burden that the disease or condition places on the community.

CVD : is the leading cause of death in Australia Cancer : Second largest leading cause of death in Aus, And the greatest burden of disease in Aus, Advances in treatment and diagnosis have led people living and surviving for longer. Diabetes : Respiratory diseases : Have amongst the highest levels of morbidity in the world. One of the most common reasons for the hospitalisation of school children. Mental Health : Affects as many as 1 in 5 people in Aus, Currently third greatest burden of disease in Australia. Injury : Mortality is on the decrease. It is currently the greatest cause of death in the first half of life. Fourth greatest burden for disease in Australia.

Potential for Prevention and early intervention - For changes to occur and sickness and illness to be reduced we must address both individual and environmental determinants. Most of the chronic illnesses, mental health and injuries have social and individual determines that can be modified. So prevention of an illness can lead to improved health outcomes for individuals.

Potential for early intervention means ability to avoid the condition from occurring.

Costs to the individual and the community - Costs include : money, time, time off work, mental health, interdependence.Cancer is a high cost while arthritis is not. If an individual is i njured or sick it will significantly reduce their ability to be productive they won't be able to work and money for rehab may be more than the individual can afford. The emotional health and social upheaval all that often result in illness and injury are another burden. Illness disease and death all an economic burden on the community. We don't see how there mental health has been affected.

It will either result in direct costs or indirect costs Direct costs : money spent on diagnosing, treating and caring for the sick. Plus the money spent on prevention. Indirect costs : the value of the output lost when people become too ill to work.

Focus Question 2.What are the priority issues for improvingAustralia’s Health?

Groups experiencing health inequities

● Aboriginal and Torres Strait Islander peoples● Socio-economically disadvantaged people

Trends for ATSI people / Nature and extent of health inequities.: ● Experience one of the largest gaps in health outcomes in Australia. ● Have a 50% smoking rate compared to 30% for normal Australians.● Only 30% live in cities● 41% of indigenous smoke compared to 18%● Just over 1 in 5 were studying for educational qualifications ● 8% had educational involvement ● 16% are unemployed compared to 5% for non indigenous. ● Life expectancy for indigenous is almost 10 years lower than non indigenous. ● Have higher rates of death, diabetes, obesity and elevated blood pressure. ● Higher infant mortality, mortality and morbidity rates.

The sociocultural, socioeconomic and environmental determines. Have lower levels of education and lack skills to work in the workforce. Less educated about society and health promoting choices. Live in remote areas and have limited access to health care services and facilities. Working environments are more blue collar labour intensive and come with a higher risk of injury. Many factors contribute to this health inequity. Social disadvantage such as lower education rates and employment rates is a factor, as well as lower levels of physical activity, higher smoking rates, poor nutrition and physical inactivity.

The roles of individuals, communities and governments in addressing health inequities. Individuals are empowered to make informed choices about their health Communities and leaders were and are involved in many controlled and health promoting initiatives.Governments Closing the gap and Aboriginal community controlled health services.

Are responsible for creating health policies ad new initiatives. This can be achieved through improving infrastructure as well as addressing the problems by having an office for ATSI peoples health.

Low SES people

The nature and extent of the health inequities Are people who experience poor health outcomes due to factors relating to education, employment and income. They have higher rates of chronic disease, incusing higher rates from CHD, incidence from lung cancer, more obese, higher rates of mortality from all cancers and lower life expectancy.

People who have poor levels of education, low income, poor housing, unskilled work or long levels of unemployment,

● Have a higher mortality rate and a lower life expectancy rate ● Higher rates of smoking ● Are less informed about health, make less health promoting choices ● Make less use of preventative health services and don't know what all the services do

and the benefits of modifiable health promoting choices. ● People living in low SES areas were 1.6 times as likely to have at least two chronic

health conditions. ● Lower education leads to limited employment options. That will result in working

high risk jobs or being unemployed. This can have a negative effect on your mental health.

● Live in low SES areas, and they have more blue collar jobs, as these jobs don't require high levels of education. These jobs are often more dangerous and have negatives effects on your health.

● Often live rurally where there is less access to health promotion and prevention services.

● Lower life expectancy rates by 2.1 years. ● Higher burden of stroke and cancer. (x6 the incidence of lung cancer)● 40% higher rates of CVD. ● Sociocultural - are exposed to greater risk factors, that negatively impact their

health. Substance abuse, discrimination, violence and conflict are common. ● Socioeconomic - Have a lower health literacy which limits which reduces there

employment options and also results in higher levels of unemployment. ● Environmental - may have poorer living conditions ● Governments are responsible for funding healthcare services, PBS scheme,

medicare, School immunisation programmes.

The sociocultural, socioeconomic and environmental determines. Living in low ses areas usually results in greater risk factors.

SE - are likely to receive lower rates of education = which reduces employment opportunity as well as income. Environmental = poorer living conditions as well as lesser access to health related services.

The roles of individuals communities and governments in addressing the health inequities. Individuals are responsible to access health information and participate health promoting initiatives. This info should implemented into their daily lives. Communities can address the health inequities by providing relevant health care services such as PCYC and Youth off the streets. The Australian government helps address this inequity by supporting community programmes and providing funding for free or reduced cost of health care. Medicare and PBS

https://www.aihw.gov.au/

http://www.ausstats.abs.gov.au/Ausstats/subscriber.nsf/0/367D3800605DB064CA2578B60013445C/$File/1244055001_2011.pdfIdentify 5 findings that you would believe would have the greatest impact on ATSI health ? P3210% of people live more than 100km from a hospital Just 1 in 5 were studying for educational qualifications 8% had educational involvement 41% still smoke compared to just 18%

By living rurally it significantly reduces your access to health care services It will reduce and significantly lessen the importance of health care to Indigenous people.

By not valuing and knowing how important education can be and that it is a flow on cycle it will continue to stay at a steady rate. Can be seen in the overall life expectancy 10 year gap. Will reduce their ability to get a good job and reduce their overall immunity and access to health care as they wont have the money and knowledge of what these diseases are and how they can be stopped.

By increasing there educational involvement, it will give them more opportunities after school allow them to get a better paying job that will will be positive for there socioeconomic status, it will allow them to live productive lives. It will allow them to make better personal decisions that will continue to improve their health and allow greater access to health support services.

Preventable chronic diseasesCardiovascular disease

Refers to damage to the heart, arteries, veins and or smaller blood vessels. It is a major health and economic burden on Australia. It is one of the leading causes of sickness and death in Australia.

The nature of cardiovascular diseases The three major forms are :Coronary heart disease : the poor supply of blood to the muscular walls of the heart by its own blood supply vessels, the coronary arteries. Stroke : the interruption of the supply of blood to the brain.Peripheral vascular disease : diseases of the arteries, arterioles, and capillaries that affect the limbs usually reducing blood supply to the legs.

Atherosclerosis Is the buildup of fatty material on the interior walls of arteries. This build up hinders the flow of blood to the body's tissues and also increases blood pressure. The build up occurs in patches known as atheroma or plaque and is characterised by the presence of chelostrole. It may occur in any artery of the body, but it is the greatest threat to an individuals health when it is present in the arteries leading to the brain, the eyes, legs or the heart.

Arteriosclerosis Is the hardening of arteries. It often begins in childhood. It develops as the fatty of fibrous deposits build up and the arteries become less aesthetic and harder.

Coronary heart disease / also called ischemic heart diseaseManifests as a heart attack or angina

Heart attack Generally caused by the complete closure of a coronary artery by atherosclerosis, it may also occur when a blood clot forms and blocks a narrowed artery. The efficient functioning of the heart relies on regular oxygenated blood flow, so the cessation of flow to any part of the heart results in tissue death.This is a heart attack. During the healing process following a heart attack nearby arteries grow new branches to supply the damage tissue.

Some common symptoms are : ● Sudden short of breath or unconsciousness ● Nausea, vomiting, sweating. ● Pain felt as a burning sensation in the centre of the chest between the shoulder blades

or behind the breast bone. ● Chronic pain lasting for days ● Acute pain extending to the shoulders, neck arms and jaws.

Angina Pectoris

Is a medical term used to describe the chest pain that occurs when the heart has an insufficient supply of oxygenated blood. This may be experienced by heart attack sufferers. It is usually caused by coronary atherosclerosis. The narrowed arteries allow enough oxygenated blood to flow to the heart to enable everyday activity, but chest pain or tightness occurs when the heart becomes overloaded by exertion, excitement or overeating.

Stroke / Cerebrovascular accident.Stroke results from a blockage from the blood flow to the brain. It may occur in a similar fashion to a heart attack. The effect of a stroke on the functioning of the body can be severe, even though the damaged area appears to be quiet small. If the affected artery is large there may be paralysis on one side of the body. On the other hand if damage occurs to the dominant hemisphere of the brain the individual may lose the ability to speak.

Heart failure Heart failure is a reflection of the heart's inability to cater for the demands placed on it during everyday life. It may mean that the heart cannot contract sufficient to supply the body with its oxygen requirements. Heart failure doesn't mean that the heart has failed, rather one part of the heart has stopped beating or working and that the other parts have to compensate.

Peripheral Vascular Disease Is the result of reduced blood flow to the legs and feet usually to atherosclerosis or arteriosclerosis. It usually affects the arteries, arterioles, and capillaries of the legs and feet. Warning signs are tingling or cramping in the legs or buttocks.

Atherosclerosis = Blocked occurs when blood vessels become blocked by fat or cholesterol, reducing or completely preventing blood flow. Atherisclerosis = Hard when blood vessels lose their elasticity and harden.

The extent of cardiovascular disease in Australia. One in six Australians are affected by CVD. Accounting for more than 4.2 million people. It is the second leading cause of death, just behind cancer.

Mortality CVD accounted for almost 30% of all deaths among Australians in 2015.Ischemic heart disease / Coronary heart disease is the leading cause of death in the population overall, Accounted for 12% of deaths in 2015. Stroke is the next leading cause of CVD.

Morbidity CVD is the leading cause of disability in Aus, with around 1.4 million Australians estimated to have a disability associated with CVD.

Risk factors and preventative factors for CVD.

Family history People with a family history of heart disease are more likely to get CVDGender CVD death rates are much higher for men than women. Advancing age risk increases with age Smoking it is the most modifiable risk factor. The risk of heart attack and stroke is doubled by heavy smoking.

- High blood pressure - Raised blood fat levels - Obesity - Physical inactivity - Abdominal obesity. - Family history - Gender - Age - Diabeties

Cancer Cancer refers to a diverse group of several hundred diseases with a common feature - the uncontrollable growth and spread of abnormal body cells. It involves a mutation and is believed to originate from a single cell whose genetic material has been influenced or damaged by some foreign agent. It divides and multiplies uncontrollably transferring is damaged genetic material to its offspring.

There are two different types of cancers Benign tumors - will most likely stay in the same spot and stay confined. Malignant tumors - Can spread to other parts of the body. Metastases - are secondary or new tumors. They are able to travel and have the capacity to affect the rest of the body.

Carcinoma = Skin, membranes lining Sarcome = Bones, cartilage, muscle. Leukemia = Blood forming organs such as bones, the liver, the spleen. Lymphoma = Infection fighting organs.

The prevalence of cancer is growing. It is estimated that one on two males and females will develop cancer before the age of 85. It contributes to 19%of the total disease burden in Australia. At the end of 2012, there were 994,605 people in Australia who were diagnosed with cancer in the previous 31 years (4.3% of the Australian population), including 410,530 diagnosed in the previous 5 years.9

Incidence Cancer is the only major cause of death in Australia that is increasing in both sexes. The most common have been : breaks cancer, skin cancer, melanoma and prostate cancer.

Mortality account for 27% of all deaths in 2017. It is currently the leading cause of death in Australia, behind CVD. In 2017, the risk of dying from cancer before the age of 85 is estimated to be 1 in 4 for men and 1 in 6 for women. 7

In 2012, the leading cause of cancer death was lung cancer (8,137), followed by bowel cancer (3,980), prostate cancer (3,079), breast cancer (2,819) and pancreatic cancer (2,524)

Males occurs more than females

In the age bracket of 25-54 the rates are 3x more likely

Why the rates are staying steady and dropping in numbers/prevalence Better technologyMandatory checks Better information public awareness and information tv ads banners flyers

Lung Cancer It is currently the leading cause of cancer deaths in Australia for men and women, yet it is largely preventable.Cigarette smoking is the major preventable risk factor. The risk of developing lung cancer is 10 times higher among smokers than among non smokers. Less than 10% of all cases of lung cancer occur in non smokers, as a result of occupational hazards, air pollution and other environmental factors are linked to the incidence of lung cancer.

Breast cancerIs the second most common cause of cancer related death in Australia. It affects 1 in 8 women in Australia and as you age the risk and the incidence of cancer rises. There is no known cause yet but there are a number of factors that contribute such as increasing age, family history, a diet high in fat, obesity, menstruation starting at an early age and late first pregnancy or not having children.

Skin cancer Are the most common type of diseases affecting Australians. This type of cancer occurs as a result of prolonged exposure to ultraviolet radiation. A significant number of deaths from malignant melanoma skin cancers could be avoided through skin protection and early detection.

Groups at risk of developing cancer Lung cancer : Smokers, people with blue collar occupations, who may also be exposed to environmental hazards asbestos, people aged over 50.

Breast cancer ; Obese Women, who haven't given birth, aged over 50, who have a relative who has cancer, who do not practice self examination.

Skin cancer ; people in lower latitudes, who have fairer skin, who have outdoor occupations and people who do not choose to use protection methods.

Stats

Estimated number of deaths from cancer in 2018

48,586 = 27,552 males + 21,034 females

Estimated number of new cancer cases diagnosed in 2018

138,321 = 74,644 males + 63,676 females

Chance of surviving at least 5 years (2010–2014) 69%

Prevention

Slip slop slap campaign snapshot p51

Australians aren't wearing wide brim hats and not applying sunscreen as much today as they were in the past. This can be seen through the different facts and figures. These measures are not protecting them from the sun.

Topic 3 Role of health care facilities and services in achieving better health Health care in Australia They play a vital role in achieving better health for all Australians. Health care in Australia is mostly about clinical diagnosis, treatment and rehabilitation. Two main types are primary and secondary health care

Primary Secondary are specialists

GPs Nurses Midwives

Therapists Psychiatrists Physiotherapists

Health workers DentistsFocus includes prevention, promotion and clinical care

Hospitals Public hospital = don't pick time or doctor Private hospitals = are owned and operated by individuals and community groups. It costs more but private health insurance and medicare will rebate most of the cost, Get to pick your own time, place and doctor. They provide same day short stay surgeries.

EquityIs the allocation of resources according to the need of individuals and populations.

There are three types of nursing homes = private charitable, private for profit and state government. But the Australian government assumes responsibility for most of the financial costs of running nursing homes.

Psychiatrist hospitals Treatment has changed for severe mental illness over the years, moving away from institutional care to a system of care that integrates both hospital services and continuing care with the community settings.

Medical services The most extensively used service is that of the GP who diagnose and treat minor illnesses. GPs usually refer their patients to a specialist, who have better skills in a particular field.

Pharmaceuticals Pharmaceticules are provided through hospitals and doctors by private prescription and over the counter in shops.

Community supports Community supports are a significant factor in the provision of an environment that is conducive to positive health. They support health but they are not apart of the healthcare system, eg implementations in food policies o ensure the production and

delivery meets the safe standards. Another example is town planners and engineers have a role in providing infrastructure that is safe and promotes positive health.

Responsibility for health care facilities and services

Community groups there are many different community groups that promote health. These are formed largely on a local needs basis and are established to address problems specific to an area or region. Eg Cancer Council Australia. RFDS,

Local government Are mainly focused with environmental control and a range of personal, preventative and home care services. The state gov are responsible for controlling these services while the local govs implement them.

Private sector - this sector provides a wide range of services such as private hospitals, dentists and alternative health services. These services are approved by the commonwealth department of health. Many religious organisations, charity groups and private practitioners run such services.

State and territory governments They have the prime responsibility of providing health and community services.Hospital services, mental health programmes, community care, youth and family services, health promotion, rehab programmes, regulation inspection licensing and monitoring premises, institutions and personnel.

Commonwealth government - They are concerned with the formation of national health policies and the control of health system financing through the collection of taxes. It provides funds to the state governments for health care, and influence their health policy making and delivery.

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Equity of access to health care facilities and programmes. They must be able to provide affordable and appropriate health care to people when they require it. There also must be equal distribution of health care services and facilities across to all sections of the Australian population.

One example has been the federal government greater funding the RFDS to provide better rural health care services and access, they have also providing better incentives for doctors to work rurally. Access to doctors in remote areas is a challenge.

GPs are not paid by medicare for teleconference consultations. There must be a greater focus on prevention rather than curative when it's too late. There must be a significant boost in GP numbers in all areas.

Health care expenditure versus early intervention and prevention expenditure. Health care expenditure is the allocation of funding and other economic resources for the provision and consumption of health services. Health care expenditure has steadily been increasing and so has the focus on curative medicine. Money cannot all be pumped into prevention as resources and other funds are focused on reducing mortality and saving the number of lives from new diseases that are heavily affecting the population today.

It takes many years for results/benefits and trends to start occuring once a preventative programmes has been implemented. Some preventative programmes for CVD, cancer and traffic accidents have been visible over the years. QUIT, Sunsmart, Girls make your move, stop revive and survive and drink driving campaigns. Curative measures are more costly and contribute continuously more to health expenditure. Many may feel that prevention is undervalued and under recoursed even though funding for health promotion and illness prevention has increased in recent years.

Some strategies that can be used to prevent illness and death include : Educating children in schools about positive health behaviours. Restrictions on advertising, Higher taxes on poor health products, Legislation. The provision of support programmes

There are strong arguments for increasing funding and resources to preventative health strategies.

1. Cost effectiveness - will save funds and resources that go into the curative approach.

2. Improvement to quality of life - are many positive health outcomes for individuals that will result in improvements in morbidity and mortality.

3. Containment of increasing costs - prevention is the best way to keep costs down.4. Maintenance of social equity - A policy of prevention helps to provide greater

equity. 5. Use of existing structures - prevention uses existing structures rather than relying

on special services and technological procedures.6. Reinforcement of individual responsibility for health - These prevention strategies

empower individuals to take control of their own personal health.

Impact of emerging new treatments and technologies on health care There are constantly new treatments and technology being developed that help our health. MRIs are more commonly used with X-rays.In AustraliaUnfortunately, these new technologies take a lot of time and money to develop. Some of these new technologies are also unaffordable uness funded by the government or privately donated.

Much research is currently being done on early detection, because of the benefits both personal and financial far outweigh surgery and other curative techniques.

Health insurance medicare and private Medicare Medicare is Australia's universal health care system, established to provide all Australians with affordable and accessible health care Medicare provides individuals with access to

● Free treatment as a public patient in a public hospital.● Free or subsidised treatment by medical practitioners, including GPs and

specialists.

Introduced in 1984 as a national system of health care funding. Designed to protect people from thehuge costs of sickness and injury. All Australian residents are eligible.

Principles upon which Medicare is based:O universalityO equityO simplicity

Funded by Taxpayers who pay a Medicare levy of 2.0% of their taxable income.The Medicare levy and any reductions are calculated from information provided in your Tax return.https://www.iselect.com.au/health-insurance/tax/medicare-levy-surcharge/

PBS SCHEME Introduced in 1986 by the Commonwealth gov’t, the PBS subsidises most prescription medicines to allow all individuals to have access to prescriptions, regardless of socioeconomic status. Antibiotics and other prescription medicines are priced lower, with Medicare covering a large portion of the real cost of the medication. If people need a lot of medication, the P.B.S. Safety Net reduces the cost of prescription medicines for individuals and families once they pay up to a certain threshold.

Private health insurance This extra insurance allows people to cover private hospital and ancillary expenses. People choose private health insurance for a number of reasons because Shorter waiting times, Can have a doctor of their own choice, and hospital of own choice. Private rooms, Security, protection and peace of mind, insurance covers while overseas.

Lower levels of private health insurance are found the young, elderly, and other groups that have less available income.The fall in the number of people with private health insurance creates pressure on the public health system. The strain on the health care system was mainly caused by the increasing demands for service from an ageing population and an increase in the number of free medicare patients.

Snapshot Health insurance isn't right for everyone there has been an increase in charges, costs and taxes in relation to private health care which has seen less people taking out private health insurance.

Social Justice issues.

Equity = The fair allocation of resources and entitlements without discrimination. This allows ALLAustralians the opportunity to be healthy and have their needs met.

Diversity= Involving all community groups in the planning and decision making process. It alsorecognises cultural and social diversity, as well as beliefs and attitudes. Eg, Translation services at Medicare offices is a culturally sensitive way to enable overseas born citizens the opportunity of taking advantage of the services available.

Supportive environments =We all have the right to be healthy and to receive adequate health care.Environments must be structurally supportive, (ie) affordable, accessible and able to overcomedisabilities and language barriers. The action to create a supportive environment needs to be physical, social, spiritual, economic and political

The Medicare system is one such example of providing a supportive environment. It is the cornerstone of the public health care system in Australia. Its philosophy, that all Australians, regardless of their personal circumstances, should have access to adequate health care at an affordable or no cost.Medicare provides;

- Essential medical care at affordable or no cost- PBS (Pharmaceutical Benefits Scheme) which provides government subsidised (or

reduced) cost of selected drug treatments. In 2016, max cost of a prescription drug was $38.30 (Pensioners

- $6.20 for those on a concession card). 80% of all ‘scripts’ are subsidised by the PBS Medicare Safety Net: Establishes a threshold (In 2016, $1475.70) over which basic medicalcosts will be further subsidised by up to 80% for the rest of the year. Useful for socio-economically disadvantaged people or those who require frequent and ongoing treatment

What role do healthcare facilities and services play in achieving better health for all AustraliansComplementary and alternative health care approaches 108 Complementary and alternative medicine refers to healing practices that do not fall within the area of conventional medicine.

Recent studies show that two thirds of Australians are using CAM treatment with an expenditure of $4 billion. This trend has a lot to do with social change. Many people see CAM as an opportunity to exercise choice, exerting greater choice over their health through empowerment.

Some of the ranging products and services available are Acupuncture - is based off ancient Chinese beliefs, widely used for pain relief, asthma and arthritis. Aromatherapy - is the use of pure essential oils to influence or modify the mind, body or spirit. The Bowen - Therapeutic technique Chiropractic - is used to relieve pain and improve health through spinal manipulation.Herbalism - uses plants and herbs exclusively. Meditation - is the state of inner illness. Homeopathy - based on the notion that substances promoting illness in a healthy person can be sures for a sick person. Iridology - is the analysis of the human eye to detect signs of the the individuals physical, emotional and spiritual well being.

How to make informed consumer choices Always further inquire and ask questions Make sure that they are accredited. It is important to make informed decisions when choosing an alternative health care approach. The individual needs to investigate the services on offer, the cost, the qualifications and experience of the practitioner and the health claims that are being made before committing to it.

Actions required to address Australia's health priorities. 117

Health promotion is a combination of science, medecine, practical skills and beliefs aimed at maintaining and improving the health of all people.

Levels of responsibility for health promotion NSW health an equity statement, In all fairness. 2004 There has been a much heavier focus on prevention rather than cure. The health care system is evolving into a system that deals the holistic care of the entire Australian population. The healthcare industry is working with other sectors in order to create an environment that supports good health and works to prevent illness, especially chronic disease which requires a lot of funding.

Federal government : are responsible for building healthy public policy, developing infrastructure and funding for health promotion in order to create an environment that supports the improvement of the health of all Australians.

State government : are responsible for implementing these strategies and delivering adequate health services throughout their states and territories. They license private hospitals and use legislation for to operate public hospitals. They regulate the sale of drugs, tobacco, alcohol, the use of paracetamols, blood products and private health insurers.

Private sector : Are responsible for monitoring health promotion and ensuring that it is creating a healthy environment that supports the community's well being. They should also ensure that the community has adequate access to health services and goods.

Communities : are responsible for the implementation of these initiatives and ensure that members are actively participating. It is most effective when there is strong community engagement. Examples are meals on wheels and programmes developed by Cancer Council. The standing council of health, the Australian health ministers, The running of each individual system falls to the realant health ministers.

Individuals : Are responsible for developing personal skills by implementing what they learn through the health promotion in their own lives. Example is that they can adopt a healthy lifestyle by staying fit and active and also having a nutritious diet.

Benefits of partnerships in health promotion Partnerships in health promotion allow for an efficient and effective system in which various members of the community are able to participate in improving the health status of the entire nation. Different sectors must work together to join their resources, knowledge and experience to effectively develop and implement strategies. Some of the benefits are that it addresses the needs of individuals and communities, more comprehensive health promotion, better results, empowers individuals to act, more efficient health promotion healthy spaces and places. Reduced time and money.

How health promotion based on the ottawa charter promotes Social Justice. WHO state that health promotion should advocate, mediate and enable. The ottawa charter utilises the principles of social justice in its implementation. It promotes equity, so that societies most disadvantaged have access to information and health care. Thus, they become more knowledgeable and empowered, and have more atomonity over their health. This is done by reducing social, economic and personal barriers that may limit their access to health services and facilities.

The Ottawa charter in action.

Closing the Gap CSE - seeks to train health professionals, ensure fresh health food is available and develop house waste supplies/removal systems to improve house quality. SCA - Involves the ATSI people and community elders in the planning at local and regional areas. DPS - Seeks to increase ATSI education levels and provides primary health care services. RHS - It seeks to utilise primary health care to both prevent and promote health in balance with curative services. BHPP - the ‘close the gap statement of intent’

Road safety DPS - Road safety introduced school education programmes ad safer driver courses to improve the knowledge and driving ability of young drivers. BHPP - introducing legislation, having fixed speed cameras around Sydney and an urban speed limit of 50Km/HSCA - Road safety works with community based organisations to provide “Driver reviver stops” to combat fatigue related accidents. CSE - Has sought to make speeding socially unacceptable through the “speeding - no one thinks big of you” campaign. Road have been upgraded to have higher safety standards and cycle anes have been introduced to keep them safe on roads and encourage this way of transport. RHS - The many campaigns increase road safety awareness and promote a preventative approach to road safety issues. It has been successful in reducing road fatalities.

National Tobacco StrategyDPS - Informing individuals through ads in the news and public awareness on the negative effects that of tobacco smoking, such as lung cancer and other respiratory diseases. BHPP - the government's implementation of legislation, having graphic imaging packaging and hiding them from view in shops. SCA - introducing new health promotion campaigns, such as quit now and quitline, which is an over the phone service designed helpline designed to empower people and encourage them to make better choices over their health. CSE - introducing more non smoking places in public, and that will also convey the message that it is not socially acceptable to smoke now days, thus contributing to the pressure to quit. RHS - that services, resources and funding are focused on prevention rather than curative.