Improvements in health since 1900's

- life expectancy increased

- cancer death rates increased due to uptake in cigarette smoking
- death rates from injury & poisoning have halved over last 100 years

Public health
the ways in which governments monitor, regulate and promote health and wellbeing and
prevent illness

Old public health

government actions that focused on changing the physical environment to prevent the
spread of disease, such as providing safe water, sanitation and sewage disposal, improved
nutrition, improved housing conditions and better work conditions

Policies & practices under old public health

- government funded water & sewerage systems ( clean drinking water= decrease in
infection diseases eg. cholera)
- elimination of housing slums and introduction of better quality housing ( to be connected to
a ventilation & sewerage system to decrease risk of overcrowding= less infectious diseases
eg diarrhoea)

Health promotion
the process of enabling people to increase control over and to improve their health

New public health

an approach to health that expands the traditional focus on individual behaviour change to
one that considers the ways in which physical, sociocultural and political environments
impact on health. Also referred to as the social model of health.

Differences between old and new public health

- Old focuses on infectious diseases, new focuses on lifestyle diseases
- Old focuses on removing contaminants from the environment, new encourages
people to live healthier lives
- Old focuses on addressing physical environment whereas new focuses on social
cultural enviornment

Biomedical model of health

Focuses on the physical or biological aspects of disease and illness. It is a medical model of
care practised by doctors and health professionals and is associated with the diagnosis, cure
and treatment of disease.
Key Features of the Biomedical model
- focuses on individuals who are ill
- concerned with disease, disability and illness
- relies on services provided by doctors, specialists and hospitals
- quick fix approach
- relies on tech to diagnose, treat and cure

biomedical model technology examples

- development of covid-19 vaccines
-x-ray machines
- MRI scans
- CT scans

HEALTHCARE
- filling of decayed teeth
-surgery to remove a tumour
- setting a cast to heal a wrist

Adv of biomedical model

- funding bring improvements in tech and research
-enables many illnesses and conditions to be effectively treated
- improves quality of life and HALE

EXPLANATION
- there would be relatively little knowledge how to diagnose and treat without tech
- many causes of death such as infectious diseases can be treated and cured through
medication/tech thus increase life expectncy

disadvantages of biomedical health

- it relies on professional health workers and technology thus is costly
- it doesn't always promote good health and wellbeing
- not every condition can be treated

Social model of health

an approach that recognises improvements in health and wellbeing can only be achieved by
directing effort towards addressing the physical, sociocultural and political environments of
health that have an impact on individuals and population groups
The social model of health aims to address the sociocultural and environmental factors that
influence health behaviours. It works to prevent premature death and ill-health by focussing
on health promotion. An example of this has been the TAC advertising campaigns that have
worked to change the culture of dangerous driving. This has assisted in reducing deaths
from road crashes and increasing life expectancy.

The social model of health aims to improve health for all people and prevent diseases and
injuries from occurring where possible. This includes introducing increased taxes on tobacco
and the banning of smoking in many public places. This has resulted in a decrease in the
proportion of males who smoke which contributes to lower rates of lung cancer and higher
life expectancy.

The social model of health targets populations in an attempt to promote health. This model
works to provide people with the skills and knowledge they need to reduce their risk of ill-
health.

Advantages of social model

-promotes good health and wellbeing, assists in preventing diseases
- it takes a more holistic approach
- less expensive than biomedical
- focuses on vulnerable population groups

Disadvantages of social model

- not every illness or condition can be prevented
- does not promote development of technology and medical knowledge

Key principles of social model (IDEAR)

- involves INTERSECTORAL collaboration
- addresses broader DETERMINANTS of health
- EMPOWERS individuals and communities
- acts to enable ACCESS to healthcare
- acts to REDUCE social inequalities

The ottawa charter

an approach to health developed by the World Health Organization that aims to reduce
inequalities in health. It reflects the social model of health and provides five action areas that
can be used as a basis for improving health status, all of which are centred around three
strategies for health promotion which are enabling, mediating and advocacy.
3 strategies for health promotion outlined in ottawa charter
enable- allow people to get EQUAL access to health (education & resources)
mediate- resolve conflict (eg. gov decrease speed limits around schools)
advocate- seek to gain support

Action areas of ottawa charter (Bad cats smell dead rats)

- Build healthy public policy ( decisions made by gov and organisations that develop
policies and laws that help people make healthy choices)
- Create supportive environments ( regonises impact of broader determinants have on
hwb and hs, involves making healthy choices easier and creating a physical and social
environment to stimulate enjoyable environments)
- strengthen community action ( centred on the community working together to achieve a
common goal)
- develop personal skills (educate people with the health and knowledge and skills to make
informed decisions about their health)
- reorient health services ( shift the health system towards health promotion and
prevention)

Medicare
australia's universal health insurance scheme which gives all australian citizens and those
from countries with a reciprocal agreement access to basic healthcare subsidised by the
government

what does medicare cover/ doesn't

does
- essential services such as GP consultations, x-rays, blood tests, eye tests, surgeries
- accomodation in public hospitals
-75% of schedule fee
doesn't
- cosmetic surgery
- anulance
- allied health services such as physiotherapy
- dental examination and treatment

how is medicare funded

- general taxation
- medicare levy (additional 2% surcharge placed on taxable income)
- medicare levy surcharge ( extra 1-1.5% tax for individuals who earn above a certain
amount and dont have phi)
schedule fee
standard costs for medical services set by the federal government

patient copayment
practitioners may charge more than the schedule fee and patient pays the difference known
as the patient co-payment

bulk billing
when a gp only charges the schedule fee so there is no out of pocket expense for the patient

adv and disad of medicare

advantages
- available to all australian citizens
- covers basic healthcare such as gp consultations

disadvantages
- waiting list for many treatments
- does not cover allied health services
- patients may need to make copayments

PBS
provides essential medicines to help people who need them by subsidising medication

NDIS
provides services and support for people and families who have permanent/ significant
disabilities
- funded by gov
- has an eligibility requirement such as citizenship criteria, their condition must be
permanent)

health promotion
the process of enabling people to increase control over, and to improve, their health
why is smoking targeted
- it is a preventable risk factor
- a leading cause of preventable, premature death
- modifiable risk factor for major health concerns
- disproportionately impacts vulnerable population groups

government laws and policies (smoking)

- increase tax/ higher price on tobacco=lower prevalence of smoking
- laws banning smoking in public places such as transport
- no advertising that encourages people to smoke/ use tobacco

QUIT campaign ottawa charter links

c- quitline telephone service helps people to call for support throughout their journey and get
advice on how to quit
s- a program funded by victorian government and vic health
d- provides info regarding tobacco smoking and benefits associated with not smoking
r- quit provides free online learning training program for health

initiatives indigenous hwb

feedin the mob
- a nutrition, physical activity and healthy lifestyle program for indigenous australians
- funded by federal gov (builds public health policy)
- (strengthens community action) by encouraging the community to be involved in activities
- (develops personal skills) by teaching the benefits of healthy eating and lifestyle

Criteria
- Is it culturally appropriate?
- Feedback provided by participants so they can gauge customer feedback and
improve efficiency
- Are people and communities being empowered
- Does it achieve areas of the ottawa charter
-

Dietary guidelines
1. To achieve and maintain a healthy weight, be physically active and choose amounts
of nutritious food and drinks to meet your energy needs.
2. Enjoy a wide variety of nutritious foods from these five food groups everyday and
drink plenty of water
 3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
4. Encourage, support and promote breastfeeding
5. Care for your food; prepare and store it safely.

AGHE
a food selection model that is intended to be used by consumers to assist them in planning
and consuming adequate proportions of the five food groups

AGHE five food groups

grain foods, vegetables and legumes/beans, meat and alternative, fruit, milk, dairy and
alternatives

Similarities and differences in dietary guidelines and AGHE

similarities
- both use the same 5 food groups
- both recommend water as the main drink
- both recommend to limit intake of salt and sugar alcohol
differences
- dietary guidelines are provided in written form whereas AGHE is a visual representation
- Dietary guidelines include detailed info about serving sizes whereas AGHE provides
proportions of food groups but not serving sizes

Nutrition australia Healthy eating pyramid

- non-gov organisation
- a food selection model based on australian dietary guidelines
- visual guide to the types of proportions of foods individuals should eat everyday for good
hwb
- contains same 5 core food groups as AGHE

Challenges in bringing about dietary change

- time constraints and convenience
- education, nutrition, knowledge
- food security
- attitude and beliefs
- influence of family and culture