2802NRS Chronic Conditions In Australia
Question:
Assessment One is a written as an essay. You will be required to evaluate a national health system as follows:
Your overview should be based on sound data from the World Health Organisation, as well as studies or reports published by the World Bank or Non-Governmental Organisations such as the Red Cross, Médecins Sans Frontières, etc. You will need to describe the scale and nature of the main health challenges and clarify which social groups are most affected.
The historical account, or timeline, should be concise. You will need to refer to key events – i.e. civil wars, droughts, outbreaks of disease etc – but the purpose of this is to link these to the health systems and how they have dealt with these events. The priority in this section is to describe how and why the country’s current health system and policies are functioning as they are.
Again, start with the WHO global health tables – life expectancy, infant mortality etc – and provide evidence of the country’s movements up or down these tables over time. Finally, predicting future health should be based on this progress – or regression – and also take account of contemporary social, economic and political factors, such as recessions, wars, natural disasters, changes of government etc.
Answer:
Also known as non-communicable diseases (NCDs), chronic conditions refer to medical illnesses that are not transmittable from one person to another. These diseases can progress slowly and last for a long period. These conditions include cancer, autoimmune diseases, stroke,and heart disease as well as diabetes, just to mention a few (Hunter and Reddy, 2013).Australia is considered one of the most developed countries in the world and therefore like many other developed nations, it has a major problem with chronic illnesses. The most common chronic disease among Australians is hypertension (high blood pressure).Hyperlipidemia (high cholesterol), osteoarthritis, asthma, anxiety,and depression are also very common. An estimated 50.8 % of the Australian population has at least a single chronic condition. 17.4% of the population have hypertension, 12.7% hyperlipidemia, depression (10.5%), osteoarthritis (11.1%), and asthma (8.0%) (Harrison et al., 2013).
Biomedical risk factors are human conditions that pose specific and direct risks to health, for example, hypertension. They are habitually influenced by health behaviors such as physical activity and diet. Conversely, they can additionally be influenced by socioeconomic, genetic as well as psychological aspects. Altering biomedical risk factors can diminish a person’s possibility of developing a chronic condition.Certain chronic conditions influence the occurrence of further illnesses, for instance, a larger percentage of people with cardiovascular disease have abnormal blood lipids which can result in hyperlipidemia. That is, 78 percent compared with 63 % of adults in Australia with abnormal amounts of lipids in their blood but do not suffer from heart disease. Other risk factors of chronic conditions relate to the behavior and the environment of the individual (WHO, 2016). In addition, there are non-modifiable risk factors (person’s psychological and physical aspects) as well as the social and economic determinants of health which include education, income, cultures and beliefs of the individual (AIHW, 2012).
The chronic diseases affect older people more than younger individuals as 84 percent of the burden of disease resulting from obesity and overweight is among persons aged between 45 and 84. The risk factors of these conditions are often overweight, obesity, lack of physical exercises and other activities such as smoking and excessing alcohol consumption. 7 percent of the total disease burden in Australia is due to overweight and obesity. 53 % of diabetes cases results from these factors as well (AIHW, 2014). In addition, people in lower socioeconomic regions suffer from chronic diseases more than their rich counterparts indicated by a 1.5 times differential in the burden of disease. 1.7 times the rate of disease burden is experienced by people in very remote regions in comparison with those in the major metropolitan areas of the country. Another social group that is adversely affected by chronic conditions in Australia are the Aboriginal and Torres Strait Islander people. These are Australia’s first peoples, also known as the indigenous Australians who have undergone extreme adversities since the colonization of the nation by European settlers. These hardships affect their health in addition to declining its abundance. These indigenous Australians experience the burden of disease 2.3 times more as compared to non-indigenous people (AIHW, 2014).
In 1999, Australia established an Enhanced Primary Care (EPC) to improve the coordination of care among people with complex care requirements as well as those with chronic conditions. The aim of this scheme was to provide a multidisciplinary approach to caring for individuals with chronic conditions and to health care in general. It worked along other associations such as the Practice Incentive Program (PIP) and Service Incentive Payments (SIP) to provide financial incentives to General Practitioners (GPs) to promote coordination of health care services. There were, however, inconsistencies in the uptake of these incentives by the GPs due to complex and inflexible administration structures causing managerial issues (Nolte and Knai, 2008).
Australia is still trying to deal with chronic issues by coming up with various policies and frameworks such as:the Australian National Diabetes Strategy 2016-2020, the National Strategic Framework for Chronic Conditions and the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.
The National Aboriginal and Torres Strait Islander Health Plan is an evidence-based directorial framework which guides all policies, programs and stratagems developed to promote the health of the Aboriginal and Torres Strait Islander people. This group of people’s destitutionhas vastly affected their health and wellbeing (Vos et al., 2009). These challenges include institutionalization, abuse,and displacement from the country. One historical event that acts as a trauma to this group of people is The Stolen Generations whereby the Australian State and Federalgovernment organizations and church missions, under acts of their corresponding parliaments removed children of the Australian Aboriginal and Torres Strait Islander descent from their families. In 2008, a probable 8% of people from this group aged 15 and over recounted being detached from their natural family and 38% had kinsfolks who had been removed from their family (ABS 2009). This can be intergenerational trauma, affecting the health and wellbeing of children of the subsequent generations (Atkinson, 2013).
More of the Aboriginal and Torres Strait Islander people suffer from chronic conditions than non-indigenous Australians and also a larger percentage of them are involved in smoking and alcoholism. Cardiovascular diseases lead to the death of 25% of this groups population while cancer causes 20 %, making these two diseases the leading causes of death among the Aboriginal and Torres Strait Islander people. Endocrine, nutritional and metabolic disorders,and respiratory conditions are also conspicuous causes of death among these people as they lead to 8.9% and 7.9% of all deceases respectively (AIHW, 2016). The framework was developed as a part of the efforts to close the gap between the health and life expectancy of the indigenous Australians and non-indigenous Australians (ISLANDER, 2013). It advocates for accountability and partnership with various organizations, the government and peak bodies of the Aboriginal and Torres Strait Islander people to solve the varied health issues faced by this group of people (Kimpton, 2013). Its vision is to ensure a health system lacking of racism and inequality and one that is affordable, effective and appropriate to all Australians. Also, it takes into account the enhancement of the social determinants of health among these people as these are the main causes of ill health among them (Marmot et al., 2008).
The National Strategic Framework for Chronic Conditions was developed in response to Australia’s obligation as a member state of the World Health Organization’s (WHO)Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2013-2020. The main reason for its establishment, however, was the fact that chronic conditions are the leading causes of illnesses, death,and disability in Australia (AIHW, 2014).Chronic illnesses are responsible for 9 of every 10 deaths in Australia in 2015. Cardiovascular diseases, chronic respiratory disease, lung cancer, Alzheimer’s disease,and dementia are common causes of death as together, they have a mortality rate of 37 percent among the Australian people (ABS, 2016). The framework was thus also developed as a multisectoral collaborative agent to prevent and manage chronic diseases all around Australia. It guides the formation of policies, principles, strategies, actions,and services by other entities which are meant to enhance the outcomes of people’s health in Australia. This framework is principally focused on health issues but also takes into consideration the necessity of partnering with other sectors such as education and housing to accomplish its goal (CSDH, 2008).
The Australian National Diabetes Strategy 2016-2020 is a program which summaries the response by the nation in relation to diabetes and evaluates how the narrow assets available can be better targeted and coordinated to manage diabetes across Australia at all levels of the government. It highlights the appropriate and most effectual approaches to minimize the negative effects of the disease and its associated complications. The framework calls upon collaboration and effort by organizations, non-governmental associations, all levels of government, health care professionals, families, people ailing from diabetes, carers and all other groups in the community to help prevent the incidence of and manage this chronic condition (Wutzke et al., 2017).
Mortality rate from chronic conditions in Australia is very high as they are projected to account for 89% of all deaths; cardiovascular diseases (28%), cancers (29%), communicable diseases, nutritional conditions, perinatal and maternal deaths (5%), chronic respiratory diseases (7%), diabetes (3%) and injuries (6%) while other NCDs are responsible for 23% of all deaths in Australia (WHO, 2012). When compared with a country such as the United Kingdom, the death rates resulting from chronic conditions are almost the same. NCDs are accountable for an estimate of 89% of all deaths in the UK estimated as: 25% cardiovascular diseases, 1% diabetes, 28% cancers, 8% chronic respiratory conditions 8% maternal, perinatal, communicable diseases and nutritional conditions and 3% of all deaths from injuries. Other non-communicable diseases account for an estimate of 26% of all deaths in the UK.Additionally, the life expectancy in both countries is estimated to be 72years of age and (WHO, 2012), indicates an increase in healthy life expectancy within the last 3 years in both nations.
Australia in comparison with other countries is doing quite well in its battle with chronic conditions.With the different frameworks and policies still in place for managing chronic conditions, it is expected that the health of the country will continue to improve in the future. Since the agendas take into account social determinants of health, the living standards and lifestyles of people are also anticipated to progress to better states.
References
Hunter, D.J. and Reddy, K.S., 2013. Noncommunicable diseases. New England Journal of Medicine, 369(14), pp.1336-1343.
Australian Institute of Health and Welfare 2012. Risk factors contributing to chronic disease. Cat. No. PHE 157. Canberra: AIHW.
Harrison, C., Britt, H., Miller, G. and Henderson, J., 2013. Prevalence of chronic conditions in Australia. PloS one, 8(7), p.e67494.
Nolte, E. and Knai, C., 2008. Managing chronic conditions: experience in eight countries (No. 15). WHO Regional Office Europe.
Australian Institute of Health and Welfare, 2014. Australia’s health 2014. Australia’s health series no. 14. Cat. no. AUS 178. Canberra: AIHW.
ISLANDER, T.S., 2013. Based publications.
Atkinson, J., 2013. Closing the gap.
Australian Bureau of Statistics, 2009. National Aboriginal and Torres Strait Islander Social Survey 2008. ABS cat. no. 4714.0. Canberra: ABS.
Australian Bureau of Statistics, 2016. Causes of Death, Australia, 2015. Canberra: ABS.
Australian Institute of Health and Welfare, 2016. Australia’s health 2016. Australia’s health no. 15. Cat. no. AUS 199. Canberra: AIHW.
World Health Organization, 2016. Health Topics: Risk factors. Geneva, Switzerland: WHO.
World Health Organization, 2012. Statistical Profile. Geneva, Switzerland: WHO.
Marmot, M., Friel, S., Bell, R., Houweling, T. A., Taylor, S., & Commission on Social Determinants of Health, 2008. Closing the gap in a generation: health equity through action on the social determinants of health. The lancet, 372(9650), 1661-1669.
Vos, T., Barker, B., Begg, S., Stanley, L. and Lopez, A.D., 2009. Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap. International journal of epidemiology, 38(2), pp.470-477.
Kimpton, T.M., 2013. Partnership and leadership: key to improving health outcomes for Aboriginal and Torres Strait Islander Australians. The Medical Journal of Australia, 199(1), pp.11-12
Wutzke, S., Morrice, E., Benton, M. and Wilson, A., 2017. What will it take to improve prevention of chronic diseases in Australia? A case study of two national approaches. Australian Health Review, 41(2), pp.176-181.
Commission on Social Determinants of Health (CSDH), 2008. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: WHO.
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