HLTH200 Final: EXAM NOTES
28 May 2018
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HLTH200: EXAM NOTES
Week 1:
Definition of Health –
• “A state of complete physical, emotional and social wellbeing and not merely the absence of
disease or infirmity” (WHO)
• Indigenous Australians’ view of health – “Not just the physical wellbeing of the individual,
but the social, emotional and cultural wellbeing of the whole community”
• In Bhutan, health and happiness are intertwined as are their determinants. Health in Bhutanese
is often summed up in a popular statement of ‘no physical illness and mental worries’
o Government departments build in happiness indicators in all policies
• Health is about:
o Diet
o Physical activity
o Infection
o Causes of death
o Mental health
o Social support
o Adequate housing, conditions of living
o Policy
• HOLISTIC APPROACH TO HEALTH
Changing Nature of Health –
• Leading causes of death: 1900 and 2010
o 1900 = pneumonia/influenza followed by tuberculosis then gastro then heart disease
o 2010 = heart disease and cancer, followed by accidents, Alzheimer’s, diabetes, CVD
etc.
• Situation in Australia (2013)
o Heart disease, cancer and Alzheimers
Factors influencing the decrease in infectious disease in 20th century:
• Better nutrition
• Antibiotics
• Better housing
• Immunisations
• Improved hygiene and sanitation
• Safe food and water
Changing nature of disease –
• Non-communicable diseases also known as chronic diseases or degenerative disease:
o Are not passed from person to person
o They are of long duration and generally slow progression
o Rarely ‘cured’ but ‘managed’
o Require long-term care
• Non-communicable diseases are responsible for 63% of all deaths worldwide
o Low, middle and high income countries
• The 4 main types of non-communicable diseases are:
o 1. Cardiovascular disease (like heart attacks and stroke)
o 2. Cancers
o 3. Chronic respiratory diseases (such as chronic obstructed pulmonary disease and
asthma)
o 4. Diabetes
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• Cardiovascular diseases account for most NCD deaths
• These 4 groups of diseases account for 82% of all NCD deaths
Modifiable behavioural risk factors:
• Tobacco use
• Physical inactivity
• Unhealthy diet
• Harmful use of alcohol
Health determinants – what makes people healthy/unhealthy?
• There are positive and negative health determinants
• Protective factors (positive):
o A high daily intake of fruit and veggies
o Vaccinated against disease
o Good social support
• Risk factors (negative)
o Behavioural risk factors: e.g. risky alcohol consumption
WHO, 2008 → current estimates suggest that up to 80% of heart disease, stroke and type 2 diabetes
and more than 1/3 of cancers worldwide could be prevented by eliminating shared modifiable risk
factors – mainly tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol
Summary:
• Changing nature of disease from infectious disease to non-communicable disease
• Longer duration and widespread across the world
• Have a modifiable, causal component
Health Priorities in Australia (Lecture 2)
Life expectancy:
• Often expressed as the number of years of life a person born today is expected to live
• Life expectancy has improved over the years
• Girls live longer than boys (males life expectancy rate lower than females)
How does Australia compare? (2013 data)
• 4th/5th best life expectancy rates
• Japan = best LE rates
• Sierra Leonne = lowest
• Rates have improved since 1990 (Aust & Japan increase)
Infant mortality rates:
• The infant mortality rate is the number of deaths of children aged less than one year in a
calendar year per 1000 live births in the same calendar year
• 1990-2011 = child mortality rate is better/improvements
Significant inequality within Australia (Indigenous vs. non-Indigenous)
• Indigenous men and women have lower life expectancy than non-Indigenous (10 year life
expectancy gap)
• Infant mortality → Indigenous have higher infant mortality rate, especially in NT
Mortality vs. Morbidity:
• Mortality → refers to the numbers of deaths in population
• Mortality rate, a measure of number of deaths in a given population
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find more resources at oneclass.com
• Premature mortality → potential years of life lost before age of 70 years
• Morbidity → refers to being in a diseased state, disability or poor health e.g. ‘burden of
disease’
• Leading underlying causes of death by sex, 2014
o Coronary heart disease = more in men than women
o Dementia/Alzheimers = more in women than men
o CVD = more in women than men
Burden of Disease:
• Looking at the burden of disease is another way to get a picture of health priorities
• Burden of disease analysis is a technique used to assess and compare the fatal and non-fatal
effects of different diseases and injuries on population groups
• Measure = DALY (disability-adjusted life year) → one DALY is 1 year of ‘healthy life’ lost
due to premature death, prolonged illness or disability or a combination of these factors
• Years of Life Lost (YLL) due to premature mortality in the population + the Years Lost due
to Disability (YLD) for people living with the health condition or its consequences
o THUS, DALY = YLL + YLD
• Alzheimers
o Increasing prevalence in the population, concentrated in old age brackets
o People who experience this, the majority are living in some form of health
establishments i.e. assisted care
• Burden of disease in Australia (2011 data)
o DALY = highest percentage is cancer, then CVD, then mental
o YLD = highest percentage is mental, musculoskeletal
o YLL = highest percentage is cancer then CVD
Australian Health Priorities – 9 NHPs
• Cancer control
• CVD health
• Injury prevention and control
• Mental health
• Diabetes
• Asthma
• Arthritis and musculoskeletal
• Obesity
• Dementia
Consequences of an ageing population
• Increase in dependency ratio
• If the retirement age remains fixed, and the life expectancy increases, there will be relatively
more people claiming pension benefits and less people working and paying income taxes. The
fear is that it will require high tax rates on the current, shrinking workforce
• Increased government spending on health care and pensions. Burden on the health system,
with a shortage of workers
• E.g. Australia faces a shortage of more than 150,000 paid and unpaid carers for people with
dementia by 2029
The Social Determinants of Health (Lecture 3)
The determinants of health → the range of personal, social, economic and environmental factors
which determine the health status of individuals/populations
The Biopsychosocial model: Different factors involved in health
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Definition of health : a state of complete physical, emotional and social wellbeing and not merely the absence of disease or infirmity (who) Indigenous australians" view of health not just the physical wellbeing of the individual, but the social, emotional and cultural wellbeing of the whole community . In bhutan, health and happiness are intertwined as are their determinants. Factors influencing the decrease in infectious disease in 20th century: better nutrition, antibiotics, better housing. Improved hygiene and sanitation: safe food and water. Cardiovascular disease (like heart attacks and stroke: 2. Chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma: 4. Diabetes: cardiovascular diseases account for most ncd deaths, these 4 groups of diseases account for 82% of all ncd deaths. Modifiable behavioural risk factors: tobacco use, physical inactivity, unhealthy diet, harmful use of alcohol. Summary: changing nature of disease from infectious disease to non-communicable disease, longer duration and widespread across the world, have a modifiable, causal component.
