National Health Priority Areas (NHPAs)

National Health Priority Areas (NHPAs)

NHPAs

• Cancer control• Cardiovascular disease• Injury prevention and control• Mental health• Arthritis and musculoskeletal conditions• Asthma• Diabetes• Obesity• Dementia

Arthritis and musculoskeletal conditions

• Arthritis is a term used to describe a disorder of one or more joints. Arthritis disorders are part of a broader group of disorders of the muscles and bones called musculoskeletal disorders.

This NHPA is focussed on:• osteoarthritis• rheumatoid arthritis • osteoporosis.

OsteoarthritisA degenerative joint condition affecting the weight-bearing joints such as the hips, knees and ankles as well as the hands and spine. In the initial stages pain occurs in the joints during and after activity, but as the condition progresses pain may be experienced from minimal movement

or during rest.

Rheumatoid arthritis

• An auto-immune disease causing chronic inflammation of the joints. It most commonly affects the hand joints and can lead to deformities

• of the hands.

Osteoporosis

• A condition whereby there is a progressive loss of bone density and decrease in the strength of the skeleton with a resultant risk of fracture.

StrategyWaves Warm Water Wellness Program•Arthritis Victoria’s Waves program provides gentle warm water exercise classes in hydrotherapy pools and offers a general workout for the whole body. Exercising in warm water is one way to help people with arthritis remain physically active

Arthritis and musculoskeletal conditions

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Affects 31% of Australians – more than 6 million people

• Obesity • Osteoporosis: Physical inactivity and joint trauma• Arthritis: Environmental link, perhaps virus or bacterial infection

• Self management courses• Exercise programs for elderly• Healthy Bones Week

• $24 billion in health care, lost work time, shortened lives and years spent with disability

• Family members need to act as carers• Isolation, lack of self esteem and depression due to chronic pain

Asthma

• A chronic condition that affects the small air passages of the lungs. When exposed to certain triggers, the airways of people with asthma will narrow, making it difficult to breathe.

Asthma Friendly Schools ProgramThe Asthma Friendly Schools Program is a national program that targets school students, staff and parents and was developed to help schools provide a safer environment for children with asthma. The aim of this program is to achieve improved quality of life, health outcomes and wellbeing for school children with asthma. Schools are required to meet a number of essential criteria in order to become an Asthma Friendly School.

Asthma

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Affects more than 2 million Australians • Often coexists with other chronic respiratory diseases• Leading cause of disability

• Age• Higher prevalence for females

• Viral infections• Exercise• Air pollutants• tobacco smoke • Allergens (dust mites, pollen and animal danders)

• Self-management programs• Asthma friendly schools

• in 2000-01, $615 million in direct costs• Individual costs include preventative medicine and inhalers

• Time off work, therefore loss of productivity and cost to employer

Cancer control is about attempting to control or stop the growth of a group of diseases in which the cells become defective and behave abnormally. Eight priority cancers have been identified;• Lung cancer melanoma,•non-melanocytic skin cancer• colorectal cancer prostate cancer•non-hodgkins lymphoma, cervical and breast cancer

Cancer control

Which cancers were the most common in 2007?

In 2007, the most commonly reported cancers were:•Prostate cancer (19,403 cases) •Bowel cancer (14,234 cases) •Breast cancer (12,670 cases) •Melanoma of the skin (10,342 cases) •Lung cancer (9,703 cases).

How many people died from cancer in 2007?

• A total of 39,884 people died from cancer in 2007 (22,562 males and 17,322 females), this equates to an average of 109 people dying from cancer every day.

• Cancer was the second most common cause of death in 2007, accounting for approximately three of every ten deaths (29%).

• http://www.aihw.gov.au/cancer/

Why was it selected?

1.Because it is the leading cause of disease burden in Australia 2.Because of the potential for the prevention of many cases of cancer3.Due to the large economic burden it places on the health care system

National Bowel Cancer Screening Program

Medicare Australia and the Department of Health and Ageing are working together to implement this program. Currently fewer than 40% of bowel cancers in Australia are detected early. Bowel cancer screening involves testing for bowel cancer in people who do not have any obvious symptoms of the disease. Screening involves a test called a Faecal Occult Blood Test (FOBT), which involves an individual sending a sample to a laboratory for analysis. The goals for this program are to reduce the incidence and mortality rate of bowel cancer through screening to detect abnormalities early.

Cancer control

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Leading cause of death• Leading cause of total burden of disease• More than 39,000 deaths each year

• Genetics• Age

• Smoking (lung cancer)• UV radiation (skin cancer)

• Screening and vaccination programs• SunSmart

• In 2000-01, direct costs of $2.8 billion• Cost to individuals – medication, treatment and surgery

• Personal suffering• Feeling of loss• Time off work

Cardiovascular Health

Cardiovascular health is about maintaining a healthy heart and circulatory system. Cardiovascular diseases include all diseases and conditions of the heart and blood vessels including coronary heart disease, stroke and peripheral vascular disease. It is caused mainly due to damage to the blood supply to the heart, brain and legs.

The main types of CVD in Australia are:• coronary heart disease • stroke • heart failure and cardiomyopathy • acute rheumatic fever and rheumatic heart disease • peripheral vascular disease • congenital heart disease. • The main cause of most CVDs in Australia is atherosclerosis,

which is an abnormal build-up of fat and other substances which form plaque inside the arteries.

• Atherosclerosis is most serious when it leads to reduced or blocked blood supply to the heart (causing angina or heart attack) or to the brain (causing a stroke).

The major preventable risk factors for cardiovascular disease are:

• Tobacco smoking • Poor diet and nutrition • Physical inactivity • Overweight and obesity • High blood pressure • High blood cholesterol • Diabetes

Why was it selected1. To improve the cardiovascular health of Australians by reducing coronary heart disease and the impact that it has on the population2. Because it is the largest cause of premature death and the second leading cause of disease burden in Australia 3.Because of the potential for the prevention of many cases of cardiovascular disease4.Due to the large economic burden on the health care system as the most expensive disease group

Cardiovascular health

• Cardiovascular disease is the largest cause of premature death in Australia

StrategiesThe Tick Program

The Tick Food Approval Program is a public health nutrition program that was established in 1989 as part of the Heart Foundation’s long term strategy to improve the eating patterns of all Australians. It is a guide to help people make healthy food choices quickly and easily. Its also encourages food manufacturers to develop products that support the Heart Foundations guidelines. To earn the Tick, foods need to meet a standards in relation to fat levels, trans fats, kilojoules, salt, fibre and calcium. To earn the Tick products need to be lower in fats and salt and higher in other nutrients such as fibre than other

foods in the same defined food category.

Cardiovascular disease

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Leading cause of premature death (18% of all deaths in 2005)• Leading causes of disability • Second leading cause of disease burden

• Overweight and obesity• Diabetes• Genetics

• Tobacco smoking• Poor diet and nutrition• Physical inactivity

• Heart Foundation Tick• Jump Rope for Heart• Go Red for Women• FAST (Stroke Foundation)

• In 2004-05, $5.9 billion in direct costs (11.2% of total health care spend)

• Impact on lifestyle• May affect capacity to work and participate in activities

Diabetes Mellitus

• Diabetes is a long-term (chronic) condition in which the body loses its ability to control the level of glucose (sugar) in the blood. Insulin is a hormone produced by special cells in the pancreas that helps the body to convert glucose from food into energy. People with diabetes either don’t have enough insulin or their body cannot use insulin effectively

Type 2 Diabetes Mellitus• Type 2 diabetes is the most common form of diabetes.• It occurs mostly in people aged 50 years and over and, • People with type 2 diabetes produce insulin, but cannot use

it effectively or may not produce enough. • Type 2 diabetes may initially be managed with changes to diet

and exercise, and/or oral glucose-lowering drugs. • People with type 2 diabetes may progress to needing insulin

or a combination of these therapies if their condition cannot be managed through lifestyle changes and/or oral drugs.

• Type 2 diabetes accounts for 87% of all people with diabetes, according to self-reported data from the 2007–08 National Health Survey.

Risk factors

• http://www.aihw.gov.au/diabetes/risk-factors/

Diabetes mellitus

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• More than 1 million Australians have diabetes

• Genetics• Age

• Physical inactivity

• National diabetes action program

• In 2000-01, $836 million in direct costs• Ongoing costs for daily medication for type 1 diabetes

• Impact on daily lifestyle for people with type 1 diabetes

injury prevention and control

• This NHPA aims to reducing the incidence of injuries such as intentional harm including suicide and unintentional injuries such as falls, poisoning and transport accidents

• Injury contributes substantially to the burden of disease. In 2010, injury was estimated to account for 6.5% of the total burden of disease in Australia.

• Each year about 400,000 people suffer an injury severe enough to be admitted to a hospital.

• Older people, particularly women, have higher rates of injury as a result of falls.

Why was it selected?

1.Because it is a significant cause of disease burden in Australia 2.Because of the potential for the prevention of many injuries3.Due to the large economic burden it places on the health care system

Arrive Alive 2008-2017Arrive Alive 2008-2017 is the Victorian Government’s new 10-year road safety strategy to help combat road trauma, deliver further major improvements to our road transport system and improve safety for all Victorian road users. The strategy incorporates the Safe System approach to road safety –safer roads and roadsides; safer vehicles; safer road users. It also incorporates initiatives in the key areas of: road improvements; drug driving; young drivers; strategic enforcement; safe vehicles. Arrive Alive’s target is by the end of 2017, a reduction in deaths and serious injuries by 30% and save an extra 100 lives a year, prevent over 2000 serious injuries and reduce the severity of serious injuries.

Injury prevention and control

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Major cause of death for people under 45 • Leading cause of death for children• Can result in permanent disability

• Age• Excess weight increases risk of falls in older people

• Unsafe environment (e.g. Pools with open gates)• Drink driving

• National Prevention Plans • National Kidsafe Day• TAC: “If you drink and drive, you’re a bloody idiot”

• In 2000-01, $4061 million in direct costs • Cost to individual families e.g. modifying home for disabled family member

• High costs for health care for people living with disability• Pain and suffering

Mental Health

• Mental health is about promoting a state of wellbeing in which the individual realizes his or her own abilities, can cope with the stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community

• 3.2 million Australians (20% of the population aged between 16 and 85) had a mental disorder in the twelve months prior to the survey.

Why was it selected?

1.Because it is the leading cause of non-fatal disease burden in Australia 2.Due to the large economic burden it places on the health care system

MindMattersMindMatters is a national mental health initiative for secondary schools funded by the Australian Government Department of Health and Ageing and is implemented by Principals Australia. MindMatters uses a whole school approach to mental health promotion and with this focus, embeds promotion, prevention and early intervention; enhances the development of school environments; develops social and emotional skills; helps school communities; develops strategies; and working with families all with the aim of raising awareness and providing coping strategies for all individuals.

Mental health

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Leading cause of burden of disease• More than 20% of Australians will experience mental illness

• Genetics• Physical (chemical imbalance)

• Unhealthy family environment• Stress

• beyondblue• National Suicide Prevention Strategy• KidsMatter• MindMatters

• High number of hospitalisations, therefore high costs for individuals and families

• Personal suffering• Stigma

obesity

• http://www.aihw.gov.au/overweight-and-obesity/burden-of-disease/

Obesity

Reason why NHPA

Biological risk factors

Behavioural risk factors

Health promotion strategies

Direct costs Indirect and intangible costs

• Global epidemic• Increases risk of other diseases

• Weight • Poor diet and overconsumption

• National Obesity Strategy • Measure Up

• Estimated $11 billion per year

• Stigma• Discomfort

Dementia

• Dementia is not a single specific condition. Rather, it is an umbrella term that describes a syndrome associated with more than 100 different conditions which are characterised by the impairment of brain functions, including language, memory, perception, personality and cognitive skills.

Alzheimer disease is the most common type of dementia, accounting for about 50% to 75% of dementia cases worldwide. It is characterised by short-term memory loss, apathy and depression in the early stages. Onset is gradual and decline is progressive. This form is most common among older people with dementia, particularly among women.

Vascular dementia is generally considered to be the second most common type of dementia, with about 20% to 30% of dementia cases thought to be this type. It is caused by cerebrovascular conditions (for example, stroke). Symptoms in the early stages are similar to Alzheimer disease, but memory loss is not as great and mood fluctuations are more prominent. Physical frailty is also evident. Onset can be sudden.

An overview of the stages of dementiaMild or earlyDeficits are evident in a number of areas (such as memory and personal care) but the person can still function with minimal assistance. Symptoms include: moderate memory loss especially for recent events, some disorientation in time, moderate difficulties with problem solving, reduced interest in hobbies, and the need for prompting regarding personal care tasks.Moderate or middleDeficits become more obvious and severe, and increasing levels of assistance are required to help the person maintain their functioning in the home and community.Symptoms include: severe memory loss, considerable difficulty orienting to time and place, obvious difficulties in finding words, severe impairment of judgement and problem solving, need for assistance with personal care tasks, and emergence of behavioural difficulties (for example, wandering, aggression, sleep disturbance and disinhibited behaviour).Severe or lateCharacterised by almost total dependence on the care and supervision by others.Symptoms include: very severe memory loss, very limited language skills, unable to make judgements or solve problems, regularly not recognising familiar people, frequent incontinence, requires substantial assistance with personal care, and increased behavioural difficulties.By this stage the majority of people with dementia are in residential care.

• Sunday night last week on the relationship between head trauma and dementia: http://au.news.yahoo.com/sunday-night/video/watch/c299b651-1129-3986-a9a4-1e146547279a/the-price-of-playing-the-game/aunews_sunday_night/

• factsheet from the WHO: http://www.who.int/mediacentre/factsheets/fs362/en/#.USyYwt98d3Y.mailto

• (two from Alzheimer’s Australia about Dementia becoming an NHPA): Alzheimer’s Australia: http://www.youtube.com/watch?feature=endscreen&NR=1&v=v3ZNcK758ZY (1.57)

• Alzheimer’s Australia: http://www.youtube.com/watch?v=9g-xvfsXbw4 (2.47)

• What is dementia?: http://www.youtube.com/watch?v=6q-H1-XwCZA

DementiaReason why NHPA

Biological risk factors

Behavioral risk factors

Health promotion strategies

Direct and indirect cost

Ageing population298,000 Australians had dementia in 2011,3rd leading cause of death accounting for 6% of all deaths

Twice as many women asmen died from dementia (6,083 and 2,920 respectively)AgeingFamily historyhypertension

vascular risk factors (such as smoking, sedentary lifestyle, obesity,head trauma, depression

Alzheimer’s Australia provides a range of freesupport services to people living with dementia, their families, carers and health

there were at least 200,000 informal carers of people with dementia health and aged care system expenditure$4.9 billion in 2009–10,

Summary

• NHPAs are a collaborative effort involving Commonwealth, State and Territory Governments

• Eight current NHPAs collectively account for almost 80% of total burden of disease and injury in Australia

• Obesity is the most recently added NHPA – announced in April 2008