DISEASE CONTROL andPREVENTION IN AUSTRALIA

Public Health Association Conference 2011

CANBERRA –

4 April 2011

Professor Jim Bishop AOChief Medical Officer

Australian Government Department of Health and Ageing

UNITED STATES GOVERNMENTCentres for Disease Control and Prevention

OBJECTIVES

• Monitor health• Detect and investigate health problems• Conduct research on prevention• Develop sound public health policies• Implement prevention strategies• Promote healthy behaviours• Foster safe environment

Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)

7538

5004

4627

42104079 4063 3970

3793 3737 3696 36773540 3470

3359 33533129 3060 3008 2902 2870

2729 2687 2683

2151

1801 1781 1737

14371213

999852 767

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

1. Refers to insured population rather than resident population. 2. Current expenditure. 3. 2006. 4. 2007. Source: OECD, OECD Health Data, June 2010

Public expenditure on health Private expenditure on health

OECD HEALTH DATA 2010How Does AUSTRALIA Compare

COMMONWEALTH GOVERNMENT HEALTH & HOSPITAL EXPENDITURE

UNDER THE NHHN

Source: Commonwealth Budget Papers, DOHA and PMC Analysis

MAJOR DISEASE BURDEN in AUSTRALIA

PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010

Source: AIHW Australia’s Health 2010

AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006

Source: AIHW Australia’s Health 2010

BROAD CAUSE MORTALITY TRENDS IN AUSTRALIA

Source: AIHW

Source: AIHW Australia’s Health 2010

AGED ADJUSTED DEATH RATESFrom CVD, 1907 -

2006

Source: Tracey et al –

Cancer Institute NSW

CHANGES IN DEATH RATES IN MALES -

using Joinpoint Analysis

Source: IARC 2010.

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1.0

Kenya

Nigeria

Egypt

Viet N

amTurk

eyInd

iaChinaRuss

iaSou

th Afric

aGreec

eBraz

ilJa

pan

Czech

Rep

ublic

Italy

United King

domCana

daGerm

any

Sweden

New Zealan

dUSA

Austra

liaM

orta

lity-

to-in

cide

nce

ratio

MalesFemales

ALL CANCER –

MORTALITY/INCIDENCE

ratios for selected countries -

2008

Source: AIHW Australia’s Health 2010

DEATH RATES FROMINFECTIOUS DISEASES, 1922-2007

TRENDS IN LEADING CAUSESOF DISEASE BURDEN 2003-2023

Source: AIHW Australia’s Health 2010

TOTAL CANCER CASES & DEATHS per year (1972 to 2036)

Source: Cancer Institute NSW

AUSTRALIAN GOVERNMENTSOCCUPATIONAL HEALTH and SAFETY

• Safework Australia• National Centre for Injury Prevention and Control•

Jurisdictional responsibilities in State and Territory Departments of Health

• Quality and Safety in Health Care-

Australian Commission on Quality andSafety in Health Care

-

Jurisdictional Quality and Safety initiativeseg: Clinical Excellence Commission (NSW)

AUSTRALIAN GOVERNMENTSPUBLIC HEALTH PREPAREDNESS

• Office of Health Protection (OHP)• National Incidence Room (NIR)• Australian Health Protection Committee (AHPC)

-

Jurisdictional, CDNA, enHealth, ADF, PHLN• Links to:

-

Emergency Management Australia (A/G)- ADF-

Other Commonwealth Portfolios (DFAT, AusAID)

CENTRES FOR DISEASE CONTROL & PREVENTIONUS GOVERNMENT

NON –

COMMUNICABLE DISEASES

• National Centre for Birth Defects• National Centre for Chronic Disease Prevention• National Centre for Environmental Health• National Centre for Injury Prevention

Research component within the National Institutesof Health funding

AUSTRALIAN GOVERNMENTSNON-COMMUNICABLE DISEASES

•

Australian National Preventative Health Agency•

Australian and Jurisdictional Government Population Health programs

•

Australian Population Health Development Principal Committee (AHMAC Committee) –

Screening Sub-committee•

Jurisdictional enHealth programs and enHealth sub-committee of AHPC

•

National screening programs in breast, cervix and bowel: Australian and Jurisdictional programs

•

Specific Commonwealth, Jurisdictional programs on Chronic Diseases

Research components within the NHMRC Funding

CENTRES FOR DISEASE CONTROL & PREVENTION

SURVEILLANCE and REPORTING

• Health Statistics• Laboratory Policy• Public Health information• Public Health Surveillance• Epidemiology and analyses• Scientific education and professional development

AUSTRALIAN GOVERNMENTS*

SURVEILLANCE AND REPORTING

• Australian Bureau of Statistics• Australian Institute of Health and Welfare• National Notifiable Disease Surveillance System• Sentinel Surveillance System• TGA adverse event reporting• DFAT Travellers Advisory• Cancer registries in each State and Territory• Screening and pap test registers• FSANZ and OZFoodNet

* National Health Security Act and agreement

AUSTRALIAN GOVERNMENTS

INFRASTRUCTURE

•

AHPC (enHealth, PHLN and CDNA)•

OHP Epidemiology Branch

•

State and Territory Epidemiology Programs•

National Immunization Program (NIP)

•

Australian Technical Advisory Group on Immunization (ATAGI)

AUSTRALIAN GOVERNMENTS

GOVERNMENT SUPPORTED or ACADEMIC PROGRAMS

•

Cancer Australia (NBOCC)•

National Centre for Injury Prevention and Control

•

National Centre for Asthma monitoring•

National Centre for HIV Epidemiology and Research

•

National Centre for Immunization Research and Surveillance

•

National Centre for Asbestos related diseases

THE KEYS TO PREVENTION

0.0 2.0 4.0 6.0 8.0

Tobacco

Blood pressure

Overweight/obesity

Physical inactivity

Blood cholesterol

Alcohol

Fruit/vegetables

Illicit drugs

Air pollution

Unsafe sex

% DALYs

Total of 32%

Source: Table 4.1 AIHW Australia’s Health 2008

AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006

Source: AIHW Australia’s Health 2010

AUSTRALIAN HEALTH SURVEY

Four components run by ABS 2011-13

-

Health Survey- ATSI Health Survey

-

Nutrition and Physical Activity Survey

-

Health measurement Survey

Around 50,000 participants

De-identified data available as summary statistics, tables

Anti-smoking campaigns ($27.8m)

COAG agreed•

Increased tobacco excise

•

Plain packaging •

Restricting internet advertising of tobacco products

•

Further funding for National Binge Drinking Strategy ($50m)

•

Survey of Australia’s Health ($54m)

National Preventative Health Agency

Budget 2010-11

CONCLUSIONS

•

Australia’s health outcomes are good by International standards

•

Prevention programs have some success and remaining challenges

•

Well Supported health emergency responses occupational health, food and medicines safety

•

Chronic diseases are the major burden of disease in Australia supported with substantial infrastructure

•

Australian Governments have invested in academic centres to lead research and training in similar areas to the US CDC rather than bureaucratic structures