• Outcome 2• Summary

• Biomedical Approach• Preventative Approach• Social model for health• Ottawa Charter

• Focuses on Illness and disease.• Relies heavily on technology to

diagnose and treat disease.• Deals with disease only once it is

present.• Developed as scientists began to

discover new cures for diseases.

Advantages Disadvantages• “Fixes” disease. If you get a

disease, you can have it cured or managed.

• Australia’s life expectancy improves. People aren’t dying from diseases as much.

• Very expensive as there is still a lot of disease occurring –cheaper for the disease to not happen at all.

• Life expectancy increased but not healthy life expectancy. People still get disease and have to live with it.

• Creates a “Quick Fix mentality” – Why should you do anything if someone can fix it for you?

• Focus on changing lifestyle to prevent disease.• Each persons own responsibility to be healthy.• Gives people the information they need to be healthy.

Advantages Disadvantages• “Cheaper than Biomedical –

Stops disease from occurring as much so it doesn’t need to be treated.

• Increased Healthy Life Expectancy – people live longer before they get the disease.

• Promotes the idea that you are responsible for your own health – more likely that people will do something about it.

• Ignores environmental factors that affect peoples health. You can tell people what to do but they may not be in a position to do anything about it.

• Promotes the idea that if you get sick it’s “Your fault”

• Idea that intervention is needed to address environmental factors that reduce health status.

• All about enabling people to make healthy decisions and access health care, not just giving information.

• Much more holistic model, includes elements of preventative and biomedical.

• Helps people, doesn’t just tell - empowers.• Improves access to health care• Increases healthy life expectancy• Increases health status by targeting risk groups and

reducing inequalities.• Tackles issues from multiple angles/determinants

• HOLLISTIC!!!!

• Address all determinants of health.

• Reduce social inequality

• Empower individuals and the community

• Accessibility to healthcare

• Sectorial collaboration

• 21 November 1986• AIM: taking action to achieve

health for all by the year 2000 and beyond.

• 3 basic strategies• 5 elements or priority action areas

for health promotion are outlined….

The Ottawa Charter identifies three basic strategies for health promotion:

• Advocate • Enable • Mediate

• Build healthy public policy.• Create supportive environments.• Strengthen community action.• Develop personal skills.• Re-orient health services.

Remember: Bad Cats Smell Dead Rats!

• It is important to note as we go through the different models, that as we have moved to new ways of doing things, it does not mean that the previous way was ‘wrong’. We keep the good points, and address the flaws in creating new models. As such, there is and ‘interplay’ between the three models – some are

better than others, but elements from all three need to be used – it is NOT one or the other.

• Role• Mission• Priorities• Alignment to the Social Model of Health• Potential Outcomes

• Established in 1987 to stop tobacco advertising at sporting and arts events by advertising positive messages.

• works in partnership with organisations, communities and individuals to make health a central part of our daily lives.

• Work on the idea that health promotion is an extremely cost effective way to improve health as it is avoids costly treatments.

• Principles guiding our strategic focus are consistent with the World Health Organisation’s (WHO) and the Ottawa Charter for Health Promotion 1986.

VicHealth mission is to build the capabilities of organisations, communities and individuals in ways that:• change social, economic, cultural and physical

environments to improve health for all Victorians• strengthen the understanding and the skills of

individuals in ways that support their efforts to achieve and maintain health

There are a number of areas that VicHealth targets to help improve Australia’s health (2009-2013):. Reduce Smoking Improve Nutrition Reduce Harm from Alcohol Increase Physical Activity Increase Social and Economic Participation. Reduce Harm from UV Exposure

VicHealth works to address to the reasons (determinants) that people are seek, and fix these, rather than just trying to prevent or treat the disease itself.

It matches up to the principle of social health on the following ways; Acknowledges social, economic, cultural and physical environments as

well as lifestyle, genetics and income. Targets factors like low socio-economic status and other factors to

promote social equality. Provides people with resources and knowledge they need to make

appropriate decisions about their health. Work closely with government departments and non-government

organisations to implement initiatives.

If VicHealth is being successful, the areas it targets should be costing us less and not impacting on peoples health as much. How do we know if this is happening? Changes in community attitudes Reduces production, sales and availability of harmful

products Reduced deaths/burden of disease Increased regulation on harmful products

There are a number of examples which you can look at on p186.

• Local• State• Federal

• Local and municipal governments are responsible for providing a safe environment for it’s community.

• These could include;• Public health programs like immunisation• Community activity centres• Garbage collection and disposal• Maintaining roads• Health inspections in restaurants

• Provides guidance to local government and provide health services.• Funding public hospitals• Funding early detection

schemes• Provision of education schemes• Controlling pollution• Research into public health

issues

• Responsible for health care that has an impact on all Australians• Medicare• Pharmaceutical benefit scheme• Regulates private health insurance• International health care – AusAid• Quarantine• Legislation• Research

• In designing and implementing the health care systems we currently have in place, there are a number of values that each level of government attempts to uphold.

• Health care in Australia needs to be:

• Effective• Appropriate• Efficient• Responsive

• Accessible• Safe• Continuous• Capable• Sustainable

MEDICARE OBJECTIVES

• To make healthcare more affordable for all Australians.

• To give all Australians access to healthcare services with priority according to clinical need.

• To provide a high quality of care

SCHEDULE FEE• The benefits you receive from Medicare are

based on a Schedule of fees set by the Australian Government.

• Doctors may choose to charge more than the Schedule fee.

• TheMedicare Benefits Schedule (MBS) lists all the Medicare item numbers.

BULK BILLING

• Bulk billing is when your doctor bills Medicare directly, accepting the Medicare benefits as full payment for a service.

SAFETY NET• The Medicare Safety Net gives families and individuals

financial assistance for high costs for out-of-hospital medical services that attract a Medicare benefit.

• Once you reach a Medicare Safety Net threshold, you may be eligible for additional Medicare benefits.

GAP• A 'gap' is the amount you pay either for medical or

hospital charges, over and above what you get back from Medicare or your private health insurer.

• Schedule Fee - The Benefit (Usually 15%) • Some health funds have gap cover arrangements to

insure against some or all of these additional payments.

OUT-OF-POCKET EXPENSE• The amount you have to pay that is not covered by your

Private Health Insurance, or medicare.• Usually the "GAP" plus any extra the service is

charging above the Shedule Fee.

PRIVATE HEALTH INSURANCE• Provides individuals with additional health care services

than those provided by medicare.• Services that are considered non essential.• Usually includes two parts – hospital and non hospital.• You can choose to pay for hospital cover, extras cover,

or comprehensive.

GOVERNMENT INCENTIVESFederal Government has introduced three incentives for people to take up Private Health Insurance:• 30% rebate• Lifetime health cover• Medicare Levy

PHARMACEUTICAL BENEFIT SCHEME• The Pharmaceutical Benefits Scheme (PBS) gives all

Australian residents and eligible overseas visitors access to prescription medicine in a way that is affordable, reliable and timely.

• Through the PBS, the Australian Government subsidises the cost of prescription medicine, making it more affordable for all Australians.

• Surveys• Nutrient Reference Values• Australian Guide to Healthy Eating• Dietary Guidelines• Legislation

THE ROLE OF AUSTRALIA’S GOVERNMENTS IN

PROMOTING HEALTHY EATING

SURVEYSRole:• Monitor and assess what we are eating.• Identify Problems• Help direct/focus policy and campaign development.• Monitor changes / improvements / effectiveness of

programs….

SURVEYSExamples:• 1995 National Nutrition Survey – Diet Habits Vs RDIs – eg.

Children 8-11 not enough Fruit and Vege…• 2007 Children’s Nutrition and Activity Survey – 69% of

children met Phys Act Guidelines - >22% overweight or obese!

• Healthy Food Basket Survey – Cost of basket increased significantly over time, Cost of healthy foods has increased more than less nutritious alternatives, higher in Very Remote.

NUTRIENT REFERENCE VALUES• Provide Nutrition advice to Health

Professionals and General Public (detailed).

• Recommend intake of essential nutrients considered, on the basis of available scientific knowledge, to be adequate to meet the known nutritional needs of practically all healthy people…they incorporate generous factors to accommodate variations in absorption and metabolism.

EAR Estimated Average Requirement• A daily nutrient level estimated to meet the requirements of half the healthy individuals in a particular life stage and

gender group.RDI Recommended Dietary Intake• The average daily dietary intake level that is suffi cient to meet the nutrient requirements of nearly all (97–98 per

cent) healthy individuals in a particular life stage and gender group.AI Adequate Intake (used when an RDI cannot be determined)• The average daily nutrient intake level based on observed or experimentally-determined approximations or

estimates of nutrient intake by a group (or groups) of apparently healthy people that are assumed to be adequate.EER Estimated Energy Requirement• The average dietary energy intake that is predicted to maintain energy balance in a healthy adult of defi ned age,

gender, weight, height and level of physical activity, consistent with good health. In children and pregnant and lactating women, the EER is taken to include the needs associated with the deposition of tissues or the secretion of milk at rates consistent with good health.

UL Upper Level of Intake• The highest average daily nutrient intake level likely to pose no adverse health effects to almost all individuals in the

general population.

NUTRIENT REFERENCE VALUES

Example:

NUTRIENT REFERENCE VALUES

AUSTRALIAN GUIDE TO HEALTHY EATING• Help “everyday” - Australians choose a healthy diet

using a variety of foods.• The advice applies to most people, except very young

children and people with special needs • Food is not just a source of nutrients. It is important for

good social and emotional health as well as physical health. Food and eating are part of the way people live their lives.

AUSTRALIAN GUIDE TO HEALTHY EATING

AUSTRALIAN GUIDE TO HEALTHY EATING

DIETARY GUIDELINES• “The Dietary Guidelines for Australians is your best guide to

food, nutrition and health.”• The guidelines for Adults, Children and Adolescents are shown.• The Dietary Guidelines highlight the groups of foods and

lifestyle patterns that promote good nutrition and health. • No guideline is more important than another. • Each guideline deals with a key health issue and is like a piece

of a puzzle. • This guide will help Australians put the pieces of the puzzle

together.

DIETARY GUIDELINES

DIETARY GUIDELINES

LEGISLATION – FOOD LABELLINGAny food product must contain a list of information.

• Name/description of the food

• Name and address of manufacturer

• Allergy warnings and advice

• Ingredients list

• Net weight

• Nutritional info panel

• Used by or best before date

• Country of origin

• Lot number

• Percentage labelling

• Food additives

LEGISLATION• Nutrient Claim: A statement that sets out in general

terms the nutritional consequences for good health of the intake of nutrition.

• Health Claim: A direct connection between consuming a food product or nutrient found in the food and the decreased risk of a specific disease.

• In Australia, nutrient claims are allowed to be printed on foods labels and used in product advertising.

• Current regulations prohibit the use of health claims!

• Heart Foundation• Nutrition Australia

THE ROLE OF AUSTRALIA’S NON-GOVERNMENT

AGENCIES IN PROMOTING HEALTHY EATING

NGO’SNon-government organisations (NGOs) provide:• advice and information to improve eating habits • services to improve healthy eatingSome NGOs have a vested interest in changing dietary patterns (such as the Australian Dairy Corporation). Other NGOs receive government funding, which means that their policies must be in line with those of the government

HEART FOUNDATION• Aims to improve heart health and reduce disability and death

from heart disease.• Promotes and conducts research for prevention and treatment• Promoting and influencing behaviour to improve heat health.

Also produce publications.• Their message is;

• Enjoy healthy eating• Be active• Don’t smoke• Go to the doctor

HEART FOUNDATION - TICKThe Heart Foundation tick of approval is printed on foods that are low in nutrients that promote heart disease and high in one that reduce it:• Low saturated fat, trans fat, energy, salt.• High fibre.

Limitations• Commercial investment required• Healthier options without tick?

NUTRITION AUSTRALIA• Founded in 1979 to promote educate about nutrition

using scientifically based information.• Offers services like funding for research, seminars,

consults with food industry, menu assessments• Developed the Healthy Living Pyramid.

models of health and health promotion including: biomedical model of health social model of health the Ottawa Charter for Health Promotion;

the role of VicHealth in promoting health including its values, priorities and how it reflects the social model of health;

potential health outcomes of a VicHealth funded project; Australia’s health system including

local, state and federal governments’ responsibility for health including funding the values that underpin the Australian health system Medicare, Pharmaceutical Benefits Scheme (PBS) and private health insurance;

the role of Australia’s governments in promoting healthy eating through: the information provided by nutrition surveys and how it is used the purpose of Nutrient Reference Values to guide dietary intake the Australian Guide to Healthy Eating and Dietary Guidelines legislation developed by Food Standards Australia and New Zealand governing the safety

and quality of food; the role of Australia’s non-government agencies, including Nutrition Australia and the Heart

Foundation, in providing dietary advice to promote healthy eating.

analyse the different approaches to health and health promotion; identify and explain key components of Australia’s health

system; describe the role, values and priorities of VicHealth and potential

health outcomes of a VicHealth funded project for promoting health;

identify the principles of the social model of health evident in a project used by VicHealth;

explain and draw informed conclusions about the role of government and non-government agencies in promoting healthy eating.

• Discuss and analyse approaches to health and health promotion, and describe Australia’s health system and the different roles of government and non-government organisations in promoting health.