Epidemiology and Health Status

Measuring Health Status

• Epidemiology studies patterns and causes of health and disease in populations
• It applies this knowledge to improve health outcomes
• Epidemiology identifies health and disease patterns, analyzing health service utilization
• It provides insights into ethnic, socioeconomic, age, and gender-related health differences
• Epidemiology helps manage diseases, develop vaccines, and inform government policy
• It may not fully account for broader determinants influencing quality of life

Utilizing Measures in Epidemiology

• Researchers, health officials, the government, and medical practitioners use epidemiological measures
• Epidemiological data aids in identifying key health concerns and potential disease causes
• Observations and statistics describe and compare health patterns across groups, communities
• It helps to identify health needs and allocate healthcare resources
• Resources are allocated to evaluate health behaviors and strategies, control and prevent disease

Limitations of Health Status Measures

• Measures don't always reflect the health status variations within subgroups, like ATSI vs. non-ATSI Australians
• Measures fail to fully explain ongoing health inequities
• Health measures may not capture the complete health landscape - mental or spiritual health
• These measures often overlook health determinants like social, economic, and cultural factors
• Can be inaccurate in representing the true impact or severity of illnesses through statistics
• Subject to skewed interpretations
• Health measures tend to emphasize negative health aspects rather than positive

Analyzing Trends

• Health reports' tables and graphs are used to analyze current trends in life expectancy
• Health reports' tables and graphs are used to find the major causes of morbidity and mortality in the general population
• Health reports' tables and graphs are used to compare the differences between males and females

Approaches to Data Collection

• The Australian Bureau of Statistics (ABS) conducts the National Health Survey
• ABS collects data from a sample of households with adults and children
• This provides a snapshot of the overall health status of Australians
• This data collection is more reliable for common conditions like asthma and colds
• This data collection is less reliable for illnesses such as cancer
• An accurate health status picture requires data from hospitals and nursing homes with strict privacy

The Role of Epidemiology in Public Health Decisions

• Epidemiology is crucial for making well-informed public health decisions
• These decisions should be based on understanding the disparities, or differences, between communities

Prevalence vs. Incidence

• Prevalence is the current number of cases of a specific illness or disease
• For example, 20,000 people in Australia infected with HIV
• Incidence is the number of new cases of a disease or illness in a set time period
• For example, about 800 new diagnoses of HIV per year

Factors Influencing Life Expectancy

• Medical advancements contribute to increased life expectancy
• Greater educational successes
• Better living conditions
• Increased access to health care

Differences in Life Expectancy by Sex

• Males take more risks
• Males are employed in 'blue collar' careers that often lead to poor nutritional habits

Leading Causes of Death

• Coronary heart disease is the leading cause of death in Australia
• Dementia is the second leading cause of death in Australia
• Coronary heart disease is main cause of death for males
• Lung cancer is leading mortality rate for Cancer in males at 5.6%, prostate cancer is second at 4.2%
• Dementia/Alzheimer's is main cause of death for females
• Lung cancer is leading mortality rate for Cancer in females at 4.8%, breast cancer is second at 4.1%
• Coronary heart disease was the top cause of death for males in 2022 (10% of deaths)
• Dementia and Alzheimer's was the top cause of death for females (8% of all female deaths)
• The total number of cancer deaths (44,100) exceeded CVD deaths in 2013
• Coronary heart disease is a specific leading cause of death in Australia

Leading Causes of Death by Age Group

• Under 1: Perinatal and congenital conditions
• Ages 1-14: Land transport accidents
• Ages 15-24 and 25-44: Suicide
• Ages 45-64, 65-74, and 75-84: Coronary heart disease
• Ages 85+: Dementia/Alzheimer’s disease

Understanding Infant Mortality

• Infant mortality is the single greatest determinant of life expectancy
• Australia's infant mortality rate has steadily declined
• Australia's infant mortality rate reached a record low of 3.1 deaths per 1000 live births from 2016-2020
• The Indigenous infant mortality rate between 2014-2016 was 6.2/1000
• The non-Indigenous rate was 3.2/1000

Factors Reducing Infant Mortality Rates

• Improved medical diagnosis
• Improved public sanitation
• Health education
• Improved support services for parents, newborns, babies and children

Disparities in Infant Mortality Rates

• Higher infant mortality rates are seen among Indigenous infants
• The 2014-2016 infant mortality rate for Indigenous infants was approximately 6.2 per 1000 live births
• The rate was about twice that of non-Indigenous Australians with 3.2 per 1000 live births
• Most Indigenous infant deaths were linked to pregnancy, labor, delivery, and sanitation complications

Main Causes of Morbidity

• 15-24 (Females): Anxiety disorder (10.2%)
• 25-44 (Females): Anxiety disorder (8.9%)
• 65+ (Females): Dementia (11.1%)
• 15-24 (Males): Suicide/self-inflicted injuries (14.1%)
• 25-44 (Males): Suicide/self-inflicted injuries (11.1%)
• 65+ (Males): Coronary heart disease (10.4%)

Measures of Morbidity

• Hospital use (cause and number of admissions)
• Doctor visits and Medicare statistics
• Health surveys and reports
• Disability and handicap

Most Commonly Diagnosed Cancers in Australia (2021)

• Males: Prostate cancer
• Females: Breast cancer
• Second diagnosed cancer in males is melanoma of skin, females is colorectal cancer
• Third diagnosed cancer in males is colorectal cancer, females is melanoma of skin

Factors Affecting Cancer Incidence

• Increases can be partly attributed to aging and population growth
• Improvements in diagnostic technologies have identified more cases early

Influence of Prevalence

• ATSI populations experience a higher prevalence of many chronic health conditions
• Disease prevalence is generally higher in rural and remote areas of Australia than in major cities

Australian Life Expectancy Trends

• Life expectancy in Australia is 85.3 for females and 81.2 for males due to advancements in medical care
• Educational attainment is increasing
• Chronic disease decreases with life expectancy
• Access to health services is increasing
• Motor vehicle safety is increasing
• Living/work conditions are improving

Framework for Setting Health Priorities in Australia

• Health priorities are guided by justice principles
• Considerations around target population groups
• prevalence of a condition
• potential for early intervention or prevention
• overall direct and indirect individual and community cost

Social Justice Principles

• Promote health equity, inclusivity, and supportive environments

Role of Social Justice in Health Priorities

• Support the provision of equal access to health resources, services, and education, to reduce the occurrence of sickness and death

Principles of Social Justice (EDSAR)

• Applying social justice principles means providing equal access to resources, health services, education
• By closing the gap within ATSI for the 10-year gap in life expectancy reduce diabetes instance
• The aim is to reduce health inequities and improve health outcomes for all Australians

Equity

• Resources are allocated based on individual and population needs to achieve equality
• Focuses on providing resources for priority groups, like ATSI leading to additional funding

Diversity

• Acknowledges differences among individuals and populations within Australia's multicultural society

Supportive Environments

• Focuses of creating places where people live, work and play to protect well being
• Involves creating supportive environments for all groups by addressing the environments of people groups for poor health outcomes.

Access

• Providing equal services in health, information and education.

Rights

• Ensuring fair health oppurtunity for all persons.

Strategies of Health Prioritization

• Recognizing priority population groups is important due to health issues, health disadvantages
• Understand the needs of justice principles
• Provides statistics on populations for prioritizing

Additional Factors

• Epidemiology can show data like ATSI males living 10 years less
• People in rural areas have higher death rates
• Lower oral health is found with lower socioeconomic status
• Men have greater risk of heart disease

Influence of Funding and Resources

• Based on the greater health issue health programs are adapted.

Prevalence

• Number of people affected by prevalence is linked to identifying health problems.
• Focus priority on High conditions that can cause cardiovascular disease

Trends and Impact

• Reduction of smoking has lead to reduction in Cancer deaths in Australia.
• Dementia and Alzheimers rates affect the mortality and prevalence.
• Diabetes high priority issues for Australia due to the High disease incidents.
• High Major Issues for CVD cerebrovascular disease due to similar cause.

Planning for Effective Intervention

• Prioritize prevention and create a good focus is making successful health treatment.

Direct and Indirect Costs

• Direct costs (money)- prevent measure and treating the sick.
• Indirect (Loss output value)- output value of loss that person became sick

Defining Target Groups (Priority)

• The defined priority groups are socio-economic and environmental factors, ATSI, Disabilities, Rural locations.