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HSC PDHPE – Core 1 - Health Priorities in Australia Study Notes – How are Priority Issues for Australia’s Health Identified
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Core 1: Health Priorities in Australia:
How are Priority Issues for Australia’s Health Identified? (page 1 – 3)
What are the Priority Issues for Improving Australia’s Health? (page 4 – 9)
What Role do Health Care Facilities Play in Achieving Better Heath for all Australians?
(page 10 – 13)
What Actions are Needed to Address Australia’s Health Priorities? (page 14 – 16)
How are Priority Issues for Australia’s Health Identified?
M e a s u r i n g H e a l t h S t a t u s
Role of epidemiology:
Epidemiology is the study of the patterns of illness and disease in a population. It considers the
patterns of disease in terms of
o Prevalence – Number of cases at a point in time
o Incidence – New cases in a period of time
Role of Epidemiology:
o Identify risk factors of a disease
o Determine extent of a disease
o Evaluate prevention strategies
o Provide suggestions for public policy
o Identify and promote behaviours that can improve health status (e.g. ↓ fat ↑ fibre)
Users of Epidemiology:
o Government: Public health policy & taxes etc
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o Individuals: Make informed decisions
o Health Care Workers: E.g. doctors
o Businesses: Consumer friendly/healthy products
Limitations of Epidemiology:
o Based on statistics & can’t be accurately applicable to individuals
o If data is incorrect, epidemiology is futile
o Only deals with information of the past can only predict future
o Can’t explain “why” of trends
o Only accounts for those who actively seek medical help
o Doesn’t show variations in population subgroups (e.g. priority groups such as ATSI)
Measures of epidemiology (mortality, infant mortality, morbidity, life expectancy):
Mortality: Death rates in population
630 per 100, 000 persons in 2005 (51% males, 49% females)
Mortality rates ↓
Infant Mortality: Rate of deaths under 1 year of age
Halved between 1985 & 2005
IM rates ↓
Morbidity: Measure of disease and disability rates
Cancer is leading cause, followed by cardiovascular disease & mental disorders
Morbidity ↓ (or at least happening later in life)
Measures: hospital use (cause & admissions), doctor visits, Medicare statistics, absent days
from work (pregnant women misleading), health surveys & reports
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Life Expectancy: Average number of years a person can expect to live
Men = 79, Women = 83
LE ↑
Improvements due to: ↓ IM rate, ↓ deaths in young adults from MVA, ↓ deaths from CVD
Trends of Prevalence & Mortality:
Problem: Mortality Trend: Prevalence Trend:
CVD ↓ ↓
Cancer ↓ =
Diabetes = ↑
Respiratory Disease ↓ (asthma) = (asthma ↓ in young people)
Injury ↓ ↓
Mental Health ↓ ↑
Differences for Males and Females:
Males: Females:
o Higher cancer rates
o Higher injury rates
o Higher diabetes rates (4% Vs. 3%)
o Higher CVD rates (55% Vs. 45%)
o > 60 years higher hospitalization rate
(falls)
o Higher asthma rates
o Higher mental health problems (11.4% Vs.
10%)
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I d e n t i f y i n g P r i o r i t y H e a l t h I s s u e s
Social justice principles:
o Aims to remove inequity from a population
o Involves:
o Equality of Rights: eliminate discrimination, promote rights
o Equality of Opportunities: so all individuals can fulfill their potential
o Equity in Living Conditions: Or quality of life redistribute wealth where necessary
Priority population groups:
o Groups more affected by illnesses & death than the general population
o Aboriginal & Torres Strait Islander peoples (ATSI)
o Socioeconomically disadvantaged
o People living in rural/remote areas
o Born overseas
o Elderly
o Disabled
Prevalence of condition:
o Number of cases in population
o Identified as health priority when higher
Potential for prevention and early intervention:
o Disease is preventable & can be reduced by early intervention & protection or from
modifiable lifestyle
o High likelihood of recovery when detected early
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o Environmental, social, cultural & political factors must be addressed health status to
improve
Costs to the individual and community:
o Direct or indirect
o Direct: Hospital & medical expenses, pharmaceuticals, $ on research, prevention programs
& edu
o Indirect: Absenteeism, lost productivity, burden on carers & family, lost life expectancy &
quality of life
What are the Priority Issues for Improving Australia’s Health?
G r o u p s E x p e r i e n c i n g H e a l t h I n e q u a l i t i e s
Aboriginal and Torres Strait Islander peoples:
o ATSI = 2.5% population in 2006
o Young ATSI median age 20 compared to 37 of non ATSI
Nature and Extent of Health Inequalities:
Mortality:
↑ mortality rates for ATSI
71% deaths for < 65 years (compared to 21% of non-ATSI < 65)
↑ difference in mortality rates between ATSI and non-ATSI
Infant Mortality:
3 x ↑ for ATSI
Gap is ↓ however better maternal & infant health care for ATSI
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Morbidity:
↑ rate of disability
Poorer dental health ↑ decayed, missing & filled teeth
↓ mental health 2 x more likely to report high levels of psychological stress
Hospitalisation rates ↑
3 x more likely to have diabetes
30 x more likely to have kidney disease when from remote area
↑ lung, throat & mouth cancer (↑ smoking & substance abuse)
61 x more likely to have syphilis
60 x more likely (females) to notify for AIDS/HIV
Life Expectancy:
Life Expectancy: Males Life Expectancy: Females
ATSI 59 65
Non-ATSI 79 83
Sociocultural, Socioeconomic and Environmental Determinants:
Sociocultural:
Culture
o Many reluctant to use modern medicine (e.g. maternity care)
o Language barrier
Policies
Community affluence
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Media
Socioeconomic:
Education
o Only 23% ATSI finished year 12 in 2006
o Lower education ↑ health risks (e.g. smoking, alcohol intake, sedentary lifestyle
& poor diet)
Employment
o Less likely to be in workforce (41% ATSI non in labour force)
Income & wealth
o 2006, median income of ATSI ($280) just over half median income of non-ATSI ($470)
Access to services
o 83% not in private health insurance compared to 49% non-ATSI
Housing
Environmental:
Safety of environment
Urban design
Freshwater depletion
The Role of Individuals, Communities and Governments in Addressing the Health Inequalities:
Governments:
Office of Aboriginal & Torres Strait Islander Health (OATSIH)
o Bring ↑ focus to ATSI health
o 80% ATSI controlled
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National Aboriginal Community Controlled Health Organisation (NACCHO)
o Works with Department of Housing, Community Services & Indigenous Affairs
Aboriginal Health & Medical Research Council of NSW (AH&MRC)
o Health service delivery, developing ATSI health education, research in ATSI health,
policy development & evaluation
Communities:
ATSI communities run 100’s of local health services
Nature varies on one community to another range from clinical care, education,
screening, immunisation, counseling, aged care, transport, sexual health, substance abuse &
mental health
Individuals:
Women & mothers often targeted as custodians of health knowledge & practice
Healthy for Life (H4L) health training & education for ATSI individuals
Socioeconomically disadvantaged people:
Nature and Extent of Health Inequalities:
Mortality:
↑ than broader population
Infant Mortality:
↑ than people of higher socio-economic status
Morbidity:
↑ CVD, diabetes, asthma, mental illnesses & arthritis
Life Expectancy:
↓ diabetes, CVD, MVA’s & lung cancer
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Sociocultural, Socioeconomic and Environmental Determinants:
Sociocultural:
Policies
o E.g. single parent allowance, pension, living away from home etc social welfare
payments
Community affluence
Socioeconomic:
Education
o Not as well educated about health informed decisions
Employment
o Smoking ↓ as occupational status ↑
Income & wealth
Access to services
o Use ↓ preventative health measures (e.g. immunisations, dental check ups)
o Cannot afford private health insurance waiting lists, limited cover etc
Housing
Environmental:
Food
Urban design
Safety of environment
The Role of Individuals, Communities and Governments in Addressing the Health Inequalities:
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Governments:
Medicare & PBS designed to provide lower cost health care
Health priority areas bridge gap between best & worst health
Strategies to improve: child health, immunisation, mental health, obesity, oral health,
chronic disease, urban planning, ↓ smoking, drugs & alcohol
Individuals & Community:
↓ exposure to risk factors
Develop community based work force
Agencies to provide healthcare, childhood services, maternity services, language services,
employment assistance, meals, migrant services
High Levels of Preventable Chronic Disease, Injury and Mental Health Problems
Cardiovascular diseases (CVD):
Nature & Extent of the Problem:
CVD is all diseases of the heart & blood vessels
Major conditions: coronary heart disease, stroke, angina, peripheral vascular disease
Major factor leading to CVD is atherosclerosis ( fatty build up in arteries) &
arteriosclerosis ( hardening of artery walls)
Extent of the Problem:
↓ mortality rates
↓ morbidity rates
Leading cause of death 35% in 2005
Risk Factors and Protective Factors:
Non modifiable: age, hereditary factors
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Modifiable:
o Smoking (↑ chances of CVD by 5 x)
o High blood pressure (from high salt diet or obesity)
o Lack of physical activity
o Other influences (e.g. alcohol consumption, contraceptive pill, diabetes)
o High fat diets ↑ cholesterol ↑ atherosclerosis CVD
Sociocultural, Socioeconomic & Environmental Determinants:
Socioeconomic status
Education
Employment
Geographic location
Culture
Access to services
Groups at Risk:
ATSI
o Overweight or obese people
o Smokers
o Family history
o Low levels of education
o SED
o Blue collar workers
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Cancer (skin, breast, lung):
Nature of the Problem:
Cancer is caused by cells in the body becoming defective & spreading
Main ‘National Health Priority Areas’ of cancer are: lung, skin, breast
Extent of the Problem:
36 000 deaths per year (98 people daily)
1 in 3 men or 1 in 4 women
↑ 10% since 2004
Skin cancer is most common form
For under age of 15, leukemia, brain cancer CNS cancer
Risk Factors and Protective Factors:
Males at higher risk
Age ↑ risk
Smoking
Excessive exposure to the sun
Obesity
Sociocultural, Socioeconomic & Environmental Determinants:
Education (↑ screening & checkups)
Culture (E.g. Aus society’s attitude has changed toward smoking ↓)
Groups at Risk:
Socioeconomically disadvantaged
Smokers
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People who sustain high fatty diets
Those who don’t apply sun cream
Elderly
ATSI
Diabetes Mellitus:
Nature of the Problem:
Diabetes is the body’s inability to break down sugar. It affects the body’s ability to take
glucose & use it for energy. Insulin is the hormone produced by the pancreas to helps this
glucose process, however if the body produces insufficient insulin, glucose will not enter
bodily cells
Type 1: Insulin dependent
Type 2: Non insulin dependent (depends on lifestyle factors)
Extent of the Problem:
3.5% population diagnosed with diabetes in 2004-5
↑ significantly over past 10 years
Australia’s prevalence high compared with other OECD countries (9th highest)
85% of diabetes is Type 2 from lifestyle factors
Australia’s 7th leading cause of death
Incidence of type 1 ↑ by 30% in last 5 years
Prevalence ↑ with age
Risk Factors and Protective Factors:
For Type 1: Non modifiable risk factors
For Type 2:
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o High blood pressure
o Obesity
o High sugar/saturated fat diet
o High alcohol consumption
Sociocultural, Socioeconomic & Environmental Determinants:
Education
Access to services
Socioeconomic status (lower: worse diets ↑ obesity)
Groups at Risk:
Elderly (50 +)
Overweight
ATSI
Socioeconomically disadvantaged
Alcoholics
Those with poor diets
A G r o w i n g a n d A g e i n g P o p u l a t i o n
o Aus population = ↑
o 50% natural increase (births over deaths) & 50% from net overseas migration (more in
than out)
o Also, Australian population is ageing
o Due to ↑ life expectancy & ↓ birth rate (↓ fertility levels & lifestyle choices)
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Healthy ageing:
o 9% population = 70 +
o Figure expected to increase to 20% in 2051
o Gov planning for financial security, independence & good health for aged (e.g. compulsory
superannuation, pension) if people unhealthy in aged life ↓ working life ↓
economic growth
o Government appt. ‘Ambassador for Ageing’, who:
o Promotes positive & active ageing
o Encourages contributions made by old people
o Community gov. programs and initiatives to public
Increased population living with chronic disease and disability:
o As number of people surviving heart attacks, strokes, cancer ↑ chronic disease/disability
o Future levels could ↓ if young people control risk factors (e.g. smoking, diet, drinking)
o Poor health not inevitable with age, but risk of disease/disability ↑ with age (↑ exposed to
risk factors)
Demand for health services and workforce shortages:
o As demand for health & aged care services ↑ gov. initiatives:
o Provision of more nurses
o Expansion of their role
o Increase in community care, such as meals on wheels
o Means tested age pension & compulsory superannuation (9% of employees earnings)
o Promote voluntary super contributions
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o Huge demand on public health
o Reforms being made to improve health workforce shortages: investment in health care
sector, national registration schemes to allow carers and volunteers to move more freely
between states
o World Health Org estimates: $4.3 mil shortage of health workforce in Australia
o Reasons:
o ↓ students being trained
o Working hours per week ↓ over pat 15 yrs
o Retirement of health care workers
Availability of carers and volunteers:
o Carer: Person who, through family or friendship relationship looks after an older person or
someone with a disability or chronic disease
o Volunteer: Person who offers to perform a service for the community on a voluntary
(unpaid) basis
o Australians aged 55 + contribute approx. $75 billion per annum in unpaid caring &
volunteering
o Half a mil. Volunteers aged 65 + who volunteer for non-profit organisations
o Projected there will be little growth in the number of available workers, compared to ↑ in
demand
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What Role do Health Care Facilities and Services Play in Achieving Better Health for all
Australians?
H e a l t h C a r e i n A u s t r a l i a
Ranges and types of health facilities and services:
Public Health Services:
o Cancer Screening
o Immunisation
Hospitals:
o Acute short term care
o Admitted patient care
o Maternity ward
o Out-patient services (e.g. physiotherapy)
Primary Care and Community Health Care Services:
o GP
o Dental
o Community Health
o Ambulance
o Royal Flying Doctor Service
Specialised Health Care Services:
o Specialist medical practitioners
o Orthopedic services
o Alcohol & drug treatment
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o Sexual & reproductive health
o Mental health
Responsibility for health facilities and services:
Federal
Government:
Policies & legislation
Funding
Cares for war veterans and ATSI
State Government: Provides actual services (e.g. hospitals)
State health promotion campaigns
Regulation of facilities and personnel
Local Government: Local health promotion campaigns
Community health services
Monitoring/regulating health standards in community
Private Sector: Services (e.g. private cover & hospitals)
Research & resources (e.g. National Heart Foundation, Cancer Council)
Health care facilities such as workplace gyms, healthy canteens etc
Communities: Often voluntary services such as meals on wheels, home nursing etc
Individuals: Responsibility for wise decisions to ↓ risk factors & ↑ screening &
testing
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Equity of access to health facilities and services:
Factors Influencing Equity of Access to Facilities and Services:
o Finance
o Education
o Geographical location
o Communication (language barriers)
o Culture (conflicting attitudes, beliefs & customs with Aus. health care system)
o Transport (e.g. for elderly cannot drive)
Groups most Affected:
o Socioeconomically disadvantaged:
o Cannot afford private health care miss out on services & waiting lists
o ↓ education ↓ knowledge about risk factors
o ↓ self esteem & ↑ anxiety ↑ mental health problems
o Rural dwellers:
o Distance from facilities
o Often great imbalance of health services ↓ doctors in rural per head of
population
o ↓ education
o Overseas born:
o Barriers: poor English language skills, conflicting cultures
Health care expenditure versus expenditure on early intervention and prevention:
o 2006 – 7 total expenditure = $94 billion
o Majority funded by governments (69%), rest by insurers, non gov. sources
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o Most spent on cure rather than prevention
o Expenditure: hospitals, medical services (e.g. GP’s) & pharmaceuticals & medication (e.g.
PBS scheme)
o Preventative health = ONLY 1.8% expenditure
o Growing at 5.6% per year over past 9 years
o In Australia’s interest to work preventatively rather than cure disease
o E.g. Anti-smoking campaign costs $400 per person, rather than $50 000 lung cancer
operation
o ↓ rate of mortality & morbidity
o Hard to make transition people need to be cured
Impact of emerging new treatments and technologies on health care, e.g. cost and access,
benefits of early detection:
o Examples include:
o Imaging scans (inc. MRI magnetic resonance imaging)
o Keyhole surgery, stents (through blood vessels) & grafts
o Vaccines (e.g. Gardasil cervical cancer)
o Laser surgery
o Telemedicine videoconferencing computer technology for those with no access
o More effective, less invasive, safer
Cost:
Accounts for large most other industries technology $
Machinery/technology expensive then hire someone to operate ( in labour costs)
Small savings on patient length of stay in hospital over last 10 years offset by cost of tech.
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Additional capacity alleviated some of pressure on public health care system
Living with managed conditions cost of pharmaceuticals & hospital visits to treat (gov.
expenditure)
However reduces indirect health care costs e.g. quality of life, return to productivity in
workforce
Access:
Area of concern most benefit who live in close proximity or can afford services
In future, will be remotely available with telemedicine
Uneven distribution socioeconomic status access (many funded by private health
insurance) & awareness of treatments (better able to advocate for interests)
Gov. initiatives to overcome inequities: free vaccinations, mobile breast screening bus
(geographical)
Benefits of Early Detection:
Screening (technology) (e.g. mammogram)
Survive disease if detected early evidenced through life expectancy
Evident in elderly population managing conditions (particularly CVD) led to general
of other illnesses a person otherwise may not have lived to contract (e.g. some cancers)
Cancer drugs, for e.g., prolong patient’s life
Health insurance: Medicare and private:
Medicare:
Medicare is the universal public health insurance system in Australia which came into
operation in 1984
Largely funded by taxes (through Medicare levy paid by wealthier Australians who could
afford private insurance but do not have it)
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State Gov. runs hospitals, but funded by Federal Gov.
Works on the principle that the wealthiest are the healthiest & the poorest suffer the worst
health
‘Guiding Principles’: Access, Equity, Efficiency, Simplicity
Government sets a ‘scheduled fee’ for services of medical practitioners Medicare
reimburses 85% If doctor charges more patient must pay ‘gap’
‘Bulk billing’ is when doctor pays only the scheduled fee & the patient pays nothing
Works
Advantages Disadvantages
Free treatment in public hospitals
Some other treatments (e.g. some dental,
physio, optometry & psychiatrist)
Shared ward accommodation
No choice of doctor
Long waiting lists with elective surgery
Doesn’t cover many services (e.g.
ambulance, speech therapy, hearing aids,
glasses, prosthetic limbs)
Private:
Private Health Insurance is extra cover bought by Australians from private companies,
where a premium is paid (usually in monthly installments) & the customer can receive extra
treatments at lower or no cost
By the end of 2006, only 44% of Australians had private health insurance
Incentives:
o Taxation which must be paid by wealthier Aus. who could afford private insurance
o Rebates on premiums
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o Lifetime health cover If join before certain date covered for life
Pay 25% of gap cost
Apart from the rule that companies must seek permission from the government to change
premiums design own product competitive
Advantages Disadvantages
Choice of doctor & location
Even in public hospital, treated as private
patient
Ancillary benefits
No waiting list for elective surgery
Those who don’t want or need private
cover are disadvantaged by tax
Cost often inclusions in insurance which
customer doesn’t need but pays for
anyway
C o m p l e m e n t a r y a n d A l t e r n a t i v e H e a l t h C a r e A p p r o a c h e s
o Alternative medicines are those which fall outside the realm of mainstream medical services
o Aus. spend approx. $2 billion per yr on complementary or alternative medicine
o In 2009, 2/3 of adult population used an alternative product (Complementary Health Care
Council Sydney)
Reasons for growth of complementary and alternative health products and services:
o Alternative approaches cannot be scientifically proven wrong
o cost of alternative health care vs. traditional health care
o WHO’s recognition of usefulness of many alternative approaches & a list of helpful medical
plants
o Health consumers being more open minded & prepared to act on recommendations from
friends, GP’s etc.
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o acceptance by Aus. of value of multicultural influences
Range of products and services available:
o Acupuncture: Fine needles which stimulate change in energy balance
o Aromatherapy: Oils from flowers, plants, trees to stimulate or relax, stop infection &
disease
o Chiropractic: Disorders of body can be due to spinal displacements which can be relieved
through spinal manipulation
o Reflexology: Reflexes in the hands & feet relate to parts of the body & can promote
relaxation
o Colonic Therapy: Uses water to flush out lower intestine & relieve back/headache, bad
breath & fatigue
How to make informed consumer decisions:
o Compare the cost of the product to others in the same market. Research if your health fund
will refund you some of that money.
o Check for formal qualification & experience
o Look at testimonials, preferably from friends or family (otherwise check the documentation)
o Ask professionals in the area
o Steer clear of ‘cure alls’ & fad promotions
o Compare range of products
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What Actions are Needed to Address Australia’s Health Priorities?
Health Promot ion Based on the 5 Act ion Ar eas of the Ottaw a Charter
o ‘Health promotion is the process of enabling people to increase control over, and to
improve their health.’ (WHO, 1986)
o In 1947 WHO made health a holistic concept (physical, mental, emotional, social)
o By the 1970’s awareness of risk factors & education to risk factors
o Created a situation where death from infectious disease but lifestyle diseases
o Faced challenge New Public Health Approach (NHPA) adopted
o Guiding Principles (REC):
o Recognition of Social Determinants of Health:
Health no longer seen as determined only by individual’s behaviour &
lifestyle other factors (e.g. social determinants such as income, education,
culture, geographical location)
o Empowerment of the Individual:
Provision of education, skills, equal access to resources
o Community Participation
Levels of responsibility for health promotion:
o Governments (Federal & State): large role in providing funds, (e.g. Medicare) setting
legislation (e.g. seatbelts), health infrastructure (e.g. hospitals) & the collection of
epidemiological data
o Government (Local): Provide & fund local health care services (e.g. fun runs, AA meetings,
counseling), control over urban planning & establishment of enough health facilities to
meet needs of community (e.g. dentist, GP)
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o Health Workers: Teach protective behaviours & early detection intervention strategies,
have better understanding of particular group they are involved in
o Communities & Individuals: Eliminate or change of lifestyle disease by living low risk
lifestyle, make good health decisions (e.g. nutrition, P.A, checkups), participate in
government & community health activities
The benefits of partnerships in health promotion, e.g. government sector, non-government
agencies and the local community:
o ‘Intersectoral Collaboration’ is the collaboration of different parties in order to promote
health (e.g. the government & local community)
o By combining a range of sectors in health promotion initiatives, all social determinants of
health are better addressed & an environment is created which offers optimum chance at
success
o The gov. & non gov. & local community can pool their resources to ensure a better outcome
for health promotion strategies
o Avoids any duplication in the health promotion effort
o Especially if local community is involved, helps government to tailor health promotion
initiatives to needs of community
o Development of stronger community network as people work together towards mutual
goals
How health promotion based on the Ottawa Charter promotes social justice:
o DR. HSC
Developing Personal Skills:
o Providing health info & giving people the opp. to develop personal skills that will empower
them to execute control over their health
o Can be provided for in the home, at school, in the workplace & within the community
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o Examples include:
School Healthy Harold, drug & sex ed, compulsory PDHPE year 7 – 10
Community talks
Health websites
Courses for labourers to avoid injury
Reorienting Health Services:
o In the ‘cure vs. prevention’ argument directing as many resources toward prevention
strategies as possible, whilst maintaining adequate curative treatment of illness & disease
o It stresses health promotion is not solely the responsibility of he health sector, but relies on
collaborative efforts of govs, orgs, communities, individuals & the health sector
o Examples include:
Free sun cream at beaches
Immunisation
Subsidies on mammograms
Regular checkups
Building Healthy Public Policy:
o Legislation, financial & tax incentives for improved health, healthier environments & more
health conscious goods & services
o Make health choices easier for citizens
o Foster greater equity in health
o Examples include:
Food labels
No smoking in public places
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40km school zones
Compulsory PA hours at school
cigarette taxes
Strengthen Community Action:
o Establishing self help groups, encouraging social support & participation in health related
matters
o Members of comm. together to solve problems & individual’s needs (e.g. school wheelchair
access)
o Gain increased influence over social determinants of health in their community
o Examples include:
Complementary shuttle bus
Fun runs (e.g. Sutherland to Surf)
National Day of ‘Violence Against Women’
Walk to Work Day
Creating Supportive Environments:
o Take care of each other, communities & environment
o Create safe, stimulating, enjoyable working & living conditions for people to live healthy
lives
o Examples include:
Bike paths
Suicide & mental health counselors
AA meetings
Driver survivor stops
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The Ottawa Charter in action:
o Lung Cancer Promotion & Prevention:
Developing Personal Skills:
o School education, websites, advertisements on packaging, brochures in GP’s to educate
about the dangers
Reorienting Health Services:
o Build a preventative health service e.g. anti-smoking campaign costs the gov. only $500
per person, but a lung cancer operation costs $50 000 per person
o Recognises in short term more expensive, but in long term = very cost effective
Building Healthy Public Policy:
o Ban in public places, illegal for < 18 y.o, taxation (Aus. cigarettes = 1 of highest prices in
the world)
o Banning tobacco advertising
Strengthening Community Action:
o Adhering to the regulations which relate to smoking e.g. not smoking in public place, not
knowingly selling to minor
o social acceptance of smoking & tolerance
Creating Supportive Environments:
o Quit Hotline
o Pharmaceutical promotion of quit products (e.g. tablets, patches, gum)
o QUIT for Life, aims at giving people the support necessary to quit
o Doctors counseling to quit highly regarded by patients
