HHD - UNIT 3 AOS 1 PT. 2

Biological determinants

- Body weight — Being overweight or obese will defiantly impact on the NHPA's, the individual will be more at risk at developing like threatening disease such as cardiovascular disease (impacting on cardiovascular health) as it increases blood pressure and blood cholesterol levels, developing Type 2 diabetes (impacting on diabetes mellitus) and possibly effecting the mental state of the individual (impacting on mental health) as they may feel bullied, isolation or excluded due to their body weight, this may cause the individual to suffer from depression or experience self-esteem issues. (Risk factor) . - Genetics inc. sex — Depending on what sex you are (male or female) you have the risk of developing different life threatening disease, for example. If you are a female you are more at risk of developing several cancers including breast cancer, developing arthritis and colorectal cancer in comparison to males who have lower risk of developing these diseases. (Risk/protective factor).

Name the 9 NHPAs

- Cardiovascular health - Asthma - Dementia - Injury control and prevention - Cancer control - Diabetes Mellitus - Arthritis and musculoskeletal conditions - Obesity - Mental Health

Why is Diabetes Mellitus an NHPA

- Diabetes is a leading contributor to the burden of disease. In 2010, diabetes was estimated to be ranked sixth with regards to burden of disease, contributing 6.2 per cent of total DALYs. - Results from the 2011-13 Australian Health Survey indicate over 850000 Australians (about 4 per cent) reported having diabetes as a long-term condition. - In 2012 diabetes mellitus was the underlying cause of death in 2.8 per cent of all deaths registered. In a further 10 per cent of deaths in 2012, diabetes was listed as an associated (or contributing) cause of death. Diabetes was considered to play a role in approximately 13 per cent of all deaths.

Physical Environment determinant

- Housing — If a house has good ventilation and hygiene this will impact on the individuals overall health in comparison to if their house was unhygienic, they could possible find mould which could result in the individual experiencing respiratory and asthma related symptoms such as coughing or wheezing. This would then impact the NHPA's known as Asthma, Cancer and possibly Cardiovascular health as the individual would be more at risk of developing harmful diseases related to these NHPA's. (Risk/protective factor) . - Air quality — living in an area that offers bad quality air e.g. an industrial area can increase the risk of developing asthma due to the dirty air in which the lungs are breathing in on a daily basis. This is mostly common to develop in younger children. (Risk factor).

Why is dementia an NHPA

- In 2010, dementia was the third most common cause of death, accounting for 6 per cent of all deaths nationally - 4% of total Burden of Disease (BOD) in Australia, 4th largest contributor to BOD overall. - For those aged 65+, dementia is the second largest contributor to BOD - Rates of dementia are predicted to increase to 400,000 in 2020 and 900,00 in 2050.(in 2014 there were 332000 (appox.) people living with Dementia). - Dementia accounted for $5 billion in heath-related costs in 2009-10.

Why is Injury prevention and control an NHPA

- Injury was projected to be responsible for about 7% of burden of disease in disability adjusted life years (DALY) in 2010. - 6.3% of all deaths in Australian in 2012 were injury related - Injury is the main cause of death for people under the age of 45. - Most injury cases are considered to be preventable - Injuries incur significant direct, indirect and intangible costs.

Why is Cardiovascular health an NHPA

- Large contribution of cardiovascular diseases to the burden of disease and associated costs and the fact that it can be prevented. - 3.7 million Australians reported having a chronic (ongoing) cardiovascular condition - Hypertension was the most common cardiovascular condition (9.5% of the population) - Cardiovascular disease accounted for 43946/30% of all deaths - Many determinants that contribute to cardiovascular disease are modifiable due to lifestyle changes, leading to cardiovascular disease being prevented. - Cardiovascular disease cost the health system almost $7.7billion in 2008/09

Why is Cancer Control an NHPA

- Many cancers are preventable with lifestyle changes in 2012, cancer accounted for 42457 deaths or 29 per cent of all deaths registered (23 994 male deaths and 18 463 female deaths). Lung cancer was the leading cause of cancer deaths, accounting for 19 per cent of all cancer deaths. - Cancer contributes more to YLLs than any other cause. - It's the largest contributor to overall burden of disease - It contributes significant costs to the community and to individuals.

Why is Mental Health an NHPA

- Mental illness is most common non-fatal burden of disease in Australia. Accounts for 13% of total burden of disease in 2010 and was exceeded only by cardiovascular disease and cancer. - Estimated that 45% of Australians will experience mental illness at some stage of their lives - Prevention and treatment strategies such as medication and therapy, can be extremely effective in managing the condition - Mental illnesses can be increased in the Australian population in recent years - Mental health problems have a relationship to other risk factors (alcohol & drug use), poorer health and higher rates of death.

Why is Obesity an NHPA

- Obesity is a key biological determinant in a range of diseases and conditions including cardiovascular disease, type 2 & gestational diabetes, arthritis & kidney disease. - Overweight and obesity have risen over time - By 2025 one in three adults in the world will be obese if current trends continue. - Obesity was thought to be responsible for 7.5% of the total burden of disease in 2003 - Obesity is preventable by changes of lifestyle choices and maintaining a healthy body weight .

Social determinants

- Socioeconomic status (SES) — The wealthier the individual, the healthier you will be. If an individual has a good income, good job and education they armour likely to have a higher SES, in comparison to those with a lower income, poorer job and education. (Protective factor ). - Unemployment — By an individual being unemployed, they are at a higher risk of dying and/or suffer from more illnesses in comparison to those of the same age but are employed. Rates of suicide, lung cancer and cardiovascular disease are higher for those who are unemployed in comparison to those who are employed. The long-term effects of unemployment are mainly due to the psychological and financial factors, especially is the individual finds themselves in debt. This is likely to impact the NHPA's known as Injury prevention and control and cardiovascular health as most people will either pick up bad habits e.g. Tobacco smoking, or could possibly attempt to kill themselves due to the stress they experience. (Risk factor).

Why is Arthritis and Musculoskeletal conditions an NHPA

- They lead to high rates of morbidity - Account for 5% of the burden of disease in Australia. - Associated with significant costs to individuals and the community - More than 3 million Australians (15% of the population) had some form of arthritis and over 700,000 (3%) has osteoporosis in 2011-12. - Overall prevalence of arthritis was 18% for females and 12% for males - Osteoarthritis affected over 1 million Australians in 2011-12. - Rheumatoid arthritis affected around 450,000 people in 2011-12 - Almost 2 million Australians had some form of back problem in 2007-08.

Behavioural determinants

- Tobacco smoking — Tobacco smoking increases the individuals chances of developing health concerns such as: Cardiovascular disease, respiratory conditions (e.g. emphysema) and many forms of cancer including lung cancer and coronary heart disease. This will impact the NHPA's as it will increase the risk of individuals having a negative cardiovascular health. (Risk factor) . - Risk taking behaviours — If individuals take part in more risky types of activities e.g. jumping off tall buildings they are more at risk of getting injured and hurting themselves. This impacts on the NHPA known as 'Injury prevention and control', individuals will need time in which to recover from their 'accident' as it will more than likely have a negative health outcome. (Risk factor).

Why is Asthma an NHPA

- Was responsible for 2.3 per cent of the disease burden in 2010 - Was suffered by about 2.2 million Australians in 2011-12 - Most commonly reported long-term condition of 0-14 year olds and is the leading contributor to the burden of disease in this age group is one of the most frequent reasons for hospitalisation among children aged 0-9 has significant treatment costs.

Calcium

99% of Calcium is stored in our bones, with the other 1% in the blood, muscles and intracellular fluid. The most important role of calcium is as a hardening or ossifying agent for hard tissue such as teeth, bones and cartilage. If the individual does not consume enough calcium they are more at risk at developing arthritis and musculoskeletal conditions (Protective factor). Food source: Milk/cheese/yoghurt, sardines/salmon, green leafy vegetables e.g. spinach, tofu, fortified orange juice.

LiveLighter Campaign - Obesity

Aims to assist individuals in eating well, being physically active and maintaining a healthy body weight. The program began in 2014 with funding from the Vic Gov., however it was implemented by the Heart Foundation and Cancer Council. It also aims to reduce the impact of related conditions such as cardiovascular disease, type 2 diabetes and some cancers inc. breast and colorectal cancer.

The Sensitive Choice Program - Asthma

Aims to assist those with asthma and allergies make better lifestyle choices. As a result, exposure to triggers and therefore asthma symptoms and allergic reactions may be reduced. To achieve this goal, the Sensitive Choice Program encourages manufacturers to produce products and services that reduce the risk of asthma and allergic reactions. The program works by allowing manufacturers of approved products to display the Sensitive Choice blue butterfly logo on packaging and advertising. The blue butterfly logo allows consumers to easily identify and choose products and services that may carry a reduced risk of triggering asthma symptoms and other allergic reactions.

The National Road Safety Strategy - Injury prevention and control

Aims to cut the road toll by at least 30 per cent by 2020, by addressing the range of factors that contribute to road-related injuries, such as infrastructure, road laws, human behaviour and vehicle safety. The National Road Safety Strategy reflects the Safe System approach by working to achieve four key objectives: safe roads, safe speeds, safe vehicles, and safe people.

The Heart Tick Foundation - Cardiovascular health

Aims to reduce the number of people living with or drying from heart, stroke and blood vessel diseases. It encourages people to choose healthier food options by showing consumers which food are better options compared to similar products. The program also aims to influence the nutrition context and labelling of foods by enforcing strict standards for producers who wish to display the Tick logo on their products. (Food products are classified into one of over 50 different categories, once categorised the foods must meet certain criteria for that particular category).

The determinants of health

Biological— Biological determinants of health relate to the structure of the cells, tissues and systems of the body and how adequately they function. Behavioural— The behavioural determinant of health relate to the choices people make in their lives that impact on their health status. Physical Environment— The physical environment has a well-established relationship with health and consists of the physical things that surround us. Social— The social determinant of health refers to the determinants within the social environment that impact on health status.

Carbohydrates, protein and fat are

Carbohydrates, protein and fat are all stored as fat if they are not used for other functions. This can increase the risk of obesity and related conditions such as cardiovascular disease and type 2 diabetes.

Direct costs

Costs associated with the prevention, diagnosis and treatment of disease and disability and providing health services to people suffering from it. Individual costs: - Ambulance transport - Diagnosis tests such as sigh or hearing tests, blood tests and dental x-rays not covered by Medicare - Doctor and specialist fees not covered by Medicare - Surgery/hospital fees not cover by Medicare or private health insurance - Pharmaceuticals Community costs: Costs are associated with implementing health promotion strategies and diagnosis and treating the condition, but which are paid for by the community. - Medicare - Pharmaceutical Benefits Scheme - Private health insurance providers

Indirect costs

Costs not directly related to diagnosis and treatment of the disease, but occur as a result of the person having the disease, such as loss of productivity. Individual costs: - Loss of income due to not being able to work - Employing someone to mow the lawns after bypass surgery - Paying for a house keeper to perform home duties - Transport costs if the person is no longer able to drive Community costs: - Lost productivity e.g. loss of employers for a business - Social security payments - Lost taxation revenue

Fibre

Fibre is a type of carbohydrate that is essential for the health of the digestive system, it does not contribute as a source of energy as it passes through without being digested. By consuming enough fibre decreases the risk of developing conditions such as colorectal cancer, obesity, diabetes mellitus and cardiovascular disease. (Protective factor) . Food source: Bran flake cereal, wholemeal bread, fruit and vegetables e.g. apples & corn, baked beans.

Phosphorous

Its main function is to work with calcium to harden/ossify bones and teeth. Calcium and Phosphorous work together to form calcium phosphate (an ossifying agent to harden tissue). Those who suffer from diabetes and alcoholism can prevent phosphorus from being absorbed, resulting in an insufficient amount of phosphorus which can cause a loss of bone density, weakness and poor appetite (Risk factor). Food source: Dairy products e.g. milk/cheese/yoghurt, meat, eggs, fish, nuts, legumes.

What is the purpose of the NHPAs and why were these particular NHPAs identified?

NHPAs are diseases or conditions selected by the Commonwealth Government as key focus area for improvement. The 9 NHPAs (National Health Priority Areas) were identified as they significantly contribute to the overall burden of disease of Australians. All conditions have preventable components, therefore understanding these conditions can assist the population in living healthier lives and improving health status. There are also health promotion programs that are offered to reduce the burden of disease attributable to these conditions and disease. Also these diseases can contribute significant costs to both individual and the community.

Macronutrients

Nutrients that are needed in larger amounts: - Carbohydrates - Fibre - Protein - Fats (4 types)

Micronutrients

Nutrients that are needed in smaller amounts: - Calcium - Phosphorous - Vitamin D - Sodium - Water

Sodium

Sodium assists in the regulation of fluid in the body and the functioning of the nervous system. Too much sodium can lead to high blood pressure or hypertension, and can also cause calcium to be excreted, therefore increasing the risk of osteoporosis (Risk factor). Food source: Table salt, olives, fish, meat (pork), cheese, processed foods e.g. pies.

SunSmart - Cancer Control

SunSmart is an initiative of the Cancer Council Victoria and is funded by the Cancer Council Victoria and the Victorian Health Promotion Foundation (VicHealth). This program Aims to minimise the human cost of skin cancer in Victoria by taking a leadership role to promote a balance between the benefits and harms of ultraviolet (UV) radiation exposure. SunSmart has helped prevent more than 103,000 skin cancers and more than 1000 deaths since 1988, but there is still work to do to remind people to be vigilant.

Carbohydrates

The main function of carbohydrates is to provide energy to the body. They are the body's main source of energy, providing 17 kilojoules of energy per 1 gram. If carbohydrates are continuously eaten, they can contribute to obesity and related conditions such as cardiovascular disease, diabetes mellitus (particularly type 2 and gestational) and colorectal cancer. Food source: Pasta, rice, bread, corn, breakfast cereals, beans.

Fats

The main function of fat is to provide a fuel for energy production. Each gram of fat produces 37 kilojoules of energy, making it more concentrated source of energy than carbohydrates. 4 types of fat: - Monounsaturated fats - Polyunsaturated fats - Trans fats - Saturated fats A diet high is fat is associated with increased weight (obesity) some cancers, type II diabetes and cardiovascular disease. A diet high in saturated fat/trans fat increases the risk of cardiovascular disease, whereas a diet high in poly and mono unsaturated fats are a protective factor. If energy input is greater than energy output, weight gain results.

Protein

The main function or protein is for the growth, repair and maintenance of body tissues. It can also be used as a source of energy is carbohydrate intake is low. However excess protein can contribute to weight gain and can decrease the amount of calcium in the bones. Protein deficiency can reduce bone density and increase the risk of developing osteoporosis. (Protective factor). Food source: Animal origin: eggs, milk/cheese, beef, chicken, seafood; Plant origin: Soy products e.g. tofu/soya milk, legumes, nuts, whole grain cereals & brown rice.

Intangible costs

Things that cannot be measured physically or with a monetary measure, such as pain and suffering. Individual costs: - Pain and suffering - Stress - Loss of self-esteem Community costs: - Loss of participation in social activities - Emotional impacts

Life! Take Action on Diabetes - Diabetes mellitus

Victorian State government-funded strategy and administer by Diabetes Australia (Victorian Branch). Aims to reduce the incidence of type 2 diabetes among those at risk. This program is aimed at Victorians aged over 50 and Aboriginal and Torres Straight Islanders of all ages. The Life! Program has two diabetes risk tests; one is over the phone (13RISK) and the other is through their website. These can be used to identify prospective participants and to provide feedback for members of the general public who feel they may be at an increased risk of developing type 2 diabetes. They also offer a Life! Lifestyle and behaviour change course that involves six group sessions over an eight-month period that educates individuals about type 2 diabetes and the lifestyle and behavioural changes required to reduce their risk, including those relating to eating habits and physical activity. The Life! Taking action on diabetes program has also established an informative website that provides resources and education to individuals and health professionals regarding the prevention of type 2 diabetes.

Vitamin D

Vitamin D assists in the absorption of calcium and phosphorus from intestine to bloodstream and is therefore important for bone health. Vitamin D is generated in the body when the skin is exposed to ultraviolet radiation. If an individual lacks Vitamin D, this can lead to weakened bones and teeth and a higher risk of developing Osteoporosis which is a common musculoskeletal condition. (Protective factor) Food source: Beef liver, cheese, egg yolks.

While water has no nutritional value it plays a valuable role in our health. How is water linked to the NHPAs?

Water is vital in order for human survival, we require 1.2-3 litres per day. Water makes up 55-75% of our body mass and is vital for may functions in our body. Regular consumption of water can reduce the risk of obesity and related conditions such as cardiovascular disease and diabetes. Water is also absorbed by fibre and therefore plays a role in digestive health and the prevention of colorectal cancer.

Water

Water makes up majority of body weight and is required for a range of functions inc. chemical reactions, allows cells to function properly. Water also contain no kilojoules therefore may assist with weight management. Regular consumption of water can reduce the risk of obesity and related conditions such as cardiovascular disease and type 2 diabetes (Protective factor). Food source: Water in its pure form, other drinks containing water e.g. cordial/tea, fruits e.g. apples/watermelon, vegetables e.g. celery/lettuce.

Bone Health for Life - Arthritis and musculoskeletal conditions

Works to provide practical advice for women and their health professionals relating to achieving and maintaining healthy bones. The Bone Health for Life website provides an online quiz and a variety of fact sheets provided by experts at Jean Hailes for Women's Health that explain osteoporosis, how it is diagnosed and how it can be treated, food intake, exercise programs and medical check-ups.

Your Brain Matters (Alzheimer's Australia) - Dementia

Your Brain Matter is a program initiated by Alzheimer's Australia and is a non-government organisation that raises awareness and works to reduce the risk of dementia. The program Focuses on improving modifiable risk factors in order to reduce the risk of developing dementia. Your Brain Matters works by providing a number of resources including '5 Simple Steps to Maximise Your Brain Health' (Look after your Heart, Be physically active, Mentally challenge your brain, Follow a healthy diet, Enjoy social activity) , the BrainyApp (educates individuals and provides them with suggestions for reducing the risk of developing dementia and includes a quiz that assesses an individual's current level of risk for dementia), and dementia-related help sheets (assist people from different cultures to understand and implement dementia-preventing behaviours).

Youthbeyondblue - Mental health

Youthbeyondblue is beyondblue's youth program aimed at 12-25-year-olds from all walks of life in Australia. This program aims to empower young people, their friends and those who care for them to respond to depression and anxiety. Youthbeyondblue.com provides information on anxiety and depression, where to get help, personal stories and links to services. It also provides information for friends, family and people who work with young people on how they can help someone with anxiety and depression. They also work with schools, workplaces, community groups and not-for-profit organisations and promote key messages through social media, public advertising, campaigns, local community events and local fundraisers. Youthbeyondblue's key messages are: Look for the signs and symptoms of depression and anxiety, Listen to your friends' experiences, Talk about what's going on and Seek Help together!

Monounsaturated fats& Polyunsaturated fats

~ Monounsaturated fats — Decrease LDL or 'bad' cholesterol and play a part in protecting people from cardiovascular disease. Food source: Avocado, olive oil, canola oil, nut & peanut butter. ~ Polyunsaturated fats — Increase HDL or 'good' cholesterol and decrease LDL cholesterol. They reduce blood clotting and inflammation and decrease the risk of cardiovascular disease. Food source: Omega 3: Oily fish e.g. tuna/salmon, soy and canola oils/canola margarine. Omega 6: Most nuts and seeds, corn, safflower & soy oils.

Trans fats & Saturated fats

~ Trans fats — Increase LDL cholesterol and increase the risk of cardiovascular disease. Also interferes with cell membrane and can contribute to impaired glucose regulation. Food source: Beef, mutton and dairy products, processed foods e.g. pies/pastries/cakes. ~ Saturated fats — Increase LDL cholesterol and increase the risk of cardiovascular disease. Food source: Fatty cuts of meat, full cream milk/cream and cheese, coconut milk/cream, most fried takeaway food & most commercially baked goods e.g. pastries/biscuits.