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HHD: Unit 3 AOS2
Transcript of HHD: Unit 3 AOS2
1900 - now
Australia's health system in massive. In 2014-15, 21 million people (90% of the population) accessed over 368 million individual services on the Medicare Benefits Schedule.
Our health care can be categorised into two areas:
- Primary health care: the first point of contact a person may have with health services, and includes services like health promotion, prevention programs, treatment of acute conditions and management of chronic conditions. It is delivered through general practitioners, community health centres, allied health practices (e.g. psychology, pharmacy, physiotherapy, etc) and technologies such as video health.
- Secondary health services: care provided by a specialist or facility where a patient has been referred by a primary care provider.
Australia's health system
Australia's health system was developed to meet the needs of the Australian population while also advancing health in a contemporary and modern way.
WHO describes a health system's primary purpose as being to promote, restore ans maintain health while delivering quality services when and where they are needed.
* Improvements in Australia's health status since 1900 and reasons for these improvements, focusing on policy and practice relating to:
- 'old' public health
- the biomedical approach to health and improvements in medical technology
- development of 'new' public health including the social model of health and Ottawa Charter for Health Promotion
- the relationship between biomedical and social models of health
*Australia's health system, including Medicare, private health insurance, the Pharmaceutical Benefits Scheme and the National Disability insurance Scheme, and its role in promoting health in relation to funding, sustainability, access and equity
Main roles of government in Australia's health system
Australian (Federal) Government
sets national policies
is responsible for Medicare (including funding, with states and territories, of public hospital services)
funds the Pharmaceutical Benefits Scheme
supports access to private health insurance
State and Territory Governments
manage public hospitals
license private hospitals
community-based and primary health services (including mental health, dental health, alcohol and drug services)
provide environmental health-related services (e.g waste disposal, water fluoridation, water supply, food safety monitoring)
deliver some community-based health support services (e.g. vaccinations)
maintenance of local parks, footpaths, bike paths
Medicare is Australia's national health insurance scheme. It aims to deliver affordable, accessible and high-quality health care to all Australians.
Medicare promotes health through funding free or subsidised medical care in hospitals, as well as medical services and general treatment.
Medicare hospital treatment:
Hospital treatment covered by Medicare includes:
- being treated as a public patient in a public hospital by a doctor appointed by the hospital
- free treatment and accommodation in a public hospital with consumables such as bandages provided at no cost
Medicare does not cover:
- Being treated as a private patient in a public hospital
- ambulance services
- overseas medical and hospital costs
- medical services or surgery that's not clinically necessary e.g. cosmetic procedures
Medical services/general treatment
Medical services and treatments covered by Medicare include:
- Consultation fees for doctors (100% GP, 85% specialist)
- Bulk billing
- Pathology tests
- eye tests performed by optometrists
- Surgical treatment performed by a doctor
- some procedures performed by a dentist
Medicare does not cover:
- most dental examinations - podiarty
- physiotherapy - acupuncture
- occupational therapy - glasses or contact lenses
- speech therapy - hearing aids
- eye therapy - home nursing
Australian's can choose to access all their health care through Medicare and pay out-of-pocket costs for items and services not covered by Medicare, or they can choose a combination of Medicare and private health insurance.
Medicare is funded in three ways:
- Medicare Levy: Most working Australian's contribute 2% of their taxable income to Medicare
- Medicare Levy Surcharge: If deemed a high income earner (threshold changes each year) AND you do NOT have PHI, you may be required to contribute an extra 1-1.5% of your taxable income to Medicare (on top of the Medicare Levy)
- General taxation
*The Medicare 'safety net'
Another element of the Medicare scheme is known as the 'safety net'. The safety net ensures equity of access to health care, by enabling people to continue to access health care when they need it and not avoid treatment because of mounting costs.
An individual or family requiring constant doctor's visits or diagnostic monitoring may incur a lot of fees throughout the financial year. For this reason, extra funding is available to cover the costs of those who need it most.
The safety net places a cap (or threshold) on payments within a financial year. Once the threshold is met through gap payments, Medicare will cover further costs.
Private health insurance
Private health insurance can be purchased by an individual, couple or family to allow them more options and access to health care services.
*You still have access Medicare even if you have PHI
- Treatment as a private patient in a public hospital
- decreased waiting list on non-emergency surgeries and procedures (subject to wait periods)
-choice of doctor
- cover for other medical services such as physiotherapy, chiropractic, dental
Pharmaceutical Benefits Scheme
The PBS aims to provide access to necessary medicines in a timely, affordable and reliable manner.
The Australian government funds the PBS as it is seen as a way of maintaining the health of the community and helping reduce the cost of the wider health system.
Through the PBS, the cost of essential medicines are subsidises to an individual, who pays the remainder of the fee through a co-payment.
National Disability Insurance Scheme
The NDIS is an insurance scheme for Australian citizens under the age of 65 who have a permanent and significant disability.
It aims to ensure equity for Australian's who have a disability.
The NDIS takes a lifetime approach to supporting people with a disability, providing a mix of funding and links to community community and health services.
It was launched in 2013 and will be introduced over 3 years (starting in July 2016)
How the NDIS works:
Individuals who meet the NDIS criteria meet with a 'planner' to determine the support and care the participant needs and to develop a plan that best meets their needs and goals.
E.g. the meeting may result in:
- no changes to the individuals daily routine as needs are already being met
- providing community links to increase socialisation opportunities
- employment opportunities being explored to help promote financial independence
- arranging care options
- funding for therapies
- funding for home modifications, vehicle modifications, mobility equipment
-access to transport
The NDIS also helps the person's family and carers get the assistance that they need.
E.g. In some cases, family provide transport, meaning that they may need to work part-time or not at all to cater for this need. Having transport provided through the NDIS can mean that family members or carers can be present, but can also have the option of fulfilling their own goals and needs .
In other cases, one intervention, such as providing a prosthetic limb, might allow an individual to return to full-time work and gain mobility and independence, and not need the NDIS again.
PHI Incentives Schemes
The federal government has introduced and updated a number of incentive schemes so that more people will want to take out private health insurance as this helps ease the burden on the public healthcare system.
- Private health insurance rebate
- Medicare levy surcharge
- Lifetime health cover
How is the NDIS funded?
The Commonwealth Government, also from July 2019, there will be an increase in the Medicare levy of 0.5% (so from 2% to 2.5%). The increased levy will help ensure that there is ongoing funding for the scheme.
Role in promoting health in relation to
sustainability, access and equity
Sustainability: meeting the needs of the present without compromising the ability of future generations to meet their own needs.
Access: refers to an individual being able to make use of particular services without barriers such as location, knowledge, time or cost.
Equity: closely linked to fairness and social justice. It is about ensuring that we all are on an even playing field by providing extra support for people in need so that they can have the same opportunities in life as everyone else. It means that the needs of people should guide the distribution of support.
S: Medicare is expensive to fund; however, it is hoped that by reducing or removing the cost of healthcare for individuals, they will access healthcare sooner, which will lead to improved health outcomes and reduce the cost of treatment in the long term.
Medicare only covers essential healthcare services, and does not cover other treatments such as elective surgery or most allied health services. It aims to provide the care that is deemed medically necessary without incurring additional expenses. This will help to meet the health needs of the current generation but also ensure that Australia will be able to financially support the health needs of future generations.
A: Medicare is accessible, as rebates are provided for a range of healthcare services. This makes these services more finacially accessible, which can improve health as people are more likely to have their condition diagnosed and treated earlier if they can access these services at a reduced cost, which can help to reduce the impact of the condition and improve health.
Medicare aims to treat patients in hospital based on need, which means that those most in need are treated first e.g. a heart attack before a broken arm. This makes essential and life-saving healthcare more accessible to those that need it most, reducing mortality.
E: Medicare promotes equity, as it includes a safety net to protect those who experience higher costs of healthcare, those who have concession cards and big families from large out-of-pocket costs for healthcare services, thus providing extra support to those who need it most.
Medicare is available to all Australian citizens and does not discriminate on the basis of age, gender, race, location, income or health status.
S: The PBS aims to be economically sustainable by subsidising the cost of a wide range of essential medications to treat chronic conditions in order to make them more affordable to all Australians so they can meet their health needs. Being able to afford these essential medicines may mean than conditions do not worsen or are completely cured - decreasing level of ill-health.
A: The PBS provides timely access to medication at local pharmacies at a reduced cost, which can promote access as individuals are able to get the medication they need without having to travel. This means that individuals can access medication quickly to enable them to treat their condition. This should reduce the impact of the condition and reduce the amount of time spent in ill-health.
The PBS also aims to make medications more affordable, which in turn helps to make them more financially accessible.
E: The government also added the Closing the Gap PBS Co-payment Program in 2010, as one of 14 measures in the Indigenous Chronic Disease Package. This was aimed as reducing the cost of PBS medicines for eligible Aboriginal and Torres Straight Islander people living with, or at risk of, chronic disease. Under this program, eligible Aboriginal or Torres Straight Islander people who would normally pay the full PBS price for medication ($38.80) only have to pay the concession rate ($6.30) and those who would normally have to pay the concession rate receive their PBS medication without having to make a co-payment.
This program promoted equity by providing additional support for one of the most disadvantaged population groups in Australia and might mean that this group is more likely to get the medication that they need which can lead to improvements in health status.
The PBS also includes a safety net to protect those who suffer chronic illness, those who need many medications or expensive medications and large families from large out-of-pocket costs for PBS medications thus providing extra support to those who need it most.
S: PHI is economically sustainable, as it helps to meet the healthcare needs of the current generation (both those with PHI and without) through placing less burden on the public system. It also aims to meet the needs of future generations by implementing incentive schemes to make access to PHI more affordable, and therefore decreasing the demand on the public system as out aging population continues to grow. Less demand on the public system means that more people are able to be treated sooner, leading to better health outcomes.
A: Through implementing incentives such as the PHI rebate scheme, the government has tried to make PHI more financially accessible, with the aim of increasing the number of people who can afford to access PHI. This increases the number of people who will receive subsidised access to a wider range of services, which may contribute to improvements in health as people will have access to a wider range of treatment options with shorter waiting times.
PHI also improves access for patients who rely on the public system. By treating some people in private hospitals, it reduces the waiting times in public hospitals, meaning people can access the treatment they need sooner.
E: PHI promotes equity through PHI inceves. Those who earn more pay more for their PHI, as they receive less or no rebate on their policies while those who earn less receive bigger rebates.
The medicare levy surcharge also protects those who earn less from paying a levy if they can't afford PHI. This means that higher income earners are encouraged to take out PHI, which reduces the burden on the public hospital system, meaning that those who can't afford PHI have better access to the public system.
S: The NDIS has been/is being introduced in stages around Australia over three years, rather than all at once, in order to ensure that it is successful and sustainable. This will assist in promoting the health of those with a disability over the long term, as they will have the support they need over the duration of their life.
The extra 0.5% added to the Medicare levy to support the NDIS will also make it more financially sustainable.
A: the NDIS aims to ensure that Australians with a disability receive the reasonable and necessary funded support required for them to financially access all the services they need to live an ordinary life and to achieve their goals and promote health.
E: Through ensuring that people with a disability and their carers receive full access to the support they need, the NDIS promotes equity, as there are more resources being provided to support those who need help the most.
*the role of health promotion in improving population health, focusing on one of: SMOKING, road safety or skin cancer, including:
- why it was/is targeted
- effectiveness of the health promotion in improving population health
- how the health promotion reflects the action areas of the Ottawa Charter for Health Promotion
What is health promotion?
Health promotion is the process of enabling people to increase control over and to improve their health.
E.g. social marketing, education, legislation and regulations that all aim to change the social, political and physical environment in order to promote behaviours.
HP involves the population as a whole in the context of their everyday life, rather than focusing on people at risk for specific diseases – it enables people to take responsibility and have control over their own health. This requires full access to health related information.
HP is directed towards action on the factors ... or causes of health – this relies on co-ordination of services beyond health services to address a wide range of health issues. Local, state and federal governments have an important role in ensuring that the physical and social environment (including that which is beyond the control of an individual) is suitable to promote good health
HP combines diverse, but complementary methods or approaches including communication, education, legislation, fiscal measures, organisational change, community development and spontaneous local activities against health hazards
HP aims particularly at effective and concrete public participation – this requires clear problem definition and development of life skills including problem solving among individuals and within communities
HP is basically an activity in the health and social fields, and not medical service; health professionals (especially those in primary health care) still have an important role in nurturing and enabling health promotion. Health professionals have an important contribution in relation to education and health advocacy.
The role of HP in reducing the impact smoking
Tobacco smoking is a dangerous lifestyle behaviour, as tobacco contains more than 4000 chemicals, of which many have been associated with an increased risk of cancer.
According to the AIHW, smoking is the single most important preventable cause of ill-health and death in Australia. When tobacco smoke is inhaled, these chemicals enter the lungs and spread through the body via the lymphatic system.
Most people start smoking when they are in their teens, and are addicted by the time they reach adulthood; therefore, it is important that health-promotion initiatives target young people before they start smoking.
Many smokers have tried to quit but have returned to cigarettes because smoking is such a strong addiction. It is a habit that is very difficult to break.
Some of the main reasons why young people choose to smoke are to look mature, to be like their friends, to manage their weight and to experiment.
Adults smoke for other reasons. Many adults identify stress and pressures because of economic and personal problems as a reason for smoking. There are also some people who say they smoke because smoking makes them feel good
Health-promotion initiatives have an important role in preventing young people from taking up smoking through education and awareness programs, and in supporting those who already smoke to quit through education, support programs, changing the environment and changes to policy and legislation.
Why is smoking targeted?
Smoking is identified as a risk factor for a number of different cancers, cardiovascular disease, type 2 diabetes, rheumatoid arthritis, fractures and reproductive problems in women. The chemicals in a cigarette affect the smoker but they also affect other people exposed to the smoke, known as secondhand or passive smoking.
The incidence of lung cancer increased from 5953 cases diagnosed in 1982 to
10 926 cases in 2012. In 2016, lung cancer was the fifth most commonly diagnosed cancer, with 12 203 new cases diagnosed, making up 9.4 per cent of all cancers diagnosed.
The mortality rate for lung cancer increased from 2883 deaths in 1968 to 8217 in 2013, and this was estimated to have increased to 8839 in 2016.
In 2016, it was estimated that the risk of dying from lung cancer was one in 22 and 18.8 per cent of cancer deaths were attributed to lung cancer.
Tobacco smoking was a leading risk factor contributing to death and disease in Australia in 2011, and was responsible for 9 per cent of the total burden of disease and injury. It was also estimated that in 2011 tobacco smoking accounted for 80 per cent of lung cancer and 75 per cent of chronic obstructive pulmonary disease.
Other reasons why tobacco smoking has been targeted for health promotion include the fact that the most vulnerable population groups are more likely to smoke than other Australians, which further increases the inequity in health status experienced by these population groups. For example, smoking rates are:
- twice as high in remote/very remote areas compared with major cities
- three times as high in the lowest socio-economic status (SES) areas compared with the highest
- 2.7 times as high among single parents with dependant children compared with couples with dependant children
- 5.7 times as high for prisoners
- 1.7 times as high for unemployed people
- 2.6 times as likely for Aboriginal and Torres Strait Islander people.
Finally, tobacco smoking was targeted because it is a totally modifiable risk factor, meaning that it is one risk factor with an impact that the Australian community can totally reduce. Australia has set a goal to reduce the smoking rate to 5 per cent by 2025. This will have a positive impact on the burden of disease attributed to smoking in the future.
look at the SES/smoking table I printed out for you.. it's too big for here. Soz.
It is also important that the Australian Government invests in health promotion to assist Australians to quit smoking, as smoking is very addictive and many people struggle to quit alone.
One of the main reasons smokers might find it difficult to quit smoking is withdrawal caused by the impact of nicotine. Nicotine is one of the chemicals in cigarettes that causes addiction to smoking.
Over time, an individual’s body gets used to having nicotine and the more they smoke the more nicotine they need to feel normal.
When they try to stop smoking, their body doesn’t get nicotine, so they may feel uncomfortable and crave cigarettes.
Another challenge for people quitting is triggers like having a cup of coffee or being around other smokers. Stress may also be a reason why people find it difficult to quit, as some people use cigarettes to help them cope with stress.
Examples of HP to address smoking:
There have been many health-promotion initiatives implemented over the past few decades to address the high rate of smoking, including:
- changes to laws, policy and taxation
- QUIT Victoria and the wide range of initiatives it has implemented
- the National Tobacco campaign, Quitnow, and a range of initiatives it has implemented, such as a national media campaign, the My QuitBuddy app, the Quit for You – Quit for Two app and iCanQuit Calculator.
QUIT is a program of Cancer Council Victoria. QUIT Victoria began in 1985, when a ministerial review of health promotion identified tobacco as the most significant health priority in the state. A committee was formed with the Health Department Victoria and Cancer Council Victoria, joined later by the National Heart Foundation of Australia (Victorian Division). This committee provides advice to the Minister for Health on legislation and policy aimed at reducing the prevalence of smoking in Victoria
In 1987, the Victorian Tobacco Act was passed. It introduced a levy on the sale of tobacco products. The Victorian Health Promotion Foundation (VicHealth) was established to distribute funds raised by the new levy and provided expertise and support to assist the QUIT program. Today, QUIT is funded by Cancer Council Victoria, the National Heart Foundation of Australia (Victorian Division), VicHealth and the Department of Health, and these organisations form QUIT’s steering committee.
QUIT’s purpose is to encourage, support and promote people to quit smoking for preventative health reasons as well as the economic impacts that smoking can have on both the individual and the healthcare costs borne by the Australian Government.
Examples of the QUIT program’s health-promotion initiatives include:
- QUIT Coach
- QUIT media campaigns
- QUIT learning hub for health professionals
- Supporting the development of Critics Choice resources.
How the QUIT program reflects the Ottawa Charter for HP
Build health public policy.
In conjunction with the Victorian Government, QUIT has assisted in the implementation of a range of policies and laws aimed at reducing the impact of smoking on the health of Victorians. These include the banning of tobacco advertising, the banning of smoking in public places, changes to tobacco taxation, the introduction of plain packaging on tobacco products via the Tobacco Plain Packaging Act 2011, increasing the age at which people can legally purchase tobacco and banning the display of tobacco in retail outlets.
Strengthen community action
QUIT has worked with a range of groups within the community to increase the success of its program and initiatives. These include working with the state government to change legislation, working with community health-promotion agencies such as VicHealth and the Australian Network on Young People and Tobacco to develop health-promotion initiatives, and providing resources for schools and other community groups.
Develop personal skills.
Via its website, QUIT provides information about the impact of smoking, and advice and strategies to assist people to quit smoking. It also invests in media campaigns to educate the community about the harmful effects of smoking. QUIT partners with the Australian Network on Young People and Tobacco and VicHealth to produce the Critics Choice resources for use in schools to educate young people about the harmful effects of smoking.
Create supportive environments.
Through the Quitline, QUIT provides a supportive social environment with the purpose of assisting individuals to quit smoking. It also has online support available via the QUIT website. Through working to ban smoking in public places, QUIT has also improved the physical environment by reducing the impact of passive smoking.
Reorient health services.
QUIT provides a range of face-to-face and online learning opportunities designed to help health professionals support their patients to quit smoking.
Effectiveness of HP to reduce smoking for improving health:
According to the Australian Health Policy Collaboration (2016):
'Mass media campaigns are effective, they have a direct influence on young people and adults. They can contribute to the efforts to de-normalise smoking by influencing family and peer discussions about smoking and therefore social norms and attitudes towards smoking. Importantly, they complement and support the implementation of other tobacco control policies, such as tobacco tax increases, plain packaging and efforts to reduce smoking among disadvantaged groups. Mass media campaigns are also cost effective, as large numbers of people can be reached by campaign messages. There are numerous studies that have demonstrated that returns on investment exceed the costs of the campaigns.'
Due in part to the effectiveness of anti-smoking campaigns, there have been some positive changes to smoking rates
People are delaying the uptake of smoking (with the age at which people aged 14–24 smoked their first cigarette increasing from 14.3 in 2001 to 15.9 in 2013)
Smokers are smoking fewer cigarettes (with weekly cigarettes smoked decreasing from 113 per week in 2001 to 96 per week in 2013)
Fewer people are being exposed to secondhand tobacco smoke (with the number of children exposed to tobacco smoke in the home having decreased from 31 per cent in 1995 to 3.7 per cent in 2013).
While there have been significant improvements in reducing exposure to tobacco smoke, these are yet to be reflected as positively in the death rates for lung cancer.
This is because the damage caused by tobacco smoking can often take a long period of time to result in cancer.
This means that with the declines seen in smoking rates over the past decade, it can be expected that over time there will be a decline in lung cancer rates.
Changes to policy, legislation and taxation are also examples of health promotion that have been effective in reducing tobacco smoking rates. Legislation that has banned smoking in public places such as pubs and clubs has had a significant impact on reducing smoking rates among low-SES population groups, while increases in taxation on cigarettes have also led to reductions in smoking.
*initiatives introduced to bring about improvements in Indigenous health and wellbeing in Australia and how they reflect the action areas of the Ottawa Charter for health promotion
Aboriginal and Torres Strait Islander people tend to suffer poorer health than other Australians.
In general, they have poorer diets, with 85 per cent of Aboriginal and Torres Strait Islander children aged 1–14 and 97 per cent of adults aged 15 and over having an inadequate daily fruit and/or vegetable intake
Aboriginal and Torres Strait Islander adults are more likely to smoke (44 per cent) compared with other Australians (14.5 per cent).
The data for alcohol consumption are more complex. More Aboriginal and Torres Strait Islander adults aged over 15 years reported not drinking any alcohol in the previous 12 months (26 per cent), which is 1.6 times higher than the rate for other Australians.
Aboriginal and Torres Strait Islander people who do consume alcohol, however, are more likely to drink to harmful or risky levels, with 50 per cent reporting that they had consumed more than four standard drinks on a single occasion at least once in the previous 12 months compared with 44 per cent of other Australians.
Aboriginal and Torres Strait Islander people are twice as likely to have coronary heart disease than other Australians
four times as likely to die from diabetes
twice as likely to die from injuries
have approximately 10 years lower life expectancy
and a higher infant mortality rate (six per 1000 live births) compared with other Australians (four per 1000 live births)
As a result of the inequality that exists between the health status of Aboriginal and Torres Strait Islander people and other Australians, the Commonwealth Government and the state and territory governments must invest in Aboriginal and Torres Strait Islander health in an attempt to address these differences.
Although most Aboriginal and Torres Strait Islander people (approximately 75 per cent) live in major cities and regional areas, where healthcare services typically are readily available, these services are not always socially, culturally and geographically accessible to Aboriginal and Torres Strait Islander people.
It is important that the Commonwealth Government invests in a range of specific primary health services to meet the needs of Aboriginal and Torres Strait Islander people.
In 2015–16, there were 277 Australian Government-funded organisations that provided health services to Aboriginal and Torres Strait Islander people, many of which provided health-promotion activities (targeting smoking, physical activity, maternal and child health and chronic diseases). Approximately one-third of these organisations provided services in very remote areas.
Red Dust Healing
Red Dust Healing is a targeted cultural healing program that has been written from an Aboriginal point of view. It aims to engage Aboriginal and Torres Strait Islander Australians in order to help them recognise and confront problems that stem predominantly from rejection and grief.
It is a Caritas Australia initiative that was implemented in conjunction with partner agency Spread Out and Stick Together. The program includes individual case management plans, and draws on the tools of Red Dust Healing to provide ongoing support for participants.
The program links Aboriginal and Torres Strait Islander cultures and other cultures by making use of holistic learning models to help participants with their own journey of personal growth.
It also makes use of the train the trainer approach, which trains individuals to be able to run Red Dust Healing programs in their own communities.
The program aims to reduce levels of substance abuse and promote empowerment in communities.
Since being implemented, the program has resulted in positive outcomes for participants, including increased employment rates and reduced incidence of domestic violence.
*initiatives to promote healthy eating in Australia including Australian Dietary Guidelines and the work of Nutrition Australia, and the challenges in bringing about dietary change.
The nutritional status of Australians is a key indicator of the population’s overall health. Both government and non-government organisations work towards increasing the nutritional knowledge of Australians. The desire to improve the health status of the nation has seen the promotion of healthy eating at all levels of government.
Nutrition-related initiatives such as the
Australian Dietary Guidelines
provide a reference for good nutrition and good health and wellbeing for all Australians.
The Australian Dietary Guidelines is a publication that seeks to encourage healthy eating to reduce the risk of diet-related disease and chronic conditions, and to improve the community’s health and wellbeing.
It provides guidance on foods, food groups and dietary patterns that protect against chronic disease and provide the nutrients required for optimal health and wellbeing
It has three main aims:
- to promote health and wellbeing
- to reduce the risk of diet-related conditions that act as biological factors influencing overall health and wellbeing, such as high cholesterol, high blood pressure and obesity
- to reduce the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers.
The Australian Dietary Guidelines recognise that the foods we eat are important to our long-term health and wellbeing. This is especially true for children, given the impact of nutrition on healthy growth and development. For adults, healthy eating can help prevent some illnesses that become particularly evident during the later years of life.
The Australian Dietary Guidelines provide recommendations for healthy eating that are realistic and practical. Presenting the recommendations and the scientific evidence that underpins them in a single volume, the guidelines are designed to help health professionals, policy-makers and the Australian public make informed decisions.
Guideline 1: To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.
The primary factors that influence energy balance are physical activity and dietary energy intake. Regularly obtaining more energy from food eaten than is needed to meet energy requirements can lead to energy storage in the form of excess body fat.
Insufficient physical activity in relation to energy intake can also lead to excess body fat, which is associated with adverse health consequences, including increased mortality – now a major public health problem in Australia. Likewise, being inactive is associated with poorer health and increased mortality. Furthermore, the health benefits that result from regular physical activity are substantial and are not restricted to control of excess body fat.
- Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.
- Older people should eat nutritious foods and stay physically active to help maintain muscle strength and a healthy weight.
Guideline 2: Enjoy a wide variety of nutritious foods from these five groups every day:
- Plenty of vegetables, including different types and colours, and legumes/beans
- Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
- Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
- Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced-fat milks are not suitable for children under the age of two years)
And drink plenty of water.
Eating a variety of nutritious foods means consuming different food types in appropriate amounts that enable the attainment of all the required nutrients without excess energy intake.
Ideally, people should choose a range of items from within each food group, particularly within the plant-based groups (vegetables, fruits and cereals), in order to achieve variety.
A diet containing a wide range of foods from the different food groups is most likely to offer protection against non-communicable chronic diseases such as cardiovascular disease, obesity, diabetes and some cancers.
Guideline 3: Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks.
• Replace high-fat foods which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods which contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.
• Low-fat diets are not suitable for children under the age of 2 years.
b Limit intake of foods and drinks containing added salt.
• Read labels to choose low-sodium options among similar foods.
• Do not add salt to foods in cooking or at the table.
c Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.
d If you choose to drink alcohol, limit intake. For women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.
Guideline 4: Encourage, support and promote breastfeeding
Breastfeeding is included in the Australian Dietary Guidelines because it contributes to the health of all Australians from birth. Breastfeeding is the normal and most appropriate method for feeding infants, and is closely related to immediate and long-term health outcomes. Breastfeeding provides health benefits to infants, including reduced risk of infection and asthma, and contributes to improved intellectual development. Breastfeeding is also indicated as protective against obesity, hypertension and some chronic diseases in later life. Exclusive breastfeeding to the age of six months gives the best nutritional start to infants and is now recommended by a number of authorities. Apart from their nutritional suitability, colostrum and mature human milk are hygienic and provide immunoglobulins and other anti-infective agents, which play a major role in protecting infants against infection and disease.
Guideline 5: Care for your food; prepare and store it safely
Despite having one of the world’s safest food-supply systems, Australia recently has seen an increase in the number of reported food-borne illnesses. Food-borne illness can have very serious consequences on health, particularly for vulnerable groups in the population such as the elderly. Correct handling of food is required during all stages of its preparation and storage in order to reduce the incidence of food-borne illness. To optimise food safety, care should be taken at all stages of the consumer’s ‘food chain’: purchasing, transport, storage, preparation, cooking, serving and cleaning.
The work of Nutrition Australia in promoting healthy eating:
Nutrition Australia is a non-government, non-proﬁt, community-based organisation that aims to promote the health and wellbeing of all Australians. Nutrition Australia is Australia’s primary community nutrition education body, providing scientiﬁcally based nutrition information to encourage all Australians to achieve optimal health through food variety and physical activity.
National Nutrition Week
Nutrition Australia coordinates the annual National Nutrition Week campaign that runs each year in the week of World Food Day (16 October). During this week, a number of activities and challenges are hosted in early childhood services, schools and workplaces relating to a specific theme (different every year). It also provides a variety of recipe and information resources as well as offering seminars and cooking demonstrations for workplaces to promote the annual campaign.
The Healthy Eating Pyramid
The Healthy Eating Pyramid categorises the different types and amounts of foods people should eat every day to achieve good health. The Healthy Eating Pyramid, following the Australian Dietary Guidelines (2013), includes healthy fats in addition to whole foods and minimally processed foods in the five main food groups as the basis for a balanced diet.
The foundation layers feature the three plant-based food groups: legumes and vegetables, grains, and fruit.
These layers take up the biggest section of the Pyramid since plant-based foods should form the biggest portion of our diet – they should make up about 70 per cent of it.
The aim for older children, teenagers and adults is to eat at least 2 serves of fruit and 5 serves of vegetables or legumes every day.
When consuming grains, preference should be given mostly to whole grains like brown rice, oats and quinoa, and to wholemeal or wholegrain types of bread, pasta and cereal foods.
The middle layer of the Pyramid includes the yoghurt, cheese, milk and alternatives food group, as well as the lean meat, fish, poultry, seeds, nuts, and eggs food group. Reduced fat options of milk, yoghurt and cheese are recommended to limit excess kilojoules from saturated fat.
The top layer includes healthy fats, as people require a small amount of these each day to assist heart health and brain function. People should choose foods that have healthy fats such as extra virgin olive oil, avocados, seeds and nuts over foods that contain trans fats and saturated fats.
Additional messages in the Healthy Eating Pyramid include:
- Enjoy herbs and spices, which give colour and flavour to meals without having to add salt.
- Choose water over sugary options such as soft drinks, sports drinks and energy drinks. Water is the best drink to stay hydrated and it supports many functions in the body.
- Limit salt and added sugar intake. This includes avoiding adding salt or sugar to food when cooking or eating, and avoiding packaged foods and drinks that have salt or added sugar in the ingredients.
The success of the Healthy Eating Pyramid as an educational tool lies in its simplicity, and it continues to be in great demand from educators, health workers and the general public. It has been designed as a simple, conceptual model for people to use as a ﬁrst step to adequate nutrition.
It represents basic foods only and facilitates individual food choices in the ways that these foods can be mixed to create ﬂavours and textures that please Australia’s diverse population.
Challenges to bring about change in dietary intake:
While hunger is a person’s primary motivation for consuming food, the choices an individual makes with regard to what they eat are not driven solely by their physiological or nutritional requirements. In fact, there are quite a number of factors that influence food choice, including:
– income, culture, family and peers, attitudes and beliefs, education, knowledge and skills
– personal taste preferences, meal patterns
– age, stress
– food availability and security.