The Australian Government 2005 National Chronic Disease Strategy - Essay Example

The Australian Governments 2005 National Chronic Disease Strategy: Prevention across the continuum Student’s Name: Tariq Al-Malki Instructor’s Name: Ms Creina Mitchell Course code and name:  8011NRS - CHRONIC ILLNESS AND PALLIATIVE CARE Institution: Griffith University Introduction to the NCDS The development of the Australian National Chronic Disease Strategy can be traced to the decision that was made by the Australian Health Ministers’ Advisory Council, which, in 2002-2003, agreed to the task of developing a national strategic policy approach to the prevention and care of chronic diseases among Australians. The national approach contains two main elements: the National Chronic Disease Strategy and five National Service Improvement Networks for the purposes of providing support. Both the strategy and the frameworks were prepared by a group of individuals and expert groups, including policymakers, clinicians, members of various non-governmental organizations, peak consumer bodies, and other health organizations. They are designed in such a way that they inform various stakeholders in the health sector, with the result being that they do not target a general audience. Each of the frameworks was structured in such a way that it reflects the various phases of the journey of the patience, including reduction of risk, early diagnosis, management of acute conditions, provision of long-term care and care relating to the advanced stages of the disease. This paper will critically analyse the existing literature one of the core areas addressed through the Australian Government’s 2005 National Chronic Disease Strategy (NCDS): prevention across the continuum, with regard to the implementation framework spelt out in the 2005 National Chronic Disease Strategy (NCDS). To do so, this paper will assess the future prospects in prevention strategies, the various approaches being used in prevention of risk factors for chronic disease, the prevention process the transition from evidence to policy, the various approaches being used in prevention of risk factors for chronic disease and the key directions to be considered in the achievement of these ends. Definition of the action area: Prevention across the continuum Prevention approaches are those that focus on the chronic disease risk and protective factors influencing the development of the chronic disease. Risk factors are the variables that increase the likelihood of a disease developing or progressing. The role of protective factors is to decrease this likelihood. According to Halcomb et al. (2005), prevention is ‘an action aimed at eliminating or reducing the causes, onset, complications or recurrence of diseases’. Prevention and modification of lifestyle can be of great help to the well population, the people at risk, as well as those with disease. The diseases that were targeted for prevention across the continuum by the NCDS include asthma, diabetes, cancer, stroke, heart and vascular disease, osteoarthritis, osteoporosis, and rheumatoid arthritis. The prevention strategy is always carried out through a range of agreed-upon national directions, all of which underpin collaborative measures at all levels. This ensures that the priorities and investments are well aligned and are working together in an efficient manner (Corbett, 2005). The preventative objective of the NCDS entails prevention and/or delay of the onset of chronic disease among individuals and population groups (Ostbye & Yarnall, 2005). This objective is best accomplished within a continuum of prevention and care. The core elements of this continuum include early detection, assessment, multidisciplinary care planning, self-management support, evidence-based clinical management, care coordination, psychosocial support, rehabilitation, ongoing monitoring and end of life care (Beaglehole et al., 2008). In order for the task of ensuring that prevention across the continuum is achieved, a population health approach should be adopted whereby the emphasis is on improving the health status of the entire population as well as the reduction of inequalities among the various population groups (Dowrick (2006). . Recognizing the needs of all population groups and communities in Australia is one of the things that need to be done in order for special challenges to be confronted for the benefit of all groups and populations that are disproportionately affected by the problem of chronic disease. These groups include the Torres Strait Islander peoples, the Aborigines, older Australians, people with mental illness, those with mental and physical disabilities and those who are socio-economically marginalized (Hawkes, 2006). The NCDS envisaged a program of action where the needs of all the Australian people would be addressed, regardless of their linguistic backgrounds, their educational and socio-economic backgrounds, the types of settings, either rural or remote communities, and the various stages of one’s lifespan (Wakerman (2005). . With such a holistic foundation having been put in place, the most difficult task was to implement the ambitious prevention strategies in order to ensure that the chronic disease situation does not get any worse than it is today. The preventive measures put in place by NCDS were aimed at focusing on both the risk and protective factors influencing the way in which chronic disease develops. Risk factors were defined as those variables that increase the possibility of a disease developing or progressing. The population health approach pays attention to economic, social, cultural and environmental factors that affect health directly while at the same time influencing behavioural factors that can affect one’s health and equitable access to health care (Asaria et al., 2008). On the other hand, health promotion simply represents a process of social and political adjustments so that the right actions are taken in pursuit of strengthened skills and capabilities among individuals (Glasziou et al., 2005). These skills and capabilities have been proven to be critical in bringing about the transformation of the social, economic and environmental conditions that definitely alleviate many negative effects on individual and public health. In this regard, some of the factors to focus on as part of the NCDS implementation include employment, income, social inclusion and education (O’Dea, 2005). According to the Australian Institute of Health and Welfare (2005), prevention is “an action aimed at reducing or eliminating or reducing the causes, onset, complications or recurrence of disease". Lifestyle modification and prevention can greatly assist the well-to-do population, those people at risk and even those with chronic disease. Lifestyle modification entails exercising regularly and eating healthy foods. Through prevention, the onset of many risk factors can be avoided. Six risk factors have been identified and categorized into two groups, namely biomedical risk factors, and behavioural and social risk factors (Halcomb et al., 2008). The biomedical risk factors include high blood cholesterol, excess weight, high blood pressure, depression and genetic factors (Brenda & Grant, 2007). . The behavioural and social risk factors include tobacco smoking, poor health during early childhood, poor diet and nutrition, physical inactivity, high-risk alcohol use, social isolation and excessive sun exposure. According to National Health Priority Action Council (NHPAC) (2006), some of these risk factors are very common to some major chronic diseases (physical inactivity, tobacco smoking, harmful alcohol use, poor diet and nutrition, excess weight, high blood pressure, and high blood cholesterol). Together, these risk factors account for nearly a third of the Australian burden of chronic disease. To put this into sharp focus, nine out of every ten Australians possesses at least on one of these risk factors. Additionally, research has shown that 54% of all males and 45% females have a combination of two risk factors or even more. Jordan and Briggs (2008) indicate that it is possible for major gains to be achieved through targeting prevention interventions that relate to the most common risk factors, especially those that underlie a wide range of chronic diseases, through. Furthermore, risk reduction interventions and health promotion efforts are needed across the disease continuum, and not merely for the case of health people (Armstrong & Gillespie, 2007). Program: Be active Australia a framework for health sector action for physical activity 2005-2010 Be active Australia a framework for health sector action for physical activity 2005-2010 is a program that was formed in order to raise the issue of physical inactivity, a major health issue. The program is an initiative of The National Public Health Partnership (NPHP), whose leadership agreed in March2003, to raise awareness on the need for Australians to be physically active in order to improve their health and wellbeing. They sought to sensitive people on how this can lead to reduced health costs as well as improvement in many social, economic, environmental and community indicators. The program provides a national framework for implementation of a comprehensively coordinated health sector action. It is aimed at adding value to the work that is done at jurisdictional levels. It also identifies efficient links and opportunities where united approaches are implemented through national strategies. This includes work on nutrition, healthy weight, falls prevention, chronic disease prevention, child health, healthy ageing, and the health of the people of Aboriginal and Torres Strait Island. Be Active Australia recognizes that there are many determinants of physical inactivity, all of which are a long-term challenge and they are outside the control of Australia’s health sector. Just as the causes of physical inactivity are complex, so too are the remedies. The program is designed in such a way that various sectors, including private, public, community and non-governmental, can contribute to the creation of the solutions. Focus is on strong partnerships between the health sector and all other sector in efforts to redress the problem. Target group of the program: Youth and children The target of the program is all Australians although emphasis is put on the need to focus on weight management issues among the youth and children. This is because children and youth are at a higher risk of facing lifelong problems triggered by inactivity, such as obesity. Be active Australia emphasizes on two main physical activity recommendations for the youth and children. The first one: youth and children need to engage in at least 60 minutes of vigorous-intensity physical activity everyday. The second one: youth and children should never spend more than two hours, getting entertained on the electronic media such as computer games, TV and internet, particularly during the day. Local or national program? The program was developed by SIGPAH (Strategic Inter-Governmental forum on Physical Activity and Health) a subcommittee of NPHP. SIGPAH is a collaborative organ that was established in order to provide national leadership for physical activity-related action by the Australian government. The aim of SIGPAH is to offer assistance to NPHP its in work of promoting and protecting the health of Australians. It has representation in health departments at the state, territory and Australian government level. Priority areas for this program include populations with special needs Aboriginal and Torres Strait islander Australians. The settings for the program include health services, child care, out-of-school-hours care, schools and community environments and organizations. Aims and objectives of the program The program targets people of all ages, economic statuses, geographical regions and health states within Australia. In other words, the need for physical activity is appreciated for everyone, and the program’s aims reflect this need. Among adults and older people, physical inactivity is blamed for increase in chronic disease risk. The main objective of Be active Australia is to ensure that everyone engages in sufficient physical activity in order to maintain proper health, to cut down on health costs and to lead productive, fulfilling lives. Through the program’s initiatives, it is possible to decrease the premature death risk from cardiovascular disease, colon and breast cancer, and diabetes. It is also possible to increase bone and muscle strength. Physical activity also improves health outcomes for overweight and obese people. Physical activity is also considered to be the best way through which people with certain chronic, disabling conditions can perform their daily activities. Additionally, people with an established disease are given an opportunity to prevent deterioration of the disease through physical activity initiatives provided by the program. The Strategic Intent of Be active Australia (BAA) are founded on three main areas: (a) settings, (b) priority populations, and (c) overarching strategies. The long term policy conceived from the Strategic Intent was expected to build a public policy on physical activity and create supportive activity-friendly environments. It was also expected to facilitate the build-up of personal skills and an increase in the health sector capacity for viable actions on physical activity. Outcomes of the program The BAA program has resulted in many desirable outcomes. Thanks to the program, the health sector, at all levels of operation, has a strong commitment to the issue of addressing physical inactivity through various relevant policies, programs, plans and environments. The health sector has also started providing leadership and sufficient resources and funding in order to address this issue. All Australians, especially the inactive ones, have adequate access to the necessary physical activity assessment, information, advice, support and referral programs through the country’s health system. Healthcare professionals have the necessary knowledge, skills, confidence and resources to promote physical activity routinely in their clients and to refer them as appropriate. This has led to an increase in awareness as well as preventative strategies for chronic disease. Additionally, sustainable partnerships have been conceived within the health sector as well as with other sectors in order for a more coordinated approach to development to be conceived. This has also made it easier for physical activity initiatives to be developed, delivered, and evaluated. An evaluation of BAA’s success in relation to NCDS Australia seems to have made a significant progress in the efforts to prevent chronic disease since the introduction of the BAA program (Grant & Chittleborough, 2009). In fact, for some of the chronic diseases such as asthma and some cancers, the mortality rates are falling. The wellbeing of individuals with these diseases has improved, while the cost to the economy has reduced significantly (Beaglehole et al., 2009). The BAA program has been one of the pillars of achieving the NCDS goals as far as prevention across the continuum is concerned. The chronic disease management continuum as stipulated in NCDS would not have been successful without the initiatives facilitated through BAA. The goal of chronic disease prevention has been achieved with maximum efficiency and minimum costs to the Australian government through preventative measures, one of them being boosting physical activity levels among Australians. The creation of environments that are friendly to physical activities has also important, especially through the acknowledgement of the integral links that embody physical, social and mental wellbeing of all individuals and groups (Jordan & Osborne, 2006). Education, home, workplace and community environments are critical in the task of ensuring safe levels of physical activity for all people (Warren et al., 2008). Through such settings, NCDS engages Australians in various initiatives, one of them being the BAA. These are the types of settings whereby a better understanding of healthy lifestyles has been encouraged and reinforced through BAA. One of the ways through which the NCDS has been pursuing the chronic disease prevention goals is through the focus on strategies that promote good health and healthy living (Knight & Senior, 2006). For instance, in Tasmania, various state government departments are in the process of implementing a cross-sector ‘cluster’ initiative through which healthy wellbeing issues are tackled in response to the vision of priorities that are community-driven (Harris & Zwar, 2007). The cluster is in such a way that it is possible for a whole-of-government approach can be used in addressing health issues that are too complex to be left in the hands of only one department. Incidentally, the BAA initiative has also been working in an environment where special emphasis is put high-risk areas such as Tasmania. Strong communities that constitute all community members are essential when it comes to the task of creating a physically active environment. In such settings, BAA has been engaging the local communities in order for them to feel the need to seek empowerment through increased physical activity. With the framework laid down by the NCDS, the main role of BAA has been to provide a holistic approach to the physical inactivity problem across all sectors and communities. Through proper leadership, the right opportunities have be created so that people are able to make healthy choices. A good example is town planning whereby people can be influenced to walk to and from their places of work more often. Towards this end, BAA provides a good avenue of creating a good public policy on chronic disease. According to Dennis et al. (2008), BAA’s objectives have provided an impetus for people with special needs not to be left out of the physical-activity awareness campaign. Examples of such people include people who suffer from chronic diseases as well as crippling diseases. The implementers of the BAA’s objectives have also been sensitive to people with established diseases, most of who need advice on how to maintain a healthy level of physical activity. The ambitious BAA program has contributed greatly to meeting all the requirements that are needed to drastically reduce suffering as a result of chronic disease. The key question has been on what needs to be done in order to move it through a transition from a set of words and phrases into a highly effective set of properly implemented deeds and courses of action that are time-bound, cost-effective and efficient (Dowrick, 2009). BAA has been successful in achieving this goal. The NCDS provides for opportunities for as many healthcare encounters with professionals as possible. This not only increases the opportunities for health promotion, but it also makes it possible to inform people on the ways of reducing risks. BAA has also contributed towards a geometric increase in such encounters. The Australian government played a crucial in making BAA a good platform of encouraging physically inactive to start leading physical lives. The capacity for health workers to identify various social, behavioural and biomedical factors for chronic illness has been strengthened through the BAA physical fitness policy framework. Comparison of the FAA program with Healthy Weight 2008 The strategic intent of The Healthy Weight 2008 – Australia Future: is to assist all Australians to enjoy the highest possible levels of good health through promotion of healthy weight. In order to do this, the program is designed as a long-term initiative, unlike the BAA initiative, whose duration of implementation is between 2005 and 2010. The The Healthy Weight 2008 program emphasizes on solutions rather than problems. However, just like the BAA program, the success of The Healthy Weight 2008 is based on the assertion that behaviour change is complex process; that it takes time for people to get used to doing things in the ‘right way’ in order to manage their weight. Like the BAA program, the The Healthy Weight 2008 focuses on all groups, while at the same time paying specific attention to special-interest groups such as children, youth, the senior citizens, people with chronic disease and mentally disabled persons. Additionally, like many other programs of this nature, The Healthy Weight 2008 is targeted at the entire country. Summary Monitoring the level of progress in the Australian NCDS and BAA policies, like in other healthcare initiatives and programs undertaken in the country, is a difficult thing to do. The answer to solving the problems that are presented by NCDS is provided by Lock et al. (2005) who assert that the pressing need for an evidence base that is current is justified and that various prevention interventions should be put into place for monitoring and surveillance purposes. To conclude, since the establishment of the National Chronic Disease Strategy in 2005, the Australian government has made significant progress in combating the threat of chronic disease. The first step towards achieving the achievement of this goal of putting preventative measures into place has also been pursued and considerable levels of success have been achieved. However, many policy challenges still need to be dealt with before all individuals and community groups can be said to have witnessed the levelling out of existing disparities in healthcare coverage, specifically with regard to risk factors for chronic disease. Priority should therefore be given to dealing with the existing mismatch between evidence and policy in the task of implementing preventative policies. 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