DISEASE CONTROL andPREVENTION IN AUSTRALIA
Public Health Association Conference 2011
CANBERRA –
4 April 2011
Professor Jim Bishop AOChief Medical Officer
Australian Government Department of Health and Ageing
UNITED STATES GOVERNMENTCentres for Disease Control and Prevention
OBJECTIVES
• Monitor health• Detect and investigate health problems• Conduct research on prevention• Develop sound public health policies• Implement prevention strategies• Promote healthy behaviours• Foster safe environment
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
7538
5004
4627
42104079 4063 3970
3793 3737 3696 36773540 3470
3359 33533129 3060 3008 2902 2870
2729 2687 2683
2151
1801 1781 1737
14371213
999852 767
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
1. Refers to insured population rather than resident population. 2. Current expenditure. 3. 2006. 4. 2007. Source: OECD, OECD Health Data, June 2010
Public expenditure on health Private expenditure on health
OECD HEALTH DATA 2010How Does AUSTRALIA Compare
COMMONWEALTH GOVERNMENT HEALTH & HOSPITAL EXPENDITURE
UNDER THE NHHN
Source: Commonwealth Budget Papers, DOHA and PMC Analysis
MAJOR DISEASE BURDEN in AUSTRALIA
PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010
AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
BROAD CAUSE MORTALITY TRENDS IN AUSTRALIA
Source: AIHW
Source: AIHW Australia’s Health 2010
AGED ADJUSTED DEATH RATESFrom CVD, 1907 -
2006
Source: Tracey et al –
Cancer Institute NSW
CHANGES IN DEATH RATES IN MALES -
using Joinpoint Analysis
Source: IARC 2010.
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Kenya
Nigeria
Egypt
Viet N
amTurk
eyInd
iaChinaRuss
iaSou
th Afric
aGreec
eBraz
ilJa
pan
Czech
Rep
ublic
Italy
United King
domCana
daGerm
any
Sweden
New Zealan
dUSA
Austra
liaM
orta
lity-
to-in
cide
nce
ratio
MalesFemales
ALL CANCER –
MORTALITY/INCIDENCE
ratios for selected countries -
2008
Source: AIHW Australia’s Health 2010
DEATH RATES FROMINFECTIOUS DISEASES, 1922-2007
TRENDS IN LEADING CAUSESOF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010
TOTAL CANCER CASES & DEATHS per year (1972 to 2036)
Source: Cancer Institute NSW
AUSTRALIAN GOVERNMENTSOCCUPATIONAL HEALTH and SAFETY
• Safework Australia• National Centre for Injury Prevention and Control•
Jurisdictional responsibilities in State and Territory Departments of Health
• Quality and Safety in Health Care-
Australian Commission on Quality andSafety in Health Care
-
Jurisdictional Quality and Safety initiativeseg: Clinical Excellence Commission (NSW)
AUSTRALIAN GOVERNMENTSPUBLIC HEALTH PREPAREDNESS
• Office of Health Protection (OHP)• National Incidence Room (NIR)• Australian Health Protection Committee (AHPC)
-
Jurisdictional, CDNA, enHealth, ADF, PHLN• Links to:
-
Emergency Management Australia (A/G)- ADF-
Other Commonwealth Portfolios (DFAT, AusAID)
CENTRES FOR DISEASE CONTROL & PREVENTIONUS GOVERNMENT
NON –
COMMUNICABLE DISEASES
• National Centre for Birth Defects• National Centre for Chronic Disease Prevention• National Centre for Environmental Health• National Centre for Injury Prevention
Research component within the National Institutesof Health funding
AUSTRALIAN GOVERNMENTSNON-COMMUNICABLE DISEASES
•
Australian National Preventative Health Agency•
Australian and Jurisdictional Government Population Health programs
•
Australian Population Health Development Principal Committee (AHMAC Committee) –
Screening Sub-committee•
Jurisdictional enHealth programs and enHealth sub-committee of AHPC
•
National screening programs in breast, cervix and bowel: Australian and Jurisdictional programs
•
Specific Commonwealth, Jurisdictional programs on Chronic Diseases
Research components within the NHMRC Funding
CENTRES FOR DISEASE CONTROL & PREVENTION
SURVEILLANCE and REPORTING
• Health Statistics• Laboratory Policy• Public Health information• Public Health Surveillance• Epidemiology and analyses• Scientific education and professional development
AUSTRALIAN GOVERNMENTS*
SURVEILLANCE AND REPORTING
• Australian Bureau of Statistics• Australian Institute of Health and Welfare• National Notifiable Disease Surveillance System• Sentinel Surveillance System• TGA adverse event reporting• DFAT Travellers Advisory• Cancer registries in each State and Territory• Screening and pap test registers• FSANZ and OZFoodNet
* National Health Security Act and agreement
AUSTRALIAN GOVERNMENTS
INFRASTRUCTURE
•
AHPC (enHealth, PHLN and CDNA)•
OHP Epidemiology Branch
•
State and Territory Epidemiology Programs•
National Immunization Program (NIP)
•
Australian Technical Advisory Group on Immunization (ATAGI)
AUSTRALIAN GOVERNMENTS
GOVERNMENT SUPPORTED or ACADEMIC PROGRAMS
•
Cancer Australia (NBOCC)•
National Centre for Injury Prevention and Control
•
National Centre for Asthma monitoring•
National Centre for HIV Epidemiology and Research
•
National Centre for Immunization Research and Surveillance
•
National Centre for Asbestos related diseases
THE KEYS TO PREVENTION
0.0 2.0 4.0 6.0 8.0
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol
Alcohol
Fruit/vegetables
Illicit drugs
Air pollution
Unsafe sex
% DALYs
Total of 32%
Source: Table 4.1 AIHW Australia’s Health 2008
AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010
AUSTRALIAN HEALTH SURVEY
Four components run by ABS 2011-13
-
Health Survey- ATSI Health Survey
-
Nutrition and Physical Activity Survey
-
Health measurement Survey
Around 50,000 participants
De-identified data available as summary statistics, tables
Anti-smoking campaigns ($27.8m)
COAG agreed•
Increased tobacco excise
•
Plain packaging •
Restricting internet advertising of tobacco products
•
Further funding for National Binge Drinking Strategy ($50m)
•
Survey of Australia’s Health ($54m)
National Preventative Health Agency
Budget 2010-11
CONCLUSIONS
•
Australia’s health outcomes are good by International standards
•
Prevention programs have some success and remaining challenges
•
Well Supported health emergency responses occupational health, food and medicines safety
•
Chronic diseases are the major burden of disease in Australia supported with substantial infrastructure
•
Australian Governments have invested in academic centres to lead research and training in similar areas to the US CDC rather than bureaucratic structures