AUSTRALIA’S FUTURE HEALTH

Australian Medical Students Association (AMSA) Annual National Leadership Development Seminar

CANBERRA –

30 August 2010

Professor Jim Bishop AOChief Medical Officer

Australian Government Department of Health and Ageing

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

AUSTRALIA’S RANKING AMONGOECD COUNTRIES 1987-2006

Source: AIHW Australia’s Health 2010

SELF-

ASSESSED PHYSICAL & MENTAL HEALTH, 2007

Source: AIHW Australia’s Health 2010

MAJOR DISEASE BURDEN in AUSTRALIA

BROAD CAUSE MORTALITY TRENDS IN AUSTRALIA

Source: AIHW

Source: AIHW Australia’s Health 2010

AGED ADJUSTED DEATH RATESFrom CVD, 1907 -

2006

ALL CANCER –

MORTALITY/INCIDENCE

ratios for selected countries -

2008

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

CHANGES IN DEATH RATES IN MALES

using Joinpoint

Analysis

Source: Tracey et al –

Cancer Institute NSW

CHANGES IN DEATH RATES IN FEMALES Using Joinpoint

Analysis

Source: Tracey et al –

Cancer Institute NSW

CANCERS WITH REDUCING DEATH RATES 1997 to 2006 –

ALL AGES

Lung, -18.5Colon, -19.6 Prostate, -19.7

Leukaemia, -23.7

Stomach, -29.4

Head and Neck, -23.7

Bladder, -18.5

Testicular, -42.2

Breast, -13.8

Cervix, -38.3

NHL, -25.1

Unknown, -24.8

Rectum, -19.9

Bowel, -19.7

All cancers, -13.8

, -24.3

-18.5

Kidney, -24.1

, -15.2

-31.9

, -21.1

-19.0-19.0

, -18.9

-7.9

-45

-40

-35

-30

-25

-20

-15

-10

-5

0

Male FemaleSource: Tracey et al, Cancer Institute NSW

PROJECTED BURDEN of MAJOR DISEASE GROUPS, 2010

Source: AIHW Australia’s Health 2010

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

HOW CAN HEALTH BE

IMPROVED ?

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

SMOKING IN AUSTRALIA

SMOKINGSTATUS

NSW VIC QLD WA SA TAS ACT NT AUS

Daily 16.4 16.5 17.2 14.8 16.5 22.7 14.7 25.3 16.6

Weekly 1.2 1.5 1.4 1.2 1.5 0.6 0.9 1.2 1.3

Less than Weekly

1.4 1.7 1.3 1.4 1.8 1.6 1.6 1.3 1.5

Ex-smoker 24.7 24.4 25.7 28.3 24.1 26.5 24.8 22.4 25.1

Never smoked

56.3 55.9 54.5 54.3 56.2 48.6 57.9 49.8 55.4

National

Drug Strategy Household Survey 2007Source: 2007 Household Survey, Australian Government

AUSTRALIA’S INITIATIVES IN TOBACCO CONTROL

Advertising Bans

Under the counter at retail sites

Banning smoking in restaurants, pubs and cars

Graphic warnings on cigarette packets

Anti-tobacco campaigns

Increase in tobacco excise

Plain packaging

OBESTITY INCREASING FOR ALL

Source: AIHW: Australia’s Health 2008

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

MILESTONES IN CANCER CONTROL

Public health measures in smoking reduction,

screening breast, cervix, bowel, health literacy

Adjuvant treatment of breast, lung and bowel

cancer

New anti-cancer drugs and symptom control drugs

Cancer research translated into practice

Cancer registries, data linkage and analysis

NON-COMMERCIAL CANCER RESEARCH EXPENDITURE, 2004

(A$ per CAPITAL)

Source: Eckhouse

et al (2007), ABS

PRIORITY HEALTH AREAS

SOURCE: NHMRC Research funding 2010 facts book

SUPPORTS FOR CLINICAL DECISION MAKING

Evidence Base

Highest Impact

Range of best practice tools

Successful implementation methods

Monitor and report

CLINICAL GUIDELINES

MEASURES IN WORKFORCE

$5.4 billion

from 1 July 2010Additional $632m -

5,500 places for GPs

-

5,400 pre-vocational GP Places

-

680 Specialist places

Health Workforce Australia established Initial emphasis on Clinical training places

CONCLUSIONS

Orientated to known burden of disease

Emphasis on prevention, early interventions

Driven by evidence from medical research

More opportunities for clinical training

Evidence based standards and guidelines implemented and monitored

AUSTRALIA’S FUTURE HEALTH SERVICES