Improvements in Australia’s Health Status Since 1900

1. ‘Old’ Public Health

• Definition: Government actions focused on sanitation, hygiene, and infectious disease control.
• Focus:
  • Clean water and sewage disposal
  • Improved nutrition
  • Better housing conditions
  • Quarantine laws
  • Food safety regulations
• Impact:
  • Reduced incidence of infectious diseases (e.g., polio, measles, tuberculosis)
  • Decreased infant and maternal mortality rates
  • Increased life expectancy
• Examples:
  • Establishing sewerage systems
  • Pasteurization of milk
  • Mass vaccination programs
  • Public health campaigns promoting hygiene

KEY TAKEAWAY: ‘Old’ Public Health primarily addressed environmental factors and infectious diseases through government interventions, leading to significant improvements in health status.

2. Biomedical Approach to Health and Improvements in Medical Technology

• Definition: Focuses on diagnosing and treating illness and disease using medical interventions.
• Key Features:
  • Relies on technology and medical research.
  • Focuses on individual pathology.
  • Treatment-oriented (rather than prevention).
• Improvements in Medical Technology:
  • Antibiotics: Treatment of bacterial infections (e.g., penicillin).
  • Vaccinations: Prevention of viral and bacterial diseases (e.g., polio, measles).
  • Surgery: Improved surgical techniques and anesthesia.
  • Diagnostic tools: X-rays, MRIs, CT scans, blood tests
  • Organ transplantation: Allowed for treatment of organ failure.
  • Development of pharmaceuticals: Management of chronic conditions.
• Impact:
  • Increased survival rates from previously fatal conditions.
  • Improved quality of life for individuals with chronic diseases.
  • Increased life expectancy.
• Limitations:
  • Expensive and not always accessible to all.
  • Focuses on treating illness rather than addressing underlying causes.
  • May not be effective for chronic and lifestyle diseases.

EXAM TIP: When discussing the biomedical approach, always mention both the technological advancements and their specific impact on health outcomes.

3. Social Model of Health

• Definition: An approach to health that considers the broader social, cultural, and environmental factors that influence health and wellbeing.
• Focus:
  • Addressing the social determinants of health (e.g., poverty, education, housing, access to healthcare).
  • Promoting health equity.
  • Empowering individuals and communities to take control of their health.
  • Prevention rather than cure.
• Principles (NOT included in this Key Knowledge Point but important to know):
  • Address the broader determinants of health: Focus on social, economic, and environmental factors.
  • Acts to reduce social inequities: Target vulnerable populations.
  • Empowers individuals and communities: Give people control over their health.
  • Acts to enable access to healthcare: Ensure healthcare is available and affordable.
  • Involves intersectoral collaboration: Requires cooperation between different sectors (e.g., health, education, housing).
• Development of ‘New’ Public Health: The social model of health is also known as ‘new’ public health. It represents a shift from focusing solely on individual behaviours to addressing the broader factors that influence health.

COMMON MISTAKE: Students often confuse the social model of health itself with the Ottawa Charter for Health Promotion. Remember the model is the framework; the Charter is the action plan.

4. Ottawa Charter for Health Promotion

• Definition: An international agreement outlining a framework for health promotion.
• Date: 1986
• Strategies for Health Promotion:
  • Advocate: Actions that seek to gain political commitment, policy support, social acceptance and systems support for a particular health goal or program.
  • Enable: Health promotion activities that equip people with the skills, resources and supportive environments, to take control of and improve their health.
  • Mediate: Health promotion activities involving individuals, groups, the health sector and government working together to ensure the pursuit of health.
• Priority Action Areas:
  1. Build Healthy Public Policy:
     • Decisions made by governments and organisations that affect health.
     • Examples: taxation on unhealthy products, seatbelt laws, smoking bans in public places.
  2. Create Supportive Environments:
     • Focuses on places where people live, work and play, aiming to make these environments safe, stimulating, satisfying and enjoyable.
     • Examples: workplace stress management programs, safe playgrounds, walking/cycling paths.
  3. Strengthen Community Action:
     • Empowering communities to identify and address their health priorities.
     • Examples: community gardens, neighbourhood watch programs, local health initiatives.
  4. Develop Personal Skills:
     • Providing individuals with the knowledge and skills to make informed health choices.
     • Examples: health education in schools, cooking classes, parenting programs.
  5. Reorient Health Services:
     • Shifting the focus of health services from treatment to prevention.
     • Examples: doctors advising on lifestyle changes, health promotion campaigns in hospitals, funding for preventative care.
• Relationship to the Social Model of Health: The Ottawa Charter puts the social model of health into action by providing a framework for implementing strategies that address the social determinants of health.

STUDY HINT: Create a table linking each Ottawa Charter action area with specific examples and explain how each example contributes to health promotion.

5. Reasons for Improvements in Australia’s Health Status: Synthesis

• Combined Impact: The improvements in Australia’s health status since 1900 are a result of the combined effects of old public health measures, advancements in medical technology and the biomedical approach, and the shift towards the social model of health and health promotion strategies outlined in the Ottawa Charter.
• Disease Patterns:
  • Shift from infectious diseases to chronic diseases as leading causes of death and disability.
  • This shift necessitated a move from ‘old’ public health to ‘new’ public health and the social model of health.
• Life Expectancy: Increased due to reduced infant mortality, better management of infectious diseases, and advancements in treating chronic conditions.
• Mortality and Morbidity: Significant reductions in mortality and morbidity rates for many diseases due to prevention and treatment strategies.

APPLICATION: Consider how Australia’s approach to COVID-19 reflected aspects of old public health (quarantine), the biomedical model (vaccines), and the social model (addressing vulnerable populations).

6. Relationship Between Biomedical and Social Models of Health

• Complementary Approaches: The biomedical and social models are not mutually exclusive; they complement each other.
• Biomedical: Effective for treating acute illnesses and injuries.
• Social: Effective for addressing the underlying causes of chronic diseases and health inequities.
• Integrated Approach: The most effective approach to improving health status involves integrating both models, addressing both the individual and the broader social and environmental factors that influence health.

VCAA FOCUS: VCAA often asks students to analyze the strengths and limitations of both the biomedical and social models of health, and to evaluate their effectiveness in addressing specific health issues.