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Social issues
These areas have been specifically identified as they are all major causes of death and disability; and together account for the majority of the burden of disease in Australia. Several of these conditions, namely cardiovascular disease, diabetes and certain cancers, have modifiable risk factors in common (e.g. poor diet, smoking, physical inactivity). Hence, focus on the NHPAs has identified areas where health promotion activity might have the widest benefit. Associated issues revolve around the variation in prevalence of NHPA conditions across different population groups and regions, and the effectiveness of public health campaigns relating to the NHPAs. SOCIOECONOMIC INEQUALITIES There is an increasing body of evidence to suggest that socioeconomic conditions can influence health status. In recent years this has become a health issue rather than simply being a sociological phenomenon. Living in poor socioeconomic conditions is often associated with lifestyle behaviours known to undermine good health, which has led governments, researchers and community groups to attempt to address the wider socioeconomic determinants of health. There is seen to be an ongoing need to address fundamental questions such as whether health differentials are narrowing or widening between particular groups in the community and how social and economic factors influence these inequalities. While Australians generally enjoy a relatively high standard of living, some groups within Australia have fewer socioeconomic resources on which to draw in times of need. Not only does this jeopardise effective recovery from disease, but it has implications for the effectiveness of health prevention measures. PERFORMANCE OF THE HEALTH SYSTEM The broader Australian health system provides health care services in a range of settings as well as developing and supporting promotion and prevention activities. Consumers, services providers and governments are interested in the performance of the health system and, in particular, in the performance of health services. Levels of unmet need, factors determining service usage, and reasons alternatives may be preferred, are of interest. Of equal concern is the capacity of services to deliver help to those using them and the ability of health care services to deliver appropriate care which ensures patient safety. Providing or improving access to health services for all community groups - whether that be in terms of effective education, improved transport, disability access, through ensuring services are culturally appropriate or providing language assistance - is considered important in encouraging the use of services and improving their effectiveness. The potential for improved efficiency of, and public access to, health services arising from integrating and coordinating private, community, and government health care is a recent area of interest. HEALTH COSTS AND FINANCING The substantial financial costs associated with supporting the health system, borne by individuals and the community, is an ongoing area of public concern. Of key interest is the sustainability of the health system over the long term, particularly as the population ages and new health problems arise. Another area of interest is how cost and effectiveness goals can be appropriately balanced. For instance, immunisation is a relatively inexpensive prevention measure, which reaches a high proportion of the population. Other health treatments can be more costly, and may benefit fewer people. Debate often surrounds the appropriate allocation of responsibility for health costs. In other words, there is a question of how these should be shared among governments, communities, private organisations, and individuals. In the context of a changing private health insurance environment, there is interest in the characteristics of people who have private health insurance, and how and why these people differ from those who do not have health insurance. Private health insurance membership may not only affect the affordability of health care and health actions, but may influence use of health services, and may be seen as an effective medium through which healthy lifestyles can be promoted. WORKPLACE HEALTH AND SAFETY The effective implementation of safe and healthy work practices and conditions is of general concern. Health problems caused by conditions in the workplace impact on a number of groups. For example, injured or sick workers may suffer pain and disability from workplace related injuries or illnesses, and may lose income. Employers may face costs associated with lost working days, lowered productivity, and workers insurance liability. Surrounding families, businesses and communities can also be affected. The incidence of work-related injury and disease, effective preventative measures and appropriate compensation and insurance regulation are all related areas of interest.
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