QUESTION ONE: Environmental health justice

Nearly every indicator for quality of life is much lower for indigenous people than those of most of the non-indigenous populace. Important environmental determinants sit alongside social, political and historical influences.

The Uwankara Palyanyku Kanyintjaku [UPK] research identified health problems which can be reduced by implementation of nine Healthy Living Standards [Npanampa Health Council in 1987Keleher & MacDougall 2011].

Discuss how failure of two of these Healthy Living standards can increase the incidence of a specific pathology – thus:

How and why does inability to wash people and to wash clothes and bedding increase the incidence of S aureus [impetigo/cellulitis]?

How and why does failure to remove waste safely from house and surrounds increase the risk of hookworm, especially in infants?

In your answer, explain

how these two living standards can prevent the spread of these two diseases
identify the causative agent of the two diseases
outline the spread and pattern of the illnesses between individuals and groups
outline the pattern of the illnesses in the Australian populace
identify if any particular groups or populations are at greater risk

QUESTION TWO: Primary, secondary, tertiary disease prevention

Disease prevention can be primary, secondary, tertiary or a combination of all three.

Primary prevention is directed at the stage of susceptibility to try and prevent the disease from occurring. Secondary prevention is aimed at the subclinical stage to try and prevent clinical disease / decrease severity of disease when it emerges. Tertiary prevention applies to the clinical stage and is aimed at preventing / minimising the progression of disease.

Note: disease prevention stages relate to more than medical/nursing interventions & treatments.

Rheumatic Heart Disease has become less important in mainstream Australian society but is regrettably common in the indigenous community. Explain why this disease has almost disappeared in the white population and then discuss methods of primary, secondary and tertiary prevention today.

QUESTION THREE:  Burden of disease

Consideration of the burden of disease on the individual and on populations is important for health policy-makers and planners in allocation of resources.

In the discussion of burden of disease

o define what a DALY is

how are DALYs used by health planners/policy-makers?

how does understanding of the burden of disease and injury indicate where the most gains in health can be made?

how does understanding of burden of disease improve understanding of patients’ probable lifestyles and life expectancies on discharge from acute care?

QUESTION FOUR: Epidemiology of a chronic disease

Epidemiology can be defined as:

The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems [Fleming and Parker 2009 72].

Over 6 million Australians report having arthritis or some other musculo-skeletal complaint and Osteo-Arthritis is the most common type of arthritis [AIHW 2010 187]. Using the above definition of epidemiology, discuss Osteo-Arthritis under the following headings

Its distribution across the lifespan and any special populations of concern

Social determinants of related heath states or event

Prevention and control of the disease or lessening of disease processes

QUESTION 5 : Health Promotion

Deaths from chronic obstructive pulmonary disease per 100 000 population have fallen from over 80 men and about 40 women in 1980 to 30 men and women or less overall in 2007 [AIHW 2010].

The major causes of chronic obstructive pulmonary disease [COPD] are nicotine and/or environmental pollution. The incidence of COPD has lessened significantly due to decreased nicotine usage and cleaner environments over the past forty to fifty years. Though the stories of change in smoking and clean air in Australia have been different, the end result has been the great change in rates of COPD.

The two stories are different mixes of health promotion by reward and coercion – education, taxing, changing agriculture, advertising, changing sponsorships.

Discuss how and why

nicotine usage has decreased since the 1970s and

work/job and community environments have improved

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