Healh in Yass in NSW Australia - Research Paper Example

 «Healh in Yass in NSW Australia» Yass is a town located in south-eastern New South Wales, Australia. It is located along the Yass River, a known tributary of the Murrumbidgee. The town was established in 1837 and is a known district producing merino wool, wheat, oats, orchard fruits, silver, lead, and bismuth (Encyclopaedia Britannica, 2010). It is located on the Hume Highway near the Barton junction and has rail connections to Sydney and Melbourne. This paper shall now discuss the health, social, and community issues affecting the Yass town. It shall explore main areas related to chronic diseases, disability, socioeconomic/occupational diseases, and multicultural issues. After identifying such main points about the town, this paper shall go on to prioritize the identified issues in the town. It shall also create a preventative health strategy which addresses the most important of these issues. The strategies on solutions will be based on the perspective of my current discipline; however, it will also include details on the roles of other health professions involved. Discussion Yass community profile and demographics The population of Yass is estimated at 12,900 inhabitants occupying an estimated 3900 square kilometres land area (Yass Valley Council, 2005). Their average land value is pegged at $747,338,600; their national highways stretch to 133 kilometres; their state roads to 59 kilometres, their regional roads to 174 kilometres, their tourist roads to 30 kilometres, and their local roads to about 1000 kilometres (Yass Valley Council, 2005). Their dam capacity is at 860ML with the Murrumbateman Bore yielding 45ML/year. Their average water consumption is at 1000 ML/year. They have two sewerage treatment plants and seven pump stations for secondary treatment at 450ML/year (Yass Valley Council, 2005). Based on 2001 census in Yass, there was an estimate of 181 indigenous people in Yass; this represents 90 males and 91 females (Yass Valley Council, 2004). This represents a significant change based on 1996 figures – an increase of 24% or 35 individuals was seen since then. The median age of such indigenous people was pegged at 38 years old. All in all the summary of ancestry in Yass in 2001 is summarized as 4905 – Australian; 3722 – English; 1307 – Irish; and the rest of the remaining population belonging to the indigenous group (Yass Valley Council). In evaluating their dwellings, there are about 3300 separate houses (private dwellings) in the area based on 2001 census; 120 semi detached; 93 flats; and 62 other dwellings (Yass Valley Council, 2004). This represents an increase in private dwellings which may be attributed also to an increase in the population. Health issues in Yass After laying out the overall demographic for Yass, the different health issues in the community will now be discussed. In the South-eastern New South Wales region where Yass is situated, most of the mortality and morbidity rates have been credited to a variety of chronic diseases and conditions, including cardiovascular diseases, cancers, respiratory diseases, diabetes mellitus, obesity, falls among older adults, and mental health issues (Yass Health Services, 2010). These chronic diseases are largely attributed to various factors related to behavioural risks for chronic diseases including: smoking, limited physical activity, poor nutrition, obesity, alcohol intake, and psychological disorders. Such trends in behavioural risks are made worse by social and environmental risk factors for chronic diseases, including: increasing rates of poverty, increase number of solo households, urban designs which capitalize on driving instead of walking; reduced social interaction; barriers to higher education; and various environmental risks (Yass Health Services, 2010). The major causes of death in Yass from 1997 to 2001 included cardiovascular diseases, cancer, respiratory diseases, injury and poisoning, and digestive disease disorders (Yass Health Services, 2010). Their rates were higher than the rest of the NSW population and indicated increasing figures in the future. These risk factors in behaviour and in socio-economic risk factors are detailed enough in the studies conducted by the government. Their studies indicate that, as compared to the rest of New South Wales, the Southern Area Health Service (SAHS) where the Yass is installed has a greater involvement in alcohol risk drinking behaviour (Yass Health Services, 2010). The SAHS also has lower intake of fruits and vegetables and it has a lower usage of low fat milk. In terms of physical activity, there is no significant difference. They have a higher number of smokers, asthma sufferers, as well as higher cases of hypertension, female obesity, work related injuries, and psychological distress (Yass Health Services, 2010). The health and social situation in Yass explains the fact that its inhabitants have a higher morbidity and mortality rate in relation to chronic diseases. It does not help their situation at all when health services in the area are difficult to access. The people in the area are however eager to contribute their time and efforts to the health efforts of the government. As compared to their NSW neighbours, they indicate a higher interest and participation in the contribution of social capital for purposes of health improvement (Yass Health Services, 2010). Table 1 Summary of risk and protective factors for chronic disease in people aged 16 and over in Southern NSW, 2002 Indicator Sex SAHS Comparison to NSW as a whole (95% confidence) Health behaviours Alcohol risk drinking Males Females Higher No significant difference Nutrition Recommended daily fruit Males Females Lower Higher Recommended daily vegetables Males Females Higher No significant difference Use of low fat, reduced fat or skim milk Males Females Lower No significant difference Physical activity Adequate physical activity Both No significant difference Smoking Smoke-free households Lower Health status Self-rated health Males Females Lower Higher Current asthma Females Higher High blood pressure Females Higher Diabetes Females Higher Work-related injuries Males Higher High and very high psychological distress Males Higher Overweight and obesity Females Significantly higher Health services Difficulties getting health care Both Higher ED attendances Females Higher Social capital Attended community event Females Higher Most people can be trusted Both Significantly higher Visit neighbours Both Higher This access to health services is also expressed in some instances by the government and by the general population as an issue involving equity (Yass Health Services 2010). Yass is considered a rural area, and therefore does not have as much access to health services as its urban counterparts (Yass Health Services 2010). This limited access contributes to the higher morbidity and mortality rate for chronic diseases. Since the rural areas are not given as much notice and as many programs in health services as the urban areas, the issues on equal services for Yass have a greater impact on the general population. Moreover, programs on the primary prevention of chronic diseases in this area are not given as much focus by the local government authorities; hence, these chronic diseases are higher in rate in Yass as compared to the rest of NSW. Based on an interview with pertinent local government officials, the town has limited health facilities and there are not enough doctors and health professionals practicing in these health facilities. Moreover, there are also limited after hours’ health services and its inhabitants and forced to travel to Canberra or Sydney to seek emergency medical attention. The town has no regular dialysis, radiology treatment, chemotherapy centre; nor does it have a trauma or a surgical centre. It has only two pharmacies servicing the area. And it also has limited activities for women to get involved in. It is also important to note the issue involving the aborigines or the indigenous people living in Yass. More than any other inhabitant of the area, they are the most affected by health issues. They have a lower life expectancy – lower by about 20 years as compared to the non-aboriginal people (Yass Health Services, 2010). Their teenage mortality rate is also higher as compared to the general population and their overall perinatal mortality rate also registers at higher numbers. They are also more likely to report alcohol consumption levels which are highly hazardous to the patient’s health (Yass Health Services, 2010). Their rates of hospitalization for instances involving injuries, poisoning, diabetes, cardiovascular diseases, respiratory diseases, and otitis media (among children) is also higher as compared to the general population. Moreover, their oral health is also much poorer than the rest of the non-aboriginal population (Yass Health Services, 2010). In considering the socio-economic conditions of the aborigines, a clearer understanding of their health conditions can be gained. The aborigines have high unemployment rates; they also have lower incomes and lower post-secondary school qualifications as compared to the non-aborigines (Yass Health Services, 2010). They do not have sufficient knowledge of the available services in their communities; and the available health services in their communities are often not culturally applicable to them (Yass Health Services, 2010). The incidents of potentially avoidable deaths in the area have been decreasing in the past few years; however, they are still considerably higher as compared to the rest of NSW. These potentially avoidable deaths include: congenital anomalies and other perinatal conditions, including SIDS; injury (43% attributed to deaths among children 0-14 years of age; poisoning, suicide, road traffic injuries (58% of deaths) among young people aged 15-24 years of age; suicide and poisoning among those in the 25-44 age bracket; cardiovascular diseases, cancers, chronic obstructive pulmonary diseases among the middle aged and older individuals (Yass Health Services, 2010). In more detail, the major potentially avoidable deaths in the region include: ischemic heart disease, COPD, lung cancer, colorectal cancer, stroke, suicide, breast cancer, alcohol-related disorders, and diabetes (Yass Health Services, 2010). These deaths can potentially be avoided through primary prevention measures, like population programs and behavioural changes; secondary prevention measures, like improved community health care; and tertiary prevention measures, like medical and surgical interventions (Yass Health Services, 2010). Studies by the government also indicate that the rate of potentially avoidable deaths is higher in the areas and among individuals who suffer from socio-economic disadvantages. Table 2 Potentially avoidable deaths in the Southern slopes and Yass (1996-2000) at 0-74 years Southern Slopes N % of deaths Ischaemic heart disease 92 17.39 COPD 33 6.24 Lung cancer 30 5.67 Colorectal cancer 23 4.35 Stroke 23 4.35 Suicide 16 3.02 Breast cancer 14 2.65 Alcohol-related conditions 13 2.46 Poisoning 12 2.27 Diabetes 12 2.27 All others 73 13.8 Total 341 64.47 Based on hospital morbidity, major causes of hospitalization include care for renal dialysis, orthopaedics, obstetrics, chemotherapy, cardiology, respiratory medicine, and diagnostic endoscopy (Yass Health Services, 2010). Potentially avoidable causes of hospitalization include respiratory conditions, gastroenteritis, cardiovascular conditions, and road injuries. These causes of hospitalization can be avoided through the application of primary, secondary, and tertiary prevention measures (Yass Health Services, 2010). Once again, these hospitalizations are common among those in the lower income group. Health facilities available In relation to available health services in Yass, the current health services in the area is based on a network of internal and external interactions which help provide integrative healthcare to residents. On the external scope, it has a network with Goulburn – a major district hospital within the SAHS; it also has a network with other clinical services in the ACT for its tertiary and referral hospital services (Yass Health Services, 2010). In the local landscape, health services are delivered through the Yass hospital which is located in the Yass township. In the immediate vicinity of the hospital, the Ngunnawal community services and Burrinjuck family day care centre is also located. The hospital functions as a community acute level 2 peer group centre. It has a 24-bed capacity and provides hospital services in the following areas: general medicine, surgery, obstetrics, rehabilitation, palliative care, and emergency services (Yass Health Services, 2010). Scope of current health services available: 1. Locally through the Yass Health Services 2. From private health providers 3. From the Clinical Service Networks found in SAHS 4. By travelling to the ACT 5. Travelling to Sydney There are visiting medical officers who provide 24 hour care; one medical officer is available to work one week in a month. Its emergency services are linked with higher level of services, including diagnostic radiology, pharmacy, and pathology (Yass Health Services, 2010). The Yass Health Service has a single operating unit which is operational one day for each month and a visiting surgeon carries out scheduled surgeries on this day. Naturally, these are planned surgeries which include the removal of hernias, lesions, and varicose veins; and other elective procedures like endoscopies (Yass Health Service, 2010). The Yass Hospital also provides services in relation to maternity or births; there is only one obstetrician in Yass. Their radiology services operate only 4 days in a week (Mondays, Tuesdays, Thursdays, and Fridays) from 8:30 am to 4:30 in the afternoon. Their pathology services are provided through the South Eastern Pathology Network (Yass Health Services, 2010). Pharmacy services are available every Tuesday afternoon. Physiotherapy services operate with one full time staff member from Mondays to Fridays catering to outpatients and inpatients. An aged day care operates in a unit at the hospital for 3 days in a week (Mondays, Wednesdays, and Fridays) (Yass Health Services, 2010). Table 3: Hospital services (available beds) Available beds Number Emergency department n/a Acute multipurpose beds 8 HDU beds 2 Obstetric beds 2 Non-acute beds 2 1 ward closed (2 beds) -2 Total beds available 22 Community health services cover a large area in Yass and provide primary, extended, continuing care services. Allied health services are also available and focus on rehabilitation services for the people in relation to the following areas of care: speech pathology, diet, diabetes education, paediatric occupational therapy, physiotherapy, radiography, and occupational therapy (Yass Health Services, 2010). The table below presents the distribution of allied health services in Yass. Table 4 Yass Allied Health Services Service Frequency of service Outreach Remarks Speech Pathology 5 days a week Outreach pre-schools and primary schools Adult inpatient and outpatient also offered Dietician 2 days a week Limited service to local nursing homes Limited health promotion Diabetes Education 1 day per week Visiting service from young CH Paediatric Occupational Therapy 2 days per week Outreach to pre-schools and other schools Very limited service Physiotherapist 5 days per week Limited service to children Radiographer 4 days per week 1 day a week at Harden Expand service at Yass Occupational therapist 3 days per week Prioritization of issues 1. Cardiovascular diseases 2. Limited health services and facilities available 3. Lack of culturally appropriate health services for the indigenous people (aborigines) Preventative Health Strategy for Cardiovascular diseases Goal: to reduce the incidence of cardiovascular diseases among the general population of Yass Primary Prevention In order to achieve the primary prevention of cardiovascular diseases, behavioural changes may have to be implemented in the community. These behavioural changes include programs on smoking cessation, blood pressure reduction, cholesterol reduction, blood glucose control, and the use of pharmacological interventions (Williams, et.al., 2003). Smoking cessation can be promoted in general by the local government through the imposition of smoking bans in and around public areas, parks, schools, offices, public transport, and health centres (Williams, et.al., 2003). By imposing smoking bans in these areas, it may be possible to limit the opportunities of smokers for indulging their habit. Centres which can provide counselling for those who want to quit can also be set up by the local government unit. Health experts who can provide counselling can be called in to set schedules for atleast twice weekly sessions to assist those who want to quit smoking (Williams, et.al., 2003). A support group for these smokers can also be established in order to ensure that they have sufficient emotional support to stick to their plans of quitting. NRT or nicotine replacement therapy items can also be made available in the pharmacies in Yass. This would help extend availability for those interested in quitting; it would also assist them in sticking to their plans of quitting (Williams, et.al., 2003). Behavioural modification in relation to proper diet also needs to be integrated into the lives of the people in Yass. The local government unit can enforce a health campaign in order to encourage and remind people to be more conscious of their diet – to reduce fat, sugar, sodium in their diet and to increase their intake of fruits and vegetables (Williams, et.al., 2003). By applying such diet modification techniques, it is possible to reduce cholesterol and blood sugar in the system and consequently reduce weight, and risks for cardiovascular diseases, diabetes, renal disorders, and other chronic disorders (Williams, et.al., 2003). Coupled with daily exercise, it is possible to increase metabolism, reduce or lose extra weight, and maintain weight at healthy levels. The local government authorities can help promote exercise by promoting health activities in the community, like building basketball courts and similar sports-related complexes available to the entire community (Williams, et.al., 2003). The young adults can be encouraged to use said complexes by launching competitive activities with prizes for competitors. It would motivate the people to join and would help sustain their enthusiasm for the sports complexes. The aged home facilities can also be set up with sports-related activities – to keep the older generation healthy and to keep them away from a sedate life (Medical News Today, 2010). Engaging in these activities can also reduce their mental health problems in relation to depression, isolation, and anxiety. As a pharmacist, the prevention of cardiovascular diseases would not be an easy task to implement because more often than not, when I would encounter the patients, they have already been diagnosed with cardiovascular diseases. However, in case these patients approach me for advice on medications they can take for chest pains, dizziness, headaches, and similar symptoms which may be associated with cardiovascular diseases, I can give them health advice on what remedies they can apply to ease these symptoms. They may avail of NRT from the pharmacy; my role in this case would be to encourage them to stick to their plan and to remind them of the benefits they can gain once they quit smoking (Patient.uk, 2010). Some of them may want prescriptions filled for lowering their cholesterol, blood sugar, or blood pressure. In the process of having those prescriptions filled, I can also share health knowledge in relation to their diseases and the benefits of incorporating healthy habits into their lives (Medical News Today, 2010). As a pharmacist, I can remind the patients that it is possible for them to prevent cardiovascular diseases if they take health precautions and incorporate behaviour modifications into their lives. The pharmacist can also help in the prevention of cardiovascular diseases through the promotion of a healthy lifestyle among patients (Williams, et.al., 2003). The above-mentioned remedies can be applied by the pharmacist in his practice in order to reduce the prevalence of cardiovascular diseases. The pharmacist can also help identify the behavioural risk factors which patients display and which put them at risk for acquiring CVDs (Medical News Today, 2010). It is also important to treat and monitor underlying diseases which trigger or contribute to the manifestation of CVDs. This can be carried out through the conduct of regular physical examinations and the early treatment of underlying problems (Medical News Today, 2010). The pharmacist’s role is also focused on identifying treatment gaps among patients. If other symptoms manifest which need proper focus and attention, the pharmacist can refer the patient to the medical practitioners for proper consult (Patient.uk, 2010). Once again, this would help ensure early treatment and prevention. In the pharmacy, brochures and leaflets discussing the dangers of CVD and health teachings in relation to such disease can be given out to patients. These pamphlets and brochures can provide information about the disease which the patients can bring home, read, and use at their convenience (Plimpton & Root, 1994). They can refer to such brochure in their own time and they can look up numbers in said brochures to seek more advice if they experience any of the symptoms as seen in the brochures, or if they want to opt for healthy living activities in order to prevent such symptoms (Plimpton & Root, 1994). Works Cited About Yass Valley Census 2001. (2004) Yass Valley Council. Retrieved September 26, 2010, from http://www.yass.nsw.gov.au/about/1583/1613.html Facts about the Yass Valley LGA. (2005). Yass Valley Council. Retrieved September 26, 2010, from http://www.yass.nsw.gov.au/about/1583/1662.html Gordon, J. (2009) Prevention and Management of Cardiovascular Diseases. Diamond Back Pharmacy. Retrieved September 26, 2010 from www.diamondbackpharmacyalumni.com/.../PreventionandManagementofCVDpptslides.ppt Nicotine Replacement Therapy. (2010). Patient.uk. Retrieved September 24, 2010 from http://www.patient.co.uk/health/Smoking-Nicotine-Replacement-Therapy.htm Pharmacists May Help Patients Prevent and Detect Heart Disease. (2010) American Pharmacists Association. Retrieved September 26, 2010, from http://www.medicalnewstoday.com/articles/200476.php Plimpton, S. & Root, J. (1994) Materials and Strategies That Work in Low Literacy Health Communication, Public Health Reports, viewed 26 September 2010 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402246/pdf/pubhealthrep00062-0088.pdf Residential Aged Care Services Management Plan (2009). Yass Valley Council. Retrieved September 26, 2010, from http://yassvalley.local-e.nsw.gov.au/printversion/8423.html Services Plan 2005-2010. (2010). Yass Health Service. Southern Area Health Service. New South Wales, pp. 1-94 Williams, H., McRobbie, D., Davies, R., (2003) Primary Prevention of Heart Disease. The Pharmaceutical Journal, 270, pp. 86-88. Yass. (2010). In Encyclopædia Britannica. Retrieved September 27, 2010, from Encyclopædia Britannica Online: http://www.britannica.com/EBchecked/topic/652179/Yass Read More