Older Age and Health: Australia - Essay Example

Older Age and Health – the case of Australia I. Introduction The provisions for health regarding especially the aged people in Australia should be a major priority for the country’s government. It has to be noticed that in accordance with a report of the Australian Government (2005) “by 2050, a quarter of the population will be over 65; research evidence indicates that there are effective actions that can be taken to enable people to live longer in good health, staying mentally and physically active and able to participate and enjoy life until they die at an advanced old age”. The above findings indicate that older people ‘constitute’ a significant part of the population in Australia and for this reason the central government (also the local authorities) should proceed to the implementation of a series of measures for the improvement of the health facilities provided to elderly across the country. On the other hand, a report of the Australian Bureau of Statistics (2006) showed that “at 30 June 2004 the number of older persons aged 65 years or more in Australia was estimated to be 2.6 million, or around 13% of the total population; the proportion of older people in the population is projected to increase over time to 26% in 2051, and to 27% in 2101 (Series B) or to 28% and 31% respectively” (see also Appendix, Graph 1). The above figures show clearly a trend for the increase of the percentage of older people in the country for the years to come. All the above findings should have led to the design and the development of several appropriate strategies that could ensure the provision of adequate and effective health services to older people in the country on a long term basis (in any case according to the statistics presented above, older people will be the majority in the country’s population in the near future). Moreover, it has been found that “the reporting of many conditions increased with age; in the 75 years or more age group total or partial deafness was reported by 55% of males and 33% of females respectively, up from 35% and 18% for the 65-74 age group” (Australian Bureau of Statistics, 2006). In other words, the increase in age causes a relevant increase in the report of conditions across the country. Current paper examines the condition and the quality of health services provided to older people in Australia. At the same time, all aspects of health related with the particular category of Australian population are being examined both by a medical and a sociological aspect trying to avoid the reference to medical terms and treatment provided in each particular occasion. Instead, this study presents the patterns of health in Australia and the relevant provisions of the country’s government – always regarding the older people – while the views of theorists (like Goffman, Weber and Foucault) are being used in order to understand the health framework of the country especially for the specific part of the population. II. Health problems related with older age – the case of Australia The problems of health related with the Australian population are many. In fact it has been found that “the leading causes of ill health and disability in the Australian population are chronic non-communicable, preventable diseases that relate to the known common risk factors of smoking, nutrition (especially obesity), alcohol consumption, lack of physical activity, high blood pressure and high cholesterol; currently over 70 per cent of the burden of illness and injury experienced by the Australian population is associated with the national health priority areas of cardiovascular disease, cancers, injuries, mental health problems, diabetes mellitus and asthma” (Australian Government, 2005). The above problems also refer to the older people who can present although particular ‘patterns’ of illness because of their age. There are also elements of the older people’s daily activities that are helping the improvement of their health, even such a fact cannot be observed directly. Regarding this issue, the study of Byles (2005, 31) showed that “beyond marriage, most older people in Australia have reasonably high levels of social interaction with family and friends; however, older people with respiratory disease have a higher risk of social isolation and loneliness; it is thought that social interaction may protect against ill health (through positive effects on cardiovascular, endocrine and immune systems) and improve quality of life among people with chronic disease”. According to the above study, older people face an increased risk of illness however the intervention of social events may help towards the increase of their resistance to illness and diseases in general. Towards this direction it has been found that “advancing age heralds a growth in emotional stability accompanied by a neural transition to increased control over negative emotions and greater accessibility of positive emotions; in contrast people under age 50 experience negative emotions more easily than they do positive ones” (Bower, 2006, 239). The above study which refers to findings of the research made by a team led by neuroscientist Leanne M. Williams of Westmead (Australia) Hospital can help to understand the causes of appearance and development of illness in older people not only in Australia but in all countries around the worlds. The influence of the emotions has been found to be increased in older people comparing to younger people and this difference could possibly explain why older people present an increased risk of death from common illnesses comparing to the younger ones; it seems that illness under the influence of emotions can have a greater impact on the older people’s health. The death rate as well as the most common causes of death of older people in Australia has been examined in a research made by the Australian Report of Statistics (2006) which found that “in 2004 the death rate for persons aged 65 years or more was 4,046 per 100,000, with males (4,390 per 100,000) higher than females (3,768 per 100,000); the leading causes of death for older persons aged 65 years or more were diseases of the circulatory system and malignant neoplasms (particularly lung, prostate, and colorectal cancers)”. It seems from the above findings that the health services provided to older people in Australia are not of the appropriate level. The government’s efforts regarding the improvement of health for the older people in the country can be evaluated only through the results, which in the particular case can be represented through the figures presented above. It is for this reason, that in accordance with a report published by the Australian Government (2005) “achieving healthy ageing of the population presents a series of challenges for governments, businesses, care professionals, communities and individuals; it requires action on a wide range of fronts, from social and economic policy, through to coordinated and strategic chronic disease prevention and control, and changes in individual dietary and other lifestyle factors”. From another point of view, it is stated by Flemming et al. (2001, 57) that “while it is clear that Australias population is ageing, there have been unprecedented improvements in life expectancy at older ages; it thus becomes important to direct research and health systems resources to the prevention and treatment of non-fatal disabling diseases such as dementia, arthritis, hip fracture, and loss of vision and hearing”. Another issue that needs to be noticed is that the conditions of health services provided to the public have been differentiated a lot throughout the years. More specifically, the study of Eagar (2001, 39) showed that “for decades, health policy in Australia had been dominated by debates about health insurance and financing, with national health insurance the focal point for that debate however in 1988 the Health Targets and Implementation Committee highlighted the major health issues associated with health status inequality and inequity; priority areas for health promotion were nationally adopted: control of hypertension, improved nutrition, injury prevention, the health of older people, the primary prevention of skin and lung cancer, and the secondary prevention of breast and cervical cancer”. Although the above remarks present the need for improvement of the health services provided currently to older people in Australia, they have to be incorporated in particular plans applied throughout the country in order to respond to the needs of the older people for a more effective framework of social health. III. Sociological aspects of older age and health The provision of health services in older people has to be examined from a series of aspects. At a primary level, there is the ‘obligation’ of the doctor to provide the appropriate treatment in accordance with the needs of the specific patient. The age of the patient in this context should not be a reason for the differentiation of the doctor’s behaviour. Regarding this issue, it has been noticed by Foucault in his study ‘Birth of a Clinic’ that “the first task of the doctor is ... political: the struggle against disease must begin with a war against bad government." Man will be totally and definitively cured only if he is first liberated” (Foucault, Birth of a Clinic, p.33, in Shawver, 1998). Weber also believes that “the science of social institutions and culture arose for practical considerations, with the purpose of producing value-judgement as measures of state policy; knowledge of what is was conflated with knowledge of what should be; this was because natural laws and evolutionary principles dominated the field” (Weber in Shils et al.). The two above studies can be considered as based on the same theoretical explanation of the medicine’s role in the improvement of the health of people. More specifically, in the first study, this of Foucault, medicine is represented by the doctor who has the responsibility but also the power to propose a particular treatment or to do the required operation to the patient. On the other hand, for Weber this power of medicine over the people’s lives is expressed through the activities of medical institutions which have a direct and continuous relationship with a high number of people/ patients. However, it has to be noticed that the intervention of medicine as explained above should follow specific patterns. In this context, it has been noticed by Goffman (1956) that the role of the ‘front’ (as explained in the particular case by the doctor or nurse who face the patient when entering a medical institution) is of particular importance. However, it is made clear that “social front can be divided into traditional parts, such as setting, appearance, and manner; these two facts, taken together, lead one to appreciate that items in the social front of a particular routine are not only found in the social fronts of a whole range of routines but also that the whole range of routines in which one item of sign-equipment is found will differ from the range of routines in which another item in the same social front will be found”. In other words, the provision of appropriate health services should not be the only target for the designers of the relevant schemes. These services should be offered using the appropriate ‘front’ which can ensure that patients will be treated with the necessary respect and warm. At a next level, the conditions of health should be also examined (combined with the provision of health as presented above) in order to show the appropriate pattern of medicine’s intervention. In fact, the causes of the diseases and illnesses should be examined primarily while the methods of medical intervention applied in a particular case should follow. Regarding this issue, it is noticed by Foucault in his ‘Birth of a Clinic’ that “in the depths of its being, disease follows the obscure, but necessary ways of tissue reactivations; but what now becomes of its visible body, that set of phenomena without secrets that makes it entirely legible for the clinicians gaze: that is, recognizable by its signs, but also decipherable in the symptoms whose totality defined its essence without residue” (Foucault, Birth of a Clinic, p.159, in Shawver, 1998). In other words, the appearance and the development of disease can be explained by the events of life and the elements of the personality of the person involved. For this reason, illness is considered to be closely related with the social life and the personal attitudes. This assumption, which is in accordance with the statistics revealed above in the Introduction section, is also supported by the view of Weber who stated that “every science of cultural life must arrive at a rational understanding of the ideas which underlie every concrete end; science can judge these ideas and ends ONLY according to a logical and historically defined standard of value which can be elevated to a certain level of explicitness beyond individual sentiment “(Weber in Shils et al.). For this reason, it has been also supported that “problems of social policy are not based on purely technical considerations of specific ends, but involve disputes about the normative standards of value which lie in the domain of general cultural values; this conflict over general cultural values does not occur solely between class interests but between general views on life and the universe as well (take that, Karl)” (Weber in Shils et al.). Illness and society are therefore related. In the case of older people this issue may lead to the assumption that the plans related with the health services provided to older people need to include relevant schemes/ proposals for communication and participation in social events. IV. Conclusion The issues developed above lead to the assumption that “health, wellbeing and independence of older people can be sustained and enhanced by actions on the part of older people themselves, and by a society that values them, through positive action by whole of government policies, and partnerships including responsive industries and employers” (Australian Government, 2005). The above statements are in accordance with the views of the theorists presented above but also in accordance with the findings of the empirical research presented in the beginning of this paper. It has also to be noticed that the efforts for the improvement of health of older people should not be related exclusively with the government. Local communities should also proceed to the design and the implementation of the necessary schemes (within the borders of their power). For this reason, it is stated by Flemming et al. (2001, 57) that “communities, however defined, are central to the promotion of health, and community health promotion is wide in scope and contains many dimensions embracing planned community based programs that emphasise the reduction of behavioural risk factors through strategies such as public information and education, legislation, media-based campaigns and economic measures and including the collective efforts of communities to enhance their health”. Generally, society is proved to have a primary role in the improvement of health of older people. It is perhaps for this reason that a relevant survey in Australia showed that “in 2005 many older people rated their health as good (32%), and more than a third rated their health as very good to excellent (36%) - an increase from 2001 (32%)” (Australian Bureau of Statistics, 2006). The above findings can lead to the assumption that the level of communication and social interaction of older people in the country is increased and for this reason, their health standards remain at relatively high levels. These findings could be also justified by the fact that older people tend to proceed more often to the solution of private insurance regarding the coverage of the risks related with health – a phenomenon that is not so common among younger people. More specifically, in accordance with a report of the Australian Bureau of Statistics (1998) “levels of insurance coverage were highest in middle age groups, with 49% of persons aged 45-54 years and 45% of persons aged 55-64 years having some form of private health insurance; combined hospital and ancillary insurance coverage increased up to the 45-54 year age group, then declined in older age groups however the level of combined hospital and ancillary cover decreased by 13 percentage points from a peak of 34% of those aged 45-54 to 21% of those aged 75 and over” (see also Appendix section, Graph 2). However, it should be noticed that the existence of extended health insurance in older people cannot be regarded as the exclusive reason of their increased levels of health. In fact, their social activities could be considered as having a more important role in the improvement of their health. On the other hand, the initiatives of the Australian government regarding the implementation of appropriate plans of health services particularly for the older people have proved to be limited. There is an emergent need for the design and implementation of appropriate strategies and projects regarding the health of the particular part of the population. The proposed measures for the improvement of health services provided to older people in Australia can lead to the required results only under the terms that all the relevant parameters are going to be thoroughly considered. The issue of cost referring to the health services should be regarded as a primary issue for consideration by the country’s government when designing health – related projects. For this reason its is stated by Hancock (1999, 267) that “concern has mounted, both in Australia and the UK, over the burgeoning costs in aged care related to growing numbers admitted to nursing and retirement homes; similar to other deinstitutionalisation movements of the mentally ill and the disabled, government policy has been driven by the twin objectives of the social benefits of maintaining people in the community and of cost savings from transferring care of the frail and dependent aged from residential care to care in the community”. Furthermore, any social policy designed and applied within the country should be primarily examined as of its feasibility regarding the cost involved as it is usually going to be funded exclusively by the State. References Australian Bureau of Statistics (2006), available at http://www.abs.gov.au/Ausstats/abs@.nsf/7d12b0f6763c78caca257061001cc588/a4993d98993ebdabca2571f60017a8a2!OpenDocument Australian Bureau of Statistics (1998), available at http://144.53.252.30/AUSSTATS/abs@.nsf/productsbyCatalogue/4F937B77D2B2DA55CA25699000255C8A?OpenDocument Australian Government, Department of Health and Ageing (2005), available at http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ageing-agefriendlybuilt-phaia.htm Australian Government, Department of Health and Ageing (2005) The National Strategy for an Ageing Australia, available at http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/ageing-ofoa-agepolicy-nsaa-nsaabk7.htm Bower, B. (2006) Older but Mellower: Aging brain shifts gears to emotional advantage. Science News, 169(25): 389 Byles, J. (2005) How do the psychosocial consequences of ageing affect asthma management? Medical Journal of Australia, 183(1): 30-32 Eagar, K., Garrett, P., Lin, V. (2001) Health Planning: Australian Perspectives. Crows Nest: Publisher: Allen & Unwin Fleming, M., Parker, E. (2001) Health Promotion: Principles and Practice in the Australian Context. Crows Nest: Allen & Urwin Goffman, E. (1956) The Presentation of Self in Everyday Life. New York: Doubleday, pp. 22-30, 70-76 Hancock, L. (1999) Health Policy in the Market State. St. Leonards, N.S.W.: Allen & Unwin Shawver, L. (1998) Notes on Reading Foucaults The Birth of the Clinic, available at http://users.california.com/~rathbone/foucbc.htm Shils, E., Finch, H. The Methodology of the Social Sciences, Max Weber, available at http://www.sociosite.net/topics/weber.php#ORIGINAL Appendix Graph 1 - Projected population by age (a), 2004 to 2101 (source: Australian Bureau of Statistics, 2006) Graph 2 – Australia, PROPORTION INSURED, By Sex and Age Group (source: Australian Bureau of Statistics, 1998) Read More