Updated
Australia has a reputation as a healthy nation, with
one of the highest life expectancies in the world, but a growing number
of Australians are living with chronic illness.
Key points:
- Nearly 50 per cent of Australian now have a chronic illness
- Many of those illnesses are preventable
- Doctors are calling for an increased focus on prevention rather than just cure
Ben Harris, a health policy expert at Victoria University's Mitchell Institute, crunched the numbers from the latest National Health Survey and discovered that 11.4 million Australians, almost 50 per cent, now have a chronic disease.
"That's up from two in five just 10 years ago," he told 7.30.
"About a third of chronic disease is preventable, yet we only spend 1.3 per cent of our health budget on preventing disease.
"We need to do better with prevention and managing chronic disease. We need to start treating people, rather than treating diseases."
'This system has to change'
Chronic illnesses include things like heart disease, diabetes, cancer, asthma, mental health and dementia, which are generally long-term conditions needing complex care.Molly Lucas, 10, was diagnosed with Type 1 Diabetes two years ago and needs constant monitoring of her blood sugar levels and multiple medical appointments.
"If she doesn't have insulin she dies, basically," her mother Kirsty Lucas told 7.30.
"You don't know if she is going to have some sort of adrenalin surge which will plunge her sugar level very low and put her into a coma.
"Things can happen very fast, so you have to be vigilant and you have to be prepared."
Molly's key needs are covered by a hospital-based team of specialists, but she is a private patient for a range of other medical needs including a podiatrist, optometrist and gastroenterologist.
But in between those visits, she sees her local GP, Marek Steiner, who thinks the health system is struggling to cope with the increase in chronic illnesses.
"The current system doesn't really allow us to focus on ongoing proper care for patients over time," Dr Steiner told 7.30.
"With people with chronic conditions, we certainly want to spend a little bit more time."
He is concerned about the future if things stay as they are.
"We are going to be overwhelmed with patients with chronic need, they won't get the care that they need, simple as that," Dr Steiner said.
"This system has to change.
"When you are faced with a chronic medical condition we certainly have a two-tiered system, for those who have money and those who don't have money, and there is a big gap there."
Obesity — 'I think it's fair to call it a crisis'
Australia's chief medical officer Brendan Murphy told 7.30 that the biggest challenge for the health system was the "obesity crisis".
"I think it is fair to call it a crisis," Professor Murphy said.
"We're quite high up in the shame scale internationally of obesity — nearly a third of our population are obese and nearly two-thirds are overweight or obese.
"That is a massive challenge for us that requires a very significant multi-faceted approach in terms of nutrition, exercise, and particularly attention to early childhood in my view."
Preventing obesity would also have positive flow-on effects for other chronic diseases like Type 2 diabetes and heart disease.
"We've got to really understand the drivers in this space, understand how we empower people to understand that they are part of the solution," Professor Wood said.
"If we want to keep people out of hospital, then we need to think about prevention, wellness, health, exercise, fitness."But that may be easier said than done.
Jennifer Doggett, health policy analyst at the Australian Health Care Reform Alliance, believed it would require major structural reform of the industry.
"Our health system was set up in an era when the biggest burden of health care was short-term acute problems like infectious diseases and injuries," she said.
"We're now in an era where the largest burden is for complex and chronic problems, where people need care from a range of different providers and over a long period of time.
"That's something our health system is not able to do."
GPs on the frontline
Melbourne GP Lara Roeske is finding it difficult to deal with the needs of chronic disease in a standard consultation.
"A big area for us at them moment is managing the complex needs of chronic disease," she said.
"If you ask most GPs what their one big wish would be, it would be to be able to spend more time with their patients in a way that is appropriately supported and subsidised.
"Some of the issues with managing these conditions is they often last for months or years; they're not curable; they often involve a multi-pronged approach to management."
She argued that taking a more preventive approach would help reduce the overall workload for GPs.
"If we can see patients before they become unwell, that is just a brilliant opportunity to start working through a list of risk factors that we know can set people up for chronic disease later on," Dr Roeske said.
Diabetes: A snapshot
- According to Diabetes Australia, around 1.7 million Australians have diabetes, and a further 2 million are at high-risk of developing it
- The full cost of diabetes to the Australian economy is estimated to be as high as $14 billion per year
- The World Health Organisation predicts diabetes will be the seventh leading cause of death by 2030
"So things like what's your blood pressure like? Do we need to look at whether you are at risk of pre-diabetes with blood sugar? How is your cholesterol going?
"And then what we call lifestyle factors. So, are you physically active? Do you know how to eat nutritiously? Are you overweight?
"Perhaps talk about moderating alcohol intake, those sorts of things, are all very important and we can intervene very early in general practice."
All of which takes time and costs money.
"There is no item number for spending more than 40 minutes with our patient," Dr Roeske said.
"We are pressed but, more importantly, patients are pressed. They are the ones that are really missing out."In this year's Budget, the Federal Government announced plans to fund longer consultations and extra services for people over 70, but Dr Roeske would like to see it extended to patients of any age.
The great health divide
Health policy expert Mr Harris said where you live also plays a big part in your health.
"The best thing you can do for your health is be wealthy," he said."We know that people with lower socio-economic means are more likely to have health risk factors, and are more likely to die early from chronic disease.
"We know the wealthy communities do a lot better. Not only do they have fewer risk factors, they have less chronic disease and much greater access to health care."
As an example, the data reveals that the obesity rate in Brisbane's upmarket suburbs of Indooroopilly and Taringa is 16 per cent, but in New Chum and Redbank Plains near Ipswich, it is 40.4 per cent.
In Sydney, just 6.6 per cent of people in upper north shore Gordon smoke, whereas in Mount Druitt in the outer western suburbs, it is 31 per cent.
And the divide is even greater for regional Australia.
"We know that people in country Australia are 20 per cent more likely to die before the age of 75 than the people in the city," Mr Harris said.
"What we have in Australia is a universal health system, but it's not necessarily a fair health system."
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