A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, at the Public Health Association Conference 2011 - Canberra

1. DISEASE CONTROL and
PREVENTION IN AUSTRALIA
Public Health Association Conference 2011
CANBERRA – 4 April 2011
Professor Jim Bishop AO
Chief Medical Officer
Australian Government Department of Health and Ageing

2. UNITED STATES GOVERNMENT
Centres for Disease Control and Prevention
OBJECTIVES
• Monitor health
• Detect and investigate health problems
• Conduct research on prevention
• Develop sound public health policies
• Implement prevention strategies
• Promote healthy behaviours
• Foster safe environment

3. OECD HEALTH DATA 2010
How Does AUSTRALIA Compare
Health Expenditure per capita, public and private expenditure, OECD countries, 2008 ($US PPP)
8,000
7538
7,000
6,000
5004
5,000 4627
4210
4079 4063
3970
4,000 3793 3737
3696 3677
3540 3470
3359 3353
3129 3060
3008
2902 2870
3,000 2729 2687 2683
2151
2,000 1801 1781 1737
1437
1213
999
852
1,000 767
0
1 Refers to insured po pulatio n rather than resident po pulatio n. 2. Current expenditure. 3. 2006. 4. 2007. So urce: OECD, OECD Health Data, June 201
. 0
Public expenditure on health Private expenditure on health

4. COMMONWEALTH GOVERNMENT
HEALTH & HOSPITAL EXPENDITURE
UNDER THE NHHN
Source: Commonwealth Budget Papers, DOHA and PMC Analysis

5. MAJOR DISEASE
BURDEN in
AUSTRALIA

6. PROJECTED BURDEN of
MAJOR DISEASE GROUPS, 2010
Source: AIHW Australia’s Health 2010

7. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

8. BROAD CAUSE MORTALITY
TRENDS IN AUSTRALIA
Source: AIHW

9. AGED ADJUSTED DEATH RATES
From CVD, 1907 - 2006
Source: AIHW Australia’s Health 2010

10. CHANGES IN DEATH RATES IN MALES
- using Joinpoint Analysis
Source: Tracey et al – Cancer Institute NSW

11. Mortality-to-incidence ratio
0.0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1.0
Ke
ny
a
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Source: IARC 2010.
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ria
Eg
yp
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In
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Af
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Br
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Cz Ja
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Re
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Ca
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da
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an
Sw y
Ne ed
w en
Ze
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US
Au A
st
ratios for selected countries - 2008
ra
lia
Males
Females
ALL CANCER – MORTALITY/INCIDENCE

12. DEATH RATES FROM
INFECTIOUS DISEASES, 1922-2007
Source: AIHW Australia’s Health 2010

13. TRENDS IN LEADING CAUSES
OF DISEASE BURDEN 2003-2023
Source: AIHW Australia’s Health 2010

14. TOTAL CANCER CASES & DEATHS
per year (1972 to 2036)
Source: Cancer Institute NSW

16. AUSTRALIAN GOVERNMENTS
OCCUPATIONAL HEALTH and SAFETY
• Safework Australia
• National Centre for Injury Prevention and Control
• Jurisdictional responsibilities in State and Territory
Departments of Health
• Quality and Safety in Health Care
- Australian Commission on Quality and
Safety in Health Care
- Jurisdictional Quality and Safety initiatives
eg: Clinical Excellence Commission (NSW)

17. AUSTRALIAN GOVERNMENTS
PUBLIC HEALTH PREPAREDNESS
• Office of Health Protection (OHP)
• National Incidence Room (NIR)
• Australian Health Protection Committee (AHPC)
- Jurisdictional, CDNA, enHealth, ADF, PHLN
• Links to:
- Emergency Management Australia (A/G)
- ADF
- Other Commonwealth Portfolios (DFAT, AusAID)

18. CENTRES FOR DISEASE CONTROL & PREVENTION
US GOVERNMENT
NON – COMMUNICABLE DISEASES
• National Centre for Birth Defects
• National Centre for Chronic Disease Prevention
• National Centre for Environmental Health
• National Centre for Injury Prevention
Research component within the National Institutes
of Health funding

19. AUSTRALIAN GOVERNMENTS
NON-COMMUNICABLE DISEASES
• Australian National Preventative Health Agency
• Australian and Jurisdictional Government Population Health
programs
• Australian Population Health Development Principal Committee
(AHMAC Committee) – Screening Sub-committee
• Jurisdictional enHealth programs and enHealth sub-committee of
AHPC
• National screening programs in breast, cervix and bowel:
Australian and Jurisdictional programs
• Specific Commonwealth, Jurisdictional programs on Chronic
Diseases
Research components within the NHMRC Funding

20. CENTRES FOR DISEASE CONTROL & PREVENTION
SURVEILLANCE and REPORTING
• Health Statistics
• Laboratory Policy
• Public Health information
• Public Health Surveillance
• Epidemiology and analyses
• Scientific education and professional development

21. AUSTRALIAN GOVERNMENTS*
SURVEILLANCE AND REPORTING
• Australian Bureau of Statistics
• Australian Institute of Health and Welfare
• National Notifiable Disease Surveillance System
• Sentinel Surveillance System
• TGA adverse event reporting
• DFAT Travellers Advisory
• Cancer registries in each State and Territory
• Screening and pap test registers
• FSANZ and OZFoodNet
* National Health Security Act and agreement

22. AUSTRALIAN GOVERNMENTS
INFRASTRUCTURE
• AHPC (enHealth, PHLN and CDNA)
• OHP Epidemiology Branch
• State and Territory Epidemiology Programs
• National Immunization Program (NIP)
• Australian Technical Advisory Group on
Immunization (ATAGI)

23. AUSTRALIAN GOVERNMENTS
GOVERNMENT SUPPORTED or ACADEMIC
PROGRAMS
• Cancer Australia (NBOCC)
• National Centre for Injury Prevention and Control
• National Centre for Asthma monitoring
• National Centre for HIV Epidemiology and Research
• National Centre for Immunization Research and
Surveillance
• National Centre for Asbestos related diseases

24. THE KEYS TO PREVENTION
Tobacco
Blood pressure
Overweight/obesity
Physical inactivity
Blood cholesterol
Alcohol
Fruit/vegetables
Illicit drugs
Air pollution Total of 32%
Unsafe sex
0.0 2.0 4.0 6.0 8.0
% DALYs
Source: Table 4.1 AIHW Australia’s Health 2008

25. AUSTRALIA’S RANKING AMONG
OECD COUNTRIES 1987-2006
Source: AIHW Australia’s Health 2010

26. AUSTRALIAN HEALTH SURVEY
 Four components run by ABS 2011-13
- Health Survey
- ATSI Health Survey
- Nutrition and Physical Activity Survey
- Health measurement Survey
 Around 50,000 participants
 De-identified data available as summary statistics,
tables

27. Budget 2010-11
Anti-smoking campaigns ($27.8m)
COAG agreed
• Increased tobacco excise
• Plain packaging
• Restricting internet advertising of tobacco products
• Further funding for National Binge Drinking Strategy
($50m)
• Survey of Australia’s Health ($54m)
National Preventative Health Agency

28. CONCLUSIONS
• Australia’s health outcomes are good by
International standards
• Prevention programs have some success and
remaining challenges
• Well Supported health emergency responses
occupational health, food and medicines safety
• Chronic diseases are the major burden of disease in
Australia supported with substantial infrastructure
• Australian Governments have invested in academic
centres to lead research and training in similar areas
to the US CDC rather than bureaucratic structures