There are many things that individuals, communities and governments can do to prevent or reduce ill health. Australia has a long history of organised efforts in this area and continues to find new ways to tackle health problems.
For example, actions taken to promote good health in the community include vaccination programs, cancer screening and guidelines for drinking alcohol and eating. Some of these activities and guidelines cover the whole population, while others target particular groups based on age or other risk factors.
Getting screened for cancer
For some types of cancer, a test can be used to identify people who may have the disease before symptoms appear. Tests are offered to those who may have an increased risk of cancer because of their age, sex or other factors. This is called screening.
There are national screening programs for breast, cervical and bowel cancer in Australia, and each has its own target group based on age and sex. The latest data show that:
- 55% of women aged 50–69 took part in BreastScreen Australia programs in 2009–2010
- 57% of women aged 20–69 took part in the National Cervical Screening Program in 2009–2010
- 38% of men and women invited between July 2008 and June 2011 took part in the National Bowel Cancer Screening Program.
For each of these programs, people living in more disadvantaged areas generally were less likely to have a screening test than those in less disadvantaged areas.
Vaccinating children
Vaccination uses the body’s natural defence mechanism—the immune response—to build resistance to specific infections. Childhood is the time for vaccination against diseases such as hepatitis B, diphtheria, pertussis, measles, mumps and rubella.
The majority of children are fully immunised, that is, they have received all vaccinations appropriate for their age—92% of 1 year olds, 93% of 2 year olds, and 90% of 5 year olds. While the proportion fully immunised has remained steady for 1 and 2 year olds in recent years, there have been considerable recent improvements for 5 year olds.
In 2007, Australia was the first country to introduce a national human papillomavirus (HPV) vaccination program. It is estimated that about 7 in 10 Australian girls have been vaccinated with the recommended three doses of the vaccine.
Fluoridating water for healthy teeth
Water fluoridation is known to be a safe and effective way to reduce tooth decay. In 2010, 80% or more of the population in each state and territory had access to fluoridated water, with the exception of the Northern Territory (70%). Non-fluoridated water supplies are generally more likely to be found in regional and remote areas.
Drinking fluoridated water during childhood translates into better oral health in adulthood. Australians born after 1970 (the ‘fluoride generation’) have, on average, half the level of tooth decay of their parents’ generation.
Butting out around children
Tobacco smoke contains many toxic and cancer-causing chemicals that increase the risk of poor health outcomes, particularly among children. To prevent children’s exposure to tobacco smoke, adults should avoid smoking in enclosed spaces such as the car or home.
The proportion of households with dependent children having someone smoking inside the home has fallen dramatically, from 31% in 1995 to 6% in 2010. Consistent with the general decline in smoking, the proportion of households where no-one smoked regularly at home increased from 52% in 1995 to 65% in 2010.
As at 2012, all states and territories, except for Northern Territory, had implemented bans on smoking in cars to reduce children’s exposure to second-hand smoke.
Reducing alcohol consumption
Health guidelines recommend drinking no more than 2 standard drinks a day to reduce the lifetime risk of harm from alcohol-related disease or injury. Drinking no more than 4 standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.
In 2010, 1 in 5 people aged 14 or older were at risk of lifetime harm and about 2 in 5 put themselves at risk of an alcohol-related injury during a single occasion at least once in the previous year. Males and younger Australians were most at risk.
Levels of risky alcohol use have generally remained stable over the past decade.
Reducing illicit drug use
Illicit drugs include illegal drugs (such as marijuana/cannabis, heroin, ecstasy and cocaine), volatile substances used as inhalants (such as glue and petrol) and pharmaceutical drugs used for non-medical purposes.
In 2010, about 7.3 million people aged 14 or older (40%) had ever used an illicit drug, and almost 3 million (15%) had used an illicit drug in the previous 12 months. The most common drug used both recently and over their lifetime was cannabis.
Since 1993, the proportions using illicit drugs have fluctuated, with a peak in usage for many drugs seen in 1998. For cocaine, however, the highest use was reported in 2010 (2.1% of the population aged 14 or older)—4 times the rate in 1993 (0.5%).
Eating fruit and vegies
Dietary guidelines recommend that Australian men and women consume two to four serves of fruit and four to eight serves of vegetables per day. In health promotion messages, this is generally interpreted as two serves of fruit and five serves of vegetables.
Recent findings suggest that our consumption of fruit and particularly vegetables falls far short of these recommendations. In 2007–08, fewer than 1 in 10 people aged 12 and over usually ate sufficient serves of vegetables and about half ate sufficient serves of fruit. Females are more likely to eat sufficient serves.
Breastfeeding
Australia’s dietary guidelines recommend exclusive breastfeeding of infants until 6 months of age, with the introduction of solid foods at around 6 months and continued breastfeeding until 12 months—and beyond if both mother and infant wish. Mothers unable to breastfeed or who choose not to can use a suitable breastmilk substitute.
Although most babies (96%) in 2010 were initially breastfed, only 39% of infants were exclusively breastfed to around 4 months, and 15% to around 6 months.
Babies whose mothers (or carers) were 35 or older were 3 times as likely to be exclusively breastfed for around 6 months as babies whose mothers (or carers) were 24 or younger.
Making time for active lifestyles
Physical activity guidelines for adults recommend at least 30 minutes of moderate-intensity activity (such as brisk walking or swimming) on most, preferably all, days. Some regular, vigorous activity (such as jogging or basketball) is also recommended for extra health and fitness if possible.
In 2007–08, almost 60% of Australians aged 15 and over did not do enough physical activity as defined by these guidelines, and this proportion increased with age. Females were slightly more likely to be inactive.
Similar to many risk factors, there is a relationship between socioeconomic status and physical activity. People living in areas of lower socioeconomic status were generally more likely than people in areas of higher socioeconomic status to report insufficient physical activity. This pattern was clearer for females than males.
Visiting GPs for prevention
In addition to treating acute health problems, general practitioners (GPs) can provide preventive health advice and care. A survey of general practice activity found that many reasons patients gave for seeing a GP were related to preventive care (for example, check-ups and vaccinations).
Of the clinical treatments provided in 2009–10, about 21% were counselling or advice regarding prevention. However, some of these treatments have declined over the past decade. For example, counselling and advice about nutrition and weight decreased from 5.6% of GP visits to 3.7%. Across Australia, this equates to 1.3 million fewer occasions at which counselling and advice about nutrition and weight were given in 2009–10 than in 2000–01.