Chronic disease and comorbidities

Chronic disease and comorbidities

Chronic Disease Statistics

Chronic diseases tend to be long lasting and have persistent effects. They affect people's quality of life and also have social and economic effects. This new web release from the Australian Institute of Health and Welfare presents comorbidity data for eight selected chronic diseases. It seems that 1 in 5 Australians have two or more of these diseases: 

• arthritis
• asthma
• back problems
• cancer
• COPD 
• CVD 
• diabetes
• mental health conditions

 

Chronic disease indicators and targets for Australia

Chronic disease indicators and targets for Australia

Chronic Disease

The Australian Health Policy Collaboration has published two papers on this topic for Australia.

Development of Australian chronic disease targets and indicators is a discussion paper by Penny Tolhurst analysing baseline information for chronic diseases as a starting point for target and indicator consideration. 

Suitability of the WHO 25 x 25 chronic disease targets and indicators for Australia is a report by Jason Leung and Penny Tolhurst, which reviews the nationally available data relevant to the World Health Organisation's 25 x 25 targets and indicator with a view to identifying any existing gaps. 

Renal Care in Children

Renal Care in Children

Children Chronic Disease Kidney disease

This virtual issue focuses on “Renal care in children” highlighting previously published papers from the Journal of Renal Care on this topic. Three of the original articles explore how young adults experienced the child-to-adulthood transition, how children cope with a chronic illness, and whether the application of a specific tool can support children with CKD in achieving autonomy in the management of their disease.                                                  

Journal of Renal Care Virtual Issue: Renal Care in Children

Young Australians, illness and education

Young Australians, illness and education

Children Chronic Disease Education Youth

Chronically-ill children who need to take extended absences from school are neither officially acknowledged nor assisted to keep up, according to this report from Julie White and Karen Roauer at the Victoria Institute: Young Australians, illness and education: report on the national database project.

Advances in medicine mean that many children are surviving diseases, but are struggling to keep abreast of their education. This report provides a detailed summary of education, health and demographic information about 2360 Australian children and young people who live with significant health conditions.  The study aims to provide an empirical base for policy recommendation and further investigation and to contribute to the growing body of evidence about pressing educational issues related to these children and young people. 

Transport to treatment for people with chronic disease

Transport to treatment for people with chronic disease

Cancer Chronic Disease Kidney disease Transport

The Council of Social Service of NSW has published Staying alive: transport to treatment for people living with a chronic disease.  This report focuses on the unmet health transport needs associated with two of the most prevalent chronic diseases, cancer and chronic kidney disease. 

Gaps in the current system result in inequities in access to these services for those who need it most. This includes people with limited financial means and fewer public transport options. The extent of this unmet need in NSW is unknown, but the findings of this report are based on a national survey of health professionals engaged in cancer and kidney disease care in 2014. The report reveals that:

• 77% of respondents in dialysis units, and 81% of respondents in cancer centres, reported some level of difficulty accessing transport to and from treatment
• 66% indicated that there were not enough parking spaces to meet demand at dialysis units
• The greatest burden of unmet non-emergency transport needs was borne by older people (77%) people on low incomes (74%), people living in rural and regional areas (66%), people with a disability (44%), Aboriginal and Torres Strait Islander people (29%), and people from culturally diverse backgrounds (21%).

Young Australians, Illness and Education

Young Australians, Illness and Education

Adolescents Children Chronic Disease Education

This report by Julie White and Karen Rosauer of the Victoria Institute, provides a detailed summary of education, health and demographic information about Australian children and young people who live with significant health conditions. This study closely examined a national database of 2360 such individuals through the socio-economic indexes developed by the Australian Bureau of Statistics.The major purpose of this study was to provide an empirical base for policy recommendation and further investigation. An important secondary aim of the study was to contribute to the growing body of evidence about pressing educational issues related to these children and young people.
Click here to access the report for free.

The role of emulsifiers in chronic disease risk

The role of emulsifiers in chronic disease risk

Chronic Disease Diet Nutrition

wikipedia.com

A recent article in The Conversation, by nutrition and dietetics experts Melinda Coughlan and Nicole Kellow, looks at the results of a recent study on mice which found that emulsifiers have the potential to damage the intestinal barrier, leading to inflammation and increasing our risk of chronic disease. 

Food additives and chronic disease risk: what role do emulsifiers play? is a very readable explanation of the effects of emulsifiers on the digestive system and connections with metabolic disease.  The authors are clear that the study (published in Nature Immunology) was only on mice and the results may not transfer to humans, but they conclude with the sensible advice, "these studies drive home the importance of cooking using fresh ingredients and avoiding or minimising the use of processed foods".

Chronic disease and evidence based practice

Chronic disease and evidence based practice

Chronic Disease Evidence based practice

The authors of a recently published paper, Improving Chronic Diseases Management Through the Development of an Evidence-Based Resource, found a large gap between evidence and practice in the field of chronic disease. To improve the management of chronic disease, a collaborative partnership was established between a large university, a large regional rural hospital and a rural community health centre in rural Victoria.  The aim was to develop easily accessed, evidence-based
resources for clinicians to inform practice and support clinical decision making.

By mid-2014, 109 new evidence summaries and 25 recommended practices had been developed, detailing the best available evidence on topics related to chronic disease management including asthma, diabetes, heart failure, dementia, and others. Training sessions were provided for clinicians, and a newsletter published to notify them of updates.

Hanan Khalil, Helen Chambers, Zachary Munn, Kylie Porritt.  Worldviews on Evidence-Based Nursing, Epub ahead of print, 1-5 2015.  dx.doi.org/10.1111/wvn.12087.  Please contact your health library for the fulltext of this article.

Understanding excess body weight: report

Understanding excess body weight: report

Chronic Disease Diet Obesity

Obesity is New Zealand’s leading modifiable risk factor for health loss as it is in Australia.
 A number of diseases, including type 2 diabetes, ischaemic heart disease, ischaemic stroke and some cancers, are associated with excess body weight. Health loss can lead to premature death; life expectancy for the extremely obese is shortened by 8 to 10 years.

This NZ publication explores the increase in obesity over a 36 year period to 2013 and investigates the impact of obesity on different birth cohorts. It reviews the current status of adult and child obesity in New Zealand, looking at the population groups that are affected most. The report also looks at the prevalence of extreme obesity, where health impacts on individuals are likely to be most pronounced.

Understanding excess body weight: New Zealand Health Survey. Hilary Sharpe, Sarah Bradbury;  Ministry of Health (New Zealand) Government of New Zealand. 16 April 2015 

Health System Expenditure on Cancer and Other Neoplasms in Australia 2008-09

Health System Expenditure on Cancer and Other Neoplasms in Australia 2008-09

Cancer Chronic Disease Health policy

Health system expenditure on cancer and other neoplasms inAustralia, 2008-09 presents an overview of cancer expenditure focusing on the six cancers with the highest health system expenditure in each of four life stages 0-14, 15-24, 25-64 and 65 years and over. Findings include:

 - Cancer and other neoplasms ranked sixth in terms of estimated health system expenditure on chronic diseases, accounting for 6.9% of total health system expenditure on all chronic diseases;

 - Expenditure on national population screening programs totalled $332 million;

 - From 2000-01 to 2008-09, total health system expenditure on cancer increased by 56% from $2,894 million to $4,526 million. 

Salt Reduction Program Reduces Heart Deaths

Salt Reduction Program Reduces Heart Deaths

Chronic Disease Diet Heart disease Nutrition

The United Kingdom program of voluntary salt reduction, in collaboration with the food industry, has reduced 24-hour urinary sodium levels by 15% and prevented an estimated 9,000 cardiovascular deaths each year since the program began in 2003-2004, according to this comprehensive analysis.

The article provides an analysis of the program with the aim of providing a simple step-by-step guide for development and implementation of a national salt reduction program that other countries have already followed.

UK population salt reduction: an experiment in public health. The Lancet, Volume 382, Supplement 3, Page S43, 29 November 2013 (register on the Lancet site to get free access to the article).

Chronic Obstructive Pulmonary Disease (COPD) snapshot

Chronic Obstructive Pulmonary Disease (COPD) snapshot

Chronic Disease Lung disease

Chronic obstructive pulmonary disease (COPD) limits airflow in the lungs. It includes emphysema and chronic bronchitis. This is a snapshot of the latest statistics on COPD in Australia, updated November 2013 by the Australian Institute of Health and Welfare (AIHW). It includes a link to information re: Death rate from COPD; Hospitalisation for COPD; Money spent on COPD in 2008-9.

Monitoring Pulmonary Rehabilitation and Long Term Oxygen Therapy for People with Chronic Obstructive Pulmonary Disease (COPD)

Monitoring Pulmonary Rehabilitation and Long Term Oxygen Therapy for People with Chronic Obstructive Pulmonary Disease (COPD)

Chronic Disease Lung disease

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability in Australia. While pulmonary rehabilitation and long term oxygen therapy are recommended treatments for COPD, there is currently no national information about the supply and use of these therapies. This report, by the Australian Institute of Health and Welfare (AIHW), outlines a proposed approach to monitoring access to, and utilisation of, these therapies, by capitalising on existing data sources and identifying data development opportunities. (AIHW media release 20 November 2013)

Overweight and Obesity Rates Across Australia, 2011-12

Overweight and Obesity Rates Across Australia, 2011-12

Chronic Disease Obesity

In 2011–12, 10.8 million adults were either overweight or obese, and of these 4.7 million were obese.
This report, from the National Health Performance Authority (NHPA), shows that the percentage of adults who were obese varied threefold across local areas, from 14% in Sydney North Shore and Beaches to 41% in Loddon-Mallee-Murray. In three-quarters or more of communities for which we have comparable data, one in four adults were obese in 2011–12. The percentage of adults who were overweight or obese increased with geographic remoteness and lower socioeconomic status. Yet still half of adults (54%) in the wealthiest urban areas were overweight or obese, and two in 10 (19%) were obese. Overweight and obesity rates are increasing rapidly across Australia. In 1989, 44% of adults were overweight or obese, rising to 63% in 2011–12. Health problems related to excess body weight impact the health care system, as well as individuals, families and the community. (APO 24/10/13)

Chronic kidney disease: regional variation in Australia

Chronic kidney disease: regional variation in Australia

Chronic Disease Kidney disease Rural health

This report on chronic kidney disease shows that people from remote and very remote areas were 2.2 times more likely to die from chronic kidney disease than people from major cities. People from very remote areas were at least 4 times more likely to start kidney replacement therapy (dialysis or kidney transplant) than people from non-remote areas.  

Chronic kidney disease is a common and serious problem in Australia and its management can be resource intensive, particularly for the most severe form of the disease: end-stage kidney disease. 
Download this AIHW report here.

Chronic Disease Management: the Role of Private Health Insurance

Chronic Disease Management: the Role of Private Health Insurance

Chronic Disease Health policy

This research paper, by Amanda Biggs of the Parliamentary Library, provides background information on private health insurance arrangements, as well as the challenges emerging from increasing rates of chronic disease, and discusses the role of Broader Health Cover.

By way of introduction, in 2007, a series of major reforms to private health insurance (PHI) were introduced with the passage of the Private Health Insurance Act 2007(PHIA). One of the key reforms, in fact ‘the most significant new measure’ according to the then Health Minister Tony Abbott, was Broader Health Cover (BHC). BHC allows health insurers to offer benefits to members for programs that either prevent or substitute for hospitalisation, or that help patients with a chronic disease better manage and reduce the effects of that disease.  In effect, these reforms were intended to give health insurers a more significant role in keeping their members healthy.

This paper aims to fill some gaps in knowledge about the implementation of BHC, in order to contribute towards a better understanding of the role such programs can play, and to promote further debate and investigation. Because health insurance is subsidised by the Australian taxpayer via the private health insurance rebate, there is also a public interest in a better understanding of the impact of these programs.

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people

Chronic Disease Indigenous health Practice guidelines

The 2nd edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (‘National Guide’) has just been published. This edition has been reviewed and updated and includes:

• the National Guide, which contains evidence statements, recommendations, risk calculation tables and an outline of the development of the guide
• the evidence base: the collection of evidence underpinning the guide and recommendations (electronic only) (see the Methodology section ‘Searching the evidence base and drafting recommendations’)
• a child and adult life cycle summary wall chart listing activities recommended at each age group. 

Autoimmune rheumatic diseases

Autoimmune rheumatic diseases

Chronic Disease Journals

Two articles in this weeks Lancet journal relate to autoimmune disease:

1.  Systemic lupus erythematosus and other autoimmune rheumatic diseases: challenges to reatment

2.  Immunopathogenic mechanisms of systemic autoimmune disease   

Lancet. Volume 382, Issue 9894,  August 31–September 6, 2013 (contact your library if you cannot access the full text using the above links).

Australian Diabetes Obesity and Lifestyle Study (AusDiab)

Australian Diabetes Obesity and Lifestyle Study (AusDiab)

Chronic Disease Diabetes Obesity

The Australian Diabetes, Obesity and Lifestyle study (AusDiab) is the first national Australian longitudinal population-based study to examine the prevalence and incidence of diabetes and its complications, as well as high blood pressure, heart disease and kidney disease. Identified as being the only national study of its kind to have been undertaken in a developed nation, the AusDiab study began in 1999-2000, when over 11,000 adults across the country took part in the study. These individuals were invited to take part in two follow-up studies, the first in 2004-2005, and the second in 2011-2012. This report presents the main findings from the AusDiab 12-year follow-up based on data collected from people who participated in both the 1999–2000 baseline survey and at least one of the two follow-up surveys. The final chapter presents total mortality data over a 12-year period for the various diseases and risk factors. The authors are SK Tanamas, DJ Magliano, B Lynch, P Sethi, L Willenberg, KR Polkinghorne, S Chadban, D Dunstan, and JE Shaw (Baker IDI: Heart & Diabetes Institute).  (APO 22/8/13)