Health Policy and Advocacy Assessment for Hypertension in Australia

This paper provides a detailed analysis of the policies, guidelines and regulations developed for hypertension in Australia. It highlights the targets, stakeholders and their representation, policy solutions, and effectiveness of the developed or modified policy.

Running head: HEALTH POLICY AND ADVOCACY ASSESSMENT
HEALTH POLICY AND ADVOCACY ASSESSMENT
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Introduction
Australian healthcare system has been developed through the mix of federal as well as
state government funding process and as per the world health orgnaisations healthcare report
Webster et al. (2016), it is termed as one of the most efficient healthcare system in the world.
Despite the fact that presence of different layers of policies and regulations implemented by
the local or state government as well as the federal government, this healthcare system has
developed a universal process that has achieved positive outcome for the patients.
One of the primary aspects that differentiates Australian healthcare system from the
other parts of the world is its accurate and widely spread policies and regulations for each of
the critical health condition, affecting a wide array of population of the country. Hypertension
is one such health condition which is affecting more than 33.7% of the adult population in
Australia.
The primary aim of this paper is to analyse the policies, guidelines and regulations
developed for this particular health condition and understand the extent to which this
healthcare condition has been overlooked. Further, with development of this policy analysis,
this paper would highlight the targets, stakeholders and their representation which is or
should be in the policy development. Finally, in the final sections, the policy solutions, policy
processes and effectiveness of the developed or modified policy would be discussed would be
discussed.
The problem and the context
While discussing about the hypertension associated health condition, the primary
aspect related to its current and historical presence and the policy related context should be
discussed (Heart Foundation, 2019). Hypertension is a health condition in which the affected
individual suffers from elevated blood pressure in their arteries due to which, their risk

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factors related to myocardial infarction, ischaemic and haemorrhagic stroke, chronic kidney
disease increases (Heart Foundation, 2019). The prevalence of this condition has also
increased from past few years as more than 33.7% of adults are suffering from this condition
within which 25% of the population are Australia aboriginals. As per the report published in
the Herat Foundation (2019), more than 61% of the hypertension condition are left untreated
and this facilitates 149846 number of controllable deaths in Australia. Despite the fact that
the government has implemented several guidelines, and regulations for the treatment of
hypertension in Australia, hypertension is one aspect which lacks a proper policy
implementation so that healthcare facilities as well as professionals could provide effective
care to the patients (Heart Foundation, 2019). The guidelines developed and implemented for
the healthcare process of hypertension mentions all the important points related to its
identification, diagnosis and the possible interventions with precautions that the healthcare
facilities and patients should observe to overcome their health risk conditions. However, as
mentioned earlier in this section, more than 60% of the people in Australia, does not seek
help for their hypertension condition and suffer from the risk of critical healthcare conditions
(Heart Foundation, 2019). This is the primary aspect, which has been overlooked by the
Australian government and hence, the government should develop policy with the
amalgamation of guidelines, policies and strategies so that all the healthcare facilities in
Australia, focus on providing effective care for hypertension condition. Hence, these set of
guidelines, and instructions for healthcare professionals should be present in the healthcare
policy of Australia so that people could receive effective and quality care for their illness
(Heart Foundation, 2019).
Frame of Reference/Dominant Discourse
As per the Australian Bureau of Statistics (2019), the healthcare GDP of Australia
stands at 10% of its total expenditure and as per the documents the government spent AUD

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170 billion in the year 2018 for the health process. The government has provided effective
guidelines and frameworks for the treatment of patient suffering from hypertension however,
due to the lack of a governmental policy developed for the regulation and analysis of its
implementation, majority of the patients suffering from this condition are left untreated. This
eventually affects the population by increasing their risk of critical health condition and the
government by increasing their economic debt and increasing their cost of healthcare and
decreasing the productivity. As per Campbell, Lackland and Niebylski (2015) majority of the
population that are affected with hypertension in Australia belongs to the working age group
19 to 45 and due to untreated depression, hypertension and other conditions, their
productivity decreases by 25% approximately. As per the latest government report, due to
this unproductive workforce, more than AUD$137.2 billion has been lost (Australian Bureau
of Statistics, 2019). Hence, it is the situation in which the government should think about the
implementation of governmental policies for hypertension so that every employee, working
force, student or elderly person could be screened through for their hypertension condition
(Heart Foundation, 2019). While discussing the underlying assumptions behind this health
condition, the government should think about the implementation of this legislation or policy
in small scale and then with the success of this implementation should spread this policy
throughout the country (Heart Foundation, 2019). Further, the government should implement
strategies related to policy awareness and the benefit the population would receive after the
development of this policy throughout the country so that every individual becomes aware of
hypertension and its effects (Heart Foundation, 2019). Hence, this section provided a detailed
analysis of the frame of reference so that the government could develop or implement the
policy for the care and prevention of hypertension.

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Targets, Stakeholders and their Representation
The guidelines and regulations that the Australian government has developed for the
treatment and prevention of hypertension does not specifies the target or the population age
group which should be aimed for the care of hypertension (Heart Foundation, 2019).
However, the governmental reports and Australian statistics mentions that the age group that
is primarily affected with the risk factor of hypertension and associated health condition is 9
to 45, which is the working age group (Heart Foundation, 2019). Therefore, if the
government implements any developed and complete policy for the prevention of
hypertension related adverse conditions, then this age group and their working environment
should be specifically targeted (Heart Foundation, 2019).
The other stakeholders that should be associated with this policy are the healthcare
officials, experts with the history of working with or for hypertension affected individuals, as
well as for the aboriginal population (Heart Foundation, 2019). Further, secondary
stakeholders for the development and implementation of this policy would be the
organisations and institutes so that they could understand the work pressure of their
employees and make their work environment healthy for their mental health (Heart
Foundation, 2019). Finally, the patients affected with hypertension would also be an
important stakeholder for the prevention of this health condition as it would be their duty to
receive care on time and care for their own mental and physical health (Heart Foundation,
2019).
The subjects of the guidelines are presented in a lucid manner so that any individual
with little or less health literacy could understand the importance of their health condition and
receive care to reduce their risk of critical health conditions. However, the government
should implement the process of training, education and awareness related aspect for its
growth and development so that healthcare professionals, nursing professionals and patients

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could understand the effectiveness of the policy and implement that in their work culture and
personal life. This would eventually help to reduce the hypertension related condition among
patients. Further, hypertension would not differentiate the stakeholders or hypertension
affected individuals depending upon their risk factors and would provide every individual
including the Maori community so that they could be provided with effective interventions to
reduce their risk of hypertension and associated disease condition.
Process
The development and implementation of the healthcare policy for hypertension, the
government should focus on the involvement of the stakeholders so that they could share
their experiences of working for hypertension condition to improve the health condition of
the patients (Perry, Gallagher & Duffield, 2015). This would include healthcare experts,
federal governmental representatives and law makers for their help in developing and
implementation of the regulation, and representatives of populations with involvement of
aboriginal community. This would help the government to develop a policy in which every
community and their representatives would help to develop laws and regulations for the care
and prevention of hypertension conditions.
As per Perry, Gallagher and Duffield (2015), the current workforce of Australia
would be the current work force, for whom the policy is much needed as with globalisation of
organisations, increasing work competition and improper working environment, employees
suffer from increased work pressure. This eventually affects their mental as well as physical
health conditions. Therefore, these are the voices and conditions that should be addressed and
listened to, while developing policies for hypertension condition (Perry, Gallagher &
Duffield, 2015). Further, this paper effectively highlights the amount of financial debt the
Australian government has observed due to the presence of critical health conditions and
improper management of hypertension conditions. Therefore, the primary aim of the

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government official and healthcare facility while treating or addressing the hypertension
condition should be the fiscal deficit the government has gone through due to the lack of a
proper policy for the hypertension condition. Hence, this should be the motivation for the
officials and law makers for the development of policies related to hypertension condition.
The government implemented the guidelines and regulations for the development of
healthcare norms related to treatment of hypertension after the government suffered from
financial condition of more than 170 billion AUD (Australian Bureau of Statistics, 2019).
Hence, the government should focus on the implementation of the awareness strategies so
that the significance and importance of the policy could be understood and implemented.
Policy Solutions:
The present problem appears to be adverse that has significantly impacted the overall
health outcome of the Australian adults. The seriousness of the problem is reflected through
the rise in the morbidity and mortality rate pertaining to the proportion of the Australian
population affected with hypertension within the Australian population. In addition to this,
the annual health expenditure allotted to the treatment and management of hypertension is
estimated to be equivalent to $ 137.2 Australian dollars (Foundation, 2019). In this regard, it
should be noted that there is no proper policy in place that aims at controlling the incidence
of hypertension and the associated comorbidities. However, hypertension guidelines from the
heart foundation equip health care professionals with advanced form of technology and
evidence to control the blood pressure level of the affected adults. In this regard it should be
noted that the established guidelines have a set of prevention focus that majorly concentrate
upon the achievement of both primary and secondary health care outcome. The guidelines
recommend the following considerations (Foundation, 2019);
 Care professionals must manage patients with hypertension and consider their
absolute cardiovascular risk

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 Diverse treatment strategies for individuals at a higher risk of cardiovascular event
and individuals at a lower risk of cardiovascular event even if the readings obtained
are similar
 Application of blood pressure lowering therapies for people suffering from mild
hypertension in between the range of 140-159 mm Hg
 Consideration of the benefits of lower targets less than 120 mm Hg systolic for the
patients and at least a moderate cardiovascular risk (20% risk within the 10 years
span)
 Implementation of a healthy lifestyle that excludes smoking and consumption of a
nutritious diet and exercise routine for all Australians
Upon analysing the social, power and ethical implications of the policy, it can be
stated that the guideline focused upon integrating awareness among the Australian population
about the adverse outcome of the disorder. The power and ethical implications include
compliance with the guidelines and ensuring privacy of the patients enrolled under the
treatment program.
Effectiveness:
Upon considering the implementation of the policy, it can be said that implementation
has not yielded effective outcome. This statement is supported by the proportion of the
Australians affected with the disorder and living with unmanaged symptoms. The evidence
base reveals that approximately 33.1% of the entire population base suffers from
hypertension and that hypertension is the single most cause that leads to high rates of
hospitalization within the Australian territory (Hird et al., 2019). Thus considering the overall
health outcome, it can be said that the clinical guidelines propounded by the heart foundation
has not generated positive results.

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At present, there is no accountability for the existing set of guidelines. However,
monitoring public awareness and prevalence data can help in the creation of policy specific to
controlling hypertension within Australia. Public welfare and maintenance of positive
population health outcome can be considered as individual accountability measures for
fostering improved health outcome.
The evaluation measures taken to monitor the adherence level and success rate of the
implementation of the clinical guidelines on hypertension include, epidemiological surveys
and maintenance of a track of affected population data. However, the epidemiological
surveys have revealed a significant rise in the affected population that is indicative of the fact
that overall health outcome has not improved over the years and requires improved evidence
based measures for better health outcome.
Conclusion
While concluding this paper, it should be stated that hypertension is a health condition
which is not likely to be addressed in the Australia society. The statistics related to
hypertension indicated the lack of awareness regarding this health condition as more than
60% of the population affected with hypertension are untreated. The government has not
implemented any specific healthcare policy for the health condition, however it has
developed guidelines and regulations for the healthcare professionals and the patients so that
they could understand the effectiveness of it. However, this paper provides a detailed idea
which indicated to the fact that the government implements the legislative policy for the
hypertension condition.

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Part B:
Hypertension in Australia has emerged to be a primary health problem.
Approximately six million Australian adults suffer from hypertension and statistical evidence
suggests that approximately 33.7% of the Australians are under medication to control
hypertension (Heartfoundation.org.au, 2019). Further, the evidence base also reveals that
male adults are more affected than females as the prevalence of hypertension in males is
equivalent to 35.3% which can be considered equivalent to 3 million adult males
(Heartfoundation.org.au, 2019). On the other hand, the prevalence among female adults is
equivalent to 32.2% which constitutes 2.9 million adult females within Australia. It should
further be noted in this regard that adults within rural or remote Australia possess a 27%
higher probability of acquiring hypertension in comparison the urban population base (Hird et
al., 2019). Research studies further suggest that the probability of being affected with
hypertension increases with age. However, recent statistical data suggests that adults at any
age range is susceptible to be affected with hypertension (Heartfoundation.org.au, 2019;
Gabb et al., 2016).
Therefore, upon closely analysing the statistical evidence, it can be stated that there is
an increased need to develop a policy advocacy so as to improvise the cumulative health
outcome of the Australian adult population. The primary causes that lead to hypertension are
manifold and comprises of genetic influence and the impact of environmental stressors. In
addition to this, research studies also state that consumption of unhealthy diet and a sedentary
lifestyle deprived of any physical fitness activity contributes to hypertension. It is crucial to
note in this regard, that hypertension refers to the elevated blood pressure range which is
more than the normal limit of 120/80. Elevated blood pressure enhances the risk of
developing a number of cardiovascular disorders, including stroke that could lead to fatal

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outcomes such as mortality. Research studies reveal that long term hypertension is a
predominant risk factor that could potentially lead to coronary artery disease, atrial
fibrillation, vision loss, chronic kidney disease and heart failure (Gabb et al., 2016; Hird et
al., 2019). Research report published by the Abs.gov.au (2019), suggests that in the year
2017, approximately 4.1 million of the Australian adults suffered from hypertension. 21.6%
of the diagnoses cases were controlled and treated, however, 17.0% were left untreated and
uncontrolled and this led to an estimated 149,896 deaths across the Australian territory. In
addition to this, it is also integral to note in this context that hypertension caused a cumulative
loss of 609,801 productivity adjusted life years which was estimated to be equivalent to AUD
$ 137.2 billion gross domestic productivity over the working phase of an individual lifetime
(Foundation, 2019). Therefore, the evidence base reveals that hypertension is a primary issue
within Australia that requires immediate attention so as to ensure improved population health
outcome. With the above stated objective, the advocacy policy for hypertension would be
drafter with supporting rationale.
The condition of hypertension can be managed with the integration of lifestyle
changes such as weight management, nutrition management and incorporation of physical
fitness regime. Research studies in this regard suggests that risk factors that enhance the
probability of developing hypertension comprise of factors such as excess body weight,
excess consumption of alcohol, smoking, excess consumption of salt and sedentary lifestyle
(Harrison et al., 2016). Possible solutions to address the issue of hypertension would include,
conducting wellness promotional activities, awareness workshops, and imparting health
literacy to the adult population about the risk factors that increase the probability of
developing hypertension (Gabb et al., 2016). In addition to this, conducting obesity
management community programs and imparting self-management strategies to the
vulnerable targeted adult population about blood pressure monitoring can help to achieve

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positive outcome. As has already been mentioned in the previous paragraphs that alcohol and
smoking increases the risk of developing hypertension, therefore, one possible solution to
reduce the consumption of alcohol and tobacco would include, frequently increasing the taxes
on these items and revising the price of these substances. Increase in price could strongly de-
motivate people to spend on these products which would subsequently promote wellness and
improved health outcome.
Advocacy strategy:
Purpose: The advocacy strategy specifically targets the Australian adult population
aged 35 years and older who are susceptible to suffer from hypertension. The policy intends
to promote wellness and reduce the percentage of affected population from 33.7% to 10%.
Objectives:
The objectives of the policy can be enlisted as follows:
 Reduce the proportion of affected population from 33.7% to 10%
 Induce awareness among the targeted audience about the risk factors that enhance the
probability of suffering from hypertension
 Conduct wellness programs or promotional activities to improve cumulative health
outcome
 Increase taxation of high risk substances such as tobacco and alcohol that increase the
probability of developing hypertension
 Conduct obesity management programs across different territories so as to manage
body weight as excess body weight is directly related to an increase in the probability
of acquiring hypertension

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 Integrating a specialised multidisciplinary team of care professionals within
healthcare centres to efficiently manage blood pressure level of patients
Establishing a coalition and acquiring support from stakeholders:
The primary stakeholders involved in the process would comprise of the targeted
audience and the concerned policy makers. The secondary stakeholders would include the
healthcare administrators and the professionals who would be responsible for implementing
the policy and the tertiary stakeholders would comprise the federal and the state governing
bodies who would be responsible for financing the project plan. The policy implementation
would require a collaborative effort of the healthcare personnel, administrative bodies,
federal and state governments, the policy makers and the citizens of Australia.
Engaging and empowering the community:
The implementation of the policy would further require engaging and empowering the
community members so as to disseminate awareness about the risk factors that could elevate
the risk of hypertension. In addition to this, care professionals such as the community nurses
would be responsible for empowering the targeted audience about lifestyle management so as
to reduce the probability of developing hypertension.
Media Advocacy and communicating your messages to wider public:
Media advocacy is an integral procedure that helps to integrate awareness about an
issue to a wider mass. In this case, media advocacy would be propagate to the wider
population by means of wellness news articles and wellness magazines. The published news
articles and wellness magazine would contain lifestyle tips that could help to reduce the
probability of developing the condition of hypertension. In addition to this, the wellness
articles would also contain contacts of health promotional program which could help people
manage symptoms of hypertension, obesity and control substance abuse.

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Addressing ethical issues:
Ethical issues such as violation of data privacy and disclosure of confidentiality might
arise during the process of implementation of the policy (Walliman, 2017). In order to
address these issues, prior to implementation of the policies, approval would be sought from
the regulatory board so as to prevent violation of any ethical principle. Also, consent would
be sought from the patient who would be enrolled under the wellness programs so as to avoid
the violation of patient privacy.
Indicators used for assessing the effectiveness of the policy:
The indicators that would be used to evaluate the effectiveness of the policy would
comprise of estimating the percentage of the affected population suffering from hypertension.
The proportion of the affected population is expected to reduce equivalent to 10% and this
would determine the effectiveness of the implemented policy.

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