PUBH6000: Social Determinants of Heart Disease in Australia Report

This report examines the burden of heart disease among Australian adults, highlighting its prevalence and the significant impact of social determinants of health. It explores factors such as socioeconomic position, income, and education levels, and their correlation with increased risk. The report proposes the "Protecting Healthy Hearts Program," a nurse-led intervention focusing on screening, education, and lifestyle modifications to mitigate the risk of heart disease. Furthermore, it suggests the involvement of the transportation sector to improve program accessibility and effectiveness, particularly in remote areas, ultimately aiming to reduce health inequalities and improve cardiovascular health outcomes across the Australian population. The report emphasizes the need for a multi-sectoral approach to address the complex interplay of social determinants and health outcomes.

Running head: Healthcare 1
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Introduction
Heart disease consists of different types of circulatory conditions such as angina, stroke and heart
attack. The prevalence of heart disease is on the rise in Australia and is attributable to major
deaths. However, the prevalence of the condition varies based on different factors or social
determinants. According to Camargo (2011), social determinants of health are the “the
circumstances in which people are born, grow, live, work, and age, and the systems put in place
to deal with illness.” The Australian adults are some of the most affected and therefore this paper
will examine the burden of heart disease among the Australian adults and the social determinants
of heart disease among them. An intervention program will also be proposed that will help
prevent and manage the burden of heart disease among Australian adults. Moreover, the study
proposes other sectors that can be incorporated into the intervention for effective implementation
of the program.
Section 1: Social Determinants of Heart Disease among the Australian Adults
The burden of Heart Disease within Australian Adults
The term ‘heart disease’ is a broad term that is commonly used to refer to these conditions and is
interchangeably used with the term ‘cardiovascular disease’. Heart diseases or cardiovascular
diseases are the major cause of deaths in Australia. 27% of all deaths (43,447) in 2017 in
Australia were caused by disorders with the circulatory system (ABS, 2018). Furthermore, there
were over 1.1 million reported cases of hospitalizations in 2015 accounting for 11% of all
hospitalizations that year; all attributed to cardiovascular diseases (AIHW, 2019).
Approximately 6% (1.2 million) Australian adults aged over 18 years had one or more health
conditions associated with heart disease. Men were more affected than women by 6.5% and
4.8% respectively (Australian Bureau of Statistics, 2017). Additionally, the prevalence of heart
diseases among adults increased with age with over one out of four (26%) patients aged 75 years

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and above being diagnosed with vascular, heart and stroke diseases. There was a relatively
higher incidence of cardiovascular diseases (6.4%) among adults living in low socioeconomic
parts of Australia compared to those living in relatively disadvantaged (4.8%) parts of the
country (AIHW, 2019). According to ABS (2017), the percentage of individuals diagnosed with
heart disease in 2017-18 was less than 5% for those aged 55 years and below, then the rate
progressively increased to one out four (25.8%) of those aged 75 years and above. There was a
similarity in the prevalence of heart disease for all age categories until 64 years irrespective of
sex. There was a higher prevalence of heart disease among men (19.6%) more than women
(12.4%) belonging to the group of 65 years and above and 75 years and above (31.5% for men
and 20.4% for women) (ABS, 2017).
Social Determinants of Health and the Burden of Heart Disease among Australian Adults
The social determinants of health are interconnected and therefore do overlap. The specific social
determinants of health that affect the burden of heart disease in Australian adults include
socioeconomic position (income, education, occupation status), and residential settings (AIHW,
2016). The socioeconomic position is measured in a variety of ways and therefore terms such as
social class or economic status are often used interchangeably. Education is the commonly
referred element of socioeconomic position. Low levels of educational attainments have been
linked to a higher incidence of heart disease predisposing factors and mortality. Low health
literacy is characteristic of low educational attainments and as a result such people engage in
unhealthy lifestyle practices that predispose them further to heart disease (Li & Kinfu, 2016).
The study by Hoare, Stavreski, Kingwell, and Jennings (2017) showed that Australian adults
with lower education attainments had minimal access to medical care, were physically inactive,
engaged more in smoking, had poor dietary patterns and hence higher incidences of heart
diseases due to the high exposure to these predisposing factors.

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Income and Income inequality is another social determinant of health that affects the risk of
cardiovascular diseases in Australian adults. A higher-income allows better access to goods and
services that promote better health, for instance, nutritious food and better housing, extra
healthcare choices, and more options in pursuing improved health. Psychological changes as a
result of acute stress due to social dysfunction among unequal communities in Australia were
reported to increase blood pressure or result into the practice of harmful and unhealthy coping
practices such as smoking and intake of unhealthy diet; which predisposes them further to heart
diseases (Layte, & Whelan, 2014). Furthermore, research has associated income inequality to
increased crime which has further been linked to decreased social cohesion among the Australian
adults from low socioeconomic status (Pabayo, Kawachi, & Gilman, 2014). The apparent
insecurity due to heightened crime and reduced cohesion is likely to reduce outdoor physical
activity leading to the rise in body weight gain, blood pressure among other predisposing risks
for heart diseases (Layte, & Whelan, 2014).
Section 2: An Intervention to address Social Determinants of Heart Disease for Australians
Adults 300
The Protecting Healthy Hearts Program is an effective intervention in addressing the major
social determinant of health among Australian adults with cardiovascular diseases. The program
is a nurse-led screening and education program which is both preventive and curative. It helps to
find out the Australian adults at a higher risk of heart disease and offer educational programs that
teach about the individual risk factors, and the little practical, behavioral changes that they can
undertake to minimize their risk of getting heart diseases such as stroke, heart attack among
others (Carrington, & Stewart, 2015). The intervention will be carried out at workplaces, market
centres in the remote areas and at neighbourhood clinics.
The following consultations will be undertaken

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 Blood pressure tests
 Tests in total body cholesterol
 Blood glucose tests
 Review of lifestyle behavioural factors
 Referral to a physician, if necessary
The patients will first be screened to determine their health status against the recommended
standard status. Then the outcomes of screening will be communicated and their health status
concerning the risk of heart diseases interpreted. They will then be advised on the necessary life
changes that they need to make and be educated on how their lifestyle behaviours predispose
them to heart diseases.
The Protecting Healthy Hearts Program is likely to be successful because it aims at carrying out
health screening and offering a nurse-led education program to the participants. Studies have
shown that health education is significant in the prevention and management of cardiovascular
diseases especially among the low socioeconomic communities that are at a high risk of
developing heart disease. Dégano et al. (2017) found a direct association between education and
heart disease and concluded that interventions to reduce the incidence of the risk factors for heart
disease were likely to reduce the cardiovascular disease inequalities related to educational
attainments.
Other Sectors to be involved besides the Health Sector
Another critical sector to be involved in The Protecting Healthy Hearts Program is the
transportation sector. This is important because the intervention program will be carried out at
workplaces, market centres in the remote areas and at neighbourhood clinics. This means that
there will be a need for effective transportation, especially in remote areas. The transportation
sector can be incorporated into the program by offering accessibility through the repair and

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construction of roads and by offering transportation services. Studies have shown that
inaccessibility to remote areas is one of the leading causes of inequality in healthcare services
among Australian adults living in remote areas (AIHW, 2019). This is because poor road
infrastructure limits access to quality healthcare because some modern health equipment can not
be installed in communities with poor accessibility. The transport department can also offer to
promote the intervention by offering well equipped mobile clinic trucks that can offer health
screening and education program in any place. The clinic trucks will also be effective in case of
any emergencies.
Conclusion
The burden of heart disease among Australian adults is on the rise and is greatly affected by the
existing social determinants of health. The heart disease in Australia is attributable to a high
death rate and morbidity. The specific social health determinants influence such a high
prevalence include education and income and income inequality. Most of the individuals
diagnosed with heart disease have low levels of educational attainment which is characteristic of
low literacy in health and the involvement in unhealthy lifestyle behaviours. Better income
increases the chances of accessing better health and nutritious foods and vice versa. The
Protecting Health Hearts program will be effective in addressing the prevalence of heart diseases
among Australian adults because it is a nurse-led screening and education program. Furthermore,
it will offer its services at the convenience of the patients. However, the incorporation of the
transport sector into the health intervention will further increase its chances of success and in
offering accessibility to communities at a higher risk of heart disease by offering transport
services and the provision of well-equipped emergency trucks.

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References
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