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WEL102A Health And Wellbeing Question You are required to identify and critically evaluate any one of the following current challenges to health care in Australia:  a. Ageing population b. Health inequality among Australians c. Mental Health d. Drug and Alcohol misuse.  Choose no more than three main issues to address under your topic heading.  Answer Ageing Population Healthcare system in Australia is publicly funded that has access to free treatment. They also have an access to health insurance; however, the healthcare structure is complex. Medicare system faces many challenges and issues that affect patient care and safety. Demographic changes, technology costs, public and private funding, health inequality and rapid health issues due to urbanization are the challenges that Australian healthcare system face and need to address (Kulik et al., 2014). Among all these issues, ageing population pose a major challenge to the Australia healthcare system. According to Australian Institute of Health and Welfare (AIHW), data 14% population aged 65 years ad above and by 2053, it is expected to increase by 21% (Hillen, Vitry & Caughey, 2017). There is budgetary burden on the Australian healthcare system and they are forced to address this issue by adopting many strategies like efficiency gains and subsidization of private healthcare system. There are also policy challenges for an increasing ageing population that also need to be addressed due to changing demography, chronic illness burden and disease patterns. Following section explains how ageing population is a major challenge to Australian healthcare system and issues that need to be addressed. Australian population is ageing due to increase in life expectancy and sustained low fertility that has resulted in an increase in the population aged 65 years and above and fewer population aged 15 years. Population is ageing at a faster rate that is driven by two major factors. On an average, Australian families are having few children and as a result, there is decline in birth rates and replacement rate is low without migration and eventually falling (Kavanagh et al., 2015). However, Australian government is taking initiatives that might benefit the healthcare system, although decision to have children is an entire individual one. They have started implementing extensive changes in benefits and taxes that can assist families. The government has also recognized the concept of immigration to address the ageing population. Migrant workers are of workforce group and this would assist in enhancing the workforce strength. However, migration cannot stop the population from ageing as migrants will also age along with the native population and have to increase immigration massively to address the ageing population issue (Harvey et al., 2017). There are also some positive sides of ageing population in Australia. Increase in aged people indicates increased longevity and improvements in medical facilities, rising income and improvement in living conditions. According to Bureau of Statistics, Australia’s life expectancy is one of the highest in the world and one in three babies will live up to 100 years of age. Older people are in good health and sixth highest among Organisation for Economic Co-operation and Development (OECD) countries (Huo et al., 2016). On a contrary, due to ageing population, there is economic and workforce burden in Australia. As the workforce strength is declining, there is decrease in productivity of the country as a whole as working age group is less in strength. There is unsustainable pressure on the healthcare system, public spending, as there are major concerns regarding rising healthcare costs, and care needs in serving the ageing population in Australia. There is a large population of aged people suffering from chronic diseases, associated disability, and being the highest healthcare service users among all age groups. Healthcare system in Australia is trying to adjust to this ageing population; however, there are major challenges that need to be addressed (Bloom et al., 2015). The growing ageing population suffer from age-related typical health problems like dementia, arthritis and cancer and that pose challenge to the healthcare system in terms of cost and care needs. The social changes also pose challenges, as there are greater expectations from the healthcare services, awareness and understanding of the health issues influencing delivery of healthcare (Schofield et al., 2015). Ageing population also suffers from hearing loss, hypertension, diabetes, cardiovascular diseases and age-related vision problems. This burden of chronic diseases and related health problems is a challenge as to how to meet these healthcare needs of aged people. Older people are prone to falls and severe fractures, which increases the hospitalization posing a burden to the healthcare system. While looking at the positive side of trends in chronic diseases, there is substantial death reduction due to chronic illness due to improved healthcare facilities and delivery of healthcare needs. On a contrary, the leading cause of death in Australia is chronic diseases due to diabetes, heart stroke, arthritis and other age-related problems (Steptoe, Deaton & Stone, 2015). Disability is more common among aged population as around 53% of the total population of the age 65 and above suffers from age-related disability. One in five older Australians that is around 20% suffer from profound or severe activity limitation as disability increases with age and common among the older Australian adults. Increase in demand for health services is high among older people as they are more likely to visit general practitioners as compared to older people. They also visit specialists with 57% older people as compared to people below the age of 65 years that is 20% (Sotiriadou & Wicker, 2014). They also require community-based supports so that they able to contribute culturally and socially to the community. This results in an increase in residential homes by government subsidy. There is higher use of health services among older people and has implications for health workforce. Although, Australian labour workforce is diverse and large with mixed skilled workers, however, it is not enough to meet the increasing demands and changing needs. This may result in shortage of skilled workers that is also a challenge in the aged healthcare sector (Taylor & Earl, 2016). As the older population is the high users of health services, there is also rise in health costs posing unsustainable pressure on the health system. Australian government spends around $10 billion per annum on aged care and two-thirds to residential care. They complain that the government subsidy is not enough to meet the aged care needs and it is operating at a loss. It is posing economic challenges to the Australian government, as there is a decline in workforce. There is per capita output reduction where gives the average income amount that each family possess to maintain their standard of living. In the current Australian workforce scenario, productive and active workforce in the economy is shrinking, as there is large number of old and retired people with small share of income and low standards of living (Hunter, 2016). Due to this workforce shortage, there is increase in public spending on aged health and care posing an unsustainable strain on the Australian health system in order to serve cliental. Along with health workforce shortage, there is also increase in demand for trained workforce to address aged care chronic illnesses and disability. It is a big concern for the health system to increase trained aged care specialists in the aged care sector. Apart from specialists, carers and volunteers are also required to assist the aged people in their activities of daily living (ADL). Care approach for the older people need to be varied according to needs that include cooking, bathing, administration of medications and other activities (Britt et al., 2013). There is also a need for skilled workers and aged care facilities that includes community and personal care workers, registered nurses and midwives. The rising cost of health insurance for aged people of 65 years and above, Medicare will pose national debt for the country with no return and extreme cost pressures. As a result, there are cost pressures and reduction in health benefits as high-income people are receiving greater coverage. Ageing population not only contributes to the healthcare crisis, but, also due to the emergence of medial and diagnostic technologies and costly new drugs (Gardener et al., 2015). There is a need for strategies and comprehensive plans that respond to these issues and meet the needs of old people. Australian government need to identify the issues and implement strategies that address the issue of impact of ageing population on health system. There is requirement of young entrants supply to address ageing workforce, however, there is persistence of competition and economic growth demand. There is also need for sustainable sources to support the retirement living and positive community and individual attitudes towards ageing. Community support and age-friendly infrastructure is required that enable social inclusion for older Australians (Majeed et al., 2015). The government should promote health programs to make people understand healthy ageing and its importance so that old people stay healthy and independent as far as possible. The government should also take initiative to enhance accessible, high quality and appropriate health services for aged population. Evidence-based policy responses are also important to population ageing. The delivery of healthcare services and retirement pensions should be affordable to the ageing population so that there might be well-managed economy growth. Apart from this national strategy, there is requirement of local and community participation for building awareness, improvement of information access and evaluation of action plans (Newman et al., 2015). As outlined above, ageing population is posing challenges to the Australian health system affecting patient care and safety. There is a large population of aged people suffering from chronic diseases, associated disability, and being the highest healthcare service users among all age groups. In the current Australian workforce scenario, productive and active workforce in the economy is shrinking, as there is large number of old and retired people with small share of income and low standards of living. Immigration is a strategy to address weak workforce as migrant workers are of workforce group and this would assist in enhancing the workforce strength in the Australian health care system. References Bloom, D. E., Chatterji, S., Kowal, P., Lloyd-Sherlock, P., McKee, M., Rechel, B., … & Smith, J. P. (2015). Macroeconomic implications of population ageing and selected policy responses. The Lancet, 385(9968), 649-657. Britt, H., Miller, G. C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., … & O’Halloran, J. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press. Gardener, S. L., Rainey-Smith, S. R., Barnes, M. B., Sohrabi, H. R., Weinborn, M., Lim, Y. Y., … & Szoeke, C. (2015). Dietary patterns and cognitive decline in an Australian study of ageing. Molecular psychiatry, 20(7), 860. Harvey, L. A., Mitchell, R., Brodaty, H., Draper, B., & Close, J. C. (2017). Comparison of fall?related traumatic brain injury in residential aged care and community?dwelling older people: A population?based study. Australasian journal on ageing, 36(2), 144-150. Hillen, J. B., Vitry, A., & Caughey, G. E. (2017). Disease burden, comorbidity and geriatric syndromes in the Australian aged care population. Australasian Journal on Ageing. Hunter, N. (2016). Geodemographic and life course perspectives of population ageing in Australia: informing the policy response to population ageing. Huo, L., Harding, J. L., Peeters, A., Shaw, J. E., & Magliano, D. J. (2016). Life expectancy of type 1 diabetic patients during 1997–2010: a national Australian registry-based cohort study. Diabetologia, 59(6), 1177-1185. Kavanagh, A. M., Krnjacki, L., Aitken, Z., LaMontagne, A. D., Beer, A., Baker, E., & Bentley, R. (2015). Intersections between disability, type of impairment, gender and socio-economic disadvantage in a nationally representative sample of 33,101 working-aged Australians. Disability and health journal, 8(2), 191-199. Kulik, C. T., Ryan, S., Harper, S., & George, G. (2014). Aging populations and management. Academy of Management Journal, 57(4), 929-935. Majeed, T., Forder, P., Mishra, G., Kendig, H., & Byles, J. (2015). A gendered approach to workforce participation patterns over the life course for an Australian baby boom cohort. Journal of Vocational Behavior, 87, 108-122. Newman, L., Baum, F., Javanparast, S., O’Rourke, K., & Carlon, L. (2015). Addressing social determinants of health inequities through settings: a rapid review. Health Promotion International, 30(suppl_2), ii126-ii143. Schofield, D. J., Shrestha, R. N., Cunich, M., Tanton, R., Kelly, S., Passey, M. E., & Veerman, L. J. (2015). Lost productive life years caused by chronic conditions in Australians aged 45–64 years, 2010–2030. The Medical journal of Australia, 203(6), 260. Sotiriadou, P., & Wicker, P. (2014). Examining the participation patterns of an ageing population with disabilities in Australia. Sport Management Review, 17(1), 35-48. Steptoe, A., Deaton, A., & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. The Lancet, 385(9968), 640-648. Taylor, P., & Earl, C. (2016). Bridging the grey divide: an international perspective on the ageing workforce and longer working lives. Australian Journal of Social Issues, 51(2), 119-125.

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