PUBH6003 Health systems and Economics Assignment Sample
Individual/Group - Individual
Length - 1,500 words (+/- 10%)
This assessment addresses the following learning outcomes:
• Apply systems thinking and an intersectoral approach to public health issues.
Submission - 12-Week Module
Due week 5 on Sunday at 11:55pm AEST/AEDT*
Due week 3 on Sunday at 11:55pm AEST/AEDT*
Weighting - 40%
Total Marks - 100 marks
Instructions for assignment help:
To prepare for this assessment, choose one public health issue (e.g. diabetes, obesity, cancer, heart disease, mental health, substance misuse, air pollution, water and sanitation, road accidents, suicide, etc.) in any country and examine how systems thinking can help to identify the broader system issues, and recommend solutions for better management. This is a research- based assignment which requires to conduct literature review on the selected topic on the specific country context.
Then in approximately 1500 words (+/- 10%), please answer the following questions considering your selected public health issue and country context.
• Describe the public health issue from systems thinking perspective (consider all direct and indirect factors and explain the complexity of the issues or interconnectedness of the issues)
• Explain the roles of stakeholders, both within the health system and in other sectors in addressing this issue (consider intersectoral action perspective)
• Drawing on research evidence, explain the obstacles (e.g. lack of cooperation among stakeholders or lack of shared vision and leadership, feedback delay, lack of healthy policy, fragile and fragmented health system, funding limitation, time constraints) that are preventing the application of systems thinking and intersectoral approach to the issue.
Your report should follow the following structure. The word count includes the introduction, body and conclusion.
(Title of your assignment)
Assessment 1: PUBH6003: Student name, Student ID
Provide a short summary which gives the reader an overview of the report.
Provide a short introduction which gives the reader an overview of the whole assignment.
Briefly introduce the public health issue in your chosen population (country).
Describe the public health issue from systems thinking perspective (consider all direct and indirect factors and explain the complexity/interconnectedness of the issues.
Explain the roles of stakeholders, both within the health system and in other sectors in addressing this issue (consider intersectoral action perspective)
Drawing on research evidence, explain the obstacles (e.g. lack of shared vision a leadership/cooperation, feedback delay, lack of healthy policy, fragile and fragmented health system, funding limitation, time constraints) that are preventing the application of systems thinking and intersectoral approach to the issue.
Based on the identified obstacles and literature, offer suggestions (e.g. developing shared vision
and leadership, policy change or reform, creating supportive environment, strengthening, and
reorienting health system, increased budget allocation, empowering community and individuals)
for how systems thinking and an intersectoral approach could be applied to the issue.
In a short paragraph, provide a useful overall summary of your assignment for the reader. Do not introduce any new information/ideas.
Submit via the Assessment 1 – Report link in Assessment on main navigation menu in Blackboard
• Demonstrated knowledge and understanding ofsystemsthinking and anintersectoral approach (20%)
• Showsthe ability to interpret and analyse relevant information and literature on systems thinking and an intersectoral approach (30%)
• Demonstrates the ability to apply knowledge and understanding ofsystemsthinking and anintersectoral approach to a public health problem (30%)
• Use of academic conventions including appropriate resources and referencing (20%)
o Uses key readings and shows evidence of reading beyond the key reading
o There is a lucid introduction and clear conclusion or summary
o Complies with normal academic of referencing and bibliographical details (including reference list, use 6th version APA style)
o Is written clearly with accurate spelling, grammar and sentence
APPLYING SYSTEMS THINKING IN PUBLIC HEALTH ISSUE OF PREVALENCE OF DIABETES
The global health domain is rapidly transforming and advancing. The domain of public health issue has emerged to even greater heights, posing challenges to humanity, which is evident from the surge in the recent Covid-19 pandemic. Tackling issues in the public health domain requires not only insight into the problem but also capabilities applied to resolve them easily. Systems thinking approach in public health issue is a new approach being integrated that offers more durable insight for understanding and for taking action (Johnson et al., 2018). There are various benefits offered by the systems thinking approach while other approaches are confusing due to their enormous body of theories, methods or tools they engage. Systems thinking is being currently adopted for resolving various issues related to public health as it can provide powerful language for communicating as well as investigation of complex issues (Frank et al., 2016). The current scope of discussion relates to the application of systems thinking approach to a particular issue in public health and the ways it offers beneficial solution over other methods. While there exist enormous public health issues within Australia, one prominent issue that bears a tremendous burden of costs and responsibilities on the government is Type 2 Diabetes. Though there has been various intervention mechanisms as well as methodologies for tackling the issue yet it remains one of the most prominent which is still growing in Australia amongst the aged population. This discussion reveals ways systems thinking approach can provide a better solution for the management of the public health challenge.
The public health issue of the prevalence of type 2 diabetes in Australia
Type 2 Diabetes is a chronic condition depicted by high levels of glucose in the blood. The prevalence of type 2 diabetes amongst the aged population is associated with modifiable lifestyle factors, also genetic and family-related risk aspects. According to the National Health Survey (NHS) conducted by the Australian Bureau of Statistics (ABS), 2014-2015 almost 1 in 6 people aged 65 years reported diabetes, amounting to almost 574,000 people. Such prevalence was seen to increase with age with men reporting higher rates of prevalence as compared to women. There were a greater prevalence and incidence of type 2 diabetes amongst the Aboriginal and Torres Strait Islander people as against other Australians.
Figure 1: Rate of self-reported diabetes
Source: (AIHW, 2018)
Systems thinking perspective allows considering all direct as well as indirect factors associated with the disease type 2 diabetes (Hassmiller Lich et al., 2016). Type 2 diabetes being a large public health issue in Australia, there are various factors and system actors that have tremendous roles in this complex issue. While there remain considerable factors that leads to the challenge of type 2 diabetes, there are various system actors (participants) who are unable to tackle the issue effectively, making it a highly prevalent disease in the population. Some of the direct and indirect factors leading to type 2 diabetes are unhealthy lifestyle factors, lack of awareness of the disease, lack of physical exercise, sedentary lifestyles, genetic issues, family history of diabetes, lack of balanced diet, inefficient management of diabetes, a high body mass index (BMI), high blood pressure, lack of professional help for managing diabetes as rural locations in Australia and so on. The complexity of the issue arises from the interconnectedness of the issues and also arising from the lack of it (Keane, 2014). For instance, a lack of awareness regarding the impacts of type 2 diabetes often leads to not professionally approaching the management of the disease. Prevalence of genetic factors also sometimes the presence of type 2 diabetes individuals in the family leads to ignoring lifestyle factors, BMI, heart disease, high blood pressure that might lead to the onset of type 2 diabetes amongst aged adults and inability to tackle them as well. Australia is a country that is dominated by public health actors supported by the Federal along with State Government funding. Hence role and responsibility in tackling a public health issue by the government are of enormous importance. The public health intervention approach is primarily determined by public health policies determined centrally by Federal efforts. Hence participants (actors- stakeholders) play a predominant role in tackling the prevalent type 2 diabetes. Issues that arise in this public health issue is lack of focus of government, or governmental agencies and their healthcare providers in eliminating type 2 diabetes from Australia (Leveson, 2012). The prevalence of numerous disease and the recent outbreak of Covid-19 has to a certain extent diverted the government's attention from reducing the incidence of type 2 diabetes.
Stakeholders in the public health system include patients, GPs, doctors, hospitals, nurses, healthcare professionals, government, professional bodies and agencies aiming to tackle the challenge of type 2 diabetes. As this a dominant public health issue in Australia is primarily tackled by governmental intervention, they are the primary stakeholders apart from their healthcare providers, who in turn are supported by the policies approved by the government (Buttigieg et al., 2015). The government in the country hence has a crucial role in developing policy, procedures and fund initiatives for tackling the growing issue of type 2 diabetes amongst the aged population, which in turn bears tremendous costs on the government. The role of healthcare providers which includes doctors, nurses, and other professionals are directed by governmental policies. Hence they focus their efforts on eliminating the prevalence of the disease based on funding available or focus provided on the issue by the government. This intersectoral perspective provides relative less importance to tackling the issue as there is another major prevalent health issue in the country currently.
Hence drawing from the discussion above, it can be easily understood that the prevalence of type 2 diabetes as a public health issue has remained not due to lack of shared vision and leadership or cooperation, lack of healthy policy, delays in feedback, or fragile health system, or time constraint rather due to lack of focus and funding limitations (Battle-Fisher, 2014). There is a present tremendous intersectoral approach to the issue. The prevalence of several public health issues and especially the emergence of the Covid-19 pandemic has posed tremendous constraints on the government as well as healthcare providers to tackle the issue of type 2 diabetes (Liedtka et al., 2017). With the government having a varied focus such as controlling outbreak or coronavirus, tackling child mortality issues, comorbidity issues, prevalent public health diseases such as type 2 diabetes, heart problems or high blood pressure challenges goes to the backdrop. The importance of the issue has reduced over the years considerably with limited funding available with the government in tackling health challenges and constraint arising out of the increase in costs of healthcare.
Based on the literature and obstacles identified, certain recommendations have been developed that can assist in tackling the issue. Also, such recommendation includes systems thinking and intersectoral approach applied to the issue.
? Policy reforms: From the perspective of systems thinking, the government has a large number of different policies in healthcare. A consolidated policy on a disease affecting the aged developed can create a consolidated effort impacting the health systems to adopt an approach that is easy as well. With systems thinking approach, it is possible to realise the interconnectedness of the various disease affecting the aged and then tackling their root cause by consolidated efforts form healthcare actors can provide a solution to the challenge.
? Creating a supportive environment: Again, this is in connection with the previous point that aims at undertaking a consolidated effort from the government as well as from the side of healthcare providers. With systems thinking approach developing a supportive environment from the side of the government in the healthcare sector can render tremendous effectiveness in tackling this complex issue of type 2 diabetes amongst the aged population in Australia.
? Increasing budget allocation: With increasing costs especially in the healthcare sector, the budgetary allocation has not been revised. Budget allocation for tackling public health issues such as type 2 diabetes and other prevalent diseases amongst the aged Australian population needs a revision. This will enable creating an allocation for tackling this issue in the long-term as well.
In conclusion, the complex issue of type 2 diabetes prevalent amongst the aged population in Australia is growing tremendously. Such complex issues cannot easily be tackled by single-handed efforts which bring into role systems thinking approach. The systems thinking approach has the capabilities to handle complex issues like this one. By adopting a consolidated approach of systems thinking, this issue of type 2 diabetes can be tackled with efforts assumed by the government and healthcare providers.
AIHW. (2018). Older Australia at a glance. Australian Government – Australian Institute of Health and Welfare. Accessed from [https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-and-functioning/diabetes]
Battle-Fisher, M. (2014). Application of systems thinking to health policy & public health ethics : public health and private illness (Ser. Springerbriefs in public health). Springer. https://doi.org/10.1007/978-3-319-12203-8.
Buttigieg, S. C., Rather, C., & Eiff, W. von. (2015). International best practices in health care management (Ser. Advances in health care management, v. 17). Emerald.
Frank, M., Shaked, H., & Koral-Kordova, S. (Eds.). (2016). Systems thinking : foundation, uses and challenges (Ser. Management science: theory and applications). Nova Science Publishers.
Hassmiller Lich, K., Frerichs, L., Fischbein, D., Bogachev, G., & Pentz, M. A. (2016). Translating research into prevention of high-risk behaviors in the presence of complex systems: definitions and systems frameworks. Translational Behavioral Medicine : Practice, Policy, Research, 6(1), 17–31. https://doi.org/10.1007/s13142-016-0390-z
Johnson, J. A., Anderson, D. E., & Rossow, C. C. (2018). Health systems thinking. Jones & Bartlett Learning, LLC. https://public.ebookcentral.proquest.com/choice/publicfullrecord.aspx?p=5555416.
Keane, C. (2014). Modeling behavior in complex public health systems: simulations and games for action and evaluation. Springer Pub. Company, LLC.
Leveson, N. (2012). Engineering a safer world: systems thinking applied to safety (Ser. Engineering systems). MIT Press.
Liedtka, J., Salzman, R., & Azer, D. (2017). Design thinking for the greater good: innovation in the social sector (Ser. Columbia business school publishing). Columbia Business School Publishing.