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At the heart of Australia's identity rests an ageing population - the architects of the nation's rich history and pride. It is home to one of the oldest continuous living cultures in the world, with the country's First Nations peoples standing as the caretakers of the land for at least 50,000 years.
Between both Indigenous and non-Indigenous older Australians, there is swelling demand for healthcare services as data trends show increasing life expectancy versus lower fertility rates.
The good news is, Australia's reputation in healthcare is better than most OECD countries. However, Dr Michael Wright, chair of the expert committee of the Royal Australian College of General Practitioners, believes there is room for improvement in the context of public health.
To better understand the seriousness behind this topic, let's get into what the consequences are on public health systems when talking about an ageing population.
It's no secret that rising costs are a side effect of greater demands on resources and services; that's basic economics. For those who have studied a Master of Public Policy online in Australia, solutions to this problem probably come easily, but for the rest of us, the looming possibility of further increases to regular expenses like having a prescription filled can cause anxiety.
In the 1990s, Australia introduced a compulsory superannuation strategy under the Hawke government to help reduce the strain on age pension funding, and ensure retirees would have more to live off in the face of expected increases to the cost of living - especially as their health declines with age.
However, as chronic illnesses continue to typically affect older Australians, this requires ongoing management and as many as 3 out of 5 doctors and nurses are reporting burnout.
What's more, section 51 of the Australian Constitution says that doctors can essentially charge what they like if they believe the Medicare rebate is insufficient, and The Australian Medical Association claims that is precisely what has happened, leading to a scarcity of bulk billing services and an increase in out-of-pocket costs to patients.
Australia's population has historically been one of strong, steady growth. With its significant multicultural foundation, one of the main drivers of population growth is immigration.
As the country's total increased to 26 million people by June of 2022, so too did the percentage of residents aged 65 and over, representing now 17 per cent of the population. Anthony Grubb, director of demography at the Australian Bureau of Statistics declares that the ageing of the Australian public is likely to continue, so it's important to address the increased demand on health supports like hospital admissions and other medical services that naturally will feel the heat as the senior cross section of the population gets older and sicker.
General practitioners continue to be the most commonly visited health professionals across 2021-22, with a whopping 97.2 per cent of patients seeing GPs aged 85 and over. The proportion of people who reported reasons for not using health services like emergency rooms when needed, such as them being 'too busy' or having lengthy waiting times also increased to 8 per cent in this time, demonstrating serious strain on the country's healthcare system overall.
Chronic disease is becoming a growing concern for the healthcare sector. Within this issue is the surge of multimorbidities, that is, the existence of 2 or more chronic health conditions to an individual concurrently, and multimorbidity is something that is shown to increase with age.
Compared to only affecting 12 per cent of those aged between 15-44 years, multiple diseases affect a great deal more of the ageing Australian population, standing at 51 per cent of those aged 65 and over. We can put this kind of percentage into context when considering that certain diseases, such as diabetes mellitus, predispose patients to secondary ailments such as cardiovascular disease, retinal and renal issues: all which are especially risky as the body ages.
Musculoskeletal conditions, such as osteoarthritis, respiratory conditions like asthma and Chronic Obstructive Pulmonary Disease, and metabolic conditions including diabetes were all primarily treated by GPs in 2019, although hospitalisations for those aged between 75 and 84 continued to increase over a four year period, at a 3 per cent rate per year up to 2019-20.
One of the broader consequences of an ageing community is the need for long-term care, in a variety of forms. Nowadays, a titanic 80 per cent of older Australians want to stay at home as they age, and that has been reflected in an uptick in demand for Commonwealth-funded home care packages that allow for this sort of comfort and freedom.
To put a dollar value on the impact that long-term care poses to the public health sector, over $25.1 billion was spent on aged care by Australian governments between 2021-22. Furthermore, there is a burden on family members to step in as 'carers,' which can cause strain depending on various factors like personal characteristics of caregivers and receivers, strength of relationships, living arrangements, balancing commitments and the level of support available from social networks and formal services.
If circumstances become too difficult or the family carer is underqualified to provide this care, the decision to transition from home life to residential aged care is often arrived at, which can be difficult.
Representing a huge portion of Australia's total population, those who are part of the ageing community are an integral part of the nation's social tapestry. With age inevitably comes poorer health, injury and the need for further support, which the public health system cradles.
Public health as a concept speaks to the 3 Ps: preventing disease, prolonging life and promoting health which become especially important as our citizens grow older. Optimum longevity of our older generation means keeping abreast of the changing needs, varying health data and imbalance of demands on the industry while the demographic shifts - so that we can continue to provide the right care, disease management and quality of life that every Australian deserves.