Introduction
According to research findings, cardiovascular disease (CVD) remains to be one of the greatest causes of death and disability in Australia, killing at least 1 Australian every 10 minutes (Australian Institute of Health and Welfare (AIHW), 2010). It has also emerged that the disease is the leading killer of women aged 25 and above in the United States across all races and ethnic groups. In most developed countries, cardiovascular diseases remain the number one cause of death for women, and kills more women than all types of cancer combined (Lewis, 2003). In Australia, recent census and mortality/morbidity statistics reveal that there is alarming increase in death of women aged over 50 caused by cardiovascular disease (AIHW, 2010).
It is paramount to understand the nature of cardiovascular disease. In the medical field, cardiovascular disease encompasses all forms of diseases and conditions associated with the circulatory system which include the heart as well as the blood vessels (Kucia & Quinn, 2009). The most common of these diseases include coronary/ischaemic heart disease, heart failure, stroke, hypertension (high blood pressure), rheumatic fever and rheumatic heart disease, and peripheral vascular disease among others. Atherosclerosis has been identified as the major contributor to diseases of the circulatory system. It is a process occasioned by abnormal build-up of fat, cholesterol and other substances inside the blood vessels (arteries). This process is not instant but develops with age in a slow and complex manner and at some stage interferes with blood supply to the heart and brain causing heart attack and stroke respectively (AIHW, 2004).
Preliminary research into the situation has revealed that women over age 50 do not realise that they are at greater risk due to lack of proper information about the disease (Kucia & Quinn, 2009). Cardiovascular disease is strongly associated with menopause due to hormonal changes. This is caused by reduced estrogen in the body. The hormone helps women against cardiovascular disease by regulating the walls of the blood vessels and the levels of fats/cholesterol in blood (Wang, 2006). Reduced levels of estrogen, therefore, result in increased levels of fibrinogen which enhances blood clotting which is a leading cause of heart attack and stroke.
It has been established that between 2004 and 2005, 23% of those aged 45 to 54 years reported a prolonged cardiovascular condition compared to 13% for those aged 35 to 44 years (Wang, 2006). A larger number of females with cardiovascular disease were recorded compared to that of men across all age groups except those aged 75 years and above. However, most recent data reveal an upward trend in the number of women with cardiovascular diseases and this poses a serious risk to the Australian population (AIHW, 2010). There is need for urgent measures to be taken to address this problem if the associated costs and risks to the society are to be avoided.
The Cost of Cardiovascular Disease to the Community
Given the significant proportion of the population affected by cardiovascular disease, the community will continue to bear the increasing burden caused by chronic illness, resulting disability, and related health care system costs. The disease remains to be one of the most expensive as it takes the largest share of expenditure on all health care conditions (Australian Bureau of Statistics (ABS), 2006). In the 2000/2001 financial year, expenditure on cardiovascular disease constituted 11% of the government’s allocation to the health care system (AIHW, 2004). According to the National Health and Medical Research Center (NHMRC), research into cardiovascular disease has consumed over $439.5 million between 2000 and 2007 (AIHW, 2008). This trend has not changed over the years and the community continues to face enormous costs due to this condition.
National health survey (NHS) of 2004-2005 projected that about 3.7 million people in Australia will be suffering from cardiovascular disease in 2010-2011 (AIHW, 2006). In 2005 alone, the killer condition accounted for 35% of all deaths nationally, equivalent to 46, 134 deaths. It was also found that the prevalence of the disease was much higher in women than in men at 55% and 45% respectively (AIHW, 2006). This leaves a significantly high proportion of the population ailing.
The costs and risks of cardiovascular disease are not only medical and social but they can cause extensive financial drain and hence limit one’s ability to engage in meaningful activities. Reliable statistics from health departments indicate that cardiovascular disease remains to be one of the most common causes of disability in Australia. About 1.4 million people with disability in the country are suffering from one or more cardiovascular conditions (AIHW, 2010). In 2003, the disease burden due to cardiovascular disease constituted about 18% of the national disease burden caused by both premature death and effects of disability (AIHW, 2008). The Australian Institute of Health and Welfare further reports that huge amount of money is still being spent on health systems to cater for CVD patients and the cost remain high than any other disease in the country (2010). Over the past two decades, cardiovascular disease has been rated the most expensive disease in terms of both direct and indirect costs amounting to billions of dollars annually. Research findings indicate that the health system costs of cardiovascular disease are mainly due to a number of risk factors especially diabetes. Among other cardiovascular diseases, it has been established that strokes and coronary heart disease remain the most expensive, consuming about 20% of the total costs of cardiovascular disease in Australia (AIHW, 2010). The health system costs of the disease have been found to increase with age especially for women over 50.
Cardiovascular disease poses great costs to the community. There are direct medical costs arising from immediate charges and expenses. Once a person suffers from one of the forms of cardiovascular diseases, there will be need for ambulance services, diagnostic expenses, hospitalization costs, and in some cases surgery as well as pacemaker/ implantable defibrillator (Hobbs & Arroll, 2008). While it is easy to establish the direct costs of cardiovascular disease, its indirect costs are usually not easy to fully grasp. These costs are enormous especially the resulting reduced productivity and hence low income (Lewis, 2003). Although one may recover from a heart attack, the financial loss encountered during the hospitalization period can be quite huge. Researchers argue that most people would be financially bankrupt within 90 days of their main source of income is blocked (Thompson, 2010). Some heart diseases can be so severe that some people may never recover fully to enable them return to work. This poses even more serious risks to the community by raising the dependency levels among its members.
Moreover, the cost to the community is also increased through insurance premiums that people pay for as well as in form of taxes. Cardiovascular treatment and prevention efforts in Australia consume a lot of resources that would have otherwise been allocated to other development projects (National Heart Foundation of Australia (NHFA), (November 2010). This implies that everyone with or without cardiovascular disease has to pay for it. Hence, the societal costs of cardiovascular disease are quite enormous and cost effective measures must be taken if the trend is to be reversed.
Recommendations to the Government for Action
It is evident from research findings that cardiovascular disease has significant influence on the Australian community. The enormous costs can irredeemably cripple the financial stability of the affected population and their dependents. Efforts to address these challenges should be taken by the government in order to reduce if not eliminate the associated costs and risks. There is need to prevent cardiovascular disease since it would be less expensive compared to its treatment. The government should embrace appropriate public health strategies as well as policies that enhance healthy lifestyles, create environments conducive for living, and those that contribute to the reduction of blood pressure and levels of cholesterol in blood (NHFA, November 2010).
Furthermore, the findings from research will not be useful if the recommendations are not implemented. The government ought to embrace the suggested prevention strategies in all health care practice by enacting appropriate policies that will facilitate this process. The Australian government should also avail sufficient funds to various cardiovascular disease prevention programs. There is also urgent need to ensure that national data collection, applied research, and periodic evaluation strategies receive adequate funding. This will ensure that the government implements health reforms that will help in the modernisation of the sector and hence deal with emerging issues, particularly those related to cardiovascular disease.
According to the National Heart Foundation of Australia (2010), little has been done to reduce the gaps that exist in the prevention, treatment and provision of care to having, or at greater risk of suffering from, cardiovascular conditions like heart attack and stroke. This will go a long way in reducing the number of those with heart attack and strokes, those at risk of premature death from these diseases, and reduce the number of those living with disability as a result of cardiovascular disease. Apart from these key measures, it is strongly recommended that the government participate actively in support of appropriate health promotion strategies.
Health Promotion Strategies
Although cardiovascular disease is one of the leading causes of death in Australia, it is also one of the most easily preventable diseases. Preventive measures help will greatly reduce all the negative consequences associated with cardiovascular conditions. This can be possible through a clear understanding of the risk factors of the disease. Some of the risk factors include: smoking, overweight/obesity, high blood pressure, high cholesterol levels, inactivity, and stress or anxiety. Preventing and controlling the risk factors associated with high blood pressure and high levels of cholesterol is crucial in the promotion of cardiovascular health (Kucia & Quinn, 2009). All Australians should be able to access affordable, and the best treatment alternatives in order to reduce disability and other costs related to cardiovascular disease.
Even as researchers continue investigating how cardiovascular disease can be prevented or treated, it is necessary to employ the health promotion strategies already found to be effective. The government should embark on the provision of delivery services that will meet the needs of the Australians. Meaningful reforms in the running of hospitals will go a long in ensuring that quality health care services are provided. Modern facilities will also help in the prevention, early detection and treatment of cardiovascular disease with greater focus on preventive efforts. The introduction of reward system targeting hospitals that offer the best quality health services will significantly improve the health of the entire population.
Moreover, efforts should be made to identify those at risk of cardiovascular disease, particularly women over 50 years so as to help them deal with the risk factors before the disease attacks. They should be encouraged to go for regular cardiovascular check ups. The government and health practitioners ought to embark on sensitization campaigns as far as reduction of high blood pressure is concerned. Research has shown that women over 50 are not aware of the symptoms of cardiovascular disease and strategies of educating them about the warning signs are critical to the promotion of quality living in the community (Kucia & Quinn, 2009).
More important is the need to introduce a comprehensive programme of care services to those with cardiovascular disease like coronary heart disease, and Acute Myocardial Infarction (AMI). This will significantly reduce the number of hospitalizations. Furthermore, the government should consider introducing programs that enhance access to quality healthcare services for patients with cardiovascular disease. In particular, women over the age of 50 should be encouraged to attend cardiac rehabilitation after having AMI. This will go a long way in preventing similar occasions of cardiac failures. If these strategies are adopted and effectively implemented, the direct and indirect costs associated with cardiovascular disease will be drastically reduced and give rise to a health Australian population at the present and the future.
Conclusion
The reported has highlighted major facts concerning cardiovascular disease in Australia and their corresponding impacts on the community and the government. Given the enormous consequences of failing to address these challenges, the report has recommended some actions to the government. The list of these measures is quite long but the report has brought out critical ones. Moreover, the report has focused on crucial health promotion strategies that can help prevent cardiovascular disease as well as treat the people already with the disease with an aim of reducing the number of hospitalisations. The report emphasizes the fact that the costs incurred by the government in preventive strategies are much less than those that will be used in treating cardiovascular disease if left to attack.
References
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Australian Institute of Health and Welfare (AIHW) (2004). Heart, Stroke and Vascular Disease – Australian Facts 2004. AIHW, Canberra.
Australian Institute of Health and Welfare (AIHW) (2008). Australia’s health 2008. Author.
Australian Institute of Health and Welfare (AIHW) (2010). Australia’s health 2010. Author.
Hobbs, R. & Arroll, B. (eds) (2008). Cardiovascular risk management. John Wiley & Sons.
Kucia, A. & Quinn, T. (2009). Prevention of cardiac disease: a practical guide for nurses. John Wiley & Sons.
Lewis, M. J. (2003). Understanding public health in Australia: 1950 to present. Greenwood Publishing Group.
National Heart Foundation of Australia (November 2010). Low-cost, high-impact proposals to tackle heart disease and stroke. Melbourne: NHFA.
Thompson, P. (2010). Coronary disease manual (2nd ed.). Elsevier Australia Wang, Q. K. (ed.) (2006). Cardiovascular disease: methods and protocols. Human Press.