Postgraduate - UnitPHC5004 - Chronic illness in primary health care

Chronic illness is by definition, long lasting and at times severe. Chronic illnesses are large contributors to mortality, morbidity, disability and increased hospital admissions. They also make up a significant proportion of individuals using primary health care services. In Australia, almost half of all deaths are caused by the 12 leading chronic illnesses which include a range of physical and mental illnesses. These include coronary heart disease, stroke, lung cancer, colorectal cancer, depression, diabetes, asthma, chronic obstructive pulmonary disease, chronic kidney disease, oral diseases, arthritis and osteoporosis. Individuals with some of these illnesses - high blood pressure, depression, arthritis, diabetes and asthma - rely heavily on primary health care services for day to day management and support. The causes of chronic illness are both broad and complex. They represent a range and combination of Downstream determinants, such as biological factors; Midstream determinants, such as psychosocial factors and health behaviours; and Upstream determinants, such as social-cultural, physical and environmental factors. These factors may also impact on the management of chronic illness, in particular how health care and information is accessed, received and interpreted by individuals.

This unit, designed for primary health care professionals, aims to provide participants with an understanding of the socio-cultural and behavioural determinants of chronic illness, and how these determinants impact on health promotion, prevention, management strategies and outcomes in the primary health care setting. The unit is based on a multi-disciplinary approach, drawing on theoretical and empirical case studies from the social sciences, public health, health promotion and primary health care. The unit will examine the different causation models of the determinants of chronic illness with particular emphasis on the socio-cultural determinants of health and behavioural risk and protective factors, including early life factors. It will make the link, with a number of case study examples, between the burden associated with disease and risk and protective factors. The unit will also examine models of chronic disease self-management and how these approaches apply in primary health care settings. It will show how individual and group socio-cultural factors may influence health care decision making, and interactions with the primary health care team.