Men s Health Policy submission FINAL by 0rtRqb

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									Vision 2020 Australia’s response to the Department of
Health and Ageing’s development of a National Men’s
Health Policy
Vision 2020 Australia
Established in October 2000, Vision 2020 Australia is part of ‘VISION 2020: The Right to Sight’,
a global initiative of the World Health Organisation and the International Agency for the
Prevention of Blindness. Vision 2020 Australia is a peak body for the eye health and vision
care sector, representing over 50 member organisations. Vision 2020 Australia seeks to
eliminate avoidable blindness and vision loss by the year 2020, and ensure that blindness and
vision impairment are no longer barriers to full participation in the community.

Context
In Australia, around 500,000 people are blind or have low vision. As Australia’s population
ages, the prevalence of eye conditions is predicted to double by the year 2020. Seventy five
per cent of vision loss is preventable or treatable, and early detection leads to better
outcomes.

In 2004, the annual economic impact of blindness and vision loss was estimated at $9.85
billion. Nationally, the cost of treating eye conditions is estimated to be higher than the cost
of treating diabetes and asthma combined.1 In 2005-06, there were nearly 248,000 hospital
separations for diseases and disorders of the eye. This accounted for 3.4 per cent of all
hospital separations for that year, increasing from 3.2 per cent in 2001-02.2

National Framework
In July 2004, the Australian Health Ministers’ Conference agreed to develop a national plan
for Australia to promote eye health and reduce the incidence of avoidable blindness. This
initiative represents Australia’s response to the World Health Assembly resolution on the
elimination of avoidable blindness in member countries.

The National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness
and Vision Loss aims to provide a blueprint for nationally coordinated action by governments,
health professionals, non-government organisations, industry and individuals to work in
partnership.3

The National Framework is focused on the important work of promotion and prevention
underpinning the direction of both the National Men’s Health Policy and the National Primary
Health Care Strategy.

Eye care and men
Seventy seven per cent of all Australians suffer from a long term medical condition, of which



1
    Centre for Eye Research Australia, Clear Insight: The Economic Impact and Cost of Vision Loss in Australia (prepared by Access
    Economics, 2004).
2
    Australian Institute for Health and Welfare, Eye Health in Australia, a Hospital Perspective (2008).
3
    National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss (November 2005).
long or short sightedness constitutes over 40 per cent.4 Eye health is related to key target areas in the
National Preventative Health Taskforce’s Australia: The Healthiest Country by 2020. Being overweight or
obese can lead to diabetic retinopathy; smoking can cause vision loss and blindness; harmful drinking can
result in eye trauma; and there is evidence which demonstrates that excessive consumption of alcohol can
lead to eye disease. UV exposure can lead to cataract, and thus sun protection is important.

Men are unequally impacted by a number of injuries and conditions associated with vision loss. Specific
examples of differences in death rates (per 100,000 people) include diabetes (males - 19; females – 14) and
accidents (males – 36; females – 18). Studies demonstrate that there are expectations of risk taking among
boys and men, and men are accordingly more likely than women to experience the adverse health
consequences of this type of behaviour.

Men most at risk
Different sections of the male population are affected differently by eye conditions. Keeffe et al show that
there are differences in the use of eye care services, with gender, urban residence, need, private health
insurance, and English language competency significantly associated with eye healthcare service use.5
Men are significantly more likely to never visit an eye care provider (11 per cent) than women (eight per
cent).6 The 2004-05 National Health Survey asked respondents if they had consulted an allied health
professional in the previous two weeks, with the results suggesting that in any two-week period one in ten
Australians (2 million) consulted an allied health professional: approximately one in nine females (1.2
million) and one in 12 males (0.9 million).7

Rural versus city
Living in a rural area increased the likelihood of seeing an optometrist rather than an ophthalmologist, and
increased the likelihood of never seeing an eye care provider (13 per cent compared to seven percent).
Having private health insurance increased the likelihood of seeing an ophthalmologist (12 per cent compared
with nine per cent), while having private health insurance also reduced the likelihood of never being
checked by an eye care provider.

Languages other than English
People speaking languages other than English are about half as likely to have seen both an optometrist and
an ophthalmologist, and are more likely to have never seen an eye care provider.8

Socio-economic correlations
In poor communities, such as public housing, people experience inequity in accessing eye care services. The
2006 Community Survey conducted at the Collingwood Housing estate in Victoria indicated that only 53 per
cent of residents visited an eye specialist or clinic, which is much lower than the state average of 78 per
cent.9

Aboriginal and Torres Strait Islanders
Aboriginal and Torres Strait Islanders experience total or partial vision loss at twice the rate of non-
Indigenous Australians, and prevalence of eye disease is up to ten times that of the general community. The
proportion of Aboriginal and Torres Strait Islanders who reported having cataracts in 2001 was one third
higher than other Australians, with higher prevalence for males (five per cent) than females (two per cent).

In Australia, trachoma is found almost exclusively within the Aboriginal and Torres Strait Islander population.
A 1998 survey in central Australia found that 40 per cent of children under the age of 13 had infectious


4
    Australian Institute of Health and Welfare, Australia’s Health 2008 (2008).
5
    Keeffe JE, Weih LM, McCarty CA, Taylor HR, ‘Utilisation of eye care services by urban and rural Australians,’ British Journal of
    Ophthalmology 86: 24-27.
6
    Keeffe et al, ‘Utilisation of Eye Care Services’.
7
    Australia’s Health 2008.
8
    The Centre for Eye Research Australia, Clear Insight, 38.
9
    Department of Human Services Victoria, Victorian Population Health Survey (2005).




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trachoma. Diabetes is a major health problem among Aboriginal and Torres Strait Islander people, but there
are very limited data on the prevalence of diabetic retinopathy in the community.10

Workforce issues
Eye health and vision care workforce issues need to be addressed, particularly in rural and remote locations.
There is no longer dedicated funding for eye health coordinators in Aboriginal Medical Services, and there is
a lack of professional eye health services in rural and remote areas. Coordination of fly in/fly out services is
also an issue.

Awareness
There is some disparity in the level of education and awareness of eye health between men and women. For
instance, in 2008 the Macular Degeneration Foundation released a study showing that a significantly higher
percentage of women than men had heard of macular degeneration and understood what it was.

Continuum of care
Establishing an effective continuum of care is extremely important for men’s eye health and vision care.
Early intervention, prevention, treatment and access to low vision and rehabilitation services are all vital.
Although the National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and
Vision Loss focuses on prevention, a low vision and rehabilitation strategy is required to complete the
picture.

Transition from primary to secondary school, into tertiary education or the workforce, then into aged care
and other support services is difficult for men with low vision or blindness. Access to, and maintenance and
upgrading of adaptive technology, needs to be ensured across all phases of a man’s life.

In summary
Given the pervasive nature of eye disease in Australia, it is important that eye health be included in the
National Men’s Health Policy. Prevention and rehabilitation should be made possible across all stages of a
man’s life, and the particular needs of different men, and of men as a whole should be considered and
addressed.




10
     Centre for Eye Research Australia, Investing in Sight: Strategic Interventions to address vision loss in Australia (prepared by Access
     Economics, 2003).




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