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Asthma Control Process in Australia Assessment Answer

TORRENS UNIVERSITY AUSTRALIA

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Assessment 1 - Submission proposing a systematic review, which I think would be a good choice. The relationship between gender, occupation and Asthma is interesting as we know that there are gendered patterns in employment/occupation type and this has implications for the health of women and men. You can refine your research questions to focus on this interconnection between gender and occupation and your literature review will help with this.
Assessment 1 - Submission
This outline gives a good overview of your topic. It seems like you are proposing a systematic review, which I think would be a good choice. The relationship between gender, occupation and Asthma is interesting as we know that there are gendered patterns in employment/occupation type and this has implications for the health of women and men. You can refine your research questions to focus on this interconnection between gender and occupation and your. 

Answer

LITERATURE REVIEW: ASTHMA CONTROL IN AUSTRALIA


Introduction

The research report discusses the Asthma control process in Australia. Asthma is a chronic respiratory condition. The people who struggle with Asthma experience many complications, including shortness of breath, coughing, wheezing, and chest tightness due to the narrowing of the airways channel. The main causes of occurring Asthma are a viral infection; irritants include smoking tobacco and air pollutants. Allergens and food chemicals. Asthma is now declared as a national health care priority area in Australia. Asthma considered as a part of the chronic obstructive pulmonary disease. The report describes the key issues related to Asthma control in Australia. The report reviews the article and provides relevant information about the prevalence of Asthma in Australian male, female, and children. Additionally, the report describes the role of social and demographic factors includes gender, age, and occupation criteria in the incidence of asthma. The report also describes the occurrence of Asthma in Australian women. According to the research of the Australian health department, 10% of the Australian people is affected by Asthma. The Australian government introduces the National Asthma strategy to control the Asthma effect among the Australian people. The report also describes initiatives of the Australian health department to reduce the impact of Asthma on an individual person in Australia.  

Key issues identified with respect to control of asthma in Australia

It has been estimated that the number of cases of asthma may attribute to approximately 15.7% of the total number of global occurrences of asthma (Asthmaaustralia, 2018). In Australia, the number is substantially high, attributing to about 2.7 million, or 1 in 9 of the population is estimated to suffer from asthma (Asthmaaustralia, 2018). Furthermore, the number of women has been found to be greater owing to several factors, in the context of pathogenesis of asthma (Asthmaaustralia, 2018). In addition to that, the prevalence of asthma among the indigenous population have been found to be twice the number, with women being affected more than men, in this case as well (Asthmaaustralia, 2018). However, one of the major problems identified is the lack of access to the resources, as well as the negligence demonstrated by most people. According to Asthmaaustralia, (2018), it has been estimated that only 57% of the children below the age of 15 have a documented action plan to address the issues of asthma, while the number representing the adult population is 21%. In addition to that, it is to be noted that in 2015, an estimate of the cost of treatment for asthma for the Australian population added a per person cost of $11,740, contributing to the national net cost of $28 billion (Asthmaaustralia, 2018). 

Justification of research question

The research question for this review has been broadly characterised as the reason for the greater cases of asthma incidences on women as compared to men. The main research question was:

“Why is the prevalence of asthma, more common among women than men?”

The research question is further modified and subdivided into more objective questions such as: 

  1. Why do women fall prey to asthma more often than men?
  2. What are the major factors involved in the onset of asthma in women as compared to men?
  3. How are age and other social factors and habits related to the occurrence of asthma among women?

The questions can further be justified stating that there has a prominent link between the social habits of people and the onset of asthma. Furthermore, a number of factors including the fluctuations in hormones through the lifespan of a woman, after the onset of puberty have been found to play a crucial role in the development of pathogenesis of asthma among women more than men (Zein& Erzurum, 2015). Social factors such as smoking, pollution, owing to the location of residence (remoteness) also play a significant role in ascertaining the possibility or the likelihood of the occurrence of asthma (Moraes, Sears &Subbarao, 2018). 

Significance of research on the prevalence of asthma

This research report is significant to identify the prevalence of Asthma in Australia. Asthma is now declared as a major chronic disease in Australia. According to the result of the ABS National Health Survey, 11% of the total Australians affected by Asthma (Nationalasthma, 2019). The Australian health department implements the national asthma strategy to reduce the effect of Asthma. Asthma is the chronic respiratory disease that affects the breathing tubes because narrowing of the airways channel. According to the research of the Australian health department, more than 2.5 million Australian people have been suffering from Asthma, including adults and children. The research report helps to identify the key issues involves in asthma. The research report provides information about "why the control of Asthma in Australia is important at recent time to reduce the effects of Asthma on Australian people” (Nationalasthma, 2019). According to the research of the Australian government, in 2015, 410 deaths were occurred due to the Asthma effect. This research report provides evidence about the significant causes of Asthma and describes the effects of Asthma. This research report provides the information to good control the Asthma effects by regularly visits for medical check-ups, taken medicine in the right way at the specific time diagnosed by the doctor (Asthmaaustralia, 2019). The effective Asthma control strategy reduces the prevalence of Asthma among Australian people. The research report is significant to reduce the effects of Asthma by maintaining proper health care practices

Literature review

Prevalence of asthma in Australia

This literature review section discusses the prevalence of the Asthma effects in Australia. According to the research of the Australian health department, Asthma is affecting 11% of the total population in Australia (Asthmaaustralia, 2019). According to this article, females are more affected than male. Based on the research report of the Australian Bureau of statistics national health survey, asthma is the leading chronic disease in children aged between 5 to 14 years. According to this research report from 2014 to 2015, from the age of 0 to 14, Asthma was more affected the Australian male children, and from the age more than the 15 years, Asthma was more affected the Australian female children. According to the research, it is identified that this change in the prevalence of asthma effects occurs due to the hormonal changes among the male and female (Nationalasthma, 2019). 

According to the research of the Australian health department, 18% of the native Australian people are affected by chronic disease Asthma where 20% are Native Australian female, and 15% are Native Australian male (Asthmaaustralia, 2019). Asthma creates an impact on the psychological, physical and social well being of the Australian people. They have suffered from poor quality of life. 

Prevalence of Asthma by age and indigenous status

Fig: Prevalence of Asthma by age and indigenous status.

Source: (Asthmaaustralia, 2019)

According to the article by Mja (2019), Australian health government has been taken the initiative to improve the clinical practices to prevent the effects of the Asthma. This article identifies the cost of the Asthma-related expenditure is near about $655 million in Australia. In this article, the researcher had conducted a survey among the Australian people to identify the Asthma affected people (Mja, 2019). The result reveals that 40% of the total respondents are well-controlled their asthma-related issues by proper medication, 29% of the total respondents need special health care service for controlling the asthma effects (Mja, 2019). This data indicates the poor prescribing issues regarding Asthma medication.

According to the national Asthma strategy of the Australian health department in 2018, the main motive of this national asthma strategy is to reduce the effects of Asthma by identifying the effective areas for implementing the efficient health care action and maximize the use of the health care resources. According to the research of the Australian government in 2018, 10.8% of the total Australian population had Asthma issues means 1 in the ten people in Australia had Asthma (Nationalasthma, 2019). In 2015, 421 deaths were occurred due to Asthma effects. This research recognized that most of the children’s risk of getting Asthma is increased due to smoking by mothers while pregnancy (Nationalasthma, 2019). Other causes of the Asthma are Smoking around the children, mouldy houses, premature born, air pollution due to the traffic or from industry, low birth weight. The adults can develop the effects of Asthma by breathing smoking fumes or breathing in outdoor dust that irritates the lung.

Asthma Affected people according to the state in Australia

Fig: Asthma Affected people according to the state in Australia

Source: (Nationalasthma, 2019)

According to the statistics given by Asthma Australia, the rate of asthma is much greater, nearly double among the indigenous people comparing with the non-indigenous one. This research identifies that the people of the socioeconomically disadvantaged areas are more affected by Asthma. The prevalence of Asthma is more among the people of the inner regional areas compared with the people of major cities in Australia (Nationalasthma,2019). The research of the Asthma Australia identifies that near about  21%  people whose age is more than 15 have the written action plan for Asthma and 57% of the Australian Children have an action plan for Asthma. The action plan for Asthma is very much important for Asthma affected people to reduce the impact of Asthma.  According to the research, the estimated cost of Asthma was $28billion in 2015. Where $24.7 billion costs for premature death and disabilities, $1.2 billion costs in the productivity loss, $72.9 million costs in wage losses for carers. 34% of the people Asthma affects their daily living, 21.8% of the people between the ages of 15 to 25 report that Asthma creates an impact on their work, study, and school life (Health, 2019). In 2017, 441 Australian people died due to the effect of Asthma, in which the proportion of male and female is interesting and as per the report, 300 females and 141 male died due to this. It is evident that in the remote places, asthma contributed to a higher mortality rate. Apart from that, indigenous Australian people, and people of the lower socio-economic areas are also affected by asthma (Aihw, 2019a). The report revealed that boys under the age of 0-14, admitted in the hospital due to asthma are 1.7 times, whereas the percentages increase to 2.4 times in case of a woman   (Aihw, 2019). The research report of the Asthma Australia indicates that in 2015-16, 39448 Australian hospitalized for Asthma. 

 effects of Asthma

Fig: effects of Asthma

Source: (Australian Institute of Health and Welfare. 2019)

According to the report of the Australian Health government, Asthma considered as a part of the COPD (chronic obstructive pulmonary diseases). The COPD is another progressive, serious condition that creates an obstacle while airflow in the lung. According to the report of the national health survey 2015, the 7.1 million people in Australia were affected by the COPD, 600,000 Australians had COPD. COPD is a more common disease in male rather than the female. In 2015, 7991 people died due to the COPD (Aihw, 2019c). This research report of the Australian Health Department identifies that the risk of the development of Asthma that includes family history, genetic factors like allergic tendency and gender issue. Obesity and smoking are also an important factor in raising the effect of Asthma.

Prevalence of Asthma by Socio-economic group

Fig: Prevalence of Asthma by Socio-economic group

Source: (Health, 2019)

According to the report of the Australian government, the general practices including diagnosis, assessment, regular medication, regular review and effective provision of the action plan can manage and prevents the impacts of Asthma. The Written action plan for Asthma patients is the most important part of the Asthma health care services that control asthma in Australia. 

The occurrence of asthma in women

The literature review is conducted taking 4 peer-reviewed articles into account, and one article published online on a Government website, thereby indicating its authenticity. Firstly, one may consider the peer-reviewed article by Zein & Erzurum (2015), which discusses how the incidence of asthma is different among women. The article comes with a bibliography comprising more than 100 authors. This article has been published in the credible academic journal, Current allergy and asthma reports 2015 by the government website of NCBI and may thus be considered recent. According to Zein & Erzurum (2015), asthma has been observed to be massively prevalent in younger boys, but hitting puberty brings about a change, making women more susceptible to the disease as compared to men, due to the increased levels of IgE or Immunoglobulin E in their bloodstream during puberty. In addition to that, it has been established that the relationship between the higher levels of IgE and low FEV1/FVC ratio is evident (Zein& Erzurum, 2015). Moreover, oxidative stress causes an antioxidant response, which varies with gender and age, have been found to have a greater impact on women as compared to men (Keddem et al. 2015). This article is strictly related to the research question identified, as the reason for the widespread prevalence of asthma in women as compared to men.

In the online published article, written by Shah & Newcomb (2018), on the website of Frontiers in Immunology by NCBI, is a recent article discussing the role of gender in the onset of asthma, as depicted in Figure 1. The bibliography has been provided in this article to demonstrate the validity of the same. As per Shah & Newcomb (2018), testosterone, the male hormone may be protective against asthma, thereby reducing the incidence of the same among men. It is to be noted in this regard that pregnancy, menstruation as well as menopause are strongly characterised by the alterations of the female hormones. This, in turn, has been noted to influence and even alter the likelihood of the occurrence or the pathogenesis of asthma in women. In addition to that, it is to be stated in this context that maternal factors during pregnancy or the stage of breastfeeding, such as antibiotic usage or smoking are associated with the development of asthma in children (Raphael & Colvin, 2017). Regardless, it is to be mentioned in this accord that no specific link between the developments of asthma in gender-specific context has been identified with respect to maternal factors (Raphael & Colvin, 2017). 

 Factors affecting asthma in different sexes throughout life

Figure 1: Factors affecting asthma in different sexes throughout life

(Source: Shah & Newcomb, 2018)

Published in the academic journal Pharmacological research by Pignataro et al. (2017), the peer-reviewed article discusses the relationship between asthma and gender, and is thus, directly related to the research question. Furthermore, it comes with a section of references. As per Pignataro et al. (2017), females have been found to be affected more by asthma as compared to men and also use more medications. Regardless, any substantial and concrete data on the subject have not been available. Figure 2 illustrates the prevalence of asthma, which has been noted to be highest among the indigenous population of Australia. In addition to that, asthma constitutes the major factor in the number of respiratory diseases identified among the population, attributing to 20% out of 35% of the total (Pmc, 2014). Other diseases, such as COPD may develop due to smoking, which may also be related to the onset of asthma (Pmc, 2014).

Prevalence of asthma among other respiratory diseases in the Australian population

Figure 2: Prevalence of asthma among other respiratory diseases in the Australian population

(Source: Pmc, 2014)

The peer-reviewed article by Eftekhari et al. (2016), published in the research journal Respiratory medicine, vividly discussed with evidence of the occurrence of asthma and the impact on 10,413 women in Australia. According to the reports of Eftekhari et al. (2016), the rate of morbidity have been studied among these women, and the role of social, demographic factors, age and more aspects have been found to play a crucial role in the same. Furthermore, among older women, the prevalence of asthma has been found to be quite common, combined with the onset of COPD, as a major respiratory disease (Eftekhari et al. 2016). From Figure 3, it has been evident that the female population of Australia is more susceptible to the occurrence of asthma (Aihw, 2018c). Furthermore, it has been evident that the females grow more susceptible to the increase in age with reaching sexual maturity as previously mentioned (Aihw, 2018b). 

Prevalence of asthma in the Australia population based on gender and age

Figure 3: Prevalence of asthma in the Australia population based on gender and age

(Source: Aihw, 2018b)

The peer-reviewed article by Greenblatt et al. (2017), published in the research journal called Asthma research and practice, discuss the determinants of asthma, which are gender-specific. The study used Gender-specific regression analysis to investigate the relationship between asthma and the prevalence with respect to age, gender, smoking habits, and so on. According to the studies conducted by Greenblatt et al. (2017), it has been evident that the incidence of asthma was found to be 1.8 times higher in women who had smoking habits, as compared to women who did not smoke. Furthermore, the prevalence was found to be 10.6% in females, while only 6.2% of males suffered from asthma (Greenblatt et al. 2017). Figure 4 highlights the number of deaths that occurred due to asthma and other respiratory diseases has been found to be greater among women, as compared to men (Pmc, 2014). 

Mortality among the indigenous population in Australia owing to asthma and other related diseases between 2008 and 2012

Figure 4: Mortality among the indigenous population in Australia owing to asthma and other related diseases between 2008 and 2012

(Source: Pmc, 2014)

Role of social and demographic factors (gender, age and occupation) in the incidence of asthma

Asthma is a chronic health condition that affects both children and adults of both genders. However, the occurrence of this chronic disease is unevenly distributed in the population, and there is enough statistical evidence to prove the connection between social and demographic factors like age, gender and occupation with the incidence of asthma. The prevalence of asthma in Australia is also determined by choice of occupation by the genders as well as the age and gender in general linked with genetics and hereditary. Demographic factors like age and gender play a crucial role in the incidence of chronic disease and these social and demographic factors have been discussed in details.

Survey data from more than 12,000 adults were analyzed to understand how much age affects the incidence of asthma. More than 42% of the adults reported their onset age before 16, while 14% reported it to be from 5-9 years. However, the risk of severe asthma became higher for adults, and multiple case studies revealed that age 45 has the highest risk of incidence (Andrews, Jones & Mullan, 2013). As asthma is linked to the condition of the lungs, as people age, their ability to filter air and exposure to the various degenerating environment for occupational purpose, increases their chances of incurring asthma to a significant level. However, when acquired genetically or hereditarily, severe asthma can also occur in people of all ages regardless of the capacity and condition of their lungs.

Studies have suggested that between the two genders, boys have a higher prevalence of asthma compared to girls during their adolescence while in adulthood, women have higher prevalence when compared to men. However, as asthma is a complicated, inflammatory airway disease, the mechanism of such gender-based incidence cannot be determined. Data from 2014-15 AHS suggested clear evidence that Australians between ages 0-14, males were prone to asthma, while for age 15 or above it was more common in females (Australian Institute of Health and Welfare, 2019). The best estimation made on such correlation between age and sex with asthma is the complex interaction of the changing airway size and the hormonal changes that both genders go through from adolescent to adulthood. However, apart from the hormonal changes, differences in environmental exposures of the genders also play a role in the uneven incidence of asthma in both genders.

Social factors like occupation and economic background also play an important role in the incidence of asthma. Studies have indicated asthma associated with poor quality of life along with the severity of the disease and prevention level. Poorer people who tend to get occupation in an unhealthy environment due to their poor financial background are more prone to asthma due to the impure air inhalation. Similarly, people who have low socioeconomic status can arrange for poorer control measures for asthma and suffer a more severe level of the disease compared to people from higher socioeconomic status. The well-being of people is directly related to the socioeconomic background as well as the occupational environment, and this has a key role to play in the incidence of asthma in Australia. 

Report and data from the Surveillance of Australian workplace Based Respiratory Events (SABRE) are necessary to understand the incidence of various occupational lung disease. The reports from SABRE clearly indicates that occupational asthma is the leading occupational respiratory condition in Australia (Li et al. 2014). Age is also interlinked with occupational asthma as adults are more likely to incur this respiratory condition due to their prolonged exposure to unclean air in the workplace. Occupational asthma constitutes of about 9-15% of the total adult-onset asthma, and almost 3000 adults in Australia are exposed to it every year (Goeman et al. 2013). Due to such terrible workplace conditions, many people have to change careers, and this leads to work disruption and economic hardship. This makes the issue interlined with socioeconomic status, and due to economic hardships, they are not able to control the severity of the disease. In a way, it can be said that the social and demographic factors related to the incidence of asthma in Australia are interconnected with one another while also having a direct impact on their own. However, occupational asthma can be prevented by reducing the exposure to the irritants and sensitizers in the workplace.

To summarize, in adolescent children, asthma is more common in males than in females, while female adults suffer more from it than male adults. This is mainly due to the expansion of airway size and hormonal changes when moving from teenage to adulthood, and this determines the incidence of the disease based on gender. In terms of age, adult-onset asthma is more severe at the age of 45 and children are very less likely to incur this respiratory condition than adults who are exposed to unhealthier workplace conditions than children (Burdon, 2015). Therefore, it can be concluded that occupational environment plays the most significant role in the incidence of asthma in Australia. However, precise data is currently not available and more research is needed on the impact of occupation in the incidence of the disease and how female adults despite less exposed to occupation-related asthma are more prone to it.

Gaps in literature

The literary articles reviewed in this research study covers the most important areas of the incidence of asthma in Australia while also pointing out the condition occurring in females. However, it does not specifically state the asthma condition for males and children. This makes it tough to determine the role of gender and age on the incidence of Asthma cases. Moreover, the reviewed articles do not provide any interlinked relation between the social and demographic factors of asthma incidence and this has been done by the researcher to provide a better understanding of the topic. Additionally, the data and statistics related to the reported cases of asthma have been derived from various secondary sources and case studies which might not be accurate and updated. Also, more research and precise data are needed on each of the individual adult-onset asthma cases or from survey studies to estimate better the occurrence of the respiratory condition based on social, demographic and economic factors. 

Conclusion and recommendations

After analysing the research report of the Australian health department and articles of the different authors, it is concluded that Asthma is more common disease among the Australian female rather than the Australian male due to the hormonal changes. Asthma causes psychological issues and creates a long term impact on the quality of the life of the Australian people. The mortality rates also increase due to Asthma. 

Following are some recommendation to control the Asthma in Australia

  1. The Australian health department should reduce the health inequalities between indigenous and non-indigenous people to reduce the effects of Asthma among the lower socio-economic areas. It will help in reducing the effects of Asthma among the people living in remote areas. 
  2. The Australian health care services should improve the written action plan for Asthma patients to improve the quality of the life of Asthma patients. The effective Asthma action plan will provide an excellent framework for the Australian people to manage Asthma through regular review and ongoing care. It will reduce the severity of Asthma.
  3. Australian Health department should launch Asthma health care program for the people of Australia to enhance the self-management health care among the Australian. It will help the Australian to manage Asthma through self-diagnosis. 
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