The contribution of epidemiology to the definition of health goals and targets for Australia.
Health goals and targets may be used to improve the efficiency of investment of resources for health care and the promotion of health the better to fulfil the values and expectations of society. Australia has been developing health goals and targets since 1985. The first step was the establishment of the Better Health Commission that year. Its proposals led to the states and territories undertaking concerted health promotion activities through the National Better Health Program. Subsequently the health-care system as a whole, through the 1993 Medicare agreement, endorsed the goals and targets approach. Epidemiology has played a major role in every step in this process. Initially it was used to establish health status baselines or to point to serious data deficits which stopped a baseline being set. It provided data about the burden and distribution of illness in the community. It was used critically to appraise evidence about aetiology and the fraction of illness attributable to modifiable risk factors and the effectiveness of interventions, and to provide estimates of potential years of life lost through illness and injury. This has contributed, along with economic analysis which is a critically important corollary, to the definition of health care priorities. Epidemiology, while being necessary for these developments, however, has not been sufficient. This 'insufficiency' has three elements. First, existing epidemiological knowledge and methods have been inadequately applied or the data have been missing, or distorted by inappropriate interpretation. Second, there are now goals and targets in health literacy, the health care system, and the environment where epidemiological methods (and hence data) are poorly developed or non-existent.(ABSTRACT TRUNCATED AT 250 WORDS)
Leeder
S R
SR
Department of Public Health and Community Medicine, University of Sydney, Westmead Hospital, NSW, Australia.
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