In this episode of PodMD, NAB’s Head of Behavioural and Industry Economics, and author of the NAB Health insights report, Dean Pearson, will be discussing 2024/25 NAB Health Insights Report (Part 2) – Health Practitioners Through the Eyes of Patient.
- Transcript
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*As always, all in this PodMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.
Today I’d like to welcome back to the PodMD studio, Dean Pearson, Head of Behavioural and Industry Economics at NAB. Dean leads a team of analysts responsible for providing unique insights into consumer and business behaviour by intersecting economics, psychology and advanced data analytics. As a behavioural economist and commentator with almost 30 years’ experience, he has worked to debunk the view that humans are rational, clear-thinking beings. Instead, we behave and make choices that are often illogical and based on emotion. And, if we are to truly understand the economy, it is important that we know the underlying emotional state and motives of the people who work and live within it.
*We do hope you enjoy this podcast, but please remember that the information discussed here is of a general nature and is not intended to serve as advice. The views and opinions expressed in this podcast are those of NAB Health, not PodMD. NAB Health reminds you that any information or opinion in this podcast is general in nature and does not consider your personal objectives, financial situation or needs. Nothing in this podcast is a recommendation and you should seek independent professional advice before making any decisions based on the information in this podcast.
Dean, thanks for talking with us on PodMD today.
Dean: Hi and thanks for having me back.
The topic of today’s discussion is the key findings from part 2 of the latest NAB Health Insight Series of Reports. NAB regularly surveys thousands of Australians (representative of age, gender, income, job type, and location), and asks them simply about their own lives, from their perceptions of their emotional and financial wellbeing, their spending patterns and expectations, and satisfaction with their lives (particularly their finances).
Each year NAB also reaches out to Australians to learn more about their attitudes and experiences with the health system. In Part 1 of the Report, NAB asked Australians to once again share their experiences with health practitioners and their preferences. What emerged was still a largely satisfied patient, but also an increasingly demanding one. The results painted a clear picture of the opinions of health consumers today, giving practitioners actionable insights to help them meet their patients’ needs.
In Part 2 of the Report, NAB explored how Australians feel about their own health, how they manage it and what stops them from doing more.
Dean, with many Australians living with an ongoing medical condition, to what extent do Australians believe they are ultimately responsible for their own health and why does this matter?
Dean: Well, I think personal responsibility is extremely important, particularly just given how many of us live with an ongoing health condition. In fact, almost one in two Australians identified that they were living with a medical condition that needed ongoing treatment. Now that was down a little bit on last year, but it rises to almost eight in ten amongst those who are over 65, and I think importantly over eight in ten of those who said they needed ongoing treatment or medication, said their condition was a chronic condition, and that it had lasted or was expected to for six months or more. Now, the most common chronic conditions reported were; mental and behavioural, followed by back problems, diabetes, arthritis, heart stroke and vascular disease, asthma, osteoporosis, cancer, chronic obstructive pulmonary disease and kidney disease. Now, with these statistics in mind, taking charge of our own health is clearly really important, so we can empower individuals to prevent illness, manage their existing conditions and ultimately, really improve their quality of life, and and increase their overall lifespan. But, I think more fundamentally though, as individuals, we really should aim to promote and manage our own health by adopting a healthy lifestyle. Really encouragingly, what comes through here is Australians overwhelmingly agree, in fact, three in four were in very strong agreement that they were themselves responsible for managing their own health. Now, interestingly, considerably more people aged 45 and over strongly agreed with that statement at about eight in ten compared to just one in two aged between 18 to 24.
Question 1
The report tracks the number of Australians that report being diagnosed with a mental health illness or disorder, along with those who believe they require professional help. How have these changed?Dean: Well, while many of us continue, clearly to struggle with our mental health, few are reported being diagnosed with a mental health illness or disorder over the last 12 months. So, it was about 16% of this representative sample of the population, it was about 18% a year ago. Numbers also declined importantly, but they remain highest in rural areas, so about 19% of that population identified as being diagnosed. Now, importantly, by age, the share fell sharply amongst the 18 to 24 year old age group to about 28%, although they are still the highest by quite a considerable margin. About one in five Australians also told us that they had a mental health treatment plan, and that ranged from around 35% amongst the 18 to 24 year, versus just 3% for people aged over 65. I think of concern, though the number of Australians who felt they needed professional mental health support for a health condition, rose to 39% and that remains highest amongst the 18 to 24 year old group where over seven in ten said they felt they needed professional help. So, not being diagnosed, but felt that they needed some additional support. So, I think clearly there is still a lot of unmet care for mental health support in this country.
Question 2
How do Australians assess their mental and physical health, how satisfied are they with their perceptions of how their health is tracking, and why are their perceptions important?Dean: I think a person’s view of their health is obviously incredibly subjective, and it can be influenced by all sorts of things like personal experiences, their beliefs and expectations. While some studies suggest there is a link between healthy behaviours and self assessed health, the relationship is pretty complex and it’s not always straightforward, but I think what this really does capture is a person’s lived experience with their health, which I think is also really valuable. Now, when we asked Australians to self rate their mental and emotional health, they scored out of a potential 10 points 6.9, and that’s unchanged from last year. One in two scored very high, 8 plus points, and less than one in ten, very low. 18 to 24 year olds scored lowest, they only scored 6 versus 8 amongst those aged over 65. Now, income is clearly a differentiator here, 51% of the higher income cohort scored high versus only 39% of those on lower incomes, around 10% in the lower income groups scored very low. Now, in terms of their physical health, Australians scored on average 6.8 out of 10, which was up slightly from last year, the number who scored very high climbed to four in ten, almost one in two Australians in the higher income group reported high levels of physical health, compared to just three in ten amongst those in the lower income group. I think of concern almost four times as many people in the lower income group scored their physical health quite low compared to those on higher incomes. Now in terms of how satisfied they were with these health outcomes, overall, Australians reported a small improvement but they’re still only moderately satisfied, so you know, mid sixes out of a possible. About four in ten scored their satisfaction very high and about one in ten very low. And once again by region, overall satisfaction continues to be scored highest in capital cities, lowest in rural areas. And by age those scoring high was much greater amongst people aged 65 and over, about 47%. Compared to those in the 18 to 24 year old age group, where only 28% scored high.
Question 3
To what extent do Australians believe they are prioritising their health, and do they believe they have a ‘preventative health mindset.Dean: I think encouragingly here, the number of us who say we are prioritising our health is continuing to grow, particularly in rural areas where it has reached now about 45% of the population. But, there’s a real paradox here because significantly more people in rural areas, over one in five also they said they had prioritised their health less, and that compares to about one in ten in capital cities and I think this matters because, around 7 million people or 28% of the total population, live in rural and remote areas, and these Australians clearly face some pretty unique challenges, and they often have poor health outcomes than people living in metropolitan areas They typically have higher rates of hospitalisation, death, injury, they also have poor access to and use of primary healthcare than people in major cities. Also, substantially more people in the higher income group said they had prioritised their health, so it’s about 50% of them, compared to those in the lower income group, where it drops to about 37%. Now, many Australians also believe they do have a strong preventative health mindset, and encouragingly, the number who scored very high here rose to 42%, though it remains again, higher in capital cities compared to rural areas. It increased in most age groups and it remains highest amongst those over 65. But there was also a sizable increase amongst those between the ages of 18 to 24, who really believe they are focused on preventative health. I think it would be easy to dismiss this type of qualitative feedback, after all. David Ogilvie, who was the so-called father of advertising, once famously said, “the problem with market research is that people don’t think how they feel, they don’t say what they think and they don’t do what they say”. So this say-do gap means really that people will often say one thing and then they’ll do something completely different. So I think it’s important to not only listen to what consumers say, but also to watch for how they behave. And many of us, when answering a survey will over claim how much we engage in socially desirable activities and will downplay how much we drink or binge on fast food, for example. While some people typically overstate what they do or what they think they will do, their claims in fact usually have a a pretty clear relationship with their actual behaviour that’s informative and predictive. Now, even accounting for this, when people respond to surveys, the results are often confusing. I mean, it’s not that people deliberately lie, it’s just that we often don’t know what we’re going to do next, and we can’t even recall accurately what we’ve already done. So do I believe that nearly one in two Australians have actually made their health a greater priority over the past year? No, I don’t. Our behaviours really belie our intentions. Just one in two Australians, for example, tell tell me that they have regular health checkups. Now don’t get me wrong. I think the pandemic has clearly prompted Australians to focus more closely on their health and this has continued, the way Australians think about health has increased in importance and it’s expanded in definition, so healthy, the whole notion of being healthy has already shifted to include mental health, but I think for many people it’s also encompassing things like spiritual, emotional, social, even financial well being. But saying and doing are often very different things. Real behavioural change is quite complicated, it’s complex because it requires a person to disrupt the current habit, while simultaneously fostering a new, possibly unfamiliar, set of actions.
Regardless what we’re doing, our tastes are clearly shifting, particularly when it comes to our health. Consumers are also using things like exercise, healthier diets, Wellness retreats, to focus on their well being. Many are on their so-called longevity journey, so they’re making behavioural changes now for the betterment of their future selves. And it’s not just about wanting to live longer, to improve their lifespan, but increasingly, more of us want to feel and look better for longer, so we want to improve our health span. Increasingly that means Australians want more preventative solutions, more products that target specific concerns. But as I say, translating these ideas into action takes time, and people will typically have quite a strong emotional attachment to the things we’re doing already, be it the products we’re buying, the services we engage in, or the ideas we have – but at least aspirationally things are looking pretty good.Question 4
So did you also explore what stops people from better looking after their health?Dean: Yes, we did and I think it’s incredibly important to understand these. I think we have to acknowledge that our health comes from more than our individual choices, though. it is about the opportunities and chances we have, the communities, environments we live in. But having said that, when again we asked people well, what stops you giving you so much want to lean into preventative healthcare, what stops you from taking better care of your overall health? A broadly unchanged number pointed to a lack of motivation, followed by a lack of money, being too tired as well. However, there was also a rise in a group of people who said they simply didn’t have enough time. Now I think it’s not surprising, of course, that lack of money is a much bigger issue amongst lower income earners, and there is some evidence to suggest that incentives such as payments and vouchers can help as a way of encouraging patients to undergo preventative care, such as screenings, vaccinations and other interventions. You know they can increase preventative care particularly amongst lower income and higher risk population. Now, of course, financial incentives are really unlikely to be a cure-all, but they do appear to have a place in encouraging some groups of the population to modify particularly high risk health behaviours. I also think the the rising incidence of people citing lack of time is interesting because we do know that compared to generations prior, our sense of feeling in control of our time has diminished,and I think thanks to technology, when we always have now have access to more emails, more meetings, more entertainment options, and it also reflects the rise of more single living or dual career couples. I think it’s ironic that people with higher incomes are much more likely to report being time stressed than others, they not only spend more time working, but they also use their money to indulge in more time sucking activities like buying more things and engaging in social activities.
Question 5
Did you establish what key aspects of health Australians believe are the most important things they can do to support their health?Dean: Yes, we did. Australians believe there are really two key preventative healthcare measures. Over one in two said good quality sleep and a healthy diet were key, now rounding out the top five suggestions they had was; having an active lifestyle, a good body weight and staying connected with family and friends. Now for one in four of us, it was having regular checkups and screenings, lowering stress, getting regular general health tests, not smoking, and more time outdoors and in nature. For about one in five, they suggested drinking less alcohol, regular dental health checkups, protecting skin from the sun. And about one in seven said participating in a fitness programme. I think it’s also interesting that only 4% said monitoring their health using an app, a phone, a device or a wearable.
Question 6
Dean, as always, thank you for your time here today in the PodMD studio. To sum up for us, could you please identify the three key take home messages from today’s podcast.Dean: I think firstly, with one in two Australians living with an ongoing medical condition, I think it is significant that most continue to believe that they themselves are ultimately responsible for their own health. Now this belief is often linked to the idea that so much of our health is determined by personal choice, such as lifestyle. But I also think it really does signal a willingness to take more proactive steps to prevent illness and seek treatment early. I think second; I do think it’s also significant that fewer Australians report having been diagnosed with a mental health illness, but at the same time, more tell me that they want professional mental health support. And while almost one in two of us rate our mental health very positively, this falls to just one in five amongst young people. And I also think while Australians scored their physical health a little better, there are really notable disparities by income. And third, I’d say it’s encouraging that the number of us who report prioritising our health continues to grow. Over four in ten, identify as having a strong preventative health mindset, and Australians identify two key preventative healthcare measures, good quality sleep and eating a healthy diet. So it suggests that any conversations with a patient around those two things will resonate, but there are also some important barriers to improving our health, particularly a lack of motivation, a lack of money, simply being too tired and increasingly, a lack of time.
Thanks again for your time and the insight’s you’ve provided.
Dean: Great to be here and thank you for having me.
