Table of Contents

Glossary of Key Verbs ....................................................................................................................................................... 5

Steps to Answering Questions ......................................................................................................................................... 7
Critical Question 1: How are priority issues for Australia’s health identified .................................................................. 8
Syllabus ............................................................................................................................................................................. 8
Measuring Health Status .............................................................................................................................................. 8
Role of Epidemiology ................................................................................................................................................ 8
Measures of Epidemiology...................................................................................................................................... 10
Mortality Diagram ............................................................................................................................................... 12
HSC Past Paper Multiple Choice................................................................................................................................. 12
Answers ................................................................................................................................................................... 15
HSC Question: Outline the measure of epidemiology (HSC 2017), (Question 21a), (3 marks) .................................. 15
Marking Criteria ...................................................................................................................................................... 15
HSC Question: Describe the limitations of epidemiology (HSC 2017), (Question 21b), (4 marks) ............................ 15
Marking Criteria ...................................................................................................................................................... 15
HSC Question: Outline TWO indicators of morbidity. Include examples in your answer (HSC, 2013), (3 marks) ..... 15
Marking Criteria ...................................................................................................................................................... 16
Identifying Priority Health Issues............................................................................................................................... 16
Summary ................................................................................................................................................................. 16
HSC Past Paper Multiple Choice................................................................................................................................. 17
Answers ................................................................................................................................................................... 18
Critical Question 2: What are the priority issues for improving Australia’s health? ................................................... 19
Syllabus ........................................................................................................................................................................... 19
Groups Experiencing Health Inequities ..................................................................................................................... 19
Aboriginal and Torres Strait Islander People (ATSI) ................................................................................................ 20
The Nature and Extent of the Health Inequities ................................................................................................. 20
The Sociocultural, Socioeconomic, and Environmental Determinants............................................................... 21
The Role Individuals, Communities and Governments Play in Improving Inequities ......................................... 23
HSC Past Paper Multiple Choice................................................................................................................................. 24
Answers ................................................................................................................................................................... 25
HSC Question: Outline TWO socioeconomic determinants that contribute to health inequities experienced by
Aboriginal and Torres Strait Islander peoples (HSC 2010), (3 marks) ......................................................................... 25
Marking Criteria ...................................................................................................................................................... 25
HSC Question: Explain the roles of individuals, communities and governments in addressing health inequities
experienced by Aboriginal and Torres Strait Islander peoples. Use examples to support your answer (HSC, 2018), (8
marks) ......................................................................................................................................................................... 25
Marking Criteria ...................................................................................................................................................... 26
HSC Question: Explain how environmental determinants contribute to the health inequities experienced by
Aboriginal and Torres Strait Islander peoples (HSC, 2019), (5 marks) ........................................................................ 27
Sample Answer........................................................................................................................................................ 27
 Marking Criteria ...................................................................................................................................................... 27
The Elderly............................................................................................................................................................... 27
The Nature and Extent of the Health Inequities ................................................................................................. 27
The Sociocultural, Socioeconomic, and Environmental Determinants............................................................... 28
The role individuals, communities and governments play in improving inequities ........................................... 30
HSC Question: Explain the determinants that contribute to the health inequities experienced by ONE priority
population group other than Indigenous Australians. In your answer, provide specific examples (HSC, 2016), (7
marks) ......................................................................................................................................................................... 30
Marking Criteria ...................................................................................................................................................... 31
High Levels of Preventable Chronic Disease, Injury and Mental Health Problems.................................................. 32
Cancer ..................................................................................................................................................................... 32
The Nature of the Problem ................................................................................................................................. 32
Extent of the Problem (Trends)........................................................................................................................... 32
Risk and Protective Factors ................................................................................................................................. 33
The Sociocultural, Socioeconomic and Environmental Determinants................................................................ 34
Groups at Risk ..................................................................................................................................................... 34
HSC Question: Outline strategies that reduce the risk of skin cancer (HSC, 2011), (3 marks) ................................... 34
Marking Criteria ...................................................................................................................................................... 35
HSC Question: Breast cancer and lung cancer are two common cancers in Australia. What are the determinants of
these cancers and why do they put some groups more at risk than the general population? (HSC, 2011), (7 marks)
.................................................................................................................................................................................... 35
Diabetes .................................................................................................................................................................. 36
The Nature of the Problem ................................................................................................................................. 36
Extent of the Problem (Trends)........................................................................................................................... 36
Risk Factors and Protective Factors .................................................................................................................... 37
The Sociocultural, Socioeconomic and Environmental Determinants................................................................ 37
Groups at Risk ..................................................................................................................................................... 37
Cardiovascular Disease (CVD) ................................................................................................................................. 38
The Nature of the Problem ................................................................................................................................. 38
Extent of the Problem (Trends)........................................................................................................................... 38
Risk Factors and Protective Factors .................................................................................................................... 38
The Sociocultural, Socioeconomic and Environment Determinants .................................................................. 39
Groups at Risk ..................................................................................................................................................... 39
HSC Past Paper Multiple Choice................................................................................................................................. 40
Answers ................................................................................................................................................................... 41
HSC Question: Explain both the risk factors and the protective factors of cardiovascular disease (HSC, 2017), (5
marks) ......................................................................................................................................................................... 41
Marking Criteria ...................................................................................................................................................... 42
HSC Question: Outline TWO groups most at risk of cardiovascular disease in Australia (HSC, 2014), (3 marks) ...... 42
Marking Criteria ...................................................................................................................................................... 42
 HSC Question: Describe the determinants of health that affect a preventable condition in Australia OTHER THAN
cancer or cardiovascular disease. Use examples to support your answers (HSC, 2018), (4 marks)........................... 43
Marking Criteria ...................................................................................................................................................... 43
A Growing and Ageing Population ............................................................................................................................. 43
Healthy Ageing ........................................................................................................................................................ 43
Increased Population Living with Chronic Disease and Disability ........................................................................... 44
Demand for Health Services and Workforce Shortages ......................................................................................... 45
Availability of Carers and Volunteers ...................................................................................................................... 45
Carers .................................................................................................................................................................. 45
Volunteers ........................................................................................................................................................... 46
Practice Question: Assess the impact of a growing and ageing population on the carers of the elderly, and on the
system, services and health workforce (8 marks)....................................................................................................... 46
Marking Criteria ...................................................................................................................................................... 47
HSC Past Paper Multiple Choice................................................................................................................................. 47
Answers ................................................................................................................................................................... 48
HSC Question: Outline THREE types of carer or volunteer organisations available to help meet the needs of
Australia’s ageing population (HSC, 2012), (3 marks) ................................................................................................. 48
Marking Criteria ...................................................................................................................................................... 48
HSC Question: To what extent does Australia’s health care system benefit from having a healthy ageing
population? (HSC, 2017), (8 marks) ............................................................................................................................ 49
Marking Criteria ...................................................................................................................................................... 49
Critical Question 3: What role do health care facilities and services play in achieving better health for all
Australians? .................................................................................................................................................................... 50
Syllabus ........................................................................................................................................................................... 50
Health Care in Australia ............................................................................................................................................. 50
Range and Types of Health Facilities and Services ................................................................................................. 52
Responsibility for Health Facilities and Services ..................................................................................................... 54
Equity of Access to Health Services and Facilities................................................................................................... 55
Health Care Expenditure vs Expenditure on Prevention and Early Intervention ................................................... 56
Impact of Emerging New Treatments and Technology on Health Care, eg cost & access, benefits of early
detection ................................................................................................................................................................. 57
Health Insurance: Medicare and Private ................................................................................................................ 58
HSC Question: What are the responsibilities of each of the three levels of government for the delivery of health
services in Australia? (HSC, 2014), (4 marks) .............................................................................................................. 59
Marking Criteria ...................................................................................................................................................... 60
HSC Question: To what extent is access to health care facilities and services equitable for all Australians? (HSC,
2015), (8 marks) .......................................................................................................................................................... 60
Marking Criteria ...................................................................................................................................................... 61
HSC Question: Discuss the impact of emerging new treatments and technologies in relation to health care in
Australia. Use examples to support your answer (HSC, 2018), (5 marks) .................................................................. 61
Marking Criteria ...................................................................................................................................................... 61
HSC Question: Describe the advantages of Medicare for Australians citizens (HSC, 2012), (3 marks) ..................... 61
 Marking Criteria ...................................................................................................................................................... 62
HSC Past Paper Multiple Choice................................................................................................................................. 62
Answers ................................................................................................................................................................... 64
Complementary and Alternative Health Care Approaches ...................................................................................... 64
Reasons for Growth of Complementary and Alternative Health Products and Services ....................................... 64
Range of Products and Services Available .............................................................................................................. 64
How to Make Informed Consumer Decisions ......................................................................................................... 65
Case Study – Gerson Therapy ............................................................................................................................. 65
HSC Past Paper Multiple Choice................................................................................................................................. 67
Answers ................................................................................................................................................................... 67
HSC Question: What should consumers consider before choosing complementary and/or alternative health care
approaches? (HSC, 2013), (4 marks) ........................................................................................................................... 67
Marking Criteria ...................................................................................................................................................... 68
HSC Question: Using examples, describe the difference between alternative health therapies and complementary
therapies (HSC, 2016), (5 marks) ................................................................................................................................ 68
Marking Criteria ...................................................................................................................................................... 68
Critical Question 4: What actions are needed to address Australia’s health priorities? ............................................. 69
Syllabus ........................................................................................................................................................................... 69
Health Promotion Based on the Five Action Areas of the Ottawa Charter.............................................................. 69
Levels of Responsibility for Health Promotion........................................................................................................ 69
Benefits of Partnership in Health Promotion.......................................................................................................... 70
How Health Promotion Based on the Ottawa Charter Promotes Social Justice..................................................... 71
Ottawa Charter in Action ........................................................................................................................................ 72
The ‘National Road Safety Strategy’ 2011-2020 Initiative .................................................................................. 72
The ‘Close the Gap’ Initiative .............................................................................................................................. 73
HSC Question: How do the five action areas of the Ottawa Charter address the principles of social justice? Include
examples in your answer (HSC, 2013), (8 marks) ....................................................................................................... 74
Marking Criteria ...................................................................................................................................................... 75
HSC Past Paper Multiple Choice................................................................................................................................. 75
Answers ................................................................................................................................................................... 77
Practice Question: Evaluate the effectiveness of the Ottawa Charter in improving the health status of Australian
people. Make reference to the National Road Safety Strategy 2011-2020 in your response (8 marks).................... 77
Scaffold.................................................................................................................................................................... 77
Creating Supportive Environments ..................................................................................................................... 77
Building Healthy Public Policy ............................................................................................................................. 77
Glossary of Key Verbs
Account
Account for: state reasons for, report on. Give an account of: narrate a series of events or
transactions
Analyse
Identify components and the relationship between them; draw out and relate implications
Apply
Use, utilise, employ in a particular situation
Appreciate
Make a judgement about the value of
Assess
Make a judgement of value, quality, outcomes, results or size
Calculate
Ascertain/determine from given facts, figures or information
Clarify
Make clear or plain
Classify
Arrange or include in classes/categories
Compare
Show how things are similar or different
Construct
Make; build; put together items or arguments
Contrast
Show how things are different or opposite
Critically (analyse/evaluate)
Add a degree or level of accuracy depth, knowledge and understanding, logic, questioning,
reflection and quality to (analyse/evaluate)
Deduce
Draw conclusions
Define
State meaning and identify essential qualities
Demonstrate
Show by example
Describe
Provide characteristics and features
Discuss
Identify issues and provide points for and/or against
Distinguish
Recognise or note/indicate as being distinct or different from; to note differences between
Evaluate
Make a judgement based on criteria; determine the value of
Examine
Inquire into
Explain
Relate cause and effect; make the relationships between things evident; provide why and/or how
Extract
Choose relevant and/or appropriate details
Extrapolate
Infer from what is known
Identify
Recognise and name
Interpret
Draw meaning from
Investigate
Plan, inquire into and draw conclusions about
Justify
Support an argument or conclusion
Outline
Sketch in general terms; indicate the main features of
Predict
Suggest what may happen based on available information
Propose
Put forward (for example a point of view, idea, argument, suggestion) for consideration or action
Recall
Present remembered ideas, facts or experiences
Recommend
Provide reasons in favour
Recount
Retell a series of events
Summarise
Express, concisely, the relevant details
Synthesise
Putting together various elements to make a whole
Steps to Answering Questions

What is it?

What is it? What does it do?

What does it How / Why does it

What is it?
do? do it?

How / Why does What does it lead

What is it? What does it do?
it do it? to?

What does it How / Why does What does it How well does it do
What is it?
do? it do it? lead to? it?

Examples Examples Examples Examples Examples

IDENTIFY
Recognise and name.
EXPLAIN
Make the relationships EVALUATE
OUTLINE Indicate DESCRIBE Provide between things evident. ANALYSE
Make a judgement based
the main features of. characteristics and Identify components and on criteria. Provide points
the relationship between for and against OR the
features
DISCUSS them. advantages and
disadvantages of the topic.
DEFINE Identify issues and provide
points for and against.
State the meaning and
qualities.

Level 1 Level 2 Level 3 Level 4 Level 5

(3-4 MARKS) (4-5 marks) (6-8 marks) (9-11 marks) (12-15 marks)

Provide all of the Provide as many Write a few Write a few Write all about all of
important points. features about the paragraphs on each paragraphs the points for OR
issue briefly point using examples. explaining each advantages using
describing each component using examples.
one with examples. examples.
Write all about all of
the points for OR
advantages using
examples.
Use linking words Use linking words
Use linking words between each point
such as: for such as: for
instance, for such as: therefore, Use linking words Use linking words
instance, for thus, as a result, between each point
example, example, including such as: therefore,
and such as: to leading to: to illustrate such as: therefore, because, however,
including and the relationship. thus, as a result,
such as: to introduce your for instance, for
examples. leading to. example, as a result.
introduce your
examples.
Critical Question 1: How are priority issues for Australia’s health identified

Syllabus

Measuring Health Status

Role of Epidemiology
Critical Questions Key Points
Role of Epidemiology The study of the patterns and causes of health
and disease in populations and the application
of the study to improve health
 What can Epidemiology tell us? - Used to obtain a picture of the health
status of a population, in terms of
quantifiable measures
- Used to analyse how health services and
facilities are being used
- Provides information about ethnic,
socioeconomic, age and gender groups
- Epidemiology considers:
o Prevalence (the total number of
cases of a disease in a population
at a specific time)
o Incidence (the number of new
cases of disease occurring in a
population)
o Distribution (who and what, the
extent)
o Apparent causes (determinants
and indicators)
Where can Epidemiological Information come - World Health Organisation (WHO)
from? - Australian Institute of Health and
Welfare (AIHW)
- Australian Bureau of Statistics (ABS)
- Non-Government Organisations
- Universities
- Australian Government Department of
Health
Statistics Epidemiology Commonly Uses - Births
- Deaths
- Incidence and Prevalence
- Hospital use
- Money spent on healthcare
- Loss of productivity
Who Uses These Measures? - Researches
- Health department officials
- The government
- Health or medical practitioners
What can Epidemiological Observations and - Describe and compare the patterns of
Statistics Help Researchers and Authorities to health of groups, communities and
do? population
o For example, urban vs rural
populations
- Identify health needs and allocate
healthcare resources accordingly
o For example, increased funding
to ageing population rather than
middle-aged individuals
 - Evaluate health behaviours and
strategies to control and prevent
disease
o For example, identifying smoking
is a determinant of lung cancer
- Identify and promote behaviours that
can improve the health status of the
overall population
o For example, stop smoking
campaign
Do they Measure Everything about Health - Gives a once sided view of data
Status? information
- Excludes individuals who don’t have
access or do not want to fill in surveys
- Doesn’t always show the significant
variations in the health status of
population subgroups (e.g. ATSI vs Non-
ATSI Australians)
- Fails to explain why the health
inequities exist
- Might not accurately indicate quality of
life in terms of people’s levels of
distress, impairments or disability –
statistics tell us little about the degree
and impact of illness
- Cannot provide the whole health picture
- Don’t account for health determinants
(social, socioeconomic, environmental
and sociocultural)
Measures of Epidemiology
Measure Definition Current Trends
Mortality Otherwise known as the death - Leading causes of mortality overall
rate, is a measure of the number are:
of deaths in a group of people or o All Cancers
from a specific cause in a given o Cardiovascular Disease
period of time (usually one year) o Dementia and Alzheimer’s
Disease
- Leading cause of mortality in 2016 for
males was:
o Coronary Heart Disease
o Lung Cancer
o Dementia and Alzheimer’s
Disease
- Leading cause of mortality in 2016 for
females was:
o Dementia and Alzheimer’s
Disease
o Coronary Heart Disease
 o Cerebrovascular Disease (stroke)
- Leading cause of mortality in 2016 for
ATSI was:
o Coronary Heart Disease
o Diabetes
o COPD
o Lung Cancer
o Suicide
Infant A measure of the annual number - Declining steadily
Mortality of deaths of children under 1 year o Due to better access to health
of age per 1000 live births services, better technology,
more health education and
better sanitation
- ATSI have highest rates of infant
mortality
o Due to lack of access, lower
levels of hygiene
Morbidity Information about the level of - Incidence
disease in specific populations. o Incidence of cancer has
Main indicators are prevalence increased since 1982
and incidence o Increase in incidence of CHD
o Increases in incidence can be
partly due to the ageing and
increasing size of the population,
improvements in technology and
techniques
- Prevalence
o ATSI have a higher prevalence of
many chronic health conditions
o Prevalence is generally higher in
rural and remote areas
Life The average number of years a - Steadily rising
Expectancy person of a given age and gender - Australia has one of the highest life
can expect to live expectancy rates (top 5)
- Still gaps between ATSI and Non-ATSI –
slowly closing
- Increases result of decreases in overall
mortality and infant mortality and due
to increases in medical knowledge,
treatment and technology
Mortality Diagram

HSC Past Paper Multiple Choice

1. A limitation of epidemiology as a measure of health status is that it (HSC 2018, Qu. 7)
a. Is rarely used by health professionals and policymakers
b. Only produces information on the mortality of a population
c. Does not explain the sociocultural risk factors that contribute to the negative health
behaviours
d. Identifies broad trends only, without reference to accurate data regarding illness and
disease
2. Based on statistics, Australia has a very high incidence of cancer when compared to most
developed countries. To what is this mainly due? (HSC 2018, Qu. 17)
a. Poor dietary habits
b. Higher rates of smoking
c. Successful screening programs
d. Increased spending on sun protection
3. In Australia, women have a higher health status than men. What is the most likely reason
for this? (HSC 2017, Qu. 12)
a. Females are more likely to seek medical assistance than males
b. Females have much higher rates of health literacy than males
c. The types of health care services available for males and females differ
d. Heredity and lifestyle factors have a greater effect on males compared to females
4. Which row in the table shows the leading causes of mortality in Australia since 2013? (HSC
2017, Qu. 18)
5. Which combination of factors is most likely to account for the difference in life expectancy of
females and males in Australia today? (HSC 2015, Qu. 17)
a. Males are less likely to engage in unsafe behaviours and less likely to visit a doctor
regularly.
b. Females are less likely to engage in unsafe behaviours and more likely to visit a
doctor regularly.
c. Males are more likely to work in lower risk occupations and more likely to participate
in organised physical activity.
d. Females are more likely to work in lower risk occupations and less likely to
participate in organised physical activity
6. Which of the following terms describes the level of illness in a given population? (HSC 2014,
Qu. 1)
a. Mortality
b. Morbidity
c. Prevalence
d. Health status
7. What is the purpose of epidemiology? (HSC 2014, Qu. 3)
a. To identify causes and patterns of disease in a population
b. To track hospital admission rates and ambulance response times
c. To determine how health care budgets are managed by governments
d. To monitor prescription medicines being administered by doctors to their patients
8. Which of the following measures is NOT used to determine the health status of the
population? (HSC 2013, Qu. 2)
a. Mortality
b. Morbidity
c. Quality of life
d. Life expectancy
9. In Australia, men have a lower health status than women. What is the most likely reason
for this? (HSC 2013, Qu. 10)
a. Types of health care services available
b. Unwillingness to seek medical assistance
c. Heredity and lifestyle factors experienced in early life
d. Lack of knowledge and understanding of health care services
10. What is the current leading cause of death for both males and females in Australia? (HSC
2011, Qu. 1)
a. Cerebrovascular disease
b. Coronary heart disease
c. Lung cancer
 d. Diabetes
11. In recent times, there has been a decrease in cancer related deaths and an increase in new
cancer cases in Australia. These changes are most likely to be the result of: (HSC 2010, Qu.
4)
a. Improved detection and increased survival rates.
b. Improved detection and decreased skin cancer rates.
c. An increase in healthy eating and physical activity habits.
d. An increase in the Australian population and the influence of gender and family
history.
12. The table shows the data related to leading causes of death, by sex, in Australia in 2013.
(HSC 2018, Qu. 15)

13. Which of the following identifies the two types of cardiovascular disease with the highest
rates of mortality in Australia? (HSC 2019, Qu. 8)
a. Stroke and angina
b. Stroke and coronary heart disease
c. Peripheral vascular disease and angina
d. Peripheral vascular disease and coronary heart disease
14. Which of the following identifies epidemiology trends in Australia over the past ten
years? (HSC 2019, Qu. 18)
Answers
1 2 3 4 5 6 7 8 9 10 11 12 13 14
C C A C B B A C B B A D B B
HSC Question: Outline the measure of epidemiology (HSC 2017), (Question 21a), (3 marks)
Epidemiology is the study of the patterns and causes of health and disease in population groups.
There are four measures: Infant mortality is the measure of the annual number of deaths of
children under 1 born per every 1000 live births. Life expectancy is the average number of years a
person can expect to live, depending on their age and gender. For example, people born in the
period 2003-05, the average life expectancy at birth for males was 78.5 years and for females 83.3
years. Morbidity rate is the level of disease in populations and can be indicated through
prevalence and incidence. Lastly, the mortality rate is the annual death rate and measures the
number of deaths per specific cause. For example, in 2014-16 coronary heart disease was the
leading cause of death for individuals aged 75+.
Marking Criteria

HSC Question: Describe the limitations of epidemiology (HSC 2017), (Question 21b), (4 marks)
Epidemiology has several limitations. Specifically, epidemiology is limited because it does not
account for the health determinants. For example, it does not consider the social, socioeconomic,
environmental and sociocultural factors that shape heath. Moreover, epidemiology cannot provide
the whole health picture. For example, epidemiology reports on the physical health of a
population but does not take into account the social, emotional or spiritual health of a group. This
limits epidemiology because these dimensions of health, contribute to and shape physical health.
Marking Criteria

HSC Question: Outline TWO indicators of morbidity. Include examples in your answer (HSC, 2013),
(3 marks)
The two indicators of morbidity are prevalence and incidence. Prevalence is the number of total
cases of an illness in a population or population group. For example, the ATSI population have a
higher prevalence of diabetes than Non-ATSI individuals. Moreover, incidence is the number of
new cases in a population in a given time. For example, between 1982 and 2016, the number of
new cancer cases diagnosed more than doubled, from 47,000 to approximately 130,500.
Marking Criteria

Identifying Priority Health Issues

Summary
Measures How is this measure Example/s
used to identify priority
health issues?
Social Justice Principles It is the building blocks - Additional health funds to
The notion of eliminating (foundational = key the priority groups
inequity in health, promoting areas) to identifying the - CVD disease which is
inclusiveness of diversity and health priority issues to caused by obesity or an
establishing supportive allow for resource unhealthy diet can be
environments maximisation and addressed through the
distribution healthy canteen initiative
which is an example of
supportive environments
 making healthy choices
accessible
Priority Population Groups Can help identify health - Age groups or
Population subgroups with issues that affect socioeconomic status
inequitable health status particular groups. If there
 are population groups - ATSI have higher rates of
with a high prevalence it diabetes
is more likely to be - Elderly have high rated of
identified as a health CVD, Dementia and
priority group Alzheimer’s disease and
lung cancer
Prevalence of Condition The more prevalent the -
CHD has the highest
Total number of cases in a given issue the more likely it is prevalence
population at a given time going to be prioritised
Potential for Prevention and The greater the chance of - Skin cancer – sunscreen
Early Intervention prevention and early and hats – screening –
Preventing is the stopping of intervention, the more chemotherapy
disease, early intervention is likely the disease/illness
screening or intervention will be made a priority, so
techniques treatment is more
successful
Costs to the Individual and - Financial loss (i.e. - Dementia – high costs to
Community cost of treatment) the family – individual cost
- Time and government cost
Individual Community - Loss of
productivity/ability
Direct – Direct – costs to work
costs that spent on - Diminished quality
can be prevention, of life
measured diagnosing, and - Emotional stress
Indirect – treating the sick
costs that Indirect costs –
are the value of the
emotional, output lost
social etc when people
become too ill to
work or die
prematurely
HSC Past Paper Multiple Choice
1. Which of the following results of illness have indirect costs to the community? HSC 2010
a. Absenteeism, education and screening, loss of potential earnings
b. Absenteeism, loss of potential earnings, retraining in the workplace
c. Loss of potential earnings, pharmaceutical prescriptions, absenteeism
d. Loss of potential earnings, retraining in the workplace, pharmaceutical prescriptions
2. The criteria used to determine Australia’s priority health issues are: HSC 2010
a. social justice principles, potential for prevention and morbidity rates
b. priority population groups, life expectancy and social justice principles
c. cost to individual and communities, mortality rates and social justice principles
d. social justice principles, priority population groups and prevalence of condition
3. Four health conditions identified as W, X, Y and Z are shown in the following graph. HSC 2011
 Which of these conditions is most likely to be identified as a health priority issue?
a. W
b. X
c. Y
d. Z
4. Which of the following is a clear example of social justice principles in action? HSC 2012
a. providing children and infants with priority health care in all instances
b. providing public health policies that are passed by government officials
c. providing health materials and services that are delivered in a variety of languages
d. providing incentives for people of higher socioeconomic status to use private health
care facilities
5. Immunisation information is provided in a range of languages. HSC 2016

Which of the following best relates to the principle of social justice that is being applied in
this case?
a. Reducing equity
b. Recognising diversity
c. Reorienting health services
d. Establishing supportive environments
6. Which of the following is an example of an indirect cost of chronic disease? HSC 2016
a. Purchasing medicine
b. Bulk billing a visit to the doctor
c. Purchasing a gym or health club membership
d. Training replacement workers to cover sick days
7. Which of the following does the government consider to be most significant when
prioritising funding for Australia’s health issues?
a. The mortality rate and individual’s ability to deal with it
b. The burden of illness and the potential for reducing this burden
c. The morbidity rate and the number of health services already available
d. The prevalence of illness and the socioeconomic capacity of the affected community
Answers
1 2 3 4 5 6 7
B D B C B D B
Critical Question 2: What are the priority issues for improving Australia’s health?

Syllabus

Groups Experiencing Health Inequities

Definition of Health Inequity

 Health Inequity: refers to the unjust impact/differences in levels of health status between
groups in a society due to social, economic, environmental or cultural factors such as income,
education, or access to health services
General
- Health is to a large extent, the result of people’s decisions about health behaviours
(eating a healthy-balanced diet)
o An individual’s health is determined by a broader range of factors (determinants)
 Some factors have the potential to change (choosing not to smoke)
 Other factors are non-modifiable (genetic makeup)
- Health is not solely the responsibility of the individual
Aboriginal and Torres Strait Islander People (ATSI)
The Nature and Extent of the Health Inequities
Nature Extent (trends/statistics) Graph
Life expectancy - ATSI have a life
The average expectancy of 10 years
number of years lower than Non-ATSI
a person can Australians – life
expect to live expectancy is increasing
but the gap isn’t closing
- Life expectancy at birth
has increased by 1.6 years
for Indigenous males and
0.6 for Indigenous
females since 2005-07
(corresponding to annual
increasing of 0.3, 0.1
years of life, respectively)
Mortality - ATSI currently have
Also known as higher mortality rates for
the death rate, all ages compared with
is the number of the rates for Non-ATSI
deaths in a - 62% of ATSI males and
given 54% of ATSI females who
population from died were under the age
a particular of 65
cause and/or - ATSI are 3 times more
over a period of likely to die from
time preventable caused
compared with Australia
as a whole
- The graph to the right
shows the leading causes
of death between 2008-
12
- High percentage of
deaths are from cancer,
CVD, injuries, respiratory
 disease and nutritional
disorders (diabetes)
- There is a 5:1 ratio for car
occupant injured in
transport
- ATSI have lower levels of
deaths for stroke and
lung cancer and coronary
heart disease
- Higher levels of deaths
for liver diseases and
suicide
Infant Mortality - Infant mortality rate for
Measure of the ATSI is twice that for Non-
annual number ATSI individuals
of deaths of - Indigenous trend tends to
children under 1 fluctuate compared to
year per every Non-Indigenous
1000 live births

Morbidity - Asthma, hearing or ear

The level of problems, and diabetes
disease in are higher for ATSI than
specific Non-ATSI
populations. The
main indicators
are prevalence
and incidence

The Sociocultural, Socioeconomic, and Environmental Determinants

Determinant Statistics (2016) Impact
What, examples To what extent, what does it lead to,
evaluate
Sociocultural - Around 1 in 9 Indigenous adults Together these statistics show the
(family, peers, spoke an ATSI language as their effects of sociocultural determinants
media, language at home. Around 2 in on ATSI health. As ATSI are brought up
religion, 5 adults spoke at least some in these communities and are greatly
culture) words of an Indigenous influenced by this culture:
language
- Almost two thirds (62%) of - Language barriers may result in
Indigenous Australians poorer access to health services
identified with a clan, language this be reduced through
or tribal group translators
- Many ATSI still feel
disempowered as a result of
 years of oppression and - separation of their native can
discrimination. In studies of result increase in risk
Indigenous communities, ATSI behaviours
people who felt a lack of - Cultural beliefs may result in
control over aspects of their ATSI people being less willing to
lives, or had experienced seek support from Western
removal from their natural health care systems and engage
family were, were likely to self- in Western education systems
assess their health as ‘fair’ or due to historical experiences of
‘poor’ discrimination and
- Nearly half (47%) of Indigenous marginalisation
families with dependent - In some cases, the role
children were one parent modelling of poorer health
families behaviours such as domestic
- Reported rates of domestic violence and smoking occur by
violence are higher amongst Indigenous family and peers
ATSI families. 1 in 5 Indigenous can perpetuate these risk
adults reported being a victim behaviours
of violence and the rate of - Negative and deficit portrayal
substantiated child protection of ATSI people in the media
notifications were 8 times may lead to the disempowering
higher than that of non- of ATSI people and increased
Indigenous children likelihood of them experiencing
- ATSI people are more likely discrimination from non-
than non-ATSI people to be Indigenous Australians -
portrayed in a negative way or stereotypes
with a ‘deficit’ view in the
media compared to non- ATSI
people
Socioeconomic - Less than two-thirds (65%) of Household income, level of education,
(education, working-age ATSI people were and employment status has very large
employment, in labour force in 2008 impacts on health outcomes and
income) - ATSI households were nearly contribute to the health gap.
2.5 times as likely to be in the
lowest income bracket and 4 - Socioeconomic determinants,
times less likely to be in the top such as: unemployment and
income bracket as non- poorer levels of education lead
Indigenous households. to increased likelihood of poor
- Nearly half of all Indigenous behavioural choices causing
children were living in jobless higher prevalence of risk
families in 2006—3 times the factors. This lower health
proportion of all children. literacy leads to increased rates
of risk behaviours such as
smoking and physical inactivity.
- Unemployment is also strongly
linked with negative mental
health outcomes and higher
rates of suicide and depression.
 - Having a lower income means
that ATSI people are less likely
to be able to access expensive
health care treatments or
preventative measures such as
fresh vegetables or gym
memberships.
Environmental - Amongst ATSI people access to - Difficulty accessing health care
(geographic health services is poorer than services and technologies
location, other Australians, contributing means that ATSI people are
access to to the gap in health outcomes. less likely to be able to receive
health services - ATSI people reported having effective treatments for
and difficulty accessing health medical conditions.
technology) services such as dentists and - Royal Flying Doctor Service,
GPs in 2008 due to long PBS and Medicare influence
waiting times or the services this positively
being unavailable. - It may also mean that ATSI
- ATSI have higher rates of people visit the doctor for
renting compared to owning a medical check-ups less
house, higher rates of frequently. This reduces the
homelessness and are more likelihood of early intervention
likely to live in rural or remote and may lead to the
locations because of their exacerbation of health
culture. conditions, contributing to the
higher rates of morbidity and
mortality from preventable
disease in Indigenous
populations.

The Role Individuals, Communities and Governments Play in Improving Inequities

Individual Communities Governments
- Take responsibility - Health services for - Supports Indigenous
for own health and Indigenous people health through
adopt more healthy that cater for need of implementation of
behaviours by a particular health promotion
reducing risk community will strategies providing
behaviours decrease the barriers funding to a number
(smoking, drug of cost, transport and of health services
taking) and cultural difference and support
increasing protective preventing access to programs targeted at
behaviours (healthy traditional reducing health
eating) healthcare inequities
- Improved access to - Involvement in the - E.g. the $805 million
education and design and Indigenous Chronic
support services implementation of Disease Package aims
empower individuals to improve the way the
 to change health programs and health-care system
behaviours interventions prevents, treats and
- Responsible for - Community groups manages the chronic
promoting health of include: diseases that affect
others through Australian many Indigenous
Australians
positive role Indigenous Doctors
modelling Association –
supports ATSI
medical students and
doctors, promotes
employment
opportunities and
training
National Aboriginal
Community
Controlled Health
Organisation
(NACCHO) –
promotes community
involvement to make
sure medical
applications are
culturally
appropriate
HSC Past Paper Multiple Choice
1. Which set of socioeconomic determinants has the greatest influence on the health inequities
experienced by Indigenous populations? (2017 HSC, Question 4)
a. Income and high-density living
b. Religious and cultural influences
c. Levels of education and employment
d. Media access and geographical location
2. Which of the following is an example of a socioeconomic determinant that influence the health
of Aboriginal and Torres Strait Islander Peoples? (2016 HSC, Question 3)
a. Racism from peers and the community
b. Remoteness of some of their communities
c. Lower completion rate of Year 12 education
d. Lack of access to appropriate health services
3. Which of the following is a sociocultural determinant that explains the increase risk of
respiratory disease for some Australians? (2015 HSC, Question 13)
a. Being unemployed
b. Affordability of medical care
c. Exposure to smoking in the family
d. Presence of hazardous chemicals at work
4. Which of the following is an environmental determinant that best explains why Indigenous
Australians have a shorter life expectancy than non-Indigenous Australians? (2014 HSC,
Question 7)
 a. The types of illness Indigenous Australians develop are more likely to result in death
b. Traditional forms of medicine are no longer widely used by Indigenous Australians
c. Indigenous Australians are less likely to have access to primary health care and
adequate
d. treatment
e. Indigenous Australians have higher rates of unemployment so they cannot afford to
visit the
f. doctor regularly
5. What would a comparison of the health status of Indigenous and non-Indigenous Australians
show? (2013 HSC, Question 7)
a. Non-Indigenous Australians have higher infant mortality rates
b. Non-Indigenous Australians have a lower prevalence of acute diseases
c. Indigenous Australians have lower hospital admission rates
d. Indigenous Australians have a higher prevalence of chronic diseases
Answers
1 2 3 4 5
C C C C D
HSC Question: Outline TWO socioeconomic determinants that contribute to health inequities
experienced by Aboriginal and Torres Strait Islander peoples (HSC 2010), (3 marks)
There are 3 socioeconomic determinants that contribute to health inequities experienced by
Aboriginal and Torres Strait Islander People (ATSI), these are: income, education and employment.
Some ATSI peoples may experience poorer levels of education which can lead to an increase in risk
behaviours such as smoking and physical inactivity. This also means this population group is
getting less information regarding protective behaviours such as eating a healthy balanced diet.
A lower level of employment/a higher level of unemployment for this population group can lead to
negative mental health outcomes which can then lead to higher rates of suicide. Furthermore, a
higher rate of unemployment means a lower level of income for ATSI which means that they are
less likely to be able to have access to expensive treatments or measures such as purchasing a gym
membership to improve their level of physical activity, which will benefit their own health
Marking Criteria

HSC Question: Explain the roles of individuals, communities and governments in addressing health
inequities experienced by Aboriginal and Torres Strait Islander peoples. Use examples to support
your answer (HSC, 2018), (8 marks)
The role of Aboriginal and Torres Strait Islander (ATSI) individuals is to take some responsibility for
promoting their own health. This can be done by increasing protective behaviours such as
consistent physical exercise and eating a healthy balanced diet or reducing risk behaviours such as
smoking and taking drugs. This improves their individual health as they become educated and
empowered to either change their health behaviours or be positive role models to others.
Therefore, to empower individuals to promote their own health they need to increase protective
behaviours and reduce risk behaviours.
The role of the community is to promote the health of ATSI through providing health services.
These services help decrease barriers of cost, transport and a difference in culture that prevents
ATSI from having adequate access. Furthermore, the role of the community is to become involved
in the designing and implementing of programs which can lead to positive health outcomes as a
result from direct consultation with the group that it is aimed at. Programs such as The Australian
Indigenous Doctors Association supports ATSI medical students and doctors, and promotes
employment and training opportunities, which allows for the greater empowerment of ATSI to
take responsibility for their communities’ health. Therefore, the role of the community is to
promote the health of ATSI through providing health services and be involved in the designing and
implantation of programs and policies.
The role of the government is to promote the health of ATSI through health promotion strategies
and programs aimed at reducing health inequities. The ‘Close the Gap’ campaign is an initiative
that uses a wide range of levels of governments to achieve equality in health status. This is done
through the reduction of infant mortalities and by increasing their life expectancy. This initiative is
also trying to close the gap in education, employment and accessibility of healthcare services. It is
aimed at specifically addressing risk taking behaviours to improve their health. Therefore, the role
of the government is to promote the health of ATSI through programs and strategies.
Marking Criteria
HSC Question: Explain how environmental determinants contribute to the health inequities
experienced by Aboriginal and Torres Strait Islander peoples (HSC, 2019), (5 marks)
Sample Answer

Marking Criteria

The Elderly
Definition of Elderly
The elderly refers to individuals aged 65. They are classified as a priority population group in
Australia as there is a large gap in health inequities with more pressure due to Australia’s
growing and ageing population
The Nature and Extent of the Health Inequities
Nature Extent (trends/statistics) Graph
Life expectancy - Life expectancy is
The average increasing for older
number of Australia, at ages 65
years a person and 85 there is a large
can expect to gap
live - Large gap between
men and women
 Mortality - 82% (380,000) of all
Also known as deaths between 2014-
the death rate, 16 aged 65+
is the number - CHD leading cause of
of deaths in a mortality for 75+
given - Dementia and
population Alzheimer’s disease 2nd
from a leading cause 75+
particular
cause and/or
over a period of
time

Morbidity - 78% of all elderly suffer

The level of from a chronic disease
disease in - 50% elderly cope with
specific 5 or more chronic
populations. disease
The main - CHD leading burden
indicators are 65+
prevalence and
incidence

The Sociocultural, Socioeconomic, and Environmental Determinants

Determinant Statistics Impact
What, examples To what extent, what does it lead to,
evaluate
Sociocultural - Among the elderly family - Family - The more supportive
(family, peers, becomes very important for an elderly person's family are,
media, health and social activity. The the more likely they are to
religion, elderly is often cared for by maintain better health and seek
culture) their children when carers are treatment for health
needed. conditions. however, whilst it is
- The elderly also begins to lose beneficial there will be a higher
friends as they age reducing reliance on their family to help
their support networks. them maintain their health.
- In 2016, 1 in 3 older people places burden on the family
were born overseas; the - Cultural beliefs/backgrounds
majority of these were born in can often influence how
a non-English speaking country families care for the elderly i.e.
- Cultural beliefs can shape how placing them in aged care
elderly people are viewed by facilities vs. caring for them at
communities (i.e. as a source of home.
wisdom vs. a burden or - Peers - A reduction in support
‘useless’ networks can have significant
impacts on elderly people’s
 - Negative stereotyping of the mental health, happiness and
elderly is common in the media longevity which will show a
and may shape community and higher level of interaction with
young people’s attitudes family to compensate the loss
towards them. of their networks
- Culture - The high percentage
of elderly people from non-
English speaking backgrounds
may impact their
ability/willingness to access
health-care services due to
language barriers or alternative
views on health care (i.e.
Eastern vs. Western medicine).
however, they can improve the
willingness/ability to access this
by providing further
information in different
languages and having
translators
- Negative stereotyping in the
media can have an impact on
elderly people’s mental health
and lead to disempowerment
where elderly people feel they
are a burden rather than a
valuable part of society
Socioeconomic - Socioeconomically, the health - Reduced income - restricts
(education, of the elderly is affected by elderly people’s choice of
employment, their reduced employment. health services. It may also
income) Retirement often brings with it result in poorer housing
a reduction in income. conditions and reduced ability
- Though many look forward to to afford health promoting
retirement or reduced products such as medication
employment, work is a place and healthy foods etc.
where friendships are - Employment - retirement or
developed and provides a sense reduced workloads decreases
of achievement and self-worth. their support networks
- There is an increase in resulting in negative effect on
volunteer work amongst the mental health and higher rates
elderly of depression
- Higher education levels and - Those who participate in
health literacy contribute to a volunteer work report
higher likelihood of elderly increased mental health and
people maintaining good higher rates of social activity.
health.
Environmental - Due to the increased incidence - Difficulty accessing health care
(geographic of chronic illnesses and services and technologies -
 location, disability amongst the elderly, results in decreased likelihood
access to access to services can become of elderly people receiving
health services difficult because the elderly effective treatment and less
and need to attend specialist frequent medical check-ups.
technology) services that may not be This reduce chance of early
available in their local areas. intervention and may lead to
- There is also a reduced level of the exacerbation of health
independency (i.e. inability to conditions,
drive, lower mobility to walk to - Increased number of facilities
places) amongst the elderly, for the elderly helps to improve
which reduces access to access to services as often
services. these locations provide services
- In recent years there has been on a regular basis, or a least
an increased number of transport to health centres.
retirement villages, hostels and
nursing homes implemented by
the Government for elderly
populations
The role individuals, communities and governments play in improving inequities
Individuals Communities Governments
- Take responsibility for - Provide health services - Government focus is
their own and other to assist elderly funding and campaigns
health by making and - Meals on Wheels - Main focus is Medicare,
supporting healthier provide food delivery to PBS and Age Pension
lifestyle choices people who are less - Other initiatives to
(quitting smoking, mobile and unable to provide information,
increasing physical access food services services, education and
activity levels, eating a easily resources
healthy balanced diet) - Retirement villages
- Increase social activity often offer a range of
by increasing contact services to the elderly
with family, joining a living there
club, moving into a
retirement village or
joining a volunteer
organisation
- Have a limited capacity
to change – income and
employment, reduced
mobility
HSC Question: Explain the determinants that contribute to the health inequities experienced by
ONE priority population group other than Indigenous Australians. In your answer, provide specific
examples (HSC, 2016), (7 marks)
The elderly (65+) are a priority population group that experience health inequities. There are three
determinants that contribute to these health inequities. These are: sociocultural, socioeconomic
and environment.
Sociocultural determinants affect health inequities through peers. The elderly experience a
reduction in support networks (friends) as they get older because of the process of life which can
have a significant impact on their mental health, happiness and longevity. This shows a higher level
of interaction with family to compensate as their networks are affected by mortality and morbidity
such as coronary heart disease or dementia and Alzheimer’s disease. Furthermore, negative
stereotyping in the media can have a further negative impact on their mental health as it can lead
to disempowerment especially when they feel they are a burden rather than a valuable part of
society. This can lead to higher rates of depression amongst this group. Therefore, sociocultural
determinants have a negative impact on the mental health of the elderly population.
Socioeconomic determinants affect the health inequities of the elderly through income and
employment. The elderly experience a reduced income which restricts their individual choices of
health services because they have a reduced workload, are retired or are unemployed. For
example, inability to access private healthcare services. Furthermore, this may further result in
poorer housing conditions and may result in a reduced ability to afford health promoting products
such as healthy foods that allows them to have a healthy balanced diet. Moreover, a lack of
employment opportunities, retirement or reduced workloads can further decrease their already
smaller support networks which can result in higher rates of depression and a negative effect on
their mental health. Therefore, socioeconomic determinants have a negative effect on the health
inequities of the elderly.
Environmental determinants affect the health inequities of the elderly through geographic location
and access to both technology and services. A lower level of mobility from the elderly can result in
difficulty accessing health care services and technologies such as cancer screenings. This can result
in a decrease in the likelihood of the elderly receiving effective treatment and less frequent
medical check-ups. This can result in a lower chance of early prevention of diseases such as cancer
and may lead to the exacerbation of their health conditions. Furthermore, geographic location can
affect the elderly living in rural and remote areas as they will struggle to access adequate and
consistent health services and technology such as breast cancer screening machines. Therefore,
environmental determinants affect the health inequities of the elderly.
Marking Criteria
High Levels of Preventable Chronic Disease, Injury and Mental Health Problems

Cancer
The Nature of the Problem
Definitions
- Cancer refers to a diverse group of several hundred diseases that are characterised by
uncontrolled growth and spread of abnormal cells
- It involves mutation
o The changed cell divides and multiplies uncontrollably, eventually resulting in the
development of a tumour
- Cells that normally work together for the benefit of the tissue continue to multiply,
starving other cells of nourishment
o This group of cells is referred to as a neoplasm
- Carcinogens are agents that are known to cause cancer
o Include chemicals, pollution, radiation, cigarette smoke, alcohol and dietary factors
Types of Tumours
- Benign tumours
o Are not cancerous
o Grow slowly, surrounded by capsule that controls spread
o May cause damage to surrounding tissues but can be cured with surgical removal
- Malignant tumours
o Are cancerous
o Without restraints of capsule, spread quickly to other parts of the body tissues
through bloodstream and lymphatic channels, invading healthy cells and causing
metastases (new or secondary tumours)
 Tumours cause sickness or death
General
- Around 90% of cancers are products of an individual’s environmental and lifestyle
Extent of the Problem (Trends)
Specific Trend
Disease Mortality and Morbidity
Lung Cancer - Lung cancer is the leading cause of cancer deaths in Australia for men and
women, yet it is largely preventable.
- It is also the most prevalent type of cancer
- Lung cancer death rates have declined in men and increased in women
(reflecting the rising number of female smokers since the 1940’s)
- The rates of male lung cancer are still 3 times that of women
- The risk of developing lung cancer is 10 times higher among smokers than
non-smokers. This risk increases with the number of cigarettes smoked
and the length of time a person has smoked.
 - Young children and adolescents are at high risk because their lung tissues
are more easily damaged
- Less than 10% of cases occur in non-smokers. In these cases, occupational
hazards and environmental factors are linked to the incidence
Breast Cancer - Breast cancer is the second leading cause of cancer-related death in
Australian women, exceeded only by lung cancer
- It affects 1 in 8 Australian women with around 47 women diagnosed each
day
- As women grow older both the risk and incidence of breast cancer rises
with majority of cases being diagnosed in women aged 40-69
- Risk factors for breast cancer include - increase age, family history, a diet
high in fat, obesity, menstruation starting at an early age, late
menopause, a late first pregnancy or not having children
- Breast cancer survival is improving in Australia and is further increased
with early detection
Skin Cancer - Skin cancer and sunspots are the most common of all skin disease
affecting Australian
- Our skin cancer rates are the highest in the world
- Skin cancer has the highest incidence out of all cancers, with incidence
rates almost quadrupling in the past two decades
- It is caused by prolonged exposure to ultraviolet (UV) radiation
- Approximately 50% of lifetime exposure occurs in early childhood and
adolescent years
- The most common types include basal cell carcinoma and squamous cell
carcinoma (non-melanoma), which are non-fatal
- However, a significant number of deaths from malignant melanoma
o Malignant melanoma behaves like an internal cancer and spreads
to other parts of the both.
- Skin melanoma is most common in males and females ages 10-59 years.
- Most skin cancers could be prevented with skin protection and early
detection
Risk and Protective Factors
Risk Factors Protective Factors
Lung Cancer - Tobacco smoking - Not smoking/avoiding
- Occupational hazards exposure
- Environment factors - PPP
- Air pollution - Lower exposure
- Second-hand smoking - Exercise
Breast Cancer - Age - Have a child
- Family history - Screening/examinations
- Diet high in fat - High diet in fruits and
- Obesity vegetables and low in
- Early menstruation fat
- Late menopause - Practice self-
- Late-age pregnancy examination
- Not having children
Skin Cancer - Tanning - Wearing protective
- Excess sun time clothing
 - Fair skin - Sunscreen
- Family history - Use fake tan
- Moles - Screenings/skin check
- Excessive and history of
sunburns
- Fair or red hair and blue
eyes
The Sociocultural, Socioeconomic and Environmental Determinants
Sociocultural Determinants - People with a family history of cancer are more at risk
Culture, family, peers, media, - The incidence of lung cancer is higher for ATSI, as they
religion tend have higher rates of smoking at an earlier age
- Access to genetic technology – difficulty testing to see if
there was a family history
Socioeconomic Determinants - People with low SES or who an unemployed have higher
Education, income, death rates because income can limit heath choices
employment such as purchasing fresh fruit and vegetables
- People in occupations involving repeated exposure to
carcinogens, such as asbestos, are more at risk of lung
cancer
- People working outdoors, such as lifeguards, are more
prone to getting skin cancer
- People with low education levels are more at risk as
poor education is linked to health choices and less
knowledge and how to access and use health services
Environmental Determinants - People living in rural and remote areas are more at risk,
Access to health services and as they tend to have less access to health information,
technology, geographic health services and devices such as breast cancer
location screening
Groups at Risk
- Men have a higher risk of being diagnosed with cancer and dying from cancer than
women, largely reflecting the different gender patterns of food, tobacco and alcohol use
o Men generally eat less nutritious diets, smoke and drink more than women and
work in more ‘at risk’ environments with greater exposure to environmental
hazards
- Women in the young and middle age have a higher rate of cancer
o Cancer rate of women in 25-54 age group is almost 3 times that in males in the age
group, reflecting the prevalence of females’ cancer (cervix, breast, ovary, uterine)
- The risk of developing cancer increases with age, so elderly people at a particular risk
o Australia – ageing population and decreased total mortality rates can expect the
number of cancer cases to continue to rise
- People from rural and remote areas and ATSI have increased risk of cancer and higher
death rate from cancer due to their reduced access to health care facilities and services
which limits their potential for early detection/intervention
HSC Question: Outline strategies that reduce the risk of skin cancer (HSC, 2011), (3 marks)
To reduce the risk of skin cancer it is important to avoid excess exposure to strong sunlight. This
can be done by not going out in the hottest parts of the day or by downloading an app that notifies
you of the times in which UV rays are the strongest. Furthermore, you can reduce skin exposure to
the sun by wearing sunscreen, a wide-brim hat, protective clothing such as long-sleeve shirts and
sunglasses to protect your eyes. Moreover, getting regular skin checks such as once a year allows
you to be able to detect moles and abnormalities earlier which allows for prevention techniques to
be more effective before it spreads allowing for the continued health of the skin.
Marking Criteria

HSC Question: Breast cancer and lung cancer are two common cancers in Australia. What are the
determinants of these cancers and why do they put some groups more at risk than the general
population? (HSC, 2011), (7 marks)
There are 3 determinants that affect lung and breast cancer in Australia. They are the
socioeconomic, sociocultural and environmental determinants. Lung cancer was the highest cause
of mortality out of all cancers in 2019 in Australia and breast cancer is a major cancer that affects
women.
Socioeconomic determinants are made up of income, education and employment. Individuals in
occupations such as builders, are involved in repeated exposure to carcinogens such as asbestos
are more at risk of lung cancer. This is because the exposure damages the lungs. Individuals with a
low socioeconomic status such as those in rural or remote areas or are unemployed will have
higher death rates due to a lower income. This can affect their access to high levels of medical care
which can help prevent the spread of breast and lung cancer. Furthermore, a poor education can
negatively affect health because individuals will have less knowledge about protective and risk
behaviours such as regular physical exercise, or a low-fat diet which can prevent lung and breast
cancer respectively. Therefore, socioeconomic determinants negatively affect those in rural and
remote areas more than the general population.
Sociocultural determinants consist of culture, family, peers, religion and media. For women and
breast cancer, those with a family history of cancer (breast) are more at risk of acquiring it
themselves. Without access to genetic technology, individuals will not be able to get genetic
testing to see if there is a family history and will not be able to take the preventative steps needed.
Moreover, Aboriginal and Torres Strait Islander (ATSI) people have a higher incidence rate of lung
cancer because it can be a part of their culture to start smoking at younger ages. For example, if
your peers start smoking at a young age there can be peer pressure to “fit in”, therefore, you
might start smoking. Hence, sociocultural determinants negatively affect ATSI and those in rural
and remote areas more than the general population.
Environmental determinants are made up of geographic location, access to health services and
technology. Individuals in rural and remote areas will have less access to services technology such
as breast cancer screenings as well as information which will reduce the rate of diagnosis and
treatment of lung and breast cancer. This is due to a lower level of quality and quantity of services
provided. Therefore, environmental determinants negatively affect those in rural and remote
areas more than the general population.
Diabetes
The Nature of the Problem
Diabetes refers to disease that affects the body’s ability to intake glucose from the bloodstream
to use as energy
Insulin is a hormone needed to allow sugar (glucose) to enter cells to produce energy
Specific Disease Description Trends
Insulin Dependent - Is a chronic condition in - Around 44,700 new cases of
Diabetes Mellitus which the pancreas type 1 diabetes diagnosed
(IDDM) – Type 1 produces little to no between 2000-17
insulin o Around 2,500 new
- Insulin is a hormone cases each year
needed to allow sugar o Average of 7 new
(glucose) to enter cells to cases per day
produce energy
Non-Insulin Dependent - A disease that occurs when - Most common type of
Diabetes Mellitus – blood glucose (blood diabetes
Type 2 sugar), is too high - Approx. 1 million Australian
- Blood glucose is the main adults (5%) had type 2
source of energy and between 2017-18 –
comes mainly from the National Health Survey
food you eat - Slightly higher rates for
men (6%) than women (4%)
- Age-specific rates for males
were higher than females
from age 45+
Prediabetes - Condition in which blood
sugar is high, but not high
enough to be type 2
Gestational diabetes - Form of high blood sugar
affecting pregnant women
Extent of the Problem (Trends)
Current Trends
- In 2017-18, one in twenty Australians (4.9% or 1.2 million people) had diabetes
o Since 2001, this rate has increased from 3.3%, however, has remained relatively
stable since 2014-15 (5.1%).
- Diabetes continued to be more common among males than females (5.5% and 4.3%
respectively)
o The prevalence of diabetes has increased for both males and females since 2001
(both 3.3%).
- As found with many chronic health conditions, the rate of diabetes increased with age
o Since 2001, the rate of diabetes has remained fairly consistent up to age 64 years
whilst older adults have experienced increases
o The rate of diabetes amongst adults aged 65-74 increased from 12.5% in 2001 to
15.4% in 2017-18
o Meanwhile, of adults aged 75 years and over, almost one in five (18.7%) had
diabetes in 2017-18, which was an increase from 11.2% in 2001
Type 2 Specifically
- 56% are males and 44% are females
 - Annual cost to Australia is $6 million
- 92% are 45yrs
- 787, 500 people with diabetes
Risk Factors and Protective Factors
Risk Factors Protective Factors
- Type 1 – genetics - Eating a balanced and health diet
- Smoking - Increased physical activity
- Limited physical exercise - Maintaining a healthy weight
- Older age (45+) - Managing cholesterol levels
- High blood pressure - Managing blood pressure
- High levels of cholesterol - Joining a prevention program
- Race
The Sociocultural, Socioeconomic and Environmental Determinants
Sociocultural - Diabetes may come from family genetics (type 1) pass through
Determinants generations
Culture, peers, media, - Peer pressure to consume excessive amounts of junk/fast food
religion, family and smoking/drinking can lead to elevated blood pressure and
high cholesterol which increases the chance of becoming a type
2 diabetic
- Different culture may restrict individual
- Chinese, Indian, Pacific Island or ATSI backgrounds are more
likely to be diagnosed with type 2
- Families that have poor diets, and sedentary lifestyles are more
likely to produce children who grow up to be similar
- The cultural attitudes towards drinking in Australia also
negatively impact health.
Socioeconomic - People with low socioeconomic status have higher rates of
Determinants smoking, alcohol consumption, imbalanced diets, obesity, and
Education, income, physical inactivity
employment - People who live in low SES, rural or remote areas, have less
awareness of health promotion and prevention strategies due
to lower levels of education. These individuals are also less likely
to eat well or exercise regularly as they are poor in funds and
education
Environmental - Living in metropolitan areas with easy access to fast food
Determinants restaurants can increases the risk of developing type 2 diabetes
Access to health due to poor diet
services and - Living in rural remote areas limit the access to adequate physical
technology, geographic activity facilities
location - people who live in rural or remote areas, including ATSI, have
less access to medical services and technology like blood
glucose monitors or insulin pumps
Groups at Risk
- Those who have family history
- ATSI, Pacific Islander and individual from Chinese or Indian background
- Men
- People of SES and people living outside major cities
- The elderly
Cardiovascular Disease (CVD)
The Nature of the Problem
Cardiovascular disease (CVD) is a chronic heart condition that interferes with the circulatory
system and thus, the ability to pump oxygenated blood around the body. Often CVD will result in
atherosclerosis – build up of plaque and fat that clogs the arteries
Specific Disease Description
Coronary Heart Disease (CHD) CHD occurs when there is a blockage in the
blood vessels
that supply blood to the heart muscle. The two
major implications of the disease are heart
attack, a complete blockage of a blood vessel
to the heart, and angina, a chest pain due to
reduced blood flow.
Cerebrovascular Disease (Stroke) A stroke is a sudden interruption in the blood
supply of the brain. Most strokes are caused by
an abrupt blockage of arteries leading to the
brain (ischemic stroke). Other strokes are
caused by bleeding into brain tissue when a
blood vessel bursts (haemorrhagic).
Peripheral Vascular Disease (PVD) PVD is a blood circulation disorder that causes
the blood vessels outside of your heart and
brain to narrow, block, or spasm. This can
happen in your arteries or veins.
Extent of the Problem (Trends)
Current Trends
- 1 in 5 Australians suffers from Cardiovascular Disease (CVD), It is currently the second
leading cause of death in Australia.
- Cardiovascular Diseases accounts for the second biggest burden of disease
- CVD is the costliest disease in Australia
o CVD is responsible for 84 Million prescriptions per year at a cost of $3.3 Billion.
- The trends in deaths as a result form CVD is falling 73% in the last 30 years
o This downward trend is mostly due to medical improvements and surgical
treatment
- The rate of strokes has fallen by 25% in the last 10 years, while the total number of
people who have had a stroke has increased by 6% over the same 10-year period
- Just over ⅓ of people who have a stroke have a resulting disability
- Hospitalisation rates for stroke have fallen 17% in the last 10 years
Risk Factors and Protective Factors
Risk Factors Protective Factors
- Unhealthy diet, physical inactivity, - Regular physical activity
tobacco use and harmful use of alcohol - Eating a diet low in saturated fat, salt
- A family history of heart disease and cholesterol
- Age – risk increases - Low consumption of alcohol
- Maintaining a healthy weight
- Appropriately managing stress
- Avoiding exposure to tobacco smoke
The Sociocultural, Socioeconomic and Environment Determinants
Sociocultural - Genetics
Determinants - Individuals may inherit and adapt to their family’s lifestyle e.g.
Culture, peers, media, smoking, unhealthy diet
religion, family - Peers may also pressure/influence individuals to make poor
health choices
Socioeconomic - Education about CVD at an early age will influence future
Determinants lifestyle choices
Education, income, o Also enables the possibility of employment, which will
employment lead to the individual’s source of income to be able to
undertake health promoting activities
- Low SES families will have less opportunities to participate in
healthy choices e.g. joining the gym, buying food for a healthier
diet
Environmental - Rural and remote areas have less access to health services
Determinants - Lower chances of diagnosis and treatment
Access to health - Less access to treatment options in rural and remote areas
services and
technology, geographic
location
Groups at Risk
- Individual’s that smoke has much higher rates of CVD
- Rural and remote people, who have a much higher burden from stroke compared to
people in major cities
- People with a low SES, have a 40% higher death rate from CVD
- Individuals with high blood pressure
- Physical inactivity – being inactive can lead to fatty material building up in the arteries, if
the arteries are clogged it can cause a heart attack
- Overweight – increased total blood volume
- Individuals with high cholesterol
- Increasing age, majority of people who suffer from CVD are 65+
- People with a family history of CVD
HSC Past Paper Multiple Choice
1. What is cerebrovascular disease? (2017 HSC, Question 5)
a. A bacterial infection affecting heart valves
b. A problem with the circulation of blood to the lungs
c. A problem where the heart begins to function less effectively in its role of pumping
blood
d. A condition where the arteries supplying oxygen to the brain become impaired in
their function
2. Which group is most at risk of developing breast cancer (2017 HSC, Question 5)
a. Women who take the contraceptive pill and exercise regularly
b. Women over the age of 50 with high levels of circulating oestrogen
c. Women who have given birth to multiple children and breastfed them
d. Women with early onset menopause and using hormone replacement therapies
3. Which of the following best describes atherosclerosis (2016 HSC, Question 5)
a. Dilation of the arterial walls
b. Increased elasticity of blood vessels
c. Damage to the blood vessels in the hands and feet
d. A build-up of plaque on the interior walls of the arteries
4. Which of the following lists the most common risk factors associated with both
cardiovascular disease (CVD) and breast cancer? (2016 HSC, Question 5)
a. Ethnicity, gender, lack of physical activity
b. Family history, smoking, low sugar intake
c. Family history, obesity, lack of physical activity
d. Ethnicity, high fat diet, early onset of menstruation
5. Which of the following has contributed most to the declining prevalence of cardiovascular
disease (CVD) in Australia? (2014 HSC, Question 5)
a. Improved community awareness and treatment of CVD
b. Improved nutritional quality of food consumed by Australians
c. Increase levels of organised sport participation and exercise by those at risk of CVD
d. Increased numbers of alternative health professionals and volunteers working with
those at risk of CVD
6. In which cardiovascular condition is plaque most likely to form on the inner lining of the
arteries? (2013 HSC, Question 7)
a. Angina
b. Heart attack
c. Atherosclerosis
d. Peripheral Vascular disease
7. Which of the following best explains why breast cancer death rates are decreasing while
incidence rates are increasing in Australia? ( 2013 HSC, Question 8)
a. Enhanced detection and treatment
b. Increased use and acceptance of alternative medicines
c. Improved access to and delivery of immunisation programs
d. Advances in understanding the role of family history in surviving breast cancer after
diagnosis
8. Which of the following is a modifiable risk factor of cardiovascular disease (2011 HSC,
Question 4)
a. Age
b. Diet
 c. Gender
d. Heredity
9. Which of the following diseases is most likely to cause a stroke? (2011 HSC, Question 2)
a. A reduction of blood supply to the legs
b. Restricted oxygenated blood supply to the heart
c. A clot interrupting the blood supply to the brain
d. Cholesterol constricting the ventricles of the heart
10. Which risk factor has been linked to both heart disease and cancer? (2011 HSC, Question
6)
a. Obesity
b. Mental illness
c. Osteoporosis
d. Hypertension
11. Peripheral vascular disease is a cardiovascular disease affecting (2010 HSC, Question 1)
a. The arteries
b. The skeletal muscles
c. Blood vessels in the limbs
d. Blood vessels in the pancreas
12. In recent times there has been a decrease in cancer related deaths and an increase in new
cancer cases in Australia. These changes are most likely to be the result of (2010 HSC,
Question 4)
a. Improved detection and increased survival rates
b. Improved detection and decreased skin cancer rates
c. An increase in health eating and physical activity habits
d. An increase in the Australian population and the influence of gender and family
history
13. Which of the following are factors that protect against preventable chronic disease (2010
HSC, Question 9)
a. Maintaining a healthy weight range, not smoking, eating healthily, having regular
health checks
b. Maintaining a healthy weight range, not smoking, hypertension, having regular
mammograms
c. Maintaining a healthy blood pressure, being male, eating healthily, Maintaining a
healthy weight range
d. Maintaining a healthy weight range, not smoking, exercising regularly, being over the
age of 40
Answers
1 2 3 4 5 6 7 8 9 10 11 12 13
D B D C A C A B C A C A A
HSC Question: Explain both the risk factors and the protective factors of cardiovascular disease
(HSC, 2017), (5 marks)
There are many risk and protective factors of cardiovascular disease (CVD). CVD is a variety of
conditions that affects the circulatory system and the ability to pump oxygenated blood around
the body.
Risk factors are behaviours that contribute to the acquirement of the condition. If an individual
eats an unhealthy diet such as high in fat and sugar and undertakes low levels of consistent
physical exercise will lead an increase in obesity which increases cholesterol levels and therefore
can cause CVD. Furthermore, if an individual has a family history of a type of CVD such as coronary
heart disease (CHD), they are more likely to acquire to develop this as it is part of their genes.
Moreover, as individual increases in age, so is the likelihood of CVD. This is because the elderly
undertakes less physical exercise because of lower mobility levels and will therefore, lack the
balance needed to stay healthy. Therefore, risk factors negatively contribute to CVD.
Protective factors are behaviours that contribute to healthy behaviours that avoid the
acquirement of the condition. If an individual avoids exposure to tobacco smoke, both firsthand
and second-hand smoking, they are likely to enhance their health as tobacco smoke damages
individual’s lungs which can lead to CVD. Moreover, through the use of regular physical activity
such as 60 minutes per day and eating a healthy balanced diet that consists of fruits and
vegetables this will help individuals maintain a healthy weight which can enhances their health as
the respiratory system is healthier. Furthermore, a high level of education, can help reduce the
likelihood of CVD because individuals are more likely to see their doctor regularly and undertake
screenings and scans. Therefore, protective factors positively contribute to the health of
individuals.
Marking Criteria

HSC Question: Outline TWO groups most at risk of cardiovascular disease in Australia (HSC, 2014), (3
marks)
There are many groups that are at risk of cardiovascular disease (CVD) in Australia. CVD is a variety
of conditions that affects the circulatory system and the ability to pump oxygenated blood around
the body. Individuals’ aged 65+ are the elderly and are more at risk than the general population.
This is because a lower level of mobility can affect individual’s eating a healthy balanced diet and
undertaking regular physical activity. Furthermore, individuals that live in rural and remote areas
are more at risk of CVD than the general population. This is due to lower levels of access and
education surrounding CVD and other health conditions. With high levels of education and access
will not know the protective factors surrounding CVD and are more likely to undertake risk factors.
Marking Criteria
HSC Question: Describe the determinants of health that affect a preventable condition in Australia
OTHER THAN cancer or cardiovascular disease. Use examples to support your answers (HSC, 2018),
(4 marks)
There are 3 determinants of health that affect diabetes. these include sociocultural,
socioeconomic and environmental. diabetes is the ability for the body to take in glucose into the
bloodstream to use as energy.

Sociocultural determinants consist of family, peers, religion, media and culture. An increase in peer
pressure to consume excessive amounts of alcohol/smoke increases the likelihood of obtaining a
high cholesterol and blood pressure which can lead to the individual acquiring type 2 diabetes
(lifestyle). Furthermore, families with a consistent unhealthy diet and undertake low levels of
physical exercise are more likely to acquire diabetes. Therefore, socioeconomic determinants
affect the prevention of diabetes.

Socioeconomic determinants consist of education, employment and income. Individuals with a

lower level of education are more likely to undertake risk factors such as smoking which can lead
to as there is less awareness of health promotion campaigns and strategies used by the
government to combat and prevent diabetes. Furthermore, a low level of income can lead to an
unbalanced diet as individuals may not be able to afford healthy options. This leads to a lower
prevention of diabetes. Therefore, socioeconomic determinants affect the prevention of diabetes.

Environmental determinants consist of access to health services and technology and geographic
location. If individual’s live in areas such as the metropolitan area, there is more access to
unhealthy fast food options which can increase the risk of acquiring diabetes. Furthermore,
individuals who live in rural and remote areas don’t have the access to services and technology
such as insulin pumps which help the early detection, prevention and treatment of diabetes.
Therefore, environment determinants affect the prevention of diabetes.
Marking Criteria

A Growing and Ageing Population

Healthy Ageing
Definition
 Healthy ageing includes various behaviour and choices that affect health, such as regular
physical activity, good dietary choices, regular family contact and social activities, as well as
resilience to life’s circumstances
General
- Current population = 25.5 million
- Population predictions from 2016 to 2061 = 40 million by 2050
- Main driver for increase in population = migrants and baby fertility, longer life
expectancy
Goal of Healthy Ageing
- Enable the elderly to maintain their health into old age, which allows them to contribute
to the workforce better, and engage society better
o This increases economic growth, but decreases use of health services by the
elderly, who are the largest users of the healthcare system
What are the implications of a growing and ageing population?
- Increased pressure on health system
o Elderly individuals access health services more often than any other population
group
- Increased pressure on workforce to accommodate for changes in population
demographics
Why is it important that Australia promotes healthy ageing?
- To enable the individual to maintain their health into old age
o This allows them to work longer and engage with society better
o Decreases the pressure currently placed on health services and workforce
Increased Population Living with Chronic Disease and Disability
General
- Significant improvements in the number of people surviving heart attacks, strokes and
cancers
o Ageing population has led to an increase in the number of Australians with a
chronic disease or disability
- Chronic, non-communicable diseases account for approx. 80% of the total burden of
disease in Australia
o Estimated that they will be responsible for about ¾ of all deaths by 2020
How can future levels of chronic diseases be reduced?
- More health education
- Increased government funding
- Increased options for healthy eating
- More encouragement to improve protective behaviours
Common chronic diseases affecting Australians
- Arthritis
- Asthma
- Heart disease
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Osteoporosis
Impact of chronic diseases and disabilities on the workforce
- Men with a chronic disease are more than twice as likely to be out of the labour force
- Deaths of working age people from chronic disease also decreases potential workforce
Demand for Health Services and Workforce Shortages
General
- Concern that many people suffering poor health are unable to contribute to workforce,
leading to general shortages of labour
- Consequence of increase in population living with a chronic disease or disability, is that
the demand for health and aged care services has risen
Government Proposed Initiatives to Meet Needs of Older Australians
- Subsidised or incentives for people to go into healthcare areas
- Increased funding and resources into health facilities
- Increased support for community services
- Supporting carers more
Government Actions of Improving Retirement System
- A means tested age pension is available to provide income for people after retirement
- All Australian employers are required to provide compulsory superannuation cover for all
eligible employees
- Under the superannuation guarantee, the minimum level of superannuation cover made
by employers is 9% of an employee’s gross salary
- Voluntary, private superannuation contributions and other forms of private savings, made
by employees, are also encouraged
Availability of Carers and Volunteers
Carers
Definition
A carer is someone who provides assistance in a formal paid or informal unpaid role for
someone due to illness, disease or disability
Usually long-term care
Primary carers are individual’s 15+ who provide the majority of ongoing informal assistance
Formal Care
- Varied in order to meet demands
- Aged care can be provided through community aged care or residential aged care
- Care provided often includes daily activities such as:
o Bathing
o Cooking
o Home upkeep
o Administering medications
Informal Care
- Most informal unpaid carers are family members, particularly children or a spouse
o Informal carers often decrease their workload in order to provide care to their
loved ones
- Many carers come from charities, religious institutions, or the government
- There are three types of community are:
o Community aged care packages
 Provide low-level care-giving basic support and assistance with daily
activities
o Extended aged care at home
 Providing a higher level of care than the community aged care packages
above
o Extended aged care at home dementia
  Catering for the more complex needs of those with dementia
General
- Increase in demand has coincided with a shortage which has increased reliance on
community and government aged care facilities
o Resulted in reduced level of quality of life for elderly individuals
- Long durations and a high level of complexity of care negatively affects the quality of care
- Carers often experience a compromised level of financial security (out-of-pocket
expenses) and poorer mental health outcomes (less time to maintain own social
wellbeing)
- Often ignore own health which exacerbates physical and mental conditions associated
with their role
Volunteers
Definition
A volunteer is a person who offers to perform unpaid duties for the community, given as time,
service or skills
Usually short-term/sporadic care
General
- Numerous volunteers complement the care provided through the community service
workforce
- Volunteers often cook, drive, housework, visit, help the elderly shop
- Rates of volunteers have increased between 1995 to 2010 but between 2010-14 the rate
fell
Formal Groups
- Social such as sport
- Recreation
- Religious
- Heritage
- Civic participation – unions, professional associations or political parities
Volunteer Organisations
- Anglicare
- Alzheimer’s Australia NSW
- ARV (Anglican Retirement Villages)
- Your Aged Care at Home Ltd
- Independent Community Living Australia
- Nursing on Wheels
Practice Question: Assess the impact of a growing and ageing population on the carers of the
elderly, and on the system, services and health workforce (8 marks)

Australia’s population is growing and ageing. A growing and ageing population has and will
continue to place increasing pressure on the carers of the elderly, Australia’s health system,
services and workforce.

A carer is a person who, through family relationships, friendships, governments or community

groups provide assistance to an elderly individual. This can be in the form of an informal unpaid or
formal paid role. An increase in demand for carers has coincided with a shortage which has
increased reliance on community and government aged care facilities. This has resulted in a
reduced level of quality of life for elderly individuals. Longer duration and high level of complexity
also negatively effects the quality of care from carers. Carers often experience a compromised
level of financial security through taking responsibility for out-of-pocket costs such as medical
supplies. Therefore, a growing and ageing population has a negative effect on the informal and
formal carers of the elderly.

A growing and ageing population has resulted in a substantial increase in the reliance on the
health system and services which has placed additional pressure on the system. An increase in age
is associated with a growing number of health conditions, with the levels of lifestyle diseases such
as diabetes, dementia and cancer for the elderly rising. This increases pressure to adjust to the
growing impact of chronic disease. In the next generation of elderly individual’s there will be a
greater understanding and awareness of health issues, which will increase expectations and
influences the delivery and engagement of the healthcare services provided. Therefore, a growing
and ageing population has caused an unsustainable burden on the health system and services due
to the increasing demand in this sector.
A growing and ageing population has coincided with an increase in the demand for the healthcare
system and services but has brought about a shortage in the health workforce. Australia’s health
labour force is large, diverse and covers many occupations, ranging from support staff to highly
qualified professionals. The growing and ageing population means there needs to be an adequate
workforce, not only the amount of workers but the skills and distribution throughout the country.
An effective way to maximise productivity of the workforce is to coordinate care and the safe use
of medication. For example, My Health Record is an effective way to keep a summary of
individual’s health information and it is used widely ranging from public and private hospitals to
community pharmacies. Therefore, the growing and ageing population has negatively increased
the pressure to provide efficient and effective care on the healthcare workforce.
Marking Criteria

HSC Past Paper Multiple Choice

1. Which of the following best describes healthy ageing? (2016 HSC, Question 17)
a. Ageing at a healthy rate and trying to look younger
 b. Increasing the proportion of people who consume healthy foods throughout their life
c. Reducing the risk of illness and disease when growing older by maintaining physical,
dietary and mental health
d. Reducing the number of people who die at a young age from illnesses related to
heredity and genetic factors
2. What is the most likely consequences of a growth in the percentage of aged people in the
Australian population? (2014 HSC, Question 17)
a. Higher demand for medical services provided by hospitals
b. Better research into the effects of medication for aged people
c. Increased revenue from private patients in Australia's health care sector
d. More employment opportunities for aged people in the health care sector
3. To which of the following does the concept of ‘health ageing’ refer? (2013 HSC, Question
9)
a. Treating elderly people for commonly reported conditions
b. The behaviours and activities that contribute to quality of life for elderly people
c. Providing appropriate facilities and services to accommodate aged and elderly
people
d. Reducing the effects of poor health choices made in early adulthood that create risks
to health status later in life
4. What action has been taken to reduce the impact of an ageing population on the health
care system in Australia? (2012 HSC, Question 9)
a. Increasing the Medicare levy for older people
b. Reducing funding available to carers of older people
c. Encouraging older people to remain in the workforce
d. Decreasing access to the health system for older people
Answers
1 2 3 4
C A D C
HSC Question: Outline THREE types of carer or volunteer organisations available to help meet the
needs of Australia’s ageing population (HSC, 2012), (3 marks)

Meals on wheels is a volunteer organisation that helps meet the needs of Australia’s ageing
population by providing subsidised nutritious meals and social interaction through weekly lunch
clubs. Furthermore, retirement facilities meet the needs of Australia’s ageing population by
providing care and services to the elderly if they need but help maintain their level of
independence. Some of the services they provide once independence levels are lower are,
maintenance of home, bathing, cooking. Moreover, informal carers, family and friends carry the
burden of meeting the needs of the elderly such as administering medication, shopping and
transport. These organisations need people that are able to be multi-skilled as the elderly
generally need a high level of care.
Marking Criteria
HSC Question: To what extent does Australia’s health care system benefit from having a healthy
ageing population? (HSC, 2017), (8 marks)
To some extent, a healthy ageing population is beneficial for Australia’s healthcare system. Healthy
ageing is maximisation of opportunities and increases quality of life.
A healthy ageing population will have a lower impact on the health resources. With individuals
living better for longer, there will be a decrease of chronic illnesses therefore, aged care facilities
and other infrastructure proposed for the elderly will have less demand. For example, less
individuals will go into Anglicare aged care facilities as they have a higher quality of life and are
able to maintain their independence. The elderly currently account for a large number of
hospitalisations which carry a large burden on the hospital systems. Moreover, carers and
volunteers are at a high demand to be able to cater for the growing and ageing population.
Healthy ageing will mean there is more supply for carers and volunteers to go into other industries
more beneficial for the economy. Furthermore, healthy ageing means individuals will contribute to
the economy for a longer period of time by being in the workforce which will increase government
inflows such as taxation. This will be more beneficial for the economy in the longer term as
government expenditure can be focused more on the health care system. Therefore, to a great
extent a healthy ageing population is beneficial for Australia’s health care system
However, healthy ageing doesn’t take into account genetic conditions such as spinal muscular
atrophy. Individuals will still age and healthy ageing doesn’t prevent individuals from acquiring
chronic illnesses such as cardiovascular disease or disability but means there is a later onset of the
burden. This means that older health care infrastructure is still needed to accommodate the
growing population because individuals cannot control if they gain genetic conditions as this is part
of their DNA. Moreover, a healthy ageing population means there will be more demand for jobs in
the workforce, but the workforce may not have the supply of jobs needed. This means that there
will be an excess supply of participants in the workforce that may result in a restructuring of the
workforce. This is because if the population is healthy ageing then there will be less demand for
specialists to deal with chronic illnesses but more demand in other sectors or industries such as
teaching, which provides many with a steady income and a stable job in a growing population.
Therefore, to no extent a healthy ageing population is beneficial for Australia’s health care
system.
Marking Criteria
Critical Question 3: What role do health care facilities and services play in
achieving better health for all Australians?

Syllabus

Health Care in Australia

General
- Healthcare facilities and services play a vital role in achieving better health for all
Australians. They:
o Provide the essential services of diagnosing, treating and rehabilitating the ill and
injured, as well as preventing illness and promoting health
o Traditional health facilities (hospitals, doctors’ surgeries) are increasingly being
used to provide accurate health information to the public
o The State and Territory governments provide services specifically aimed at both
the prevention of the disease and the promotion of health
 For example, immunisation programs, anti-smoking campaigns
- Health of Australians doesn’t only depend on provision of quality of healthcare services
and facilities, but also on factors such as:
o Housing
o Employment
o Education
o Hygiene
o Income
o Environmental safety
- For healthcare services and facilities to be effective, the healthcare sector must develop
partnerships with other sectors of the community to implement health-related activities
that promote health
- Complex interrelationships of healthcare system includes:
o Commonwealth, State/Territory and Local governments
o Health insurance funds
o Institutions
o Public and private providers of services
o Other organisations
Range and Types of Health Facilities and Services
Institutional
Stay in, have a bed
Role How equitable?
Hospitals Public - In Australia, hospitals - Medicare covers the costs of
provide most institutional public hospitals making them
care. more accessible to
- Public hospitals are operated socioeconomically
and financed by the state disadvantaged people.
governments and the federal - Patients are allocated a
Gov’t. doctor by the hospital and
- They serve a greater provided with a bed — all
proportion of elderly and free of charge.
very young patients. - Equitable
- Provide more highly o Accessible to
specialised and complex everyone and can get
services, such as heart and subsidised by the
lung transplants in the large government but may
teaching hospitals. have issues with wait
- Provide same-day surgery time and beds
and take most of the non- available
admitted patients
(outpatients)
Private - Owned and operated by - Private hospitals require
individuals and community either full payment by the
groups. patient or a combined
- Provide same-day surgery payment using a private
and perform more short stay health insurer.
surgery, elective procedures - Patients may choose their
and less complex procedures own doctor but must pay for
requiring less expensive the service and
equipment, such as accommodation provided by
operations on the eye, ear, the hospital and the doctor.
nose, mouth, throat, - Not equitable
musculoskeletal system and o Have to pay for
breast private healthcare
insurance
o In urban areas rather
than rural and remote
areas
-
Nursing Homes - Nursing homes provide care - Growing industry and are
and long-term nursing expected to continue to
attention for those who are grow and Australia’s
unable to look after population continues to age.
themselves — the aged, the - The government provides
chronically ill, people with most of the funding for
nursing homes, with the
 dementia and people with a private homes requiring
disability. further payment from the
- Some nursing homes cater individual.
specifically for young people - Somewhat equitable
with a disability. o Government funding
- There are three types of at a lower standard
nursing home — private
charitable, private for profit
and state government
Non-Institutional
No bed – enter, receive, exit
Role How Equitable?
Medical Services - GPs work in medical centres, - All Australians are eligible to
(GP’s, Specialists) hospitals and many private claim refunds for their
surgeries throughout payments for medical
Australia. They are the first services outside hospitals.
point of access into medical The whole (bulk-billed) or
and health services who part of the cost of a GP
diagnose and treat minor consultation is reimbursed
illnesses by Medicare. - GP’s have
- GP’s sometimes refer their grown in order to reduce the
patients to specialists, who use of emergency services
have particular skills in a - Somewhat equitable
field of medicine as well as o Bulkbilling
the usual medical training. o Supply doesn’t meet
E.g. of specialists are the demand
cardiologists (treat heart o Rural and remote not
conditions) and fully
gynaecologists (treat accessible/specialists
disorders of the female
reproductive system).
Allied Health - Health-related services - Dentists and allied health
Services include ambulance work, provide are not generally
(physiotherapy, chiropody, dentistry, health covered by Medicare and
dentistry, OT, inspection, nursing, require the patients to either
dieticians) occupational and speech pay out of pocket, or
therapy, pharmacy, through their private insurer.
physiotherapy, optometry, However, some can claim
radiography, counselling, rebates
social work, and dietary - Somewhat/not equitable
planning and advice. o Some you can use
Medicare or private
health insurance
(payed for)
o Some services can’t
be covered
Pharmaceuticals - Pharmaceutical drugs are - Funded through the
supplied through hospitals pharmaceutical benefits
 and doctors by private scheme (PBS), which
prescription and over the provides partial payments
counter in shops. for many medications with
extra funding for people
with special needs (e.g.
pensioners)
- Somewhat equitable
o Govt subsidises a
proportion not
equitable for all
because not fully
subsidised
Responsibility for Health Facilities and Services
Funds Responsible For
Commonwealth - Has control of health system - National policy e.g. ‘Close the
(Federal) financing through the Gap’
collection of taxes: - Legislation - Regulatory
o Public and private Tobacco Laws (no smoking in
hospitals pubs and clubs)
o Primary health services, - Health promotion strategies
including medications, e.g. Go for 2 and 5 – fruit and
medical services and veg
community health
services
o Residential care e.g.
nursing homes
o Recurrent expenditure
i.e. research
o Pharmaceuticals i.e. PBS
State/Territory - Dental services - Prime responsibility for
- Rehabilitation programs i.e. providing health and
after cardiac surgery community services
- Public hospitals o Implementing hospital
services, mental,
women’s and Aboriginal
health
o Help carry out health
promotion
o Licence private hospitals
and use legislation to
operate public hospitals
o Regulate the sale and
supply of tobacco and
alcohol, the safety of
pharmaceuticals, goods,
appliances, blood
products and private
health insurers
 Local - Funds local community - Actions policies including:
programs i.e. meals on wheels, o Work Health Safety
alcoholics anonymous (WHS)
o Parks and community
spaces.
o Community health
services and clinics
o Early childhood centres
o Local health promotion
o Waste disposal
o Community health
services such as meals
on wheels.
Private - Privately owned and operated, - The private sector provides a
- Some private organisations, wide range of services, such as
such as the National Heart private hospitals, dentists and
Foundation and the Cancer alternative health services (for
Council, receive funding from example, chiropractors).
both state governments and - These services are approved by
the Commonwealth the Commonwealth
Government. Department of Health and
Ageing.
- Many religious organisations,
charity groups and private
practitioners run such services.
Community Many community groups also promote health. They are formed largely on a
Groups local needs basis and established to address problems specific to an area or
region. However, where concerns exist nationally, groups are more extensive,
usually highly structured and linked in the provision of information,
knowledge and support. Examples of prominent community groups are
Cancer Council, Cancer Support Groups, Carers Australia/NSW, Dads in
Distress, Sexual Health Services and Diabetes Australia.
Equity of Access to Health Services and Facilities
Definition
- Access to health facilities and services is about the health system’s ability to provide
affordable and appropriate healthcare to people when they require it
- Access also refers to equitable distribution of healthcare facilities and services to all
sections of the Australian population
Equity of Access
Systemic/Community Factors Individual Factors
- Shortage of qualified staff - Geographic location – rural and remote
- Lack of funding or equipment - Socioeconomic status
- Patient waiting lists for surgery or other - Culture and religious beliefs
treatment in public hospitals - Knowledge of healthcare and available
- Waiting times in outpatient clinics or services and facilities
emergency departments
Health Care Expenditure vs Expenditure on Prevention and Early Intervention
Definitions
- Healthcare expenditure includes expenditure by Australian state and territory
governments, as well as private health insurance, households and individuals
- Prevention refers to ‘approaches and activities aimed at reducing the likelihood that a
disease or disorder will affect an individual, interrupting or slowing the progress of the
disorder or reducing disability’ (WHO 2004)
Curative
- Healthcare expenditure has steadily been increasing and will continue to do while the
focus is on ‘curative’ medicine
- For example, it costs more to ‘cure’ a disease such as coronary heart disease once it has
developed than it does to fund measures to prevent the illness occurring
o In this example, early intervention might focus on education, healthy eating
practices, weight control and active lifestyle activities
o In contrast, curative measures such as treatment of heart disease, stroke, clogged
blood vessels, kidney failure, blindness and foot/leg amputation are more costly
and contribute considerably more to health expenditure.
Prevention and Early Intervention
- Major prevention activities include:
o Good hygiene
 o Safe environments
o Sanitation
o Good food and water supply
- The main early intervention strategy currently used in Australia is cancer-screening
programs (breast, prostate, skin)
- Main expenses of preventative and early intervention include:
o Immunisations
o Health promotion campaigns
o Cancer screening programs
Healthcare Expenditure (Curative Expenditure on Prevention and Early
Services) Intervention
Pros - Easier to regulate - Cheaper
- Important cost - helps the economy - Can be achieved over a large scale
 leakage - Supply vs demand
- Increases life expectancy and quality - The recognition of socioeconomic
of life and sociocultural factors
- Important for genetic diseases that - Prevention of mental and emotional
cannot be prevented issues associated with diseases
- Ethical reasons
Cons - Expensive - Low level of funding from the
- Doesn’t stop the disease but ‘treats’ government compared to GDP
it - People are still going to be sick and
- Not future focused develop these conditions
- Relies on individuals to take some
responsibility for their health
- Takes years to have an effect on the
population
- Healthy individuals may not want to
pay more taxes
Impact of Emerging New Treatments and Technology on Health Care, eg cost & access,
benefits of early detection
General
Many benefits of emerging new treatments and technologies, but there has also been an
increase in cost, raising questions of equity of access
New Treatments and Technologies
- Gene therapy technology for SMA
- MRI scanning for tumours
- Genetic engineering
- Mitochondrial replacement therapy for MELAS
- 3D printing – skull
- No touch temperature check
- HPV vaccine aimed to reduce incidence of HPV and hopefully cervical cancer
- Keyhole surgery
- Improved mechanics for joint replacements
- Nanotechnology
- Ultrasound
- New drugs for various diseases
 - Improved artificial organs
Benefits Limitations
- Improve early detection - Increased need for healthcare
- Improve treatment and prevention, expenditure if not funded through
improving treatment outcomes, Medicare, become only accessible to
improving quality of life and life people of a high SES
expectancy - Less available in rural and remote areas
– cost benefit ratio is low, and provision
becomes less cost-effective
Health Insurance: Medicare and Private
Medicare Private Health Insurance
What is it? Medicare is Australia’s universal Is extra insurance that allows people
healthcare system, established to to cover private hospital and
provide Australians with affordable ancillary expenses (such as dental,
and accessible healthcare physiotherapy and chiropractic
services) and aids and appliances
(such as glasses)
How is it paid? The funds to operate the Medicare Paid for by individuals and
system are obtained from income subsidised by the Government
taxes and the Medicare levy, paid private health insurance rebate
according to income level. This is (government contribution to your
currently 2% of a person’s taxable health insurance). This helps make
income, but can vary according to private health insurance more
individual circumstances affordable and provides an incentive
to the higher income earners to take
out private health insurance
What does it pay Medicare provides individuals with Private health insurance:
for? access to: - Provides the patient with a
- Free treatment as a public choice of specialist, GP and
patient in a public hospital care provider within the
- Free or subsidised treatment hospital system
by GPs, specialists, - It covers some of the costs
optometrists and in special for ancillary care such as
circumstances dentists and dentists and physiotherapy
allied health professionals - Begun to financially support
preventative actions such as
a gym membership
Benefits - Free to all Australians, - Choice of doctor and hospital
providing equitable access to - Insurance whilst overseas
people from all - Faster access to elective
backgrounds/SES surgery, avoiding the waiting
- Access to a variety of services lists in the public system
- PBS - Don’t have to pay the
Medicare levy surcharge
- Incentive of lifetime health
cover loading
 Limitations - No choice of doctor/care - Designed to benefit the
provided people with a high SES
- Doesn’t cover most ancillary - Expensive to take out and
care providers, other than provides those who can
allied health professionals afford it greater healthcare
and dental care provided than those who cannot
through the Allied Health o This becomes a social
Initiative justice issue, as equity
o Allows some rebate to of access it vital in
be claimed for people improving the health
who are chronically ill of ALL Australians
- Lower levels of private health
insurance are found among
the young, the elderly and
other groups with less
available income
What is PBS? - The Pharmaceutical Benefits Scheme (PBS) is an Australian
Government program that benefits all Australians by subsidising
medicines to make them more affordable
- If you are an Australian Resident and you hold a current Medicare
card, then you are eligible to receive benefits under the PBS
- Through this scheme, the patient pays a set amount for a
prescription drug ($32.90 in 2009) and the government pays the
balance of the cost of the drug to the pharmaceutical manufacturer
- Drugs are subsidised further for people with special needs,
including pensioners and concession card holders such as low-
income earners, war veterans and invalids. This subsidy reduces the
cost of a prescription to under $6.
- Jan 1st, 2020, you pay $41.00 for most PBS medicines or only $6.60
if you have a concession card
HSC Question: What are the responsibilities of each of the three levels of government for the
delivery of health services in Australia? (HSC, 2014), (4 marks)
There are three sectors of government, these are federal, state and local. Federal governments
are responsible for setting national policies. For example, the ‘Closing the Gap’ Campaign is
responsible for reducing the gap in life expectancy and improving health and literacy for Aboriginal
and Torres Strait Islander Peoples. Furthermore, the federal government is responsible for funding
pharmaceuticals though the Pharmaceutical Benefits Scheme (PBS). The PBS allows for equitable
access to pharmaceuticals such as medications for everyone. Therefore, the federal government is
responsible for national policies, funding and campaigns.
The state government is responsible for implementing health services and carrying out health
promotion campaigns. This is done through the management of public hospitals which gives
equitable access to services for everyone. Furthermore, the licencing of private hospitals allows for
higher quality healthcare for those who can afford it as there are shorter waiting times. Therefore,
the state government is responsible for implementing policies and campaigns
The local government is responsible for environment related health services such as waste disposal
and water fluoridation. This allows for improved health for all individuals by improving standard of
living through a healthy society. Furthermore, the local government is responsible for work, health
and safety (WHS). WHS is important in ensuring positive health outcomes in all workplaces and to
ensure safe practices are being undertaken. Therefore, local government is responsible for the
environment and the individuals.
Marking Criteria

HSC Question: To what extent is access to health care facilities and services equitable for all
Australians? (HSC, 2015), (8 marks)
Equity refers to the level of assistance to individuals given their situation to achieve improved
health status. Healthcare facilities and services are somewhat equitable for all Australians. Various
population groups such as Aboriginal and Torres Strait Islander People (ATSI), rural and remote
communities, low Socioeconomic status (SES) can experience some difficulties accessing these
facilities and services.
To a large extent, is healthcare facilities and services equitable for all Australians. Through the use
of Medicare, all Australians are provided with access to these healthcare facilities and services
without the worry of money. Furthermore, through Medicare, there is bulk billing where the
Medicare covers the costs of the appointment. Some GP’s use bulk billing and allow all Australians
equitable access throughout the country. Furthermore, the pharmaceutical benefits scheme
provides subsidized medication throughout Australia, allowing all Australians the opportunity to
purchase important medications at a cheaper price. Furthermore, the Australian Flying Doctor
service provides those in rural and remote areas access to doctors 24-7. This allows all Australian’s
no matter geographic location to have access to doctor services. Therefore, to a large extent,
healthcare facilities and services are equitable for all Australians.
To a limited extent is healthcare facilities and services equitable for all Australians. Individuals who
live in rural and remote areas have poorer access to healthcare facilities and services due to their
environmental determinants such as geographic location. Furthermore, ATSI individuals
experience significant differences due to language and cultural barriers due to the limited access
of education and health services and facilities. Moreover, whilst Medicare does allow for all
individuals to have access to a degree of services and facilities, it doesn’t cover specialists and
many allied health services. This could include physiotherapy, ambulances and dentists. Hence, in
public hospitals, the waiting times are longer for elective surgery which negatively affects those of
low SES status. Furthermore, Medicare only covers 10 psychology appointments each year which
makes it less accessible for those of low SES background. This can result in negative mental health
outcomes for these communities. Therefore, to a limited extent, healthcare facilities and services
are equitable for all Australians.
Marking Criteria

HSC Question: Discuss the impact of emerging new treatments and technologies in relation to
health care in Australia. Use examples to support your answer (HSC, 2018), (5 marks)
Emerging new treatments and technologies have many positive and negative impacts. These
technologies improve the quality of life due to improved care. This can be seen through the use of
keyhole surgery, which is a less invasive way of surgery that reduces recovery time. This allows the
patient to spend less time in hospital and also reduces the risk of complications. Furthermore, new
technologies allow for early detection. For example, breast cancer screening allows for individuals
to have a greater chance of recovery due to the early detection allowing for early intervention,
therefore improving quality of life and life expectancy. Therefore, there are many benefits to new
technology and treatments.
However, these new technologies have many limitations. The technologies can come at a high cost
such as the keyhole surgery equipment, which is expensive and not all hospitals have access to it.
For example, those in rural and remote areas who will have less access to keyhole and breast
cancer screening technology as it is more costly providing the equipment. Moreover, individuals
who live in rural and remote areas may have to move into major cities in order to access
technology in the later-stages of chronic disease such as dialysis machines for late-stage kidney
disease. Additionally, technology such as new glucose monitoring is expensive and because there is
a strict criteria for a subsidy it only becomes accessible to individuals with a high socioeconomic
status. Therefore, there are many limitations to new technology and treatments.
Marking Criteria

HSC Question: Describe the advantages of Medicare for Australians citizens (HSC, 2012), (3 marks)
Medicare is Australia’s federal health-care system that was established to provide all Australians
with affordable and accessible healthcare. Medicare provides all individuals access to a variety of
services such as free treatment as a public patient in a public hospital and bulk billed or subsidised
treatment from GP’s. Medicare provides equity to all individuals no matter their socioeconomic
status or background. Furthermore, individuals with a Medicare card are eligible to receive
benefits under the Pharmaceutical Benefits Scheme. This scheme heavily subsidised all medicines
and prescriptions and can be subsidised further for individuals such as pensioners and concession
card holders. This allows for equitable access to medications for all.
Marking Criteria

HSC Past Paper Multiple Choice

1. What are some features of Medicare? (2010 HSC)
a. Bulk billing, ancillary cover
b. Bulk billing, Pharmaceutical Benefits Scheme
c. Free treatment in public hospitals, Pharmaceutical Benefits Scheme
d. Free treatment in public hospitals, subsidized or free treatment by medical
practitioners
2. Which option best explains the decrease in mortality rates in Australia over the last
century? (2010 HSC)

3. What is Medicare? (2011 HSC)

a. Australia’s main private health care provider
b. Australia’s tax-funded national health care system
c. Australia’s provider of publicly subsidized medication
d. Australia’s health insurance provider for the disadvantaged
4. Which of the following is a benefit of emerging treatments and technologies in health
care? (2011 HSC)
a. Early detection of disease
b. Reduced cost for health care
c. Improved access to dental care
d. Improved participation in screening procedures
5. Who has primary responsibility for providing health care services such as public hospitals
and mental health facilities? (2012 HSC)
a. State governments
b. Local governments
c. Federal governments
d. Non-government organisations
6. Which government strategy would have the greatest potential to reduce long-term health
care expenditure? (2012 HSC)
a. Increasing spending on emergency care in hospitals
b. Directing more expenditure towards preventative health
c. Providing rebates to people with private health insurance
d. Allocating greater funding to improve existing curative health services
7. What currently is the area of greatest health care expenditure in Australia? (2013 HSC)
a. Research
b. Hospitals
c. Dental services
d. Preventative health initiatives
8. Ancillary cover in private health insurance can assist with which of the following costs?
(2013 HSC)
a. General practitioner fees
b. Prescription and other medications
c. Physiotherapy, dental services and optometry
d. Treatment as a private patient in either a public or private hospital
9. What is a benefit of emerging medical technologies? (2013 HSC)
a. They are readily accessible for all patients
b. They are inexpensive for public and private hospitals
c. They can provide a means of early detection
d. They decrease the need for Medicare and the Pharmaceutical Benefits Scheme
10. Which of the following best explains why breast cancer death rates are decreasing while
incidence rates are increasing in Australia? (2013 HSC)
a. Enhanced early detection and treatment
b. Increased use and acceptance of alternative medicines
c. Improved access to and delivery of immunization programs
d. Advances in understanding the role of family history in surviving breast cancer after
diagnosis
11. How does Medicare reflect the principles of social justice? (HSC, 2017)
a. It provides resources only to those most in need of health services and treatment.
b. It is funded by the Australian government to supply equality in health care services to
all Australians.
c. It allocates resources according to the needs of the population in order to promote
equity of health outcomes.
d. It empowers individuals and communities to be involved in planning and decision
making to achieve good health.
12. Which of the following lists three examples of institutional health care? (2018, HSC)
a. Nursing homes, private hospitals, psychiatric hospitals
b. Health promotion agencies, nursing homes, private hospitals
c. Community health clinics, physiotherapy, private health insurance
d. General practitioners, private health insurance, psychiatric hospitals
13. What is a potential benefit for individuals of emerging new surgical treatments in health
care? (HSC, 2019)
a. Higher Medicare rebate
b. Reduced waiting times for surgery
c. Greater accessibility to treatments in rural areas
d. Faster recovery time from less invasive treatments
 14. Which type of health care service has the highest expenditure by state/territory
governments in Australia? (HSC, 2019)
a. Dental services
b. Public hospitals
c. Palliative care hospitals
d. Pharmaceutical services
15. Which of the following identifies a responsibility of each level of government in
Australia’s health care system? (HSC 2019)

Answers
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
D A B A A B B C C A B A D B A
Complementary and Alternative Health Care Approaches

Definition
Complementary and alternative medicine (CAM) refers to healing practices that do not fall
within the area of conventional medicine. It encompasses health areas such as hypnosis,
homeopathy, naturopathy, meditation, herbalism and acupuncture
Complementary = beside traditional medicine e.g. chiropractic, yoga
Alternative = different to traditional medicine e.g. herbalism
Reasons for Growth of Complementary and Alternative Health Products and Services
Reasons for the Growth in CAM Products
- Recognition of CAM’s usefulness by the World Health Organisation (WHO)
- Increased number of trained personnel due to courses being provided at universities (i.e.
chiropractic)
- Effectiveness for many people for whom modern medicine has proved ineffective
- Desire for natural/herbal products
- The holistic nature of alternative medicine
- Increased migration and acceptance by Australians of the value of multicultural influences
Range of Products and Services Available
Types Examples
Biologically Based Approaches - Diets
 - Herbs
- Vitamins
Manipulative and Body-Based Therapies - Massage
- Chiropractic
- Osteopathy
- Acupuncture
Mind-Body Interventions - Yoga
- Spirituality
- Relaxation
Alternative Medical Systems - Homeopathy
- Naturopathy
- Ayurveda
Energy Therapies - Reiki
- Magnets
- Qigong
How to Make Informed Consumer Decisions
General
- Much health information is false and is promoted by people who are motivated by short-
term financial gains – these people are called ‘quacks’
- They sometimes promise quick cures on a money-back guarantee basis, and often
support their products with personal testimonies and anecdotal evidence
- Some CAM medicines are considered effective, and WHO recognises them to be valuable
and significant treatments
- When choosing any type of health or medical service it is important to investigate the
service offered and the credibility of the practitioner
Questions the Consumer Should Ask

Case Study – Gerson Therapy

Summary of Person Needing to Make an Informed Consumer Decision
- Jane 21 years old
- Diagnosed with thyroid cancer
- Doctors have suggested surgery followed by radiation treatment
- Jane would prefer to use natural alternative therapies as a cancer treatment
- Wants to try ‘Gerson Therapy’ due to Instagram influencers
Purpose What is the treatment?
http://gerson.org/gerpress/the-gerson- Gerson Therapy is a treatment that activates
therapy/ the body’s extraordinary ability to heal itself
through an organic, plant-based diet, raw
juices, coffee enemas and natural supplements
What does it involve?
Gerson Therapy involves flooding the body
with nutrients from about 15-20 pounds of
organically grown fruits and vegetables daily
What are its proposed benefits?
Uses intensive detoxification to eliminate
wastes, regenerate the liver, reactivate the
immune system and restore the body’s
essential defences
What are its potential side effects?
Unbalanced diet, hurt bowel and anus through
coffee enemas, risk of bacterial infections and
dehydration
Where can you access the treatment?
Anywhere through the Gerson Institute -
$15,000 for 2 years
Research Has it been scientifically proven to work?
http://www.cancerresearchuk.org/about- A few research studies have been done
cancer/cancers-in- internally but has not scientifically proven that
general/treatment/complementary- the treatment works
alternative/therapies/gerson-therapy Were the results conclusive (definite)/reliable
(accurate)?
No, the results were not conclusive, it was a
small sample size and done internally
therefore, not reliable
Qualifications What qualifications, training or experience do
http://gerson.org/gerpress/practitioner- the practitioners need to have?
training/ 2-3-year certification, online component and
then training camp
Gather Opinions - Doctor
- Family and friends
- Media
- Past patients
Discuss (With Gerson Practitioners) - What is the cost?
- Why should it be the first-choice
treatment?
- How long should I take the treatment?
- How do I know if it’s working?
 Evaluate Based on the information above, should this
treatment be used?
The benefits do not out-way the costs and
therefore, Jane should not use the Gerson
Therapy treatment as a means instead of
radiation treatment conventionally and
scientifically proven to work as a cancer
treatment
HSC Past Paper Multiple Choice
1. By researching the nature and benefits of a health product an individual is able to (2010,
HSC)
a. Use a holistic health approach
b. Make informed health consumer choices
c. Access alternative health care approaches
d. Access a range of complementary medicines
2. Adjusting the spine through physical manipulation is an example of which type of
alternative health care (2011 HSC)
a. Acupuncture
b. Aromatherapy
c. Chiropractic
d. Iridology
3. What is the most likely reason for the increase in the number of people seeking
alternative health care approaches in Australia? (2012 HSC)
a. Greater availability of alternative health care in public hospitals
b. Greater clinical effectiveness of alternative health care methods
c. Increased provision of Medicare subsidies for alternative approaches to health care
d. Increased acceptance of alternative medicine by the community and medical
practitioners
4. Which alternative health care treatment involves inserting fine needles into specific parts
of the body? (HSC 2019)
a. Acupuncture
b. Chiropractic
c. Homeopathy
d. Iridology
Answers
1 2 3 4
B C D A
HSC Question: What should consumers consider before choosing complementary and/or alternative
health care approaches? (HSC, 2013), (4 marks)
Before choosing complementary and alternative medicine (CAM), a non-traditional approach,
individuals should undertake research, check qualifications and discuss the use of the approach.
An individual should first start by researching whether the CAM has been scientifically proven
work, if they were conclusive results and from a reliable source. For example, the Gerson cancer
treatment has not been scientifically proven to work on patients and studies were done internally.
Furthermore, before receiving treatment individuals should check their doctor’s qualifications to
ensure that they have the correct years of studies. Ideally, this would be a university degree. For
example, the Gerson therapy treatment only requires a 2-3-year certification, with some online
and practical aspects. Moreover, an individual should discuss the benefits and limitations of this
treatment, whether it works, what is the price, and why they should use this therapy instead of
another. For example, the individual would be discussing whether to use Gerson treatment or
chemotherapy, in which chemotherapy is the conventional method which has proven to have
success. Therefore, consumers should consider a variety options before choosing CAM.
Marking Criteria

HSC Question: Using examples, describe the difference between alternative health therapies and
complementary therapies (HSC, 2016), (5 marks)
Complementary and alternative medicine refers to healing practices that do not fall within the
area of conventional medicine, that encompasses a variety of health areas. Complementary
therapies are not necessarily designed to replace orthodox medicine but are an additional
approach that can be used alongside traditional treatments. For example, a patient using
acupuncture, naturopathy and herbalism are used alongside chemotherapy to assist the patient
with pain management. Whereas, alternative health products and services are used instead of
western medicine. For example, Gerson Therapy for cancer is used to cure cancer through a
detoxification process. This is used instead of chemotherapy treatment conventionally used
Marking Criteria
Critical Question 4: What actions are needed to address Australia’s health
priorities?

Syllabus

Health Promotion Based on the Five Action Areas of the Ottawa Charter
Health & Health Promotion Definition
- Health promotion is the process of enabling people to increase control over, and to
improve their health
o Health promotion specifically looks at the individual but targets the determinants
of health
- Health is not merely the absence of disease but encompasses the emotional, mental,
physical, social and spiritual wellbeing
Levels of Responsibility for Health Promotion
Ottawa Charter Government Community Individual
Action Area
Building Creation and Involvement in the Provides input on health
Healthy Public maintenance of health implementation of issues through surveys
Policy policies such as anti- policies, that contribute and cooperating with
Laws, legislation smoking policies to the development of policies such as not
& taxation policies such as ATSI speeding and drink
contributing to ‘Close driving
the Gap’
Creating Easy access to health Taking care of Use level of knowledge
Supportive infrastructure and community groups in its and skills of health to
Environments planning, environment, such as create an environment
Environments implementation and quit lines and support that promotes health
where health is management of health groups for those who such as putting rubbish
the easy option policies such as ant- want to quit smoking in bins, not smoking
smoking ads that create
 a supportive indoors/in a car/public
environment places
Strengthening The government create Setting and Providing input, action
Community and fund community implementing priorities and leadership in
Action groups/NGOs to to improve health relation to health
Empowering promote health such as outcomes in health promotion initiatives
communities to Australian Indigenous promotion and such as individuals
advocate for Doctors Association or contributing to the lobbying local councils
their health Cancer Council development of these to fight for reduced
policies such as ATSI speed zones
contributing to the
‘Knockout Health
Challenge’
Developing Developing policies and Community groups Develop own skills in
Personal Skills funding for the providing funding for relation to health such
Empowering development of and running health as implementation of
individuals to knowledge, skills and promotion programs health advice e.g. don’t
make healthy understanding of health such as prenatal classes go outside in the hottest
choices through such as compulsory K- parts of the day
education, 10 PDHPE classes
knowledge &
skills
Reorienting Government funding Help conduct research Participating in different
Health Services and health policies that to promote health such health services such as
Shifting from a have promoted as Cancer Council being physiotherapy or gym’s
curative to preventative healthcare involved in cancer
preventative more than curative research
and isolated to healthcare, such as
coordinated immunisation programs
approach
Benefits of Partnership in Health Promotion
Benefits of Partnerships in Health Promotion
- Partnerships increase the chance of success of health promotion as individuals,
communities, government and non-government agencies are working toward a common
health goal
o Good planning and an integrated approach are more likely to occur
- Partnerships allow for greater community involvement ensuring the needs of the
community are heard & acted upon rather than imposed upon
o Such as ATSI being involved in ‘Close the Gap’ – partnership between ATSI +
Government
- Partnerships ensure the interests and needs of all groups are being met because all
groups are having a say & are involved in decision making
- Responsibility for health promotion is shared which leads to greater ownership
o Such as health school canteens – relies on the government to implement, schools
to maintain, individual school students to be responsible and buy/bring healthy
food
- Resources & expertise can be combined and shared therefore avoiding duplication, time-
wasting and reducing costs
 o Such as NGOs and government sharing research information to help the
government create and implement policies e.g. Cancer Council – ‘Slip, Slop, Slap’
How Health Promotion Based on the Ottawa Charter Promotes Social Justice
Ottawa Charter Equity Diversity Supportive
Action Area Environments
Building Healthy Public policy is Public policy accounts Policy should aim to
Public Policy designed with the aim for the diversity of our produce an
Laws, legislation & of producing equity in population, seeking to environment that
taxation health status e.g. provide for all people supports healthy
Medicare groups e.g. ‘Close the choices e.g. no smoking
Gap’ recognises in pubs/clubs – health
inequity, promoting is the easy option
diversity
Creating An environment is not In order to be Creating environments
Supportive supportive if it does supportive, the that encourage healthy
Environments not seek to provide environment must also choices is vital in health
Environments equity e.g. Royal Flying cater for the diversity promotion e.g. healthy
where health is the Doctor Service of the people in that school canteen – heath
easy option increases access in environment e.g. is the easy option
rural and remote areas translators for specific
– equity through access language groups in
hospitals/interviews
Strengthening Equity both with and Each community has its Communities that
Community Action between communities own diversity and become empowered
Empowering is important in health needs to be consulted need an environment
communities to promotion. in health promotion that supports their
advocate for their Communities of people e.g. Australia healthy choices. This
health suffering inequity in Indigenous Doctors requires access and
health need to be Association – promotes availability of services
utilised and employment and facilities e.g.
empowered in order to opportunities for ATSI groups promoting for
improve their health in this sector, allowing and wanting gyms,
e.g. ‘Knockout Health ATSI to become directly public water fountains
Challenge’ – access, involved in improving and bushwalks being
opportunity and choice their health maintained by locals
Developing All people should have Programs should be People share their skills
Personal Skills access to education personalised to cater and knowledge within
Empowering and skill development for the diversity in our their environment
individuals to regardless of population (ethnic, making it more
make healthy socioeconomic, socioeconomic, supportive e.g. parents
choices through sociocultural and geographic etc) e.g. and families, educating
education, environmental health brochures in and role modelling
knowledge & skills determinants e.g. multiple languages healthy behaviours for
compulsory K-10 children/family
PDHPE classes members
Reorienting Health Health services must Health services must Health services must
Services address the inequities meet the diverse needs help provide a
in health e.g. mental of the communities supportive
 Shifting from a health helplines such they are in e.g. environment e.g.
curative to as Beyond Blue – education on diet for ‘Knockout Health
preventative and inequity with ATSI groups who may have Challenge’ – providing
isolated to background specific cultural needs multiple service health
coordinated facilities to those in
approach rural and remote ATSI
communities
Ottawa Charter in Action
The ‘National Road Safety Strategy’ 2011-2020 Initiative
Ottawa Charter Action Area Summary of Actions Reasons for Effectiveness of
Strategy
Developing Personal Skills - Safer Drivers Course - Allows individuals to
Empowering individuals to (SFC) gain knowledge to
make healthy choices through - RYDA safety education empower individuals to
education, knowledge & skills - Media campaigns make health promoting
- Graduated licence choices
scheme - Promotes protective
behaviours
- Prevents dangerous
behaviours such as
speeding
Creating Supportive - Speed cameras - Promotes protective
Environments - Speed bumps behaviours
Environments where health is - Good road surfaces - Deters risk taking
the easy option - Effective lighting behaviours
- Traffic lights - Allows for the
- Mobile phone cameras opportunity to make
- School zones healthy choices
- Reflective bumps - Ensures safety of others
Strengthening Community - Lobbying councils - Safety of communities
Action o Potholes o Take on some
Empowering communities to o Speed limits responsibility for
advocate for their health o Provision of specific policies
speed cameras or issues related
o Provision of to them
zebra crossings
Reorienting Health Services - Road safety media - Educating individuals to
Shifting from a curative to campaigns change their
preventative and isolated to - RYDA safety education behaviours
coordinated approach - Preventative healthcare
is more cost effective –
impacts QOL
- Coordinated – more
successful – more
resources
Building Healthy Public Policy - Road safety media - Makes health
Laws, legislation & taxation campaigns promotion activities
more appealing
 o ‘Don’t trust your - Prevents risk
tired self’ behaviours
o ‘Plan B’ - Targets behaviours that
o ‘Don’t text and lead to specific illness
drive’ or injuries/disability
- Passenger limits for p-
platers
- Demerit point system
- Speed laws
- Elderly driving test
The ‘Close the Gap’ Initiative
Close the Gap
The WHO has information about the global strategy to close the health gap in a generation. In
Australia Close the Gap focuses on health and life expectancy between ATSI and non-ATSI
Australians. The national plan aims to achieve equality for ATSI health by 2030.
Ottawa Summary of Actions Reasons for Effectiveness
Charter Action of Strategy
Area
Building - The Council of Australian Governments - Decreases the gap in
Healthy Public (COAG) committed to Close the Gap in a wide variety of
Policy health inequities between ATSI and non- health outcomes –
Laws, ATSI people and the ‘Close the Gap addressing specific
legislation & Statement of Intent’ was signed in 2008 health issues through
taxation - This was in line with the WHO ‘Closing the funding
Gap in a Generation’ policy - Funding to get
- In order to close the gap, Australia cultural
established a national Indigenous understanding,
representative body and provided education of ATSI
funding to upskill the workforce to meet
the challenges of remote indigenous
education
- Measurable targets for equality were also
set
Creating - To create supportive environments, - Making health the
Supportive Closing the Gap seeks to train health easy option in ATSI
Environments professionals (especially ATSI) to deliver communities
Environments primary health care and other services for o Easy access
where health ATSI people o Education
is the easy - Closing the Gap seeks to ensure fresh o Opportunities
option healthy food is available for ATSI people
and housing and waste supplies/removal
systems to improve housing quality is
developed
- The federal Police have also recruited
ATSI people and developed training
programs on policing in ATSI communities
- They have also provided extra teachers in
remote areas
 Strengthening - Closing the Gap strengthens community - Empowering
Community action by involving ATSI people and communities to take
Action community groups/elders in the planning responsibility for
Empowering at local and regional levels their own health and
communities - Closing the Gap also delivers culturally reduce the health
to advocate for appropriate primary health services by inequities of their
their health Aboriginal Community Controlled Health culture
Services
Developing - Closing the Gap seeks to increase ATSI - Through education,
Personal Skills education levels and provide primary they are becoming
Empowering health care services through Aboriginal informed to make
individuals to Community Controlled Health Services health promoting
make healthy - Closing the Gap also seeks to provide choices
choices learning support and ensure health care is - Targets specific
through provided to ATSI mothers, babies and individuals and
education, children groups in the ATSI
knowledge & community through
skills different services
Reorienting - Closing the Gap seeks to utilize primary - Education to
Health health care to both prevent and promote empower individuals
Services health in balance with curative services to shift their
Shifting from a - It provides education through health behaviours from risk
curative to services and promotes healthy lifestyles, to protective,
preventative while trying to prevent chronic disease through preventative
and isolated to - Closing the Gap also seeks to ensure ATSI health measures
coordinated communities have housing, water such as access to
approach supplies and a system that supports health services
health equality - Navigating resources
and funding to
support prevention
of specific chronic
disease more
prevalent in ATSI
communities
HSC Question: How do the five action areas of the Ottawa Charter address the principles of social
justice? Include examples in your answer (HSC, 2013), (8 marks)
There are 5 actions areas of the Ottawa Charter that address equity, diversity and supportive
environments, the 3 principles of social justice. Developing personal skills (DPS) uses education,
knowledge and skills to empower individuals to make health promoting choices. The social justice
principle of equity allows everyone access to knowledge and education to make these choices
easier. For example, compulsory K-10, PDHPE classes in schools, empowers young individuals to
gain knowledge to improve their own health. Therefore, DPS addresses the social justice principle
(SJP) of equity.
Creating supportive environments (CSE) are environments where health is the easy option for
everyone. The SJP of supportive environments empowers individuals to choose health first, when
making choices about their individual lives and encourages an environment that does so. For
example, the healthy school canteens initiative in schools, empowers children to make a healthy
choice when eating by having healthy options. Therefore, the CSE addresses the SJP of supportive
environments.
Reorient health services (RHS) is changing an approach from curative to preventative. The SJP of
equity gives everyone access to services to help promote their own health and prevent inequities
within populations that currently exist. For example, mental health helplines such as Beyond Blue
target the Aboriginal and Torres Strait Islander (ATSI) peoples as they experience a high inequity of
mental health in Australia. Therefore, RHS addresses the SJP of equity.
Building healthy public policy (BHPP) is using laws, legislation and taxation to empower individuals
to make health promoting choices. The SJP of supportive environments produces an environment
that supports healthy choices through the use of laws and legislation. For example, no smoking in
pubs or clubs’ forces individuals to make a choice whether to leave their friends to smoke or stay
with their friends. This makes health the easy option. Therefore, the BHPP addresses the SJP of
supportive environments.
Strengthening community action (SCA), empowers communities to advocate and take
responsibility for their health. The SJP of diversity, encourages all community groups to become
empowered to improve their own health and health within the community. Diversity
acknowledges a wide range of cultures and communities that experience inequities and involve
them to promote positive health outcomes. For example, the Australian Indigenous Doctors
Association, promotes employment opportunities for ATSI in this sector. This allows for ATSI
individuals to become directly involved in improving the health of their community. Therefore, SCA
addresses the SJP of diversity.
Marking Criteria

HSC Past Paper Multiple Choice

1. Which of the following initiatives is an examples of building healthy public policy as
characterized by the Ottawa Charter? (2011 HSC, Question 9)
a. Students walking or cycling to school
b. Financial grants for community sports teams
c. PDHPE classes for all children in Years K-10
d. A doctor prescribing exercise for patients at risk of diabetes
2. A doctor prescribes nicotine patches as a strategy to help patients stop smoking (2012
HSC, Question 6)
Which action area of the Ottawa Charter is the doctor implementing?
a. Building public policy
b. Developing personal skills
 c. Re-orienting health services
d. Creating a supportive environment
3. Which of the following is a government strategy that promotes the social justice principle
of diversity? (2012 HSC, Question 10)
a. Involving community groups in the planning of their local area health services
b. Increasing the amount of funding to address the health needs of ATSI peoples
c. Road safety education programs that target behaviours of adolescents
d. Legislation to ban smoking in the workplace and public spaces
4. A driver education course is an example of which area of the Ottawa Charter? (2013 HSC,
Question 4)
a. Developing personal skills
b. Building healthy public policy
c. Strengthening community action
d. Creating supportive environments
5. Which of the following is an example of reorienting health services as specified in the
Ottawa Charter? (2014 HSC, Question 4)
a. Redirecting services from cure to prevention
b. Redirecting services from private to public health care
c. Allowing health service professionals to focus on curing ill health
d. Supporting individuals to identify personal networks and services
6. For a health promotion strategy to be classified as strengthening community action, it
must (2014 HSC, Question 10)
a. Focus on a targeted health promotion for those most at risk
b. Focus policy direction and public discussion on the health promotion strategy
c. Facilitate participation from all government departments for the health promotion
strategy
d. Facilitate the funds and infrastructure for the health promotion strategy to be carried
through successfully
7. In which action area of the Ottawa Charter does the Pharmaceutical Benefits Scheme
(PBS) belong? (2015 HSC, Question 9)
a. Developing personal skills
b. Reorienting health services
c. Building healthy public policy
d. Strengthening community action
8. Members of Aboriginal and Torres Strait Islander communities are trained to deliver Quit
Smoking programs.
Which action area of the Ottawa Charter is most likely being addressed? (2016 HSC,
Question 11)
a. Developing personal skills
b. Reorienting health services
c. Building healthy public policy
d. Strengthening community action
9. From December 2012, the Australian Government required all tobacco products to be sold
in plain packaging. Why did the government do this?
a. To increase costs at the point of sale
b. To increase taxation on tobacco products
c. To provide a mix of strategies aimed at developing personal skills
d. To implement a health promotion strategy directed at changing behaviour
 10. Bike lanes have been established in built-up areas? (2018 HSC, Question 6)
What action area of the Ottawa Charter is this an example of?
a. Developing personal skills
b. Reorienting health services
c. Strengthening community action
d. Creating supportive environments
11. Which of the following is an example of a health promotion strategy which addresses the
social justice principle of diversity? (HSC 2019, Question 12)
a. Local councils designing and providing free outdoor exercise facilities
b. Introducing legislation restricting the use of mobile phones for young drivers
c. Providing health information in different languages at a community health centre
d. Reducing the cost of prescription medication for socioeconomically disadvantaged
Australians
Answers
1 2 3 4 5 6 7 8 9 10 11
C C A A A C D D D D C
Practice Question: Evaluate the effectiveness of the Ottawa Charter in improving the health status
of Australian people. Make reference to the National Road Safety Strategy 2011-2020 in your
response (8 marks)
Scaffold
Creating Supportive Environments
Creating Supportive Environments
What is it? (Definition)
Creating supportive environments allows individuals to make healthy choices easily
What does it do? How does it do it?
The National Road Safety Strategy promotes protective health behaviours through the
implementation of road infrastructure
What does it lead to?
This gives individuals the opportunity to make health promoting choices, for the safety and
welfare of themselves and others
Example
e.g. speed cameras, traffic lights and speed bumps allow individuals to make these health
promoting choices easily
How well does it do it?
The road infrastructure is somewhat effective because it empowers individuals to make these
choices to create a supportive environment. However, it is only somewhat effective as it relies
on the individual to make these health promoting decisions
Building Healthy Public Policy
Building Healthy Public Policy
What is it? (Definition)
Building healthy public policy refers to laws and legislation that force individual behaviour
change leading to improvements in health status (e.g. speed zones)
What does it do?
Public policy improves health outcomes by empowering individuals to change or modify their
actions and behaviours
How does it do it?
 Due to fear of fines, reprisals, potential for criminal convictions and fear or future disability or
injury
What does it lead to?
These policies lead to changes in behaviour and ultimately improved health conditions
Example
e.g. driving legislation such as speeding zones, fines, RBT and demerit points force individuals to
obey the limit for fear of reprisal or injury/disability resulting in improved driving and a
significant reduction in road injuries and fatalities
How well does it do it?
Public policy is a somewhat effective method in reducing road injuries and fatalities on
Australian roads. These policies rely on the individual to make heath promoting decisions.