Evaluate the role epidemiology plays in improving ...



.Evaluate the role epidemiology plays in improving Australia’s Health Status. (10)

2000 Specimen Paper

© Assess the impact that the health status of Australians has on the provision of

health care facilities and services. (10)

HSC 2001

(a) Describe the inequities of health status experienced by people of low

socioeconomic status in Australia. (5)

HSC 2002

(b) Explain why older people in Australia experience levels of health that are different from those of other population groups in Australia. (6)

HSC 2003

(c) Analyse why cancer was identified as a priority area to improve the health of

Australians.(10)

HSC 2003

b) Explain how the application of the Ottawa Charter addresses social justice principles in relation to cardio vascular disease in Australia. (15)

HSC 2004

(a) Account for the differences in the health status of men and women in Australia.

7 marks

HSC 2005

(b) Compare the impact of the ‘individual lifestyle’ and ‘new public health’

approaches to health promotion in addressing Australia’s health priorities.

13 marks

HSC 2005

b) Explain how social justice principles are being addressed in order to improve the health status of Australians. (6 marks)

ARC 2003

c) Read the newspaper article excerpt and answer the question beneath it.

“The completion of Year 12 is the most important educational step towards good career prospects, a survey commissioned by the Federal Government shows. The survey found 22% of young men who left school early were unemployed compared with 9% of young men who had completed Year 12.

Of those young women who had completed Year 12, 20% were unemployed. But over 50% of young women who left school early were unemployed.

The data shows young people who obtain tertiary qualifications do the best in the job market. But the completion of Year 12 makes the single biggest difference to job prospects.”

From The Sydney Morning Herald (19/10/02)

Examine the reasons why education has such a significant impact on health status. In your answer, outline a range of other social determinants that impact on health status. (10 marks)

ARC 2003

a) Outline how the use of epidemiological data can be limiting when

investigating priority areas for health. 5

Able 2003

Question 21 (c) (10 marks)

MARKING GUIDELINES

Criteria Marks

|•Clearly demonstrates an understanding of the health status of Australians. |9–10 |

|Discusses how this influences the provision of health care facilities and | |

|services | |

|• Demonstrates evidence of critical analysis through, for example, a | |

|discussion that acknowledges that not all needs are being met and | |

|proposing strategies to meet future health care needs | |

|• Assessment is supported by a range of relevant examples | |

| | |

|• Establishes the health status of Australians AND describes how this has |7–8 |

|influenced the provision of health care facilities and services | |

|• Discussion is supported by relevant examples | |

| | |

|• Describes the health status of Australians AND outlines how this has |5–6 |

|influenced the provision of health care facilities and services | |

|OR | |

|• Outlines the health status of Australians and describes how this has | |

|influenced the provision of health care facilities and services | |

|•Provides examples | |

| | |

|• Briefly describes health status and provision of health care facilities and |3–4 |

|services | |

|OR | |

|•A description of the health status of Australians | |

|OR | |

|•A description of the provision of health care facilities and services | |

| | |

|• Outlines the health status of Australians OR outlines the provision of |1–2 |

|health care facilities and services | |

| | |

(c)This part required discussion of how the health status of Australians impacts on the provision f health care facilities and services,with an assessment of how well and/or to what degree his has been achieved.

In this part,candidates were required to use critical inquiry and assess the impact of health tatus on the provision of health care facilities and services.Candidates who used critical nquiry discussed possibilities for strategies to meet future health care needs.High-range esponses included the measurement and identification of health status,current trends and riority areas,and population groups experiencing health inequities,with a direct relationship o the provision of health care facilities and services.Health care facilities discussed included:

• institutional/non-institutional,

• alternative medicines,

• Medicare,

• public/private health care.

Low-range responses outlined the health status of Australians or the provision of health care acilities and services without links between the two aspects.

Part (c)attracted a range of approaches from candidates.Some candidates included population roups experiencing health inequities,while others discussed current morbidity and mortality rends in relation to the priority areas.

MARKING GUIDELINES

Criteria Marks

|Describes a wide variety of inequities experienced by people of low |5 |

|socioeconomic status in Australia | |

| | |

|• Describes some inequities experienced by people of low socioeconomic | |

|status in Australia | |

|OR | |

|• Outlines a variety of inequities experienced by people of low |3–4 |

|socioeconomic status in Australia | |

| | |

|• Identifies some of the inequities experienced by people of low |1–2 |

|socioeconomic status in Australia | |

| | |

Part (a) was a straightforward question enabling the majority of candidates the opportunity to demonstrate their level of achievement.

(a) Higher order responses explored a range of inequities and were able to relate the causative features to the inequity. The characteristics of low socioeconomic status were also linked to relevant measures of epidemiology. For example, ‘lower education levels lead to less knowledge of risk factors associated with lifestyle diseases which is evident in higher mortality rates from CVD and diabetes’. The high-range responses clearly linked inequities with health status and applied syllabus terminology accurately and consistently.

Mid-range responses tended to list a variety of inequities. Low socio-economic status was often related to disadvantaged groups, for example, ATSI and rural and isolated groups. Midrange responses were characterised by general descriptions about one or two inequities and failed to link the inequities to measures of epidemiology. Some responses had well developed lists of inequities with little or no relevant description.

Low-range responses made sweeping comments, brief lists or stereotypical generalisations,for example, ‘low socioeconomic status means low income so no education’. Additionally, some candidates gave the wrong information in their responses – ‘they can’t access Medicare’

– and were unable to demonstrate any link between inequities and health status.

Question 21 (b)

Outcomes assessed:H.2

MARKING GUIDELINES

Criteria Marks

|• Explains and proposes reasons why older people in Australia experience |5 –6 |

|levels of health that are different from other groups | |

|• Uses a range of relevant and accurate examples to support answer | |

|• Presents ideas in a clear and logical way | |

| | |

|• Outlines the main features of why older people in Australia experience |3 –4 |

|levels of health that are different from that of other groups | |

|• Uses some relevant examples | |

|• Presents ideas in a clear and logical way | |

| | |

|• Identifies some ways that older people are different from other groups |1 –2 |

|OR | |

|• Identifies some aspects about the health of Australians | |

| | |

Question 21

All parts of this question proved accessible to most candidates as evidenced through the small number of non-attempts. The question allowed ample scope to distinguish between the qualities of responses. The majority of candidates were able to identify the intent of the question and its place within the syllabus.

Quality answers demonstrated understanding and application of the syllabus content. Better responses correctly applied the key verb, eg identify, explain, analyse. Better responses also included subject specific terminology appropriately and they made frequent use of relevant examples to enhance the quality and depth of their answer.

Part (b)

Better responses demonstrated a greater level of understanding by defining clear links between the health status of the aged population and the reasons for these inequalities. Many of these candidates offered a range of health inequalities that encompassed mental health conditions and the impact of a changing social structure as a result of the aging process. Answers were concise and well structured and featured the application of appropriate terminology.

Average responses tended to outline the main reasons for differences in health status. Typical responses included discussion of a number of differences such as decreased flexibility and bone density, higher rates of CVD, cancer and diabetes, as well as increased use of health care services.

These responses focused on ‚’what’ rather than the question’s intent, ‘why’.

Weaker responses identified general information about older people without making any links to the reasons they experienced different levels of health to other population groups within Australia.

Some candidates provided extensive discussion on the inequalities experienced by a range of sub population groups, eg socioeconomically disadvantaged or Aboriginal and Torres Strait Islanders.

Question 21 (c)

|• Analyses by addressing the criteria the reasons why cancer was identified |9 –10 |

|as a priority area for improving health | |

|• Uses a range of relevant and accurate examples to justify arguments | |

|• Presents ideas in a clear and logical way | |

| | |

|• Discusses,with some analysis,why cancer was identified as a priority |7 –8 |

|area for improving health | |

|• Supports discussion by using relevant examples | |

|• Presents ideas in a clear and logical way | |

| | |

|• Discusses some and outlines other reasons why cancer was identified as a |5 –6 |

|priority area | |

|OR | |

|• Describes why cancer was identified as a priority area with some links to | |

|improving the health of Australians | |

| | |

|• Outlines some reasons why cancer was identified as a priority area with |3 -4 |

|limited links to improving the health of Australians | |

|• Provides basic support for arguments presented | |

| | |

|• Identifies why cancer was selected as a priority area |1 –2 |

|OR | |

|• Identifies some relevant information about priority areas | |

|OR | |

|• Identifies some relevant information about the health of Australians | |

|OR | |

|•Identifies some relevant information about cancer | |

| | |

Part c)

Better responses featured analysis, making the relationships between the specific criteria and cancer very clear, drawing out the implications of the relationship. These responses featured relevant and accurate examples that supported cancer’s inclusion as a National Health Priority Area (NHPA), used specific terminology and were structured in a concise and logical manner.

These responses indicated the candidate had an excellent understanding of not only syllabus content, but also the skills to apply the knowledge.

Average responses demonstrated knowledge of the criteria but failed to address the question in sufficient depth. These responses lacked analysis and merely described or discussed a range of reasons why cancer was identified as a NHPA.

Weaker responses identified very general information about cancer. This included the nature of the disease and common cancers affecting the Australian population. No links were made to improving the health of Australians or decreasing the burden on Australia. Candidates were unable to identify a link to the syllabus material relating to the application of criteria for NHPAs.

|• Makes evident the relationship between the social justice principles and |13–15 |

|the Ottawa Charter in relation to cardiovascular disease in Australia in a | |

|detailed manner | |

|• Uses relevant examples to illustrate answer | |

|• Presents ideas in a clear and logical way | |

| | |

|• Makes evident the relationship between the social justice principles and |10–12 |

|the Ottawa Charter in relation to cardiovascular disease in Australia | |

|• Uses relevant examples to illustrate answer | |

|• Presents ideas in a clear and logical way | |

| | |

|• Describes links between the social justice principles and the Ottawa |7–9 |

|Charter in relation to cardiovascular disease in Australia | |

|OR | |

|• Discusses links between the social justice principles and cardiovascular | |

|disease | |

|OR | |

|• Discusses links between the Ottawa Charter and cardiovascular disease | |

|OR | |

|• Discusses links between the social justice principles and the Ottawa | |

|Charter | |

|• Supports answer with some examples | |

| | |

|• Outlines the relationship between the social justice principles, the Ottawa |4–6 |

|Charter and cardiovascular disease | |

|OR | |

|• Describes the social justice principles with limited links to either the | |

|Ottawa Charter or cardiovascular disease in Australia | |

|OR | |

|• Describes the Ottawa Charter with limited links to the social justice | |

|principles or cardiovascular disease | |

|OR | |

|• Describes cardiovascular disease with limited links to either the social | |

|justice principles or the Ottawa Charter | |

| | |

|• Identifies some social justice principles |1–3 |

|OR | |

|• Identifies action areas of the Ottawa Charter | |

|OR | |

|• Identifies some relevant information about cardiovascular disease | |

Part (b)

This question required candidates to demonstrate an understanding of the relationship between the Ottawa Charter, CVD and social justice principles. While the majority of candidates were able to identify the five action areas of the Ottawa Charter with some supporting examples relating to CVD, the better responses also highlighted concepts of social justice such as access, equity, participation and rights.

Better responses clearly explained the application of the Ottawa Charter to CVD with substantive and relevant links to the principles of social justice. Responses in this range provided quality examples that implied a deeper understanding of access, equity, participation and rights towards theattainment of good health. These responses illustrated the skills of critical thinking and analysis,

structured in a logical and concise manner.

Average responses established the link between two of the three components of the question, most commonly the five action areas of the Ottawa Charter and CVD through a range of relevant examples. Minimal links were made to the third component (most commonly social justice) and these were often implied in a general manner.

Weaker responses either provided basic information about the Ottawa Charter, CVD or social justice. Links were not evident.

21 b Suggested Answer

• Indicates how health status of Australians is measured, including infant mortality rates, mortality rates, morbidity rates, life expectancy, prevalence and incidence.

• Social justice aims to reduce the inequalities in society on those people who experience ill health due to underlying social, economic or cultural factors.

• Explains principles of social justice – eg. participation, equity, access and rights – and links these to specific ways that they are being addressed.

• Provides specific examples of strategies used to address social justice principles

|MARKS |COMMENTS |

|6 |Clearly explains the principles of social justice and shows a thorough understanding of how it is being addressed to|

| |improve health status with the use of relevant examples. |

|4 / 5 |Describes principles of social justice and shows a clear understanding of how these are being addressed to improve |

| |health status with the use of relevant examples OR |

| |Accurately identifies some of the principles of social justice and explains in detail how these are being addressed |

| |to improve health status. |

|2 / 3 |Defines social justice and shows in a generalised way how these are being addressed to improve health status |

| |OR |

| |Identifies some of the principles and links in a clear way to improving health status. |

|1 |Some relevant information. |

Suggested Answer

• Higher levels of education increase exposure to health messages and healthy behaviours. Greater knowledge, understanding and awareness of health are achieved.

• The link between higher education levels and employment can influence socioeconomic status (SES). Higher education levels increase the likelihood of being in moderate to high SES groups. Health status is proportionally higher amongst high SES.

• Lower levels of formal education increase the likelihood of unemployment. Unemployment (particularly long term unemployment) often has a damaging effect on self esteem and relationships. Potential further effects can include depression, drug use and suicide.

• Additional social determinants other than education include: SES; Employment; Ethnicity; Gender; Age; and Geographic Location

|MARKS |COMMENTS |

|9 / 10 |Demonstrates an extensive knowledge and understanding of the social determinants and their impact on health status, |

| |with special emphasis on education. Provides a range of relevant examples to support their examination of the issues|

|7 /8 |Describes a range of social determinants and provides links to health status through relevant discussion and |

| |examples |

|5 / 6 |Shows a relationship between education and health status with limited focus on other social determinants OR provides|

| |a detailed description of a range of social determinant with limited links to health status |

|3 / 4 |Provides a general discussion about social determinants, OR provides a good description of education only. Limited |

| |links to impacts on health status |

|1 / 2 |SRI |

21. (a)

|Marking guidelines |Marks |

|Clearly indicates the main features of epidemiological data and the information required to identify priority|5 |

|areas | |

|Outlines the limiting aspects of epidemiological data e.g. impact of environmental factors | |

|The response is supported by a wide range of relevant examples | |

|Presents outline in a clear and logical way. | |

|Outlines the characteristics of epidemiological data with some relevant links to how it may be limiting in |3-4 |

|the identification of priority areas | |

|The outline is supported by examples. | |

|Provides some information on epidemiological data |1-2 |

|AND/ OR | |

|Provides some information on the identification of healthy priority areas | |

Syllabus Content Areas:

• Measuring health status

• Identifying priority areas

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