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HHD 2010 Sample Exam Answers

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observer7:
Hey, I just did the sample exam for the new study design from 2010, but there are no answers.
So I post this here for a guide, or if you want to contribute, feel free.

The 2010 sample exam can be found on the vcaa website if you hadn't seen it it.

SECTION A
Question 1
a.   Define ‘burden of disease’.
Burden of disease measures the impact that a particular disease or conditions places on society. Specifically, it measures the gap between the current health status and an ideal situation where everyone lives to an old age free of illness. It combines mortality and morbidity data and is measures in DALYs. (Disability Adjusted Life Years). DALYs are the combination of YYL’s + YLD’s
(Year of Live Lost due to premature death & Years Lived with Disability)
b. Briefly explain the difference between the meaning of life expectancy and health adjusted life expectancy
Life expectancy relates to the approximate total number of years a person can expect to live if currently mortality rates remain the same from birth. Whereas health adjusted life expectancy is adjusted for the time the individual spends in poor health.

Question 2
Consider the following table that compares the health status of Australia with a range of developed countries.
Use the data in Table 1 to compare the health status of Australia with that of three other developed countries listed.
•   Australia’s life expectancy is three years higher compared to that of the United Kingdom
•   Japan’s U5MR is 2 less than Australia’s per 1,000 live births
•   United States have a HALE 4 less of that of Australia
•   Japan has a far less mortality rate from cancer compared to Australia per 100,000

Question 3
Four nutrients are listed in the table below.
Complete the table by briefly outlining the function of the nutrient as a determinant of health.
Vitamin B12: assists in the functioning of the brain and nervous system and has been linked with reducing the risk of dementia.
Protein: assists in the maintenance of all body cells. This can prevent the risk of sports injuries through maintenance of muscle mass.
Vitamin A: is essential for normal vision.
Iron: forms the ‘haem’ in haemoglobin which assists in transporting oxygen around the body which can prevent anaemia.



Question 4
Nutrient Reference Values for Australia and New Zealand were released in 2006 by the National Health and Medical Research Council.
Outline the purpose of the Nutrient Reference Values in guiding dietary intake.
Nutrient Reference Values gives the proportion of each nutrient that should be consumed by the general healthy population. It is targeted at health professional such as doctors or nutritionists who have prior knowledge of nutrition. In terms of guiding dietary intake, the NRV’s can be used to develop healthy eating models such as the Dietary Guidelines, or used to develop menu plans which assist consumers in making healthy eating choices and eating a variety of foods.
Question 5
Two ways in which the federal government aims to improve the health of Australians is through the provision of Medicare and the Pharmaceutical Benefits Scheme.
a.   Describe how Medicare is funded.
Medicare is funded through taxes which are managed by the federal government. Specifically, the Medicare Levy is the standard tax placed on individuals and families, which is around 1.5% of their total income. The tax however varies depending on demographic and economic factors of the individual.
b.   What is the Pharmaceutical Benefits Scheme?
The pharmaceutical benefits scheme (PBS) is a federal government initiative that provides essesntial medicines at a subsided rate. It essentially aims to make essential medicines affordable for all Australian citizens by subsidising the cost and making it accessible.
Question 6
The United Nations has established Millennium Development Goals for achievement by 2015.
a.   Name one of the Millennium Development Goals where health is a central focus.
‘Combat HIV/AIDS, Malaria and other diseases’
b.   Briefly explain why this goal is important in promoting global health.
This goal is important as these major diseases contribute significantly to the burden of disease in developing countries and impact heavily on the lives of individuals and families. Not only do these conditions such as HIV/AIDS cause the death of individuals but they impact significantly on the health of families. In many countries it is the man who earns the sole income. If the man in a family has HIV/AIDS and cannot work, the family will not have an income and are unlikely to be able to access health services and the food and nutrition to stay healthy, let alone survive.
 
Question 7
In order to eradicate extreme poverty and hunger, AusAid programs are delivered across a range of sectors that include health, education, infrastructure, gender equality, law and order (political stability), rural development and the environment.
Explain why some AusAid programs would include a focus on gender equality to eradicate extreme poverty and hunger.

Gender equality relates to the equal opportunity of both males and females to participate in the community and live according to their needs and interests. This would be a focus of some AusAID programs because women are severely disadvantaged in many cultures and countries. It is also known that educating and teaching women is the best way to pass the knowledge and attitudes onto families. Thereby, reducing the poverty and hunger in communities by education women and promoting equal rights to pass on information and skills.

observer7:

Question 8
For many Australians, Non-Government Organisations (NGOs) are the most visible representation of development assistance and a major source of information on issues related to international development.
a.   Name one non-government organisation (NGO) based in Australia that promotes global health and sustainable human development.
Tabitha Foundation Australia
c.   Briefly explain the role an NGO plays in promoting sustainable human development.
Tabitha Foundation Australia aims to reduce the level of poverty in Cambodia specifically and assist individuals and families to be able to develop to their full potential and enhance their choices. Tabitha assists in building homes for poor families that are sustainable for future generations and allow families to live in accord with their needs and interests and ultimately enhance their choices and capabilities.
Question 9
The graph below shows the Human Development Index for Nepal and Afghanistan in comparison to their GDP per capita which is defined as the amount of income earned per head of the population.
a.   What is the Human Development Index?
It is a tool developed by the United Nations that attempts to reflect the level of human development in countries on a scale based on life expectancy, education levels and income.
b.   Explain one possible reason for the difference in the Human Development Index of these two countries, given they have the same GDP or income per capita (per head of the population).
Afghanistan may have significantly lower levels of education in comparison to Nepal.

SECTION B
Question 1
One of Australia’s National Health Priority Areas is diabetes mellitus. The spread of preventable diabetes has increased. There have been 15 000 new cases (on average) in Victoria each year over a seven-year period. This increased the total number of cases from 96 000 to about 200 000 people. Four out of five cases of diabetes are type 2 diabetes.
a.   Identify one reference to the prevalence of diabetes described in the paragraph above.
‘The total number of cases of Diabetes Mellitus in Victoria is risen to about 200,000 people’
b.   What is one direct cost of diabetes mellitus for the individual?
Treatment expenses such as medicines
c.   Name and describe one health promotion campaign that has been introduced to reduce the incidence of diabetes mellitus.
Name: ‘Life!’
Description: is a program run by Diabetes Australia. It aims to increase awareness of diabetes mellitus through information sessions, media campaigns and information provided on their website. It also targets specific groups at to educate them about how to adopt healthier lifestyles to reduce their risk of type 2 diabetes and therefore the incidence of diabetes.
Question 2
The data in the graph below shows the burden of disease for major disease groups for Australia in 2003. a. Identify the disease group that accounted for the greatest number of DALYs in 2003.
Cancers
c.   Explain one example of a behavioural determinant that acts as a risk factor for this disease.
A determinant would be smoking. Tobacco smoking increases the risk of getting lung cancer.
d.   The Ottawa Charter outlines five priority or action areas for health promotion. Identify one of these action areas and explain how it could reduce the impact on the burden of disease associated with the disease grouping identified in part a.
Priority or action area:  Develop Personal Skills
How it could reduce the burden of disease: In teaching and educating individuals about the consequences of smoking it may cause people to resist smoking tobacco. Thereby reducing the burden of disease associated with cancer.
Question 3
The graph below compares the age distribution of deaths between indigenous and non-indigenous people, 2001–2005. a. i. Select one age group where there is significant variation in the percentage of indigenous people who die compared to non-indigenous people.
Ages 25-44
ii. For the age group selected, describe two social determinants that might contribute to this variation.
1.   Access to health care – non-indigenous groups have much greater access to health care services which assists in preventing illness and also curing them once they are present.
2.   Food Security – non-indigenous population generally have better access to fresh and nutritious foods as they are generally more heavily populated in urban areas where transportation is much lower. Therefore diets high in saturated and trans fat can cause the onset of obesity, cvd and type 2 diabetes which may contribute to the variations between the two groups.
b.   Indigenous people are more likely to develop and die from cardiovascular disease than non-indigenous people. Describe cardiovascular disease.
Cardiovascular disease (CVD) refers to the conditions in relation to the heart and/or blood vessels. It generally refers to those related to atherosclerosis which is caused by high blood cholesterol and makes it harder for the heart to pump blood around the body.
c.   Explain the role of nutrition in the development of cardiovascular disease.
Cholesterol is the main contributor to the development of CVD. Therefore nutrients such as trans and saturated fats increase the low-density lipoproteins (bad cholesterol) in the bloodstream and attach to artery walls making it harder for blood to be pumped or get through.
d.   Explain one way the Australian Government could promote healthy eating to Indigenous Australians to improve their health status.
The Australian Government could develop a custom food selection model that is tailored to the needs and requirements of the indigenous population. For example, altering the Australian Guide to Healthy Eating by making it culturally sensitive and appropriate to the indigenous population so that as a whole, better decisions can be made in terms of healthy eating and reducing the risk of associated diseases.
 
Question 4
Read the following case study about the PATS program and answer the questions that follow.
Paying Attention To Self (PATS) program for adolescents
The PATS program was an initiative of the Peer Support Programs developed at the Centre for Adolescent Health and was funded by VicHealth, the Victorian Department of Human Services and Beyondblue. It facilitated and supported five programs across Victoria, located in various locations.
The PATS program involves young people, aged 12 to 18 years, who have a parent with a mental illness, in an 8-week peer support program facilitated by a health professional and a peer leader.
The main aims of the PATS program
• To reduce the likelihood of the development of mental health diffi culties in adolescents
• To decrease the risk factors for these young people
• To increase young people’s coping skills so they can better meet future challenges
Peer support leadership
The peer leader was a young person who attended a PATS program and peer leadership training. They were responsible for the social aspects of the groups, organising activities and getting the participants mixing and talking. They acted as a positive role model for the group and were able to share their own experiences and coping strategies. Peer leaders played an important role in education and advocacy through public speaking and presentations at conferences and professional development sessions.
The PATS program also focused on workers, organisations, and the broader community, creating awareness of issues affecting young people with a parent with a mental illness. Critical to this element was being able to use the voices of young people to talk about their personal experiences, which provided community members with a very strong and effective message regarding the needs of young people and how community organisations could best support them.

a.   Describe the role of VicHealth in promoting health.
VicHealth is government body that aims to promote health. VicHealth increases awareness of existing programs that promote healthy lifestyles, fund their own programs that assist in educating and empowering communities and individuals about healthy lifestyles. They also fund research to support these activities and monitor health trends in Victoria accordingly.
b. Identify one principle of the social model of health and explain how it is reflected in the PATS program.
Principle: ‘Empowering Individuals and Communities’
How it is reflected: The PATS program ‘increases young people’s coping skills so they can better meet future challenges’ through the peer support leadership. It allows adolescents to connect on a personal level and encourages them to be able to meet the challenges and problems they may face in the future positively.
b.   Discuss how the PATS program promotes the dimensions of health.
The PATS program would enhance the adolescents mental health as their well-being is improved as well as their ability to cope with the stresses of life. It also enables them to creative a supportive network of friends and peers to assist them in challenges that they may have (social health). Also, if a young person is able to effectively cope with the stress their physical health may be improved as their energy levels are sufficient to complete everyday tasks.
 
Question 5
The following table shows a range of key indicators for selected countries.
a. Using the data from the table, identify two countries that would be classified as being a developing country with high mortality. Justify using information from the table.
Country 1: Malawi
Justification: Malawi has an extremely high mortality as can be seen from the Adult Mortality rate which is roughly 473 higher than developed country, Australia. This is also an indicator of being a developed country, but also their HDI is 0.493 which classes them as a developing country (below 0.5).
Country 2: Mozambique
Justification: Mozambique is a developing country as their HDI is 0.402 which is below 5. This is generally indicative of high mortality rates. Furthermore, Mozambique has a life expectancy of only 50 which indicates that people are dying at an early age.

b. Select two countries, other than Australia, identified in the table on page 13 and draw conclusions about the major burdens of disease likely to be experienced by these two countries. Justify using information from the table.
Country selected: Sweden
As Sweden is a developed country, as can be seen by their HDI of 0.963, they are likely to have excellent food security and globalisation. Therefore this is more foods that are likely to be processed and high in saturated and trans fats contributing to obesity, cardiovascular disease and type 2 diabetes.
Country selected: India
India has only 18% of Population with sustainable access to improved sanitation which as result are likely to suffer from diseases such as diarrhoea which contribute significantly to burden of disease as well as HIV/AIDS.

c.   Using three elements that ensure sustainability of a program, describe a safe water and sanitation program that could be implemented in a country such as Mozambique.
Developing water wells in Mozambique would be an appropriate program as there is clearly lack of clean water being accessed and therefore appropriately targets that need. It would also need to train locals to manage the well which empowers the community to support utilise the well. Affordability is another consideration in terms of sustainability and seeing as though the end-users are unlikely to be able to pay, the program needs to be well-funded through agencies such as AusAID or World Vision. In terms of equity, there needs to be universal coverage to everyone in the community to be able to use the well. It should not disadvantage anyone in using the well regardless of age, gender or disability.
 

The following extract relates to AusAID in Papua New Guinea.
Question 6
A team of health workers has trudged* for hours on muddy tracks through the mountainous countryside of Papua New Guinea (PNG) to set up a health clinic in Kanga, a village not far from the Kokoda Track. With funding from AusAID, the health team is setting up clinics all through the area and training villagers in hygiene and the importance of basic health care and immunisation. The health teams are particularly welcome in the remote villages, where there is a high incidence of tuberculosis, malaria and asthma. In a province where many villagers still believe in witchcraft it is challenging to get them to go to a health clinic rather than a witch doctor. To address this, another part of the program is training community members to become village health volunteers so they can administer basic medical assistance and refer people to clinics and the Kokoda Hospital if necessary.

Describe the interrelationships between health, human development and sustainability in the program above.
In order for human development to be achieved, people usually need to have good health. The same can be said for sustainability, whereby a higher level of human development generally relates to better sustainability. In the case above, AusAID is aiming to improve the health of people in PNG. If the people are healthy and have the strength and abilities to be able to live their lives they can develop to their full potential and lead productive and creative lives in accord with their needs and interests. This then allows them to develop sustainable practices such as the teaching of locals to administer basic medical assistance and refer people to clinics. Therefore, through good health, sustainable human development can be achieved.
Question 7
The United Nations is an international organisation founded in 1945 after the Second World War by 51 countries committed to maintaining international peace and security, developing friendly relations among nations and promoting social progress, better living standards and human rights.
The United Nations promotes global health and sustainable human development through
• world peace
• security
• human rights.
Discuss how promoting world peace would enable global health and sustainable human development.
Promoting world peace between countries and regions reduces the conflict that occurs and enhances political stability. Conflict and wars have detrimental effects on individuals and communities. Infrastructure is often destroyed such as roads which can cause an inability to get food and essential resources and lead to malnutrition. By decreasing the conflict and promoting peace, infrastructure is maintained and people can remain healthy. Furthermore, being healthy and reducing conflict creates an environment in which people develop to their full potential and lead productive lives. This might mean that they can work and grow crops and food to sell to the community in a sustainable manner that can be continued for many years without the disruptions of war.

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