C4: variations in health status between population groups

Question 1

Biological factors contributing to heath status variations

Answer 1

factors relating to the body that impact h+wb
- body weight
- blood pressure
- blood cholesterol
- glucose regulation
- birth weight
- genetics (including gender)

Question 2

Sociocultural factors contributing to heath status variations

Answer 2

social + cultural conditions which people are born, grow live, work and age
- socioeconomic status (education, occupation, income)
- unemployment
- social connections & social exclusion
- cultural norms
- food security
- early life experiences
- access to healthcare

Question 3

socioeconomic status (SES)

Answer 3

refers to education, occupation, income
- the social standing of an individual compared to others in society

Question 4

Health literacy

Answer 4

the capacity of individuals to obtain, process and understand basic health info + services to make appropriate health decisions

Question 5

social exclusion

Answer 5

the segregation that people experience if they aren’t adequately participating in the society they live in – feeling disconnected, little opportunities to use resources available to them in society (eg. education, healthcare)
- can cause or be caused by mental illness

Question 6

social isolation

Answer 6

individuals who aren’t in regular contact with others

Question 7

food insecurity

Answer 7

individual’s inability to obtain healthy, affordable food

Question 8

food security

Answer 8

individual’s ability to obtain nutritious, adequete, culturally appropriate, safe food through local, non-emergency sources

Question 9

Environmental factors contributing to heath status variations

Answer 9

• housing
• work environment
• urban design + infastructure
• climate + climate change

Question 10

Aspects of housing that contribute to health status (know some not all)

Answer 10

• ventilation –> increased risk of respiratory conditions
• design + safety –> increased risk of injury, falls (stairs, balcony etc)
• overcrowding -
  -> strain on facilities –> increased risk of infectious disease
  –> less space to work/study –> reduced education/work opportunities
  –> no space to relax –> increased mental health issue rates
• sleeping conditions –> noise means poor quality sleep –> increased mental health issue rates
• security –> increased risk of intruders –> promotes fear in residents –> increased stress levels
• pollutants –> increased risk of respiratory conditions
• resources conducive to eating a nutritionally sound diet –> reduces risk of obesity + related conditions
• access to water + sanitation facilities –> reduces risk of infectious diseases

Question 11

Sanitation

Answer 11

process of eliminating contact between human and hazardous wastes (eg. human feces, sewage water)

Question 12

Factors of urban design + Infrastructure

Answer 12

• geographical location of resources (like hospitals, schools, workplace)
• infrastructure including roads + transport systems, electricity, communications systems, water + sanitation

Question 13

Infrastructure

Answer 13

the physical organisation structure needed for society to operate (eg buildings, roads)

Question 14

Elements of infrastructure (+ impact on health status)

Answer 14

• adequately maintained road systems –> decreases risk of road accidents –> reduced morbidity and mortality from road accidents
• public transport systems –> increase access to resources like food, employment, healthcare, social interaction –> promote health status
• information + communication technologies
  –> assists in maintaining social connections –> promotes mental + social health –> decreased risk of mental illness
  –> increases ability of people in rural areas to gain employment/education –> increases socioeconomic status
  –> increases ability to access health info (eg symptom checkers) –> increases health literacy
• electricity –> for heating, cooling, food storage, communication –> promotes h+wb
• water –> for drinking, cleaning, cooking, hygiene –> reduces risk of infectious diseases –> promotes h+wb
• adequate sanitation –> like sewage systems –> eliminates wastes from environment –> reduced risk of infectious diseases
• access to adequate public spaces (eg parks) + recreational facilities –> promotes physical activity + social interaction –> reduced risk of mental health problems & obesity

Question 15

Variations in Indigenous Australians: Biological factors – body weight

Answer 15

• have higher BMI rates across all age groups –> increased risk of CVD, type 2 diabetes, osteoarthritis
• indigenous adults obesity rate is 1.5 x higher than non indigenous population –> increases risk of syndrome X

Question 16

Variations in Indigenous Australians: Biological factors – blood pressure

Answer 16

Aboriginals are 1.3 x more likely to report hypertension –> risk factor for stroke + heart disease

Question 17

Syndrome X

Answer 17

when a person is genetically disposed to exhibit a range of factors (abdominal obesity, high cholesterol, insulin resistance) that increase the risk of CVD + type 2 diabetes, hypertension, which can lead to premature death

• NOT a biological factor but a result of biological factors

Question 18

Variations in Indigenous Australians: Biological factors – glucose regulation

Answer 18

experience higher rates of impaired glucose regulation –> higher diabetes + kidney disease rate

Question 19

Variations in Indigenous Australians: Biological factors – birth weight

Answer 19

Indigenous Australian mothers:
- 2 x more likely to give birth to baby with low birth weight
- more likely to give to birth to premature babies
–> higher under 5 mortality rate

–> maternal tobacco use, nutrition, access to healthcare contribute to this difference

Question 20

Variations in Indigenous Australians: Sociocultural factors – socioeconomic status

Answer 20

more likely to experience lower socioeconomic status
- have lower average incomes, poorer education achievements, lower homeownership rates
- low education outcomes –> lower health literacy rates –> increases risk of smoking, dietary risks, sedentary lifestyle –> higher rates of obesity, type 2 diabetes, CVD, lung cancer

Question 21

Variations in Indigenous Australians: Sociocultural factors – unemployment

Answer 21

4 x more likely to be unemployed
- indigenous Australian unemployment rate between 20-28%

increases rates of smoking, alcohol use, reduced overall feelings of wellbeing, CVD, mental health problems, lung cancer

Question 22

Variations in Indigenous Australians: Sociocultural factors – social exclusion

Answer 22

social exclusion, especially discrimination + racism lead to poorer indigenous health status

• increases risk of mental health disorders, tobacco/drug/alcohol use
• 32% of indigenous adults reported avoiding seeking healthcare bc of cultural factors – language barriers, lack of trust in health provider, experiences of discrimination –> increased length + severity of condition –> higher levels of morbidity + mortality
• high levels of racism –> high levels of psychological distress –> participation in risky behaviours –> increased risk of tobacco + alcohol use –> self-harm, CVD, respiratory diseases, cancers, type 2 diabetes, obesity, suicide
• high levels of psychological distress were increased in indigenous adults who were removed or had relatives removed from their family

Question 23

Variations in Indigenous Australians: Sociocultural factors –food insecurity

Answer 23

• more likely to report food insecurity

contributing factors – lower income, overcrowded housing, higher cost of fresh foods in rural areas, lack of transport, lack of nutritional knowledge –> food insecurity –> increased rates of obesity –> type 2 diabetes, CVD, kidney disease

Question 24

Variations in Indigenous Australians: Sociocultural factors –early life experiences

Answer 24

eearly life experiences including maternal tobacco/alcohol/drug use
- 44% of indigenous women smoked while pregnant compared to 10% of non-indigenous
- 50% of indigenous babies display effects of maternal alcohol use
- indigenous babies 3.5 x more likely to display signs of drug exposure while in uterus

• these differences –> high rates of low birth weight, infant infections, foetal alcohol spectrum disorder, under 5 mortality rate, CVD, type 2 diabetes

Question 25

Variations in Indigenous Australians: Sociocultural factors – cultural norms

Answer 25

cultural norms contribute to lower rate of indigenous access to western medicine + healthcare because they perceive western medicine as culturally inappropriate + associate hospitals with death –> undiagnosed + untreated conditions –> increased morbidity + mortality rates, reduced life expectancy

Question 26

Variations in Indigenous Australians: Environmental factors - housing

Answer 26

• lack of indigenous housing –> homelessness, poor h+wb, lower employment + education participation –> social exclusion and associated health status impacts

–> increased risk of injury, infectious disease, mental health problems

• 33% live in housing with structural problems
• 10% live in housing without at least 1 working facility (eg toilet, kitchen)
• 17.9% live in overcrowded housing compared to 4.9% for non-indigenous –> strain on food + hygiene facilities –> unhygienic living conditions –.> increased risk of injury, infectious disease, mental

Question 27

Variations in Indigenous Australians: Environmental factors - water/sanitation

Answer 27

many indigenous Australians experience inconsistent water supply + inadequate sewage systems –> lack of clean water + sanitation –> increased risk of infectious diseases like diarrhoea, dysentery, cholera –> increased morbidity + mortality rates

• 40% experience sewage leak
• indigenous people living in rural areas are less likely to access fluoridated water supply –> higher dental decay rate –> morbidity

Question 28

Variations in Indigenous health status data/summary

Answer 28

• 10 years less lower life expectancy than non-indigenous Australians
• higher mortality rates in each age group
• 2 x more likely to have severe disabiltiy
• 2 x higher infant mortality rate
• 1/2 as likely to self-assess as excellent or very good
• 2.3 x higher BoD than non-indigenous population
• 2 x injury-related mortality rate
• higher rate of chronic conditions – cancer, respiratory disease, CVD
• 3 x more high psychological distress experienced
• 3.5 x diabetes/high glucose rate
• 4 x chronic kidney disease rate
• higher STI rate
• higher dnetal decay rate

Question 29

Variations in males and females: biological factors – body weight

Answer 29

High BMI is more prevalent in males than females –> males have higher rates of hypertension, CVD, type 2 diabetes
- 32.5% of males are obese compared to 30.2% of females

Question 30

Variations in males and females: biological factors – blood pressure

Answer 30

• males are more likely to experience hypertension until they’re in the 65-74 age –> after that age group, women are more likely to experience hypertension
• leads to higher rates of CVD + kidney disease among males

Question 31

Variations in males and females: biological factors – glucose regulation

Answer 31

males have higher rates of impaired glucose regulation
- males have higher DALY contributed to by impaired glucose regulation –> higher rate of type 2 diabetes + kidney disease in males

Question 32

Variations in males and females: biological factors – genetics

Answer 32

• males tend to store fat around the abdomen –> increased male risk of CVD
• males have more testosterone in the body –> increased risk-taking behaviour –> higher risk of male injuries
• women have higher levels of oestrogen than men –> menapause leads to loss of bone mass –> increased risk of osteoporosis for women 60+
• greater risk of arthritis for women

Question 33

Variations in males and females: sociocultural factors – unemployment

Answer 33

unemployment has a greater impact on male health status
- according to gender norms, men feel a sense of duty to provide physical resources for the family –> inability to provide bc of unemployment leads to feeling inadequate + stressed –> poor mental h+wb & greater morbidity + mortality from obesity, CVD and suicide

Question 34

Variations in males and females: sociocultural factors – Socioeconomic status (SES)

Answer 34

males employed full time earn higher average incomes – males generally have higher SES –> less mental + behavioral problems & less psychological distress for men but more for women

Question 35

Variations in males and females: sociocultural factors – cultural norms

Answer 35

gender stereotypes contribute to health health status variations between men and women

males:
- men are less likely to be carers of children –> women who provide full-time care may experience social isolation –>. poor mental h+wb & higher rate of psychological distress

• physically laborious work is considered masculine (eg construction) –> increased risk of male injury in workplace
• contact sports (eg footy) are considered masculine –> increased risk of injury among males
• males are less likely to access healthcare bc they feel they need to be self-reliant/perseverant + suppress emotions –> higher male morbidity + mortality rates
• men may pressure other males to conform to traditional gender stereotypes –> promote risky behaviour like using violence to solve conflict, alcohol overconsumption –> increased male incidence of injury

females:
- media’s representation of beauty standards leads to increased incidence + prevalence of eating disorders among females

Question 36

Variations in males and females: environmental factors – work environment

Answer 36

work environment is the main environmental factor contributing to differences in health status between males and females
- males are more likely to work in unsafe environments like using heavy machinery, exposure to hazardous substances
–> increased risk of injury –> increased male morbidity + mortality
- males are more likely to work in an environment w air pollution –> respiratory conditions (eg asthma) –> increased male morbidity + mortality
- males are more likely to work outside –> increased UV ray exposure –> higher male skin cancer rates
- males are more likely to work in transport –> risk of road accidents –> morbidity + mortality from injury

Question 37

Variations between males and females health status data/summary

Answer 37

Males:
- male life expectancy 4 years less than females
- higher rates of BoD
- increased likelihood of death in each lifespan stage
- males have higher rate of injury
- males have higher suicide, road accident, violence related death
- higher rates of CVD
- higher rates of cancers – especially skin cancer from UV rays
- higher diabetes & kidney disease rate
- higher COPD rates

Females:
- higher rates of osteoporosis + arthiritis
- higher rates of mental + behavioural problems
- more likely to experience high levels of psychological distress
- more likely to experience core activity limitation

Question 38

Variations in high and low SES: biological factors – body weight

Answer 38

low SES groups have higher rates of higher body mass –> increased obesity rate –> increased death rates from CVD, type 2 diabetes –> lower life expectancy

Question 39

Variations in high and low SES: biological factors – blood pressure

Answer 39

low SES groups have higher hypertension rates –> higher rate of CVD –> higher rate of DALY + premature death

Question 40

Variations in high and low SES: biological factors – glucose regulation

Answer 40

low SES groups have higher impaired glucose regulation rates –> higher burden of type 2 diabetes + kidney disease

Question 41

Variations in high and low SES: biological factors – birth weight

Answer 41

women with low SES are more likely to give birth to low birthweight babies –> higher under 5 mortality rate, infection rate + disability among low SES groups

Question 42

Variations in high and low SES: sociocultural factors – education and income

Answer 42

low SES groups have lower levels of education + lower incomes
- influences higher rate of behaviours like unhealthy eating, smoking, pack of physical activity, lower likelihood of healthcare access –> lower life expectancy, higher morbidity + mortality rates

• lower average income + education in low SES groups –> lower health literacy –> lower rates of healthcare use –> conditions go undiagnosed + untreated –> higher rates of morbidity + mortality for low SES groups

low SES groups feel like they lack a lack of control over their life –> sense of helplessness –> risky behaviours like smoking –> higher rates of premature mortality + lower life expectancy

Question 43

Variations in high and low SES: sociocultural factors – unemployment

Answer 43

low SES groups are more likely to be unemployed
- creates cycle between unemployment + poor health status
- creates cycle between unemployment and risk-taking behaviours

Question 44

Variations in high and low SES: sociocultural factors – social exclusion

Answer 44

• low SES can lead to social exclusion as they are less likely to gain education, employment, access to community resources –> poor physical + mental h+wb

Question 45

Variations in high and low SES: sociocultural factors – food security

Answer 45

• healthy food options are more expensive in low SES areas + low SES groups have less financial resources to afford nutritious food – > food insecurity –> fruit + vegetable underconsumption
  –> less satiety from a lack of fibre–> overeating –> obesity –> associated conditions like CVD, type 2 diabetes
  –> lack of fibre –> colorectal cancer
  –> lack of antioxidants from fruit –> free radicals aren’t removed –> damaged cells –> cancers
• low SES groups have lower levels of health literacy –> more less knowledge about healthy eating –> dietary risks (see above)

Question 46

Variations in high and low SES: sociocultural factors – early life experiences

Answer 46

• women in low SES groups are 6 x more likely to smoke during pregnancy –> higher rates of respiratory conditions like asthma, low birthweight in babies –.> high infant + under 5 mortality rates
• women in low SES groups are more likely to begin antenatal care later + have higher BMI in pregnancy –> increased risk of premature + low birthweight babies –> higher under 5 mortality rate

Question 47

Variations in high and low SES: sociocultural factors – access to healthcare

Answer 47

• low SES groups are less likely to access preventative/early detection health services –> undiagnosed health conditions –> fewer treatment options when diagnosis is made –> higher mortality rates (especially for breast + cervical cancer)
• low SES groups are less likely to have private health insurance
  –> psychological distress
  –> longer waiting times for surgery –> higher morbidity + mortality

Question 48

Variations in high and low SES: sociocultural factors – neighbourhood safety

Answer 48

• low SES groups are more likely to feel unsafe home alone + walking in their local area at night –> increased anxiety/stress
  –> higher rates of mental health issues

Question 49

Variations in high and low SES: environmental factors – geographical location

Answer 49

• low SES areas tend to have more fast food outlets –> high in fat, salt, sugar –> increased likelihood of people in low SES areas eating these foods –> high obesity rates + associated conditions
• low SES groups have lower health literacy levels –> less educated about healthy eating –> more likely to be influenced by fast food marketing
• low SES areas have less sport + recreational facilities –> lower rates of physical activity –> increased obesity risk + associated conditions

Question 50

Variations in high and low SES: environmental factors – housing

Answer 50

l ow SES groups are less likely to be able to afford high quality housing leading to:
- overcrowding
–> strain on sanitation facilities –> increased rate of infectious disease
–> higher rates of psychological distress + mental health disorders

• inadequate cooking facilities –> reliance on fast food –> increased rate of obesity and associated conditions
• unsafe physical environment
  –> inadequate ventilation –> increased risk of respiratory conditions like asthma
  –> fire hazards like heating appliances –> increased risk of injury
• closer proximity to industrial sites –> air + noise pollution –> increased respitory conditions + stress
• low SES groups have higher smoking rate –> children + non smokers more likely to be exposed to environmental tobacco smoke –> increased risk of SDS, respiratory diseases like asthma, cancer, CVD

Question 51

Variations in high and low SES: environmental factors – work environment

Answer 51

• low SES groups are more likely to work in dangerous work environments (factory, manufacturing) –> increased exposure to hazardous substances + working w heavy machinery –> increased rate of injury, respiratory conditions, cancers

Question 52

Variations in those living within and outside major cities: biological factors – body weight

Answer 52

outside major cities –> higher levels of BMI –> increased risk of CVD, type 2 diabetes, cancers

Question 53

Variations in those living within and outside major cities: biological factors – blood cholesterol

Answer 53

outside major cities –> experience higher blood cholesterol –> higher rates of CVD

Question 54

Variations in those living within and outside major cities: biological factors – glucose regulation

Answer 54

outside major cities –> more likely to experience impaired glucose regulation –> increased risk of type 2 diabetes + kidney disease

Question 55

Variations in those living within and outside major cities: biological factors – birth weight

Answer 55

outside major cities –> higher rates of low birth weight babies

Question 56

Variations in those living within and outside major cities: biological factors – blood pressure

Answer 56

outside major cities –> higher rates of hypertension –> increased risk of CVD –> contributes to BoD

Question 57

Variations in those living within and outside major cities: sociocultural factors – SES

Answer 57

outside major cities –> limited opportunities for education + employment –> higher rates of risky behaviours like smoking, low levels of physical activity –> higher rates of preventable diseases like cancer, CVD + lower life expectancy

outside major cities –> lower income –> more likely to rely on social security payments –> impacts access to adequate food supply + healthcare

Question 58

Variations in those living within and outside major cities: sociocultural factors – unemployment

Answer 58

outside major cities –> higher rates of unemployment – lower health status

Question 59

Variations in those living within and outside major cities: sociocultural factors – food security

Answer 59

outside major cities –> transporting food to remote areas is costly –> high cost + lack of steady access to fresh food –> food insecurity –> consumption of discretionary food that’s higher in fat, salt, sugar –> higher rates of obesity, type 2 diabetes, CVD

Question 60

Variations in those living within and outside major cities: sociocultural factors – early life experiences

Answer 60

outside major cities –> mothers in very remote areas more likely to smoke during pregnancy –> higher rates of low birthweight babies, babies w respiratory conditions like asthma –> higher infant + under 5 mortality rate

Question 61

Variations in those living within and outside major cities: sociocultural factors – social isolation

Answer 61

outside major cities –> geographic distance causes social isolation –> feelings of loneliness –> higher rates of mental health disorders + suicide

Question 62

Variations in those living within and outside major cities: environmental factors – infrastructure

Answer 62

outside major cities –> roads are generally in poorer condition, wildlife is more likely to cross path of vehicles, roads are poorly lit –> higher rate of injury –> higher morbidity + mortality

Question 63

Variations in those living within and outside major cities: environmental factors – geographic location

Answer 63

outside major cities

• further proximity to healthcare –> people choose not to access healthcare –> undiagnosed + untreated conditions –> higher morbidity + mortality
• specialist health services or hospitalisation –> family need to take time off work to transport ill person to health services –>
  increased costs + stress levels
• geographical location influences types of food available –> difficult to access fresh food –> reliance on discretionary foods that’s high in fat salt, sugar –> increased risk of obesity. CVD, type 2 diabetes
• geographic location –> less access to fluoridated water –> increased rates of dental decay
• geographical barriers to recreational facilities, transport, employment opportunities –> low SES, unemployment –> higher morbidity + mortality, lower life expectancy
• geographical isolation –> social isolation

Question 64

Variations in those living within and outside major cities: environmental factors – climate + climate change

Answer 64

outside rural areas

more prone to unstable weather (drought, fire, flood eg) –> unstable income –> low SES + increased stress levels

• increased frequency of natural disasters (bushfire eg)
  –> increased risk of injury
  –> reduced access to support services to deal with climate change –> increased rates of mental health conditions + self harm

unpredictable rainfall –> reduced availability of water for agriculture + livestock

Question 65

Variations in those living within and outside major cities: environmental factors – work environments

Answer 65

many jobs in rural areas are based outdoors
–> higher risk of injuries
–> increased UV ray exposure –> increased incidence of skin cancer