CHAPTER TWO: exploring differences in health status

Question 1

leading causes of death in Australia

Answer 1

• cardiovascular disease - coronary heart disease (heart attack and related disorders) and cerebrovascular disease (mainly in the form of stroke)
• dementia (alzheimer’s)
• lung cancer
• chronic obstructive pulmonary disease (COPD)

Question 2

causes of mortality by age

Answer 2

• chronic conditions are the prominent cause of death among people aged 45 and over
• external causes such as accidents, suicide and poisoning are more prominent causes of death for younger people (15-44 years)

Question 3

chronic conditions

Answer 3

• non communicable
• highest contributors to morbidity and burden of disease in australia
• includes cardiovascular disease, COPD, cancer, diabetes mellitus, asthma, osteoarthritis, back problems, mental and behavioural problems

Question 4

disability

Answer 4

• blanket term to describe impairments, activity limitations and participation restrictions

Question 5

biological factors

Answer 5

• relating to the body that impact on health and wellbeing and thus overall levels of health status, including genetics, body weight, blood pressure, cholesterol levels, blood glucose levels, age and birthweight

Question 6

genetics

biological factor

Answer 6

• plays a role in determining lifespan health and wellbeing and the likelihood of developing specific diseases
• predisposition to disease: influence an individual’s risk of getting some diseases, but it does not mean that an individual will develop this condition
• other related conditions are caused by the inheritance of DNA variants, referred to as mutations, which result in a change in one of the genes affecting the way the body works or develops

Question 7

body weight

biological factor

Answer 7

• particular concern to Australia’s health status is the incidence of overweight and obesity
• overweight and obese individuals are at higher risk of cardiovascular disease, some types of cancer, arthritis, type 2 diabetes mellitus
• body weight is influenced by genetics as well as body function in relation to metabolism and hormonal control

Question 8

blood cholesterol

biological factor

Answer 8

• waxy, fatty substance found in all cells of the body
• used by the body for the production of hormones, vitamin D and digestive enzymes

Question 9

blood pressure

biological factor

Answer 9

• measurement of pressure of the blood in the artery
• rises and falls during the day and is influenced by a number of factors; for example, body position, exercise, sleep and emotional state
• hypertension: heart is working too hard, increasing the risk of heart failure
• hypertension can result in other conditions: congestive heart failure, kidney disease and blindness
• - causes of hypertension: narrowing of the arteries, a greater than normal volume of blood, or the heart beating faster or more forcefully than it should
• lifestyle choices that increase the risk: excessive alcohol use, tobacco use, too much sodium (salt) in the diet, stress

Question 10

blood glucose regulation

biological factor

Answer 10

• impaired glucose regulation (IGR) - pre-diabetes
• refers to blood glucose levels that are above the normal range, but not high enough for the diagnosis of type 2 diabetes mellitus

Question 11

birthweight

biological factor

Answer 11

• first weight of the newborn measured immediately after birth
• low birthweight: <2500 g
• reasons why a baby may be born with low birthweight
  
  • premature birth
    
    • when a baby is born before 37 completed weeks of pregnancy
  • foetal growth restriction
    
    • when feotus doesn’t gain an appropriate amount of weight before birth due to problems with the placenta, infections, the age of the mother
    • low birthweight is more prevalent for young mothers aged 15-17 and older mothers in their forties
• health problems faced by low-birthweight babies
  
  • respiratory distress syndrome (RDS)
  • bleeding in the brain
  • heart problems
  • eye conditions

Question 12

age

biological factor

Answer 12

• ageing → deterioration of body systems due to various forms of cellular damage that occur over time
  
  • causes reduction of both physical and mental function → makes individual more susceptible to diseases including osteoarthritis, dementia, cardiovascular disease, depression, diabetes, hearing loss

Question 13

sociocultural factors

Answer 13

• social and cultural conditions into which people are born, grown, live, work and age
• can often be outside of an individual’s control

Question 14

social networks - family

sociocultural factor

Answer 14

• social disadvantages in childhood → limit opportunities for health throughout a child’s entire life
• earliest years of an individual’s life → crucial impact on their path of health and wellbeing
• limitations on parental education and income can either create or restrict their ability to provide opportunities to model healthy behaviours for their children to adopt

Question 15

social networks - peers and the community

sociocultural factor

Answer 15

• support can be emotional (nurturing, encouraging), instrumental or physical (financial), or informational (advice)
• social networks → increase health outcomes → higher levels of self-esteem → improved mental hwb
• peer and community groups
  
  • negative impact
    
    • a person may be more likely to smoke if their friends do
  • positive impact
    
    • a person may participate in regular exercise if their friends do

Question 16

socioeconomic status

sociocultural factor

Answer 16

• social class; key elements of income, education level, employment status and occupational type
• people with a lower SES → poorer health outcomes → higher rates of disease and disability → lower life expectancy

Question 17

level of education

sociocultural factor

Answer 17

• high levels of education → associated with higher income and better employment prospects
• allows individuals to participate in, and connect with the wider community
• better health literacy → improved lifestyle decisions

Question 18

employment status

sociocultural factor

Answer 18

• the workplace can promote healthy activities and behaviours, a sense of identity, social status and purpose in life, as well as additional social support
• provides source of income
• unemployment
  
  • less likely to have strong support networks
  • long term unemployment → increases risk of self-harm, suicide and attempted suicide
• limited finances
  
  • limits healthy lifestyle choices → increases other behavioural risk factors such as tobacco, alcohol, drug use

Question 19

overcrowding and homelessness

sociocultural factor

Answer 19

• housing - basic human right
• overcrowding and homelessness → detrimental to an individual’s health status
• overcrowding → increased stress on health infrastructure (e.g. water supply and sewerage systems)
• main impact on the health of children and can cause respiratory conditions, skin infections and meningitis

Question 20

acess to health information

sociocultural factor

Answer 20

• culture, beliefs, affordability, education
• inability to access health information and healthcare services → detrimental to health
  
  • misdiagnosis of disease
  • lack of understanding about how to prevent disease
  • increased likelihood of mortality from a disease due to lack of treatment and/or lack of knowledge of the signs and symptoms of the condition

Question 21

environmental factors

Answer 21

• refers to the situations and surroundings that exert an influence on people’s health and wellbeing
• surroundings in which individuals exist on a daily basis
• air, water and sanitation quality; access to physical resources such as
  transport, recreation facilities or healthcare; workplace; climate change and natural disasters. Other factors can include geographic location and exposure to hazards.
• includes home, school, workplace, geographical location (city/rural) and the wider community
• can be direct or indirect, simple or complex, and immediate or delayed
• for some people, the physical environment may contain harmful or toxic substances that also impact their health

Question 22

air, water and sanitation quality

environmental factor

Answer 22

• many environmental influences are involuntary
  
  • indoor air may contain constituents such as asbestos, moulds, radon gas, carbon monoxide and methane
• water quality in australia
  
  • extremely high
  • water ways - high quality according to global standards → low count of faecal contamination and industrial pollution
  • diseases associated with poor quality water consumption → gastroenteritis, diarrhoea, typhoid fever and hepatitis
  • parasitic diseases associated with poor quality water consumption → giardiasis, dysentery, diarrhoea
  • unsafe drinking water → dehydration due to loss of fluids when experiencing diarrhoea → loss of life

Question 23

access to physical resources such as transport, recreation facilities and healthcare

environmental factor

Answer 23

• transport systems and infrastructure
  
  • PT → enables people to access a range of services, recreational facilities and healthcare → improves health status of a population
  • rural areas
• recreational facilities
  
  • lack of access to recreational facilities (e.g. parks, walking and cycling tracks and well-made sporting grounds) → risk factor for chronic diseases esp. respiratory conditions
• geographic location of resources such as healthcare

Question 24

workplace

environmental factor

Answer 24

• type of work and tasks involved → influences a worker’s risk of physical injury and illness

Question 25

climate change and natural disasters | environmental factor

Question 26

males and females

Answer 26

- an individual’s sex can lead to health differences due to the physical differences in reproductive systems, as well as hormone production and release - gender: refers to the values, norms and expectations that society attributes to being a man or a woman

Question 27

differences in health status | factors contributing to variations in health status of males & females

Answer 27

Males have: - life expectancy around 4 years less than females - higher death rates for all age groups - higher rates of mortality from lung cancer and COPD - higher rates of injury than females - higher rates of deaths due to suicide, road trauma and violence - higher rates of morbidity from cardiovascular disease and many types of cancer - higher rates of diabetes - lower rates of osteoporosis - lower rates of mental disorders - lower rates of dementia, including Alzheimer’s disease

Question 28

biological factors | factors contributing to variations in health status of males & females

Answer 28

Males experience: - higher rates of overweight and slightly higher rates of obesity - higher rates of trunk/abdominal fat - genetic predisposition to conditions such as cardiovascular disease and prostate cancer - higher rates of hypertension - higher levels of testosterone, increasing risks of some conditions Females experience: - genetic predisposition to breast cancer - higher levels of oestrogen which plays a protective role against cardiovascular disease, until menopause

Question 29

sociocultural factors | factors contributing to variations in health status of males & females

Answer 29

Males are more likely to: - have a higher SES (especially in single parent households) - experience stress related to unemployment Females are more likely to: - access health information and support services

Question 30

environmental factors | factors contributing to variations in health status of males & females

Answer 30

Males are more likely to: - be exposed to unsafe work environments - be exposed to hazardous substances in the workplace - work outdoors, increasing sun exposure

Question 31

differences in health status | factors contributing to variations in the health of A&TSI populations

Answer 31

Compared with other Australians, Aboriginal and Torres Strait Islander peoples have: - lower life expectancy of approximately 10 years - poorer self-assessed health status - higher rates of physical disability - higher death rates from cancer - higher morbidity rates from cardiovascular disease - higher rates of chronic kidney disease - higher mortality rates and burden of disease from diabetes - higher rates of infectious diseases such as STIs, ear and eye infections - higher rates of infant mortality - higher injury death and hospitalisation rates - higher levels of psychological distress - higher rates of dental decay and gum disease

Question 32

biological factors | factors contributing to variations in the health of A&TSI populations

Answer 32

Compared with other Australians, Aboriginal and Torres Strait Islander peoples have a higher prevalence of: - overweight and obesity - insulin resistance and impaired glucose regulation - hypertension - low-birthweight babies - high blood cholesterol levels

Question 33

sociocultural factors | factors contributing to variations in the health of A&TSI populations

Answer 33

Compared with other Australians Aboriginal and Torres Strait Islander peoples are more likely to experience: - higher rates of unemployment - lower incomes - lower retention rates for education - higher rates of social exclusion - lower rates of home ownership - more negative issues relating to housing, including overcrowding and homelessness - poverty - cultural barriers to accessing healthcare

Question 34

# ``` environmental factors | factors contributing to variations in the health of A&TSI populations

Answer 34

Compared with other Australians, Aboriginal and Torres Strait Islander peoples are more likely to be exposed to: - poor air quality (e.g. due to exposure to environmental tobacco smoke) - lower quality roads if living in remote areas - poor quality or limited recreational facilities - lack of access to running water and sanitation systems if in a remote area - reduced access to services due to living in rural or remote areas compared with other Australians

Question 35

biological factors | factors contributing to variations in health status of high & low SES

Answer 35

Compared with high-SES groups, low-SES groups experience: - higher rates of obesity - higher rates of high blood pressure - higher rates of glucose intolerance - higher rates of low birthweight babies

Question 36

differences in health status | factors contributing to variations in health status of high & low SES

Answer 36

Compared with high-SES groups, low-SES groups experience: - lower life expectancy - higher death rates - more avoidable deaths from causes such as injuries - higher infant mortality rates - higher rates of diabetes - higher rates of coronary heart disease - higher rates of psychological distress and mental health conditions such as depression - higher rates of morbidity from respiratory diseases - higher prevalence of and mortality rates from lung cancer

Question 37

environmental factors | factors contributing to variations in health status of high & low SES

Answer 37

Compared with high-SES groups, low-SES groups are more likely to experience: - greater rates of exposure to tobacco smoke in the home - exposure to high risks in the work environment - poor access to infrastructure and physical resources

Question 37

sociocultural factors | factors contributing to variations in health status of high & low SES

Answer 37

Compared with highSES groups, low-SES groups are more likely to have: - lower levels of educational attainment, affecting employment options - higher levels of unemployment - less likelihood of accessing preventative health services

Question 38

australians living within and outside major cities

Answer 38

- australia → geographically diverse - regional and remote populations - those living outside aus major cities and metropolitan (urban) areas - australian standard geographical classification (ASGC) - inner regional, outer regional, remote, very remote - those living outside of major cities - environment comprises a range of settings → large regional centres, coastal settlements, small inland towns, farms, outback

Question 39

differences in health status | australians living within and outside major cities

Answer 39

Compared with those living within major cities, those living outside major cities have: - lower life expectancy - higher road injury and fatality rates - higher rates of other injuries - higher reported rates of high blood pressure, diabetes and obesity - higher death rates from chronic disease such as coronary heart disease - higher prevalence of mental health problems - poorer dental health - higher incidence of poor antenatal and postnatal health - higher incidence of babies born with low birthweight to mothers in very remote areas - higher infant mortality rates in very remote area

Question 40

biological factors | australians living within and outside major cities

Answer 40

Compared with those living within major cities, those living outside major cities have: - higher rates of overweight and obesity - higher rates of insulin resistance and impaired glucose regulation - higher rates of high blood pressure - higher rates of low birthweight babies - higher rates of high blood cholesterol levels

Question 41

sociocultural factors | australians living within and outside major cities

Answer 41

Compared with those living within major cities, those living outside major cities experience: - difficulty accessing a range of healthcare facilities and services - difficulty obtaining social support fromthe wider community - higher rates of unemployment - lower incomes - lower levels of educational attainment

Question 42

environmental factors | australians living within and outside major cities

Answer 42

Compared with those living within major cities, those living outside major cities have: - harsh environmental conditions; e.g. extreme sun exposure - reduced access and reduced quality in recreational facilities - less access to fluoridated water - more dangerous work environments