NHPAs

Question 1

Injury prevention and control

Answer 1

Refers to the physical damage to the body. Can include intentional harm like falls, poisoning, drowning, burns and scalds and transport related injuries.

Question 2

The four main types of injury highlighted

Answer 2

. Falls in older people
. Falls in children
.drowning or near drowning
.poisoning in children

Question 3

Reason for selection

Answer 3

Injury is largely preventable
Injury accounted for more than 1 in 20 hospitalisations in 2009-2010
Injury is the leading cause of death for individuals under 45 years,

Question 4

Biological determinants as a risk factor for injury prevention and care

Answer 4

Age: different age groups have different rates of injuries.
.children: more likely to suffer from injuries and injury related deaths when they can’t swim and/or recognize the dangers of water
.young adults: self harm and motor vehicle are the main cause of injuries
.elderly: falls are the most common cause of injuries for older people
Sex: males are at greater risk to injuries, due to transport injury (risk taking behavior and jobs) and interpersonal violence.
Ethnicity: aboriginal and Torres Strait islander Australians have higher rates of injuries due to jobs and education

Question 5

Behavioral determinants as risk factors for injury prevention and care

Answer 5

Alcohol misuse: people affected by alcohol take unnecessary and misguided risks, such as drink driving and swimming while intoxicated
Illicit drug use: contributes to higher rates of mental illness which influences suicide and violence rates.
Physical activity: people involved in contact sport may be at an increased risk of sport-related injury

Question 6

What are the NHPAs

Answer 6

I AM ACDC OD
Injury prevention and care 
Asthma 
Mental health
Arthritis and musculoskeletal conditions 
Cancer control 
Diabetes mellitus 
Cardiovascular health 
Obesity 
Dementia

Question 7

Mental health behavioral determinants

Answer 7

Alcohol use: alcohol is a depressant and studies show that some people with depressive symptoms are more likely to develop alcohol misuse and dependence in their younger years.
Physical inactivity: physical activity releases hormones (endorphins) that relive stress and assist in maintaining optimal mental health. People who exercise more, therefore may be at a decreased risk of developing a mental illness

Question 8

Mental health social determinants

Answer 8

Social exclusion: There is a direct relationship between mental illness and social exclusion. Homelessness is also more common among socially excluded people, which could add to the risk of mental illnesses.
Early life experiences: loss of a parent, divorce or adverse parenting styles (including lack of affection and abuse) may act as a trigger for mental illness.

Question 9

Mental health physical environment determinants

Answer 9

Transport: Not having access to transport may increase levels of distress if people cannot stay in social contact with friends and family, cannot access employment or cannot access recreational facilities.
Housing: Living in overcrowded housing conditions can increase the risk of psychological distress. Housing that does not promote adequate sleep or that is not secure can also contribute to anxiety and stress.

Question 10

Arthritis and musculoskeletal conditions biological determinant

Answer 10

Genetics: People with a family history of musculoskeletal conditions are at higher risk of developing them.

Sex: Females are more likely to develop a musculoskeletal condition. Oestrogen assists in the maintenance of bone mass so post-menopausal women are more at risk.

Question 11

Arthritis and musculoskeletal conditions behavioral determinant

Answer 11

Diet:Diet lacking in the nutrients required for hard tissue formation (including calcium, vitamin D, and phosphorus), particularly during adolescence, may accelerate or even cause the onset of a musculoskeletal condition (especially osteoporosis).
Physical inactivity: being inactive is considered to be a risk factor for osteoporosis as it does not support the strengthening of bones

Question 12

Arthritis and musculoskeletal conditions social determinant

Answer 12

Food security: Lack of access to a nutritious food supply may mean a person does not receive adequate amounts of the nutrients required for hard tissue formation, which can lead to osteoporosis.

Socioeconomic Status:
People of lower socioeconomic status may not have knowledge relating to healthy food intake and the value of regular health care. This can increase the risk of musculoskeletal conditions and impact on treatment of these conditions.

Question 13

Arthritis and musculoskeletal conditions physical environment determinants

Answer 13

Access to recreational facilities: Lack of access to facilities such as parks and gardens can decrease physical activity and contribute to obesity and arthritis. Lack of access to facilities that encourage weight-bearing exercise, such as golf courses, may contribute to lower bone density and increased risk of osteoporosis.
Transport system: transport systems that do not promote active transport may contribute to weight gain which is a risk factor for arthritis and musculoskeletal conditions.

Question 14

Cardiovascular health biological determinants

Answer 14

Genetics: having a family member with heart disease increases the risk of cardiovascular disease due to genetic predisposition.
Ethnicity: aboriginal and Torres Strait Islander people have higher death rates due to cardiovascular disease

Question 15

Cardiovascular health behavioural determinants

Answer 15

Tobacco use: Smoking tobacco increases blood pressure and constriction of blood vessels caused by damage to blood vessels. Smoking increases the risk of clots that can reduce blood oxygen levels.
Diet: A diet high in saturated fat, low in fibre and high in sodium is a risk factor for obesity which is a risk factor for developing cardiovascular disease.

Question 16

Cardiovascular disease social determinants

Answer 16

Stress: stress hormones released in the bloodstream contribute to hypertension, stroke and therefore cardiovascular disease.
Socioeconomic status: people from low socioeconomic backgrounds have higher death rates of cardiovascular disease compared to those from higher socioeconomic backgrounds.

Question 17

Cardiovascular disease physical environment determinants

Answer 17

Work environment: A work environment that does not facilitate incidental physical activity such as walking up and down stairs or walking around the office or factory may increase the risk of obesity and cardiovascular disease.
Geographical location to healthcare facilities: Those loving in rural and remote areas have higher death rates from cardiovascular disease. The distance can lead to lower diagnose and preventative measures to reduce the risk of developing cardiovascular disease.

Question 18

Diabetes mellitus biological determinants

Answer 18

Body weight: Abdominal obesity often indicates that an added strain has been placed on the pancreas, resulting in less insulin production which is a risk factor for type II Diabetes.
Age: The risk of type 2 diabetes increases with age. Those over 55 are most susceptible although rates among younger Australians have increased over time, largely due to higher obesity rates among these groups.

Question 19

Diabetes mellitus behavioural determinants

Answer 19

Excessive alcohol consumption: alcohol is high in sugar, which leads to sharp increases in blood glucose levels. Excessive alcohol intake can result in obesity which is a risk factor for type 2 and gestational diabetes.
Physical inactivity: Being physically inactive can lead to weight gain, which increases the chances of obesity and therefore type 2 and gestational diabetes.

Question 20

Diabetes mellitus social determinants

Answer 20

Occupation: People in sedentary occupations may be more at risk of obesity and type 2 diabetes due to not burning off fat leading to an increase chance of obesity and therefore type 2 diabetes.

Food Security:
people with a lack of food security may be forced to eat energy- dense, processed foods that can increase the risk of obesity and contribute to type 2 and gestational diabetes.

Question 21

Diabetes mellitus physical environment determinants

Answer 21

Access to recreational facilities: If recreation facilities such as sporting ovals and walking paths are not accessible, individuals may not get the required amount of physical activity, which can increase body weight and contribute to obesity and type 2 diabetes.

Work environment:
A work environment that does not promote incidental physical activity can increase the risk of type 2 diabetes. A work environment that has car parking next to the entrance, no stairs and a small office space can reduce the level of incidental physical activity and contribute to obesity and type 2 diabetes.

Question 22

Cancer control biological determinant

Answer 22

Genetics: Some people are more likely to develop cancer than others due to a genetic predisposition. The genetic influence seems to be particularly important for certain cancers, such as breast cancer.
Age:Advancing age is a risk factor for developing cancer. The highest rate of cancer was for men and women aged 75 years and over.

Question 23

Cancer control behavioural determinants

Answer 23

Sun exposure: Exposure to sunlight and UV radiation increases the chances of developing skin cancer, which is the most common cancer in Australia.

Sexual Activity:
Being infected with the human papillomavirus (HPV) is a risk factor for cervical cancer. This is a very common virus and many forms of it are sexually transmitted.

Question 24

Cancer control social determinant

Answer 24

Food security: People who do not have access to an affordable, healthy food supply may rely on processed foods. As a result they may consume excess saturated fat, which can increase the risk of colorectal cancer.

Access to Healthcare:
access to health care does not prevent the development of cancer. However, the rate of successfully treating cancers is higher if they are found early.

Question 25

Cancer control physical environment determinant

Answer 25

Climate: Ultraviolet radiation levels are often high in many parts of Australia. Increased exposure to UV radiation increases the risk of developing skin cancer
Environmental tobacco smoke:
Exposure to environmental tobacco smoke increases the risks of many types of cancer such as lung and throat.

Question 26

Obesity biological determinants

Answer 26

Sex: males are more likely to be overweight than females
Age: metabolism slows with age and therefore weight is harder to burn off and keep off with older ages.

Question 27

Obesity behavioural determinant

Answer 27

Diet: consuming foods high in fat and sugar contribute significant kilojoules to the body. Over time, if this energy is not expended then weight gain and an increased risk of obesity can occur.
Lack of physical activity: When less energy is expended or burned than consumed the indictable is at an increased risk of weight gain and obesity.

Question 28

Obesity social determinant

Answer 28

Socioeconomic status: People living in the most socioeconomically disadvantaged areas are more likely to be obese than people who live in areas that are less disadvantaged, due to lack of education.
Food security:
People who can’t afford or can’t access a healthy food supply may rely on processed food, which tends to be higher in fat and sugar and low in fibre, therefore adding kilojoules to the diet which is a risk factor for obesity.

Question 29

Obesity physical environment determinant

Answer 29

Work environment: a work environment that does not facilitate incidental physical activity such as walking up and down stairs or walking around the office or factory can increase the risk of obesity. For example, a work environment that has car parking next to the entrance, no stairs and a small office space can reduce the level of incidental physical activity and contribute to weight gain and obesity.
Transport:
Transport systems that foster passive methods of transport, such as car travel, can increase the risk of obesity.

Question 30

Dementia biological determinant

Answer 30

Age: is much more common among older Australians. The risk of Dementia increases with age from about 65 years and doubles every 5 or 6 years.

Sex:
Dementia tends to be more common among women than men. In 2010 twice as many women died from Dementia than men

Question 31

Dementia behavioural determinant

Answer 31

Diet:
High intakes of saturated and trans-unsaturated fats are associated with increased risk of dementia. A higher intake of poly- and mono-unsaturated fats is associated with reduced risk. High blood cholesterol, particularly in mid-life, is associated with an increased dementia risk

Lack of mental stimulation:
Those who do not regularly utilise their memory, attention and problem-solving abilities, particularly throughout middle age, may experience an increased rate of dementia compared to the rest of the population.

Question 32

Dementia social determinant

Answer 32

Social exclusion: Those who are less socially active than the rest of the population may experience an increased rate of dementia.

Question 33

Dementia physical environment determinant

Answer 33

Environmental tobacco smoke: Exposure to environmental tobacco smoke can increase the risk of cardiovascular disease by clogging blood vessels and therefore increase the risk of vascular dementia.

Question 34

Reasons for selection for all nine NHPA’s

Answer 34

.contribute significantly to the burden of disease in Australia
.contribute a significant cost for both the individual and the community (direct, indirect and intangible)
.significant gains/ improvements in health can be achieved if targeted

Question 35

Diabetes risk factor nutrient

Answer 35

Soluble fibre can delay blood glucose absorption in the small intestines and thereby reduce insulin production