HSC Core 1: HEALTH PRIORITIES

IN AUSTRALIA
Critical Question 1 - How are priority issues for
Australias health identified?

Measuring Health Status

Role of Epidemiology
The collection and analysis of the data used to make this assessment
is known as Epidemiology.
Measures of Epidemiology
Morbidity: The rates, distribution and trends of illness, disease
and injury in a given population.
Mortality: The number of deaths for a given cause in a given
population, over a set time-period.
Infant Mortality: The number of deaths in the first year of life
per 1000 live births.
Life Expectancy: An estimate of the number of years a person can
expect to live at any particular age.

Identifying Priority Health Issues

Social Justice Principles

Equity
Diversity
Supportive environments
Priority Population Groups
Prevalence of condition
Potential for prevention and early intervention
Costs to the individual and community

Direct individual costs include the financial burden that is

associated with illness and disability such as ongoing medical costs
(hospital charges, medical professional fees, medications, travel
etc.) and loss of employment
In-direct individual costs include persistent pain and loss of
quality of life, possible exclusion from social activities,
increased pressure on families to offer support and the emotional
toll of chronic illness
Direct community costs include the vast funding of the Australian
health care system (which is projected to markedly increase with an
ageing and growing population). Most of this supports primary health
care and pharmaceuticals, and the nature of chronic illness tends to
require high degrees of medical intervention to manage them
In-direct community costs include the premature loss of contributing
and valuable members of society and the cost for employers in
absenteeism, decreased productivity and re-training

Critical Question 2 - What are the priority issues

for improving Australias health?
These determinants can be categorised as either:
Sociocultural determinants (E.g. family, peers, media, religion
and culture)
Socioeconomic determinants (E.g. education, employment and
income)
Environmental determinants (E.g. geographical location and access
to health services and technology)

Groups experiencing health inequities

Aboriginal and Torres Strait Islander peoples

Socioeconomically disadvantaged (Low SES)
People living in rural and remote communities
Overseas-born people
Elderly
People with disabilities

High levels of preventable chronic disease, injury and mental

health problems

Cardiovascular Disease

Nature
Cardiovascular Disease (CVD) refers to all diseases of the heart
and blood vessels, caused by a build up of fatty tissue inside the
blood vessels (i.e. atherosclerosis) and the hardening of the blood
vessels (i.e. arteriosclerosis)
3 types of CVD include Coronary heart Disease, Cerebrovascular
Disease, Peripheral Vascular Disease

Extent
The leading cause of death and sickness
Both mortality and morbidity is decreasing for males and females

Risk Factors and Protective Factors

Non-Modifiable Risk Modifiable Risk Protective Factors
Factors Factors
- Age: rates - Smoking and alcohol - Nutritious and
increase sharply abuse balanced diet
over 65 years of age - Diet high in fat, - Daily physical
- Being male salt and sugar activity
- Family history - Low physical - Responsible use of
activity levels alcohol
- High blood pressure - No smoking
and cholesterol - Maintain healthy
levels weight
- Being overweight - Control stress
levels

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Family history - Low levels of - People who live in
- Indigenous: higher disposable income rural and remote
rates of all risk - Unemployed communities
factors - Low level of
- Males: less likely education
to engage in
preventative health
measures

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Elderly

Cancer Commented [DS1]:

Commented [DS2R1]:
Nature
A group of diseases leading to the uncontrolled growth of abnormal
body cells.
Skin, Breast and Lung cancers are of most concern to health
authorities

Extent
Mortality and morbidity rates are both increasing.
The most commonly occurring cancer is non-melanoma skin cancer
(which is mostly non-life threatening). The most common life
threatening cancers include: Men: prostate, colorectal, lung and
melanoma and Women: breast, colorectal, lung and melanoma

Risk Factors and Protective Factors

Non-Modifiable Risk Modifiable Risk Protective Factors
Factors Factors
- Gender: specific - Exposure to - Avoid carcinogen
cancers carcinogens (cancer e.g. Slip, Slop,
- Age: leads to causing agents), such Slap, Wrap
increased risk as smoke, asbestos, - Personal screening
- Family history UV radiation from the habits e.g. breast
- Genetic makeup sun and testicular
e.g. being fair - Lifestyle - Public screening
skinned behaviours, such as e.g. breast
smoking, alcohol mammograms and
misuse and poor prostate blood test
dietary habits - Seeking early
medical intervention

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Smoking amongst - Unemployed: higher - People who work
young females rates of smoking outdoors
- Tanning habits, - Low levels of - People who live in
such as excessive sun education e.g. rural and remote
exposure awareness of warning communities
 signs and personal - Exposure to
testing chemicals in the
workplace

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged communities
People who live in rural and remote regions of Australia
Males and Females
Other minor groups include smokers, outdoor workers, young adults
and people with fair skin

Diabetes

Nature
A disease that affects the bodys ability to take glucose from the
bloodstream to use it for energy
Caused by a malfunctioning of the pancreas leading to insufficient
insulin levels, the hormone responsible for regulation of blood
glucose levels (BGL)
3 types:
1. Insulin Dependent Diabetes (IDDM) Known as Type 1 usually
presents early in life and patients require insulin injections
and must monitor diet and physical activity to maintain a safe
BGL
2. Non-Insulin Dependent Diabetes (NIDDM) Known as Type 2
usually presents later in life, as a result of long-term poor
health behaviours related to diet and exercise. Requires
medication and lifestyle modifications
3. Gestational Diabetes (GD) occurs during pregnancy
The long-term effect s of each type include vision problems,
kidney disease, circulatory issues in arms and legs and a strong
link to CVD (similar risk factors)

Extent
Worlds fastest growing disease similar issues are evident in
Australia
Prevalence increases with age, especially NIDDM Type 2
The age of onset is decreasing which is a growing concern,
especially for young people. Due to unhealthy lifestyles
3.5% of all Australians have Diabetes

Risk Factors and Protective Factors

Modifiable Risk Non-Modifiable Risk Protective Factors
Factors Factors
- High blood - Over 55 years of - Maintaining a
pressure age healthy weight
- Having CVD or its - Family History - A balanced and
risk factors - Over 45 years with nutritious diet, full
- Having diabetes in CVD risk factors of Low GI foods.
pregnancy - Over 35 and being Eating 5-6 smaller
- Being overweight of Aboriginal, meals per day
Chinese, India or
 Pacific Islander - Healthy use of
descent alcohol
- Daily physical
activity

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Indigenous 10-30% - Low SES more - Technology has lead
may have diabetes likely to have poor to a more passive
much is undiagnosed diet, drink excessive society e.g.
- Being Chinese, alcohol, be popularity of video
Indian or Pacific physically inactive games
Islander and be overweight - People from rural
- Social acceptance - Low education and remote and
of binge drinking less awareness of Indigenous have
- Ageing population prevention strategies difficulty in
- Being time poor and health lifestyle accessing medical
leads to increased behaviours services
reliance on - Junk food
convenient food advertising to
children

Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions

Mental Health Problems

Nature
Any illness that negatively affects a persons emotional
stability, perceptions, behaviour and social well-being, such as
depression, anxiety, addictions, obsessive compulsive disorder,
bipolar disorder, eating disorders and dementia

Extent
20% of people suffer form a mental health problem at some stage
of life
Prevalence is increasing and much is unreported
18-24 years olds have the highest rates, especially substance
abuse and depression

Risk Factors and Protective Factors

Modifiable Risk Non-Modifiable Risk Protective Factors
Factors Factors
- Drug use - Age increased - Social acceptance
- Chronic disease risk of dementia as legitimate health
e.g. arthritis - Males suffer mostly concerns
- Perceived self- depression and - Awareness of social
worth and sense of addictions (substance support structures
identity abuse) e.g. GP, online help,
- Coping skills telephone counseling
 Stressful situations - Females suffer - Strong sense of
e.g. family breakdown mostly depression and connectedness with
and occupational anxiety family, friends, work
stress - Uncontrolled life mates and neighbours
- Grief changes e.g. death or - Personal resiliency
abuse skills
- Family history

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Family breakdown - Unemployed higher - Living in remote
lack of support rates of depression regions lack of
- Difficult life - Low education support and medical
circumstances e.g. risk factors services
abuse - People in financial - Stigma amongst
- ABTSI Increased distress e.g. farmers males as well as
alcohol and drug during a drought common stoical
abuse, and difficult attitudes
life circumstances - Lack of emotional
- Elderly people support e.g. family
increased social breakdown
isolation and grief

Groups at Risk
Elderly
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
People born overseas, especially refugees
People with a disability

Respiratory Diseases

Nature
Common diseases that affect the respiratory system include:
Asthma, Chronic Obstructive Pulmonary Diseases, Hay fever

Extent
6 million Australians have a long-term respiratory disease
Morbidity rates are now decreasing, a result of reduced smoking
Mortality is also decreasing, due to effective education programs
Asthma is the leading burden of disease amongst children

Risk Factors and Protective Factors

Modifiable Risk Non-Modifiable Risk Protective Factors
Factors Factors
- Use of preventative - Environmental - Awareness of
medication for asthma changes e.g. pollen personal asthma
- Exposure to in spring and cold triggers e.g.
environmental and dry weather exercise
patterns
hazards, e.g. - Education about
chemicals personal prevention
- Stress strategies and plans
- Passive smoking in for asthma attacks
homes and cars - No smoking

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Indigenous - Increased smoking - Higher rates of
Australians higher amongst low SES pollution in cities
rates of smoking - Low income less - People who live in
- Family history money for remote region are
preventative further from
medication emergency services
- Low SES more - Childrens exposure
likely to be exposed to passive smoke
to occupational
hazards

Groups at Risk
Indigenous Australians
Socioeconomically disadvantaged
People from rural and remote regions
Smokers

Injury

Nature
There are many types of injuries, which affect all stages of life.
They often result in ling-term harm of ones physical, emotional and
social well being. Examples include:
1. Road injuries and Motor Vehicle Accidents (MVAs)
2. Suicide and self-harm
3. Injuries around the home e.g. poisonings, falls, drowning, cuts,
fires
4. Workplace accidents
5. Acts of violence
6. Sports and recreational injuries

Extent
Leading cause of death in 1-44 years age group (particularly
MVAs and suicide amongst males)
Greatest cause of potential life lost under 65 years
Major cause of hospitalisation
Deaths from injuries are decreasing in frequency, especially
MVAs
The elderly are prone to injuries such as falls, which has a
significant impact on their quality of life
Risk Factors and Protective Factors
Modifiable Risk Non-Modifiable Risk Protective Factors
Factors Factors
- Driving behaviour - Age elderly are - Minimising driving
and attitudes more at risk of distractions e.g.
- Inadequate falls Mobile phones and GPS
supervision of - Gender higher - Effective driver
children rates of risk taking education
Occupational hazards behaviour and - Positive attitude
Unsafe home suicide towards road and OHS
environment e.g. rules and regulations
chemicals, pool - Home modifications
fencing and trip for the elderly
hazards - Strong social
- Safe roads and support to prevent
effective road laws suicide
- Safe use of alcohol

Determinants
Sociocultural Socioeconomic Environmental
Determinants Determinants Determinants
- Indigenous people - Low SES higher - Workplace injuries
suffer more injuries rates of are most common in
- Attitudes towards hospitalisation from agricultural
driving and risk injuries settings
taking amongst males - Low education - Suicide is highest
- Family breakdown, less awareness of amongst males from
leading to social dangers around the rural and remote
isolation of young home regions
people - Low income makes - Unsafe home
- Societal pressure it harder to purchase environment of
for tougher road safety equipment elderly people and
laws e.g. P plate - MVAs are highest children can lead to
regulations amongst low SES increased risk of
- Societal awareness populations injury
of hazardous
environments

Groups at Risk
Elderly (Falls)
Indigenous Australians (MVAs and self-harm)
People from rural and remote regions (occupational injuries)
Children (poisoning and drowning)
Young Adults (MVAs, sport and recreational injuries and self-
harm)
Males (Suicide and MVAs)

A growing and ageing population

A number of significant trends have been observed in Australias

population in the last 50 years:
A decrease in the birth rate over this time
A decline in mortality rates, along with an increase in life
expectancy
 Sustained rates of immigration from overseas
The percentage of people aged over 70 years is set to double to 20%
over the next forty years. Also, the total population is expected to
double to 40 million people in the same time.

Healthy Ageing
Enabling and empowering people to live a healthy, productive and
contributing life for as long as possible, is a key strategy of the
government.
Increased Population Living with Chronic Disease and Disability
A larger elderly population inevitably leads to more people living
with chronic disease and disability.

Demand for Health Services and Workforce Shortages

To meet the demands placed upon our government and society by a
growing and ageing population, the full range of health services
will need to expand dramatically. This increase needs to include;
more specialist health professionals and GPs, more primary and
emergency health services such as ambulances and public hospitals
and more housing and accommodation for people who require assistance
with basic living needs.

Availability of Carers and Volunteers

Carers provide informal care of people living with chronic diseases
and disability. The contribution of volunteers is also recognised as
essential in meeting the demands of our ageing population. They
assist with activities such as transport, shopping, meals on wheels
and social activities.

Critical Question 3 - What role do health care

facilities and services play in achieving better
health for all Australians?

Health care in Australia

Range and types of health facilities and services

Category Examples
Public health services Cancer screening
Immunisation programs
Primary and community GPs
health care Ambulance services
Royal Flying Doctor Service
Dental
Hospitals Public
Private
Mental
Specialised health Specialised medical practitioners
services Reproductive health
Mental health
 Palliative care

Responsibility for health facilities and services

Health care provider
Commonwealth Government
State/Territory Government
Local Government
Private organisations
Community groups
Facilities and/or services provided
Formation of national health
policies
Collection of taxes to finance the
health system
Provision of funds to
state/territory governments
Special concern for ATSI
Pharmaceutical funding
Hospital services
Mental health
Home and community care
Family health services
Dental health
Womens health
Health promotion
Regulating health industry
providers
Vary from state to state
Environmental control
Antenatal clinics
Meals on Wheels
Private hospitals
Dentists
Alternative health services
(physiotherapy, chiropractor, etc)
Local needs basis
Cancer Council, Dads in Distress,
Diabetes Australia, etc

Equity of access to health facilities and services

All Australians should have equal access to health care facilities
and services. This is achieved in Australia through Medicare.

Health care expenditure versus expenditure on early intervention and

prevention
Health-care expenditure incorporates private health insurance,
households, individuals and all levels of government. In 2007-08
Health-care expenditure was $103.6 billion (Australias Health 2010,
AIHW). Less than 2% of this figure was spent on preventable services
or health promotion.

Reasons for increasing funding for preventative health strategies

include:
Cost effectiveness
Improvement to quality of life
Containment of increasing costs
Use of existing resources
 Reinforcement of individual responsibility
Maintenance of social equity
Reduced mortality and morbidity

Impact of emerging new treatments and technologies on health care,

e.g. cost and access, benefits of early detection
New treatments and technologies have the potential to significantly
improve the health status of Australians. Examples of developments
in emerging treatments and technologies include: development of new
machinery, image technology in keyhole surgery, improvement in
materials, drug advancements, prosthetic limb development,
artificial organs and transplant technology.

Health insurance: Medicare and private

Health care in Australia is provided by the public sector (Medicare)
or through private health insurance. Medicare is the health-care
system for all Australians. Its aim is to provide equity in terms of
cost and access for health care services.
Funding for Medicare comes from income tax (1.5% of taxable income)
and the Medicare levy surcharge (1% for high income earners).
Every Australian is covered for 85% of the scheduled fee.
Bulk Billing allows patients to pay nothing and the doctor receives
the scheduled fee from Medicare.

People have the option of increasing the health insurance they have
by taking out private health insurance. The extra insurance covers
private hospital and ancillary or extras (dental, physiotherapy,
naturopathy, etc).

Reasons for choosing private health insurance include:

- Shorter waiting times
- Hospital choice
- Own doctor of choice
- Ancillary benefits such as physiotherapy
- Peace of mind
- Private rooms in hospital
- Health cover while overseas
- Avoiding increase tax

To combat falling private health insurance numbers the Commonwealth

Government has implemented several schemes.
- 30% tax rebate for people with private health insurance
- 1% Medicare levy surcharge
- Lifetime health-care incentive with lower premiums to those who
join before age 30
Medicare Private health
insurance
Payment Commonwealth Commonwealth
Government Government
Taxpayers Individuals and
families
Payment type Income tax Annual, monthly,
Levy surcharge fortnightly premiums
Benefits Basic public hospital Hospital cover
services - Hospital services
Basic medical - Choice of doctor
services - Choice of hospital
Some specialist - Private or public
services hospital
85% of scheduled fee Ambulance cover
Availability of bulk Ancillary cover
billing
- Physiotherapy
- Chiropractor
- Naturopathy, etc
Some special benefits
such as gym
membership
Overseas cover

Complementary and alternative health care approaches

Reasons for growth of complementary and alternative health products

and services
World Health Organization recognition
Recognition of Eastern cultures
Marketing strategies
Proven results for many when traditional medicine had failed
Desire for natural medicines
Holistic nature
Addition to ancillary benefits by private health insurers
Societal changes with multiculturalism
Societal changes with globalisation
Societal changes with demographics
Formal qualifications enhancing credibility

Range of products and services available

Alternative health-care approach Description
Acupuncture Involves inserting needles into
skin
Aromatherapy Use of pure essential oils to
influence the mind, body or
spirit
Bowen therapeutic technique System of muscle and connective
tissue movements that realigns
the body and balances energy
flow
Chiropractic Adjustments are made to the
spine to realign correct body
function
Herbalism Uses plants and herbs
Homeopathy System that recognises the
symptoms are unique to an
individual
Iridology Analysis of the human eye to
detect signs of wellbeing or
otherwise
Massage Includes remedial, Swedish,
sports
Meditation State of inner stillness
Naturopathy Holistic treatment aiming to
treat the underlying cause as
well as the symptoms of the
illness

How to make informed consumer choices

It is important to investigate and critique health-care providers
and services. This can include: what is it they offer, what are the
benefits, experience, qualifications, governing body and cost.

Critical Question 4 - What actions are needed to

address Australias health priorities?
Health promotion based on the five action areas of the Ottawa
Charter

The five action areas of the Ottawa Charter are:

- Developing personal skills
- Creating supportive environment
- Strengthening community action
- Reorienting health services
- Building healthy public policy

Levels of responsibility for health promotion

The Australian government, state and local governments, non-
government organisations, communities and individuals are all
responsible for promoting health.

The benefits of partnerships in health promotion

The chance of successful health promotion is greatly increased when
all levels of government, non-government organisations, communities
and individuals work together towards one common goal.

How health promotion based on the Ottawa Charter promotes social

justice
Health promotion to be effective needs to address the social justice
principles (equity, diversity and supportive environments).
Equity Diversity Supportive
environment
Developing personal Mandatory Access to Media
skills PDHPE K - 10 Medicare campaigns
Community
based support
Creating supportive Provision of Destigmatising Legislative
environments health health bans
enhancing conditions Provision of
items health
enhancing
items
Strengthening Lobby groups Lobby groups Lobby groups
community action
Reorienting health Health Language Partnerships
services services for assistance with the
ATSI community
Building healthy Bulk billing Abstudy Health
public policy PBS Health care campaigns
card

The Ottawa Charter in action

Application of the Ottawa Charter requires critical analysis of the
5 areas of the Ottawa Charter: developing personal skills,
strengthening community action, creating supportive environments,
reorienting health services, building healthy public policy.
Examples of health promotions that are based on the Ottawa Charter
to an extent include: Closing the Gap, Fresh Tastes @ School,
National Tobacco Strategy, National Action Plan on Mental Health,
Measure Up and Swap It Dont Stop It.

HSC Core 2: FACTORS AFFECTING

PERFORMANCE
Critical Question 1 - How does training affect
performance?
Energy Systems

Alactacid Lactic Acid Aerobic system

system system
(ATP/PC)
Source of fuel Creatine Carbohydrate Carbohydrate
phosphate Glycogen Fat
Protein
Efficiency of ATP Less than 1 Approximately Glucose 36
production ATP molecule 2 ATP ATP molecules
molecules Fatty acid
130 ATP
molecule
Duration 5 - 10 seconds 30 - 45 Unlimited
seconds depending upon
intensity
Cause of fatigue Depletion of Increased Depletion of
PC accumulation fuel sources
of hydrogen
ions
By-products None Lactic acid Carbon dioxide
water
Process and rate PC Removal of Restoration of
of recovery replenishment lactic acid glycogen up
in with active to 48 hours
2 5 minutes recovery in
15 30 mins

Types of training and training methods

Aerobic
Aerobic training generally follows the FITT principle.
F = frequency at least 3 sessions per week are required for
aerobic training to be effective. Serious athletes may complete 12
sessions.
I = intensity usually measured using heart rate. Aerobic training
usually occurs between 70% and 85% of max HR.
T = time will depend upon the intensity but needs to be at least
20 minutes duration.
T = type there are a range of training types one can utilise to
develop aerobic capacity
Continuous training requires training without rest for at least 20
minutes.
Fartlek training or speed play involves continuous exercise with
sprints or a higher intensity effort (e.g. Hill climb) interspersed
throughout the session.
Aerobic interval training involves alternating repetitions of an
exercise and a period of rest or recovery.
Circuit training involves a series of exercises that are performed
one after the other with little or no rest in between each exercise.

Anaerobic
Anaerobic training involves exercise of high intensity and therefore
short duration.
Interval training is a very common form of anaerobic training
usually requiring maximal effort. Generally the recovery rate ratio
will determine the type of training and aims of the sessions.
Speed, acceleration and agility are components that can be developed
through anaerobic training.
Plyometrics is a very common training style to develop anaerobic
power. Plyometrics involves exercises that produce an explosive
muscular contraction.

Flexibility
Flexibility is the ability to move a muscle through its full range
of motion. Good flexibility will assist:
- Prevention of injury
- Improved coordination
- Muscular relaxation
- Decreasing muscle soreness
Static stretching the muscle is slowly and smoothly taken to the
end of its range of motion and held for approximately 30 seconds.
This method is useful for rehabilitation, warm up and cool down.
Dynamic stretching involves a series of movements that replicate
game movements and take the muscle through its full range of motion.
It is popular for warm-ups.
Ballistic stretching involves a bouncing action at the end of the
range of motion. This form of stretching activates the stretch
reflex. The force of the movement takes the muscle beyond its
preferred length. Therefore, this type of stretching has risks and
is only recommended for elite athletes.
PNF stretching proprioceptive neuromuscular facilitation involves
lengthening a muscle against a resistance. Generally it involves a
static stretch, followed by an isometric contraction then a period
of rest before being repeated. Used often during rehabilitation.

Strength training
Strength is the maximal force generated by a single muscular
contraction.
Hypertrophy an increase in the size of the muscle fibres and
connective tissues
Isotonic involves exercises where the muscle shortens and
lengthens
Isometric involves exercises where the muscle does not change
length
Isokinetic involves exercises where the load remains constant
throughout
Machine weights very popular method allowing for isotonic
contractions and are very simple to use. It is very easy to isolate
muscle groups using this method of training.
Free weights include dumbbells, barbells, medicine balls and
kettlebells. Allow a wide range of exercises, muscle groups and
types of contractions to be catered for. Good techniques are needed
to avoid injury.
Resistance bands are often used in rehabilitation but have become
a popular form of training lately due to their convenience. They
allow for a range of contractions and a wide range of muscle groups.
Stability balls have become popular of late. Their focus is to
develop the core muscles and majority of free weight exercises can
be adapted to be performed incorporating the stability ball.
Hydraulic resistance effort is made against an opposing force.
Resistance is constant through the entire movement.

Principles of training

Progressive overload
To continue to have training improvements, progressive overload
needs to occur. The body adapts to the training it undergoes. When
this adaptation occurs the training needs to be increased to stress
the body beyond its current capabilities to achieve further training
gains. It also needs to be progressive so that the stress placed on
the athlete does not cause injury or fatigue. Overload can be
achieved by increasing intensity, resistance, repetitions, duration,
frequency, etc.

Specificity
Exercise needs to be specific for the energy systems, muscles,
movement patterns, etc required for the athletes sport.

Reversibility
Training adaptations are lost once training ceases or lowers below
the current capacity of the athlete. A detraining effect results in
the physiological adaptations gained through training being
reversed.

Variety
Completing the same or similar activities can lead to boredom which
in turn may result in a reduced training effort. Therefore it is
important for training sessions to incorporate a range of training
types, settings, activities and drills.

Training thresholds
Training thresholds are the upper limits of a training zone and when
passed take the athlete to a new level.
The aerobic threshold (Lactate transition 1) is approx 70% of MHR.
This level is sufficient to cause a training effect.
The aerobic training zone is when athlete is working above the
aerobic threshold and below the anaerobic threshold.
The anaerobic threshold (Lactate transition 2 or Onset Blood Lactate
Accumulation OBLA) is approx 85% of MHR. Exercise beyond this point
will see a marked increase of lactic acid build up and therefore
fatigue and the cessation of exercise.

Warm up and cool down

For most sports a warm up will last approximately 20 minutes. This
will incorporate a general warm up followed by a more specific warm
up. The aim of the warm up is to prepare the body both physically
and mentally for optimal performance.
The general warm up will contain some running or aerobic activities
and dynamic stretching. The specific component of the warm up will
contain activities relating to the sport.
The cool down is recommended to form part of the active recovery for
the athlete. Generally this will involve low intensity exercise. The
aim of the cool down is to decrease blood lactate levels and to
minimise muscle soreness.

Physiological adaptations in response to training

Adaptation
Resting heart rate Decreased resting heart rate
due to more efficient stroke
volume
Stroke volume Increased at rest and
throughout exercise
Cardiac output Increased maximal cardiac
output
Oxygen uptake Increased due to an increase in
capillaries, myoglobin,
mitochondria and enzyme
activity
Lung capacity Increased maximal ventilation
but remains relatively
unchanged
Haemoglobin level Increased due to an increase in
blood plasma and RBC numbers
Muscle hypertrophy Increased size with resistance
training
Effect on slow-twitch muscle No change to percentage
fibres Increased hypertrophy,
capillary supply, mitochondrial
function, myoglobin content
enzymes and glycogen stores
 Effect on fast-twitch muscle No change to percentage
fibres Increased ATP and PC supply,
enzymes, hypertrophy and lactic
acid tolerance

Critical Question 2 - How can psychology affect

performance?
Motivation

Positive and negative

Positive motivation is the desire to be successful in a pursuit that
will result in happiness, satisfaction and pleasure. An example of
this is for a high jumper to hope to compete at the Olympics.
Negative motivation is the desire to be successful with the aim of
avoiding unpleasant consequences. The motivation is to avoid
something bad happening as opposed to a positive outcome. An
example is training hard and playing trying to avoid being dropped
from the team.

Intrinsic and extrinsic

Intrinsic motivation is internal motivation. It is emphasised by
feelings of satisfaction and enjoyment. It is self-sustaining and is
usually associated with an orientation towards the task. This type
of motivation promotes longevity as external factors are not driving
the athlete, for example continuing to play football despite
regularly being in a lower grade and losing.
Extrinsic motivation is motivation that comes from external sources.
This includes things like trophies, money and praise. It tends to
have an outcome orientation. This generally does not promote
longevity as the money and praise are not often sustainable.
Extrinsic rewards can deter from intrinsic motivation.

Anxiety and arousal

Trait and state anxiety
Anxiety is a negative emotional state. It is the result of
perceiving situations as threatening.
State anxiety is feelings of tension related to a specific event or
moment in time. For example an athlete prior to the start of a 100m
race feels nervous and anxious. The tension and anxiousness is
related to the event, the bigger event the bigger the anxiety.
Trait anxiety is a behavioural or personality disposition to display
anxiety and to perceive various situations as threatening. A person
with high trait anxiety often displays high state anxiety in
competitive situations.

Sources of stress
Stress is the imbalance between what is expected of a person and
their perceived ability to meet those expectations. When there is a
large imbalance then the person becomes stressed. There are many
sources of stress and these include: financial concerns, selection
concerns, injury concerns, contract concerns, crowds, preparation
and expectations.

Optimal arousal
Optimal arousal is the physical and emotional response related to a
specific moment or event. Arousal is important for successful
sporting performance, however, not all athletes or sports require
the same level of arousal. An archer requires a different level of
arousal (calm and quiet) compared to a weightlifter (pumped up).
Optimal arousal is generally described utilising the inverted u
hypothesis. As arousal increases so does performance until optimal
arousal and this performance is reached. If arousal continues past
this point (over arousal) then performance declines.

High
Performance

Low
Low High
Level of arousal

Psychological strategies to enhance motivation and manage

anxiety

Concentration/attention skills (focusing)

The ability to focus on appropriate cues is essential for an
athlete. Shutting out distractions and irrelevant cues will assist
the athlete to perform at a higher level.
Strategies for focusing or regaining focusing can include music,
cues, set routines, training for distractions and focus training.
Athletes often train to replicate as much as possible the same
environment as game day to ensure their focus is on the important
cues at the crucial time.

Mental rehearsal/visualisation/imagery
This involves creating mental images or pictures of the upcoming
event, action or skill. This allows the athlete to experience
(success) prior to the actual event. This allows the athlete to feel
confident due to the fact that it is as if the athlete has been in
this position previously and therefore knows how to feel and react
and more importantly can picture a successful outcome.
Athletes may use various methods of mental rehearsal. One method is
as spectators watching themself perform the skill and the other is
from their internal view as they are actually performing the skill.
Mental rehearsal needs to be as realistic as possible for it to be
effective. Therefore the detail, timing and settings all need to
replicate the real event.

Relaxation techniques
Over-aroused and anxious athletes benefit greatly from having a
range of relaxation strategies available to them. Relaxation will
lower breathing rates, heart rate, blood pressure and muscle tension
leading to greater control and focus.
Examples of relaxation include listening to music, massage, watching
TV or a movie, controlled breathing exercises, yoga, Pilates,
meditation and hypnosis.

Goal-setting
Setting long term and short term goals can assist an athlete greatly
to remain focused. The goals of an athlete can be about the outcome
of their performance (e.g. winning gold at the Olympics) or the
process (e.g. swimming a personal best at the Olympics).Short term
goals should contribute to achieving the long term goal.

Critical Question 3 How can nutrition and recovery

strategies affect performance?

Nutritional Considerations

All athletes must ensure that the food and drink they consume will
support maximum performance. These considerations are as important
for both training and actual competition. They also apply to both
before and after intense physical activity. The primary aims of good
nutrition are:
Adequate fuel reserves, such as maximum glycogen stores for
triathletes
Repair of damaged body tissue from training, such as increasing
protein intake for strength training
Prevention of dehydration, through adequate fluid intake
Optimal functioning of all body systems (e.g. Immune System), by
meeting the recommended dietary intakes for all nutrients, such
as vitamins and minerals

Pre-performance Nutrition
Changes to an athletes regular diet may be necessary in the days
and hours leading up to an intense training session and competition.
This is to ensure the required fuel reserves are full and the
athlete is well hydrated. Knowing what and how much to eat, as well
as when to eat, will enable the body to perform intense physical
activity.
The last significant meal should be eaten 3-4 hours prior to the
event. It should contain at least 100 grams of carbohydrates, be low
in fat and fibre and have a small amount of protein. At least 500 mL
of water should also be consumed. A light meal can also be eaten 1-2
hours prior, which should consist of some high GI Carbohydrates, as
well as more fluid.
Carbohydrate Loading
Endurance athletes require more carbohydrates than other athletes,
and may need to increase their intake for 3-4 days leading up to an
event. By maximising muscle and liver glycogen reserves, they ensure
that glycogen is used as a primary fuel for as long as possible.

Hydration
To avoid the negative effects of dehydration on sporting
performance, athletes should over-compensate for their projected
fluid needs. For a normal person, 2 litres of fluids should be
consumed daily; therefore a person who is expecting to perform
intense physical activity should drink at least 3 litres in the 24
hours leading up to an event.

During Performance
Continued hydration is the main priority during physical activity.
Small amounts of fluid should be consumed at all possible times,
such as time-outs, half time and stoppages (150mL per 15 minutes).
For endurance events, lasting longer than 60 minutes, refuelling may
also be necessary. This is best achieved by eating concentrated
forms of glucose such as energy gels, bananas, sports bars or sports
drinks.

Post Performance
The primary aim of post-exercise recovery is to return all body
systems as quickly as possible to their pre-event condition. The
specific details of what to eat and when will depend on the duration
and intensity of the activity itself. The primary aims of the first
12 24 hours after intense exercise are:
Restore depleted glycogen
Repair damaged muscle tissue
Rehydrate the athlete

Supplementation

Supplementation is the process of eating additional nutrients to

account for a deficiency in an athletes diet. In most cases, sports
nutritionists generally prefer to make regular dietary
modifications.

Vitamins and Minerals

Vitamins are chemical compounds, which can only be sourced through
dietary intake. They enable the normal functioning of the body and
promote growth and development. Vitamins are available in a wide
range of foods, which is why a diverse range of food is needed to
meet the RDIs of each one.
Minerals are also chemical compounds, which play a similar role in
the body. They are also normally sourced through the food eaten in a
regular diet, but can be supplemented if needed. Deficiencies of
some minerals can have a direct and adverse effect on the health and
performance of certain athletes. Minerals of significance include:
Iron
Calcium

Protein
Protein is required for the growth, repair and maintenance of muscle
tissue. Athletes must ensure they eat sufficient amounts of protein
to aid recovery and promote growth of muscle tissue. This is
especially important for athletes who are undertaking strength
training or high-intensity interval training. Good food sources of
protein include lean meat, dairy products, nuts and eggs.

Caffeine
Caffeine is a stimulant, which speeds up the Central Nervous System.
It is normally consumed through chocolate, coffee, cola drinks and
advertised energy drinks. It is also available in the form a
caffeine tablets. The supposed benefits of caffeine for athletes
include increased alertness, decreased perception of fatigue and the
mobilisation of fat cells leading to glycogen-sparing. Possible
negative side effects include an elevated heart rate, over-arousal
and uncontrolled muscle twitches leading to decreased fine-motor
control. In high-doses, it also acts as a diuretic, leading to
dehydration.

Creatine
Creatine is a fuel source, which is stored in skeletal muscles. It
is produced partly in the body cells, but regular intake of protein,
especially from meat sources, ensures the RDI for Creatine is
achieved. Its role is to assist in the production of Creatine
Phosphate, which is the fuel source for the replenishment of ADP
back into ATP. This is commonly known as the ATP-CP Energy System,
which provides for ATP regeneration during short bouts of powerful,
high-intensity exercise, such as 100m sprints or shot-put. Athletes
who either train for these types of sports or undertake a heavy
resistance-training program, may achieve training benefits such as
increased lean muscle mass and improved performance levels.

Recovery Strategies

Physiological Strategies
Both active recovery exercises and appropriate nutrition are
important factors in restoring the body to a pre-event condition,
allowing the athlete to prepare for the next training session or
game as quickly as possible. Examples include:
Hydration
Nutrition
Cool Down
Stretching

Neural Strategies
Intense physical activity is very taxing on the muscular system, but
also the Central and Peripheral Nervous System. These neural
strategies are aimed at relaxing the body and muscles, reducing the
perception of localised muscle fatigue as well as decreasing general
mental fatigue.
Hydrotherapy
Massage

Tissue Damage Strategies

Following intense physical activity and competition, it is common
for athletes to suffer from a variety of levels of tissue damage.
This can range from microscopic muscle tears as a result of heavy
resistance training, to bruises and minor sprains and strains, right
through to more significant soft-tissue injuries.
Cryotherapy

Psychological Strategies
The pressure involved in participating in elite sport can be
immense, and this can come from both internal and external sources.
For an athlete to maintain good mental and emotional health, as well
as manage their levels of motivation and anxiety, a range of
personal strategies can be employed to achieve this
Relaxation
Sleep

Critical Question 4 - How does the acquisition of

skill affect performance?
Stages of Skill Acquisition

Cognitive Stage
This stage is characterised be the learner developing an
understanding of the task requirements.

Associative Stage
This stage is characterised by the need for the athlete to practise
the skill, until a correct motor pattern is established in the mind
and body.

Autonomous Stage
In this stage, the athlete is able to perform the skills
automatically, without intentional thought about the task
requirements.

Characteristics of the Learner

Personality
Innate personality traits can have a significant effect on an
athlete in all stages of skill acquisition. Examples of relevant
traits include confidence, motivation, a positive outlook, self-
discipline, focus, enthusiasm, competiveness and whether you are an
introvert or an extrovert.

Heredity
Certain genetic features can provide a varying degree of advantage
with regard to the potential for success. Specific inherited
factors, which may be influential, include:
Muscle Fibre Type
Body Shape
Gender

Confidence
Whilst this is a personality trait, it stands alone as making a
significant contribution to sporting success at the elite level

Prior Experience
Certain sports have common characteristics, which can enable a
person to transfer their ability from one sport, and quickly adapt
and learn the specific skills and tactics in another sport. Some
factors that can be transferred from one sport to another include:
Motor patterns
Tactics and strategies
Skills
Components of Fitness
Ability
Some people seem to have a natural ability at sport, which is most
evident in the rate that they move through the stages of skill
acquisition. They almost seem to be dominant in any game they play.
Some of the factors that may underpin this phenomenon include
spatial awareness (awareness of who and what is around them),
kinaesthetic sense (awareness of the bodys position in space),
tactical awareness (awareness of what equipment should feel like as
it makes contact with the body), coordination (ability to move
multiple limbs with timing and precision e.g. hand-eye or foot-eye
coordination), fast reaction time and perceptive senses (enhanced
sensitivity of the senses, especially during fast-paced sports)

The Learning Environment

The Nature of Skill

Skills can be categorised based on the following.
Closed Skills are performed in a leaning environment which is
unchanging, stable and predictable
Open Skills are performed in a leaning environment which is
changing, less stable and somewhat unpredictable
Gross Motor Skills require the use of large muscle groups to
produce a less refined movement
Fine Motor Skills require the use of small muscle groups to
produce a precise and accurate movement
Self-paced skills are performed when the athlete chooses to, such
as when to bowl the cricket ball or when to commence a high jump
attempt
Externally paced skills are not at the discretion of the athlete,
and they must perform the skill based on forces out of their
control, such as hitting a baseball or being a goalkeeper in
hockey
Discrete skills have a clearly defined beginning and end, such as
a golf shot, a 100m sprint or a pass in football
Serial Skills are a combination of a range of discrete skills
into one whole movement. Team sports are require serial skills as
an athlete is constantly using a variety of skills in competition
Continuous Skills have no clear beginning or end, and the point
at which they start or end is at the discretion of the athlete,
such as going for a run or swim

The Performance Elements

Decision making
Strategic and tactical development
The Practice Method
Massed Practice is characterised by periods of continuous
practice with short rest intervals. This is suitable for
activities that are fun, of moderate intensity or for highly
motivated athletes. Suitable examples include golf putting or
goalkeeping
 Distributed Practice is characterised by shorter periods of work
with more regular periods of rest. This is suitable for
monotonous or difficult activities, for high-intensity activities
that cause excessive or where motivation is low. This would suit
activities such as water-skiing or tackling in rugby league
Whole Practice involves practicing the complete skill in its
entirety. This suits advanced learners or for skills that cannot
be broken down into sub-components that can be practiced in
isolation, such as archery or sailing
Part Practice involves isolating the various sub-components,
practicing each and then combining it all together in a complete
movement. This is suitable for very complex skills such as pole
vault, or for beginners who are in the cognitive stage

Feedback
Intrinsic Feedback information that is received internally
through the senses by the performer. As a learner continues to
improve, they should be developing the ability to detect and
correct their own errors. A Refined kinaesthetic sense is
critical in enabling them to analyse the feel of the movement
Extrinsic Feedback information that is received from an
external source, such as a coach, the crowd or video analysis
Concurrent Feedback is feedback that is received during the
performance, and is closely aligned with intrinsic feedback. The
athlete may be able to adjust the current movement as it is being
executed, such as a batter adjusting their shot selection as the
ball swings unexpectedly. Or they can adjust the skill the next
time it is executed
Delayed Feedback is feedback that is received after the
completion of the skill. It can be either intrinsic, via video
analysis, or through an extrinsic source such as a coach.
Sometimes this feedback can arrive days later during a video
analysis session
Knowledge of Results information concerning the outcome or
success of the skill, such as whether ball was in or not. This
information can then be used to analyse why the skills was
successful or not. This is most useful for beginners as the
develop their basic motor patterns
Knowledge of Performance information concerning the actual
technique or the patterns of play. This is used more so by
learners in the autonomous stage and can arrive from both
extrinsic and extrinsic sources. Coaches of elite athletes must
be very competent in carefully analysing performances to detect
and help correct even minor errors. Also in team sports, the
coach must be very good at analysing the play and identifying
areas of strengths and weakness in both teams, and communicating
relevant feedback and strategies for the team

Assessment of Skill and Performance

Characteristics of a Skilled Performance

There are a number of observable differences between a skilled and
unskilled performance.
Kinaesthetic Sense
 Anticipation
Consistency
Technique
Mental Approach

Objective and Subjective Performance Measures

There are a range of tests that can be used in order to make a
measurement or an appraisal as to the quality of performance.
Objective Measurement Where an assessment is not based on human
interpretation or analysis, the test is described as objective.
Sporting examples include high jump, the 100m sprint and the
score in a team sport. These measurements are the most fair and
reliable in terms of who the winner was. However, they may not
provide enough information for a complete analysis of the
technique or performance
Subjective Measurement Assessment that relies on personal
opinions and judgment is described as subjective. Some sports
rely solely on a subjective measurement, such as in diving or
gymnastics. The analysis of technique or tactical performance
also relies on subjective measures, as the coach makes a personal
interpretation

Validity and Reliability of tests

The assessment of sporting performances must measure what it
actually intends to measure (validity) and also ensure the same
results are achieved regardless of who, where or when the test is
administered (reliable).

Personal versus Prescribed Judging Criteria

When a subjective measurement is to be made of any sporting
performance, some degree of criteria is used which enables a more
complete and fair appraisal. To increase the objectivity required
for official competition, prescribed criteria are developed by the
judges or governing body. These involve rating scales, checklists
and scoring systems that minimise the chance of error or bias
affecting the results. Commitment and degree of difficulty

HSC Option 1: THE HEALTH OF YOUNG

PEOPLE
Critical Question 1 What is good health for young
people?
The Nature of Young Peoples Lives

How the Developmental Stage can vary in Motivations, Values, and

Sociocultural Background
The Influence of Family and Peers
The Influence of Prevailing Youth Cultures
The Influence of Global Events and Trends
The Influence of Technology
Epidemiology of the Health of Young People
Patterns of Morbidity and Mortality
Comparisons of Health Status with that of Other Age Groups

The Effects of the Determinants of Health on Young People

Individual Factors
Sociocultural Factors
Socioeconomic Factors
Environmental Factors

Developmental Aspects that Affect the Health of Young People

Revising roles within relationships
Clarifying self-identity and self-worth
Developing self-sufficiency and autonomy
Establishing education, training and employment pathways
Determining behavioural boundaries

Critical Question 2 To what extent do Australias

young people enjoy good health?
The Major Health Issues that Impact on Young People

Mental health problems and illnesses

Alcohol consumption
Violence
Road safety
Sexual health
Body Image
Other relevant/emerging health issues that impact on the health
young people include gambling, cyber-bullying, party crashes and
drink spiking.

Critical Question 3 What skills and actions enable

young people to attain better health?
Skills in Attaining Better Health

Building Self Concept

Developing Connectedness and Support Networks
Developing Resilience and Coping Skills
Developing Health Literacy Skills
Developing Communication Skills
Accessing Health Services
Becoming Involved in Community Service
Creating a Sense of Future

Actions Targeting Health Issues Relevant to Young People

Social Action
Legislation and Public Policy
Health Promotion Initiatives
HSC Option 2: SPORT AND PHYSICAL
ACTIVITY IN AUSTRALIAN SOCIETY
Critical Question 1 How have meanings about sport
and physical activity changed over time?
The beginnings of modern sport in 19th century England and
colonial Australia
Links with manliness, patriotism and character
The meaning of amateur and professional sport
Womens historical participation in sport

Sport as a commodity
The development of professional sport
Sport as big business
Sponsorship, advertising and sport
The economics of hosting major sporting events
Consequences for spectators and participants

Critical Question 2 What is the relationship

between sport and national and cultural identity?
Australian sporting identity
National and regional identity through sporting achievements
Government funding
Politics and sports

The meaning of physical activity and sport to Indigenous

Australians
Traditional activities and sports
Links between community and identity

Physical activity, sport and cultural identity

The role of competition
Links to cultural identity
Relationships to health
Ways of thinking about the body

Critical Question 3 How does the mass media

contribute to peoples understanding, values and
beliefs about sport?

The relationship between sport and the mass media

The representation of sport in the media

Economic considerations of media coverage and sport

Deconstructing media messages, images and amount of coverage

Differences in coverage for different sports across various print
and electronic media
The emergence of extreme sports as entertainment
Critical Question 4 What are the relationships
between sport and physical activity and gender?
Sport as a traditionally male domain

Sport and the construction of masculinity and femininity

Implications for participation
Sponsorship, policy and resourcing
The role of the media in constructing meanings around femininity and
masculinity in sport

HSC Option 3: SPORTS MEDICINE

Critical Question 1 How are sports injuries
classified and managed?
Ways to Classify Sports Injuries

Direct and Indirect

Soft and Hard Tissue
Overuse

Soft Tissue Injuries

Tears, Sprains and Contusions
Skin Abrasions, Lacerations and Blisters
Inflammatory Response

Hard Tissue Injuries

Fractures
Dislocations

Assessment of Injuries
TOTAPS

Critical Question 2 How does sports medicine

address the demands of specific athletes?
Children and Young Athletes

Medical Conditions
Overuse Injuries
Thermoregulation
Appropriateness of Resistance Training

Adult and Aged Athletes

Heart Conditions
Fractures and Bone Density
Flexibility and Joint Mobility

Female Athletes
Eating Disorders
Iron Deficiency
Bone Density
Pregnancy

Critical Question 3 What role do preventative

actions play in enhancing the wellbeing of the
athlete?
Physical Preparation

Pre-Screening
Skill and Technique
Physical Fitness
Warm-up, Stretching and Cool Down

Sports Policy and the Sports Environment

Rules of Sports and Activities
Modified Rules for Children
Matching of Opponents
Use of Protective Equipment
Safe Grounds, Equipment and Facilities

Environmental Considerations
Temperature Regulation
Climatic Conditions
Guidelines for Fluid Intake
Acclimitisation

Taping and Bandaging

Preventative Taping
Taping for Isolation of Injury
Bandaging for the Immediate Treatment of Injury

Critical Question 4 How is injury rehabilitation

managed?
Rehabilitation Procedures

Progressive Mobilisation
Graduated Exercise
Training
Use of Heat and Cold

Return to Play
Indicators of Readiness for Return to Play
Monitoring Progress
Psychological Readiness
Specific Warm up Procedures
Return to Play Policies and Procedures
Ethical Considerations

HSC Option 4: IMPROVING PERFORMANCE

Critical Question 1 How do athletes train for
improved performance?

Strength training
Resistance training
Weight training
Isometric training

Aerobic training
Continuous/uniform
Fartlek
Long interval

Anaerobic training (power and speed)

Developing power through resistance/weight training
Plyometrics
Short interval

Flexibility training
Static
Dynamic
Ballistic

Skill training
Drills practice
Modified and small-sided games
Games for specific outcomes

Critical Question 2 What are the planning

considerations for improving performance?
Initial planning considerations

Performance and fitness needs

Schedule of events/competitions
Climate and season

Planning a training year (periodisation)

Phases of competition
Subphases
Peaking
Tapering
Sport-specific subphases

Elements to be considered when designing a training session

Health and safety considerations
Providing an overview of the session to the athletes
Warm up and cool down
Skill instruction and practice
Conditioning
Evaluation
Planning to avoid overtraining
Amount and intensity of training
Physiological considerations
Psychological considerations

Critical Question 3 - What ethical issues are related

to improving performance?
Use of drugs

The dangers of performance enhancing drugs

For strength
For aerobic performance
To mask other drugs
Benefits and limitations of drug testing

Use of technology
Training innovation
Some training innovations include:
Equipment advances

HSC Option 5: EQUITY AND HEALTH

Why do inequities exist in the health of
Australians?
Factors that create health inequities

Daily living conditions

Quality of early years of life
Access to services and transport
Socioeconomic factors
Social attributes
Government policies and priorities

Critical Question 2 What inequities are experienced

by population groups in Australia?
Populations Experiencing Health Inequities
Aboriginal and Torres Strait Islander Peoples
Homeless
People Living with HIV/AIDS
Incarcerated
Aged
Culturally and Linguistically Diverse Backgrounds
Unemployed
Geographically Remote Populations
People with Disabilities

Critical Question 3 How may the gap in health

status be bridged?
Funding to Improve health
Funding for Health
Funding for Specific Populations
Limited Resources

Actions that Improve Health

Enable (Using Knowledge and Skills for Change)
Mediate (Working for Consensus)
Advocating (Speaking up for Specific Groups, their Needs and
Concerns)

A Social Justice Framework for Addressing Health Inequities

Empowering Individuals in Disadvantaged Circumstances
Empowering Disadvantaged Communities
Improving Access to Facilities and Services
Encouraging Economic and Cultural Change

Characteristics of Effective Health Promotion Strategies

Working with the Target Group in Program Design and Implementation
Ensuring Cultural Relevance and Appropriateness
Focusing on Skills, Education and Prevention
Supporting the Whole Population while Directing Extra Resources to
those in High Risk Groups
Intersectoral Collaboration