CATEGORY 1: DETERMINANTS OF HEALTH
Identify the determinant: In a rural community in a low-income country, many families cannot afford to pay for medical appointments or purchase prescribed medication. As a result, people often delay seeking treatment for preventable illnesses.
Which determinant of health is most directly affecting these families?
Economic determinant — poverty or low income. Families have limited financial resources to pay for healthcare and medication, creating barriers to treatment.
Question:
A community health programme recognises that physical illness can affect a person's mental wellbeing, relationships and ability to participate in cultural practices.
Which underlying concept of health is demonstrated by recognising these interconnected dimensions of wellbeing?
Hauora. Hauora recognises that wellbeing includes interconnected dimensions. A change in one dimension can affect other dimensions.
A child living in an area with a high prevalence of malaria experiences repeated fevers and fatigue, making it difficult to attend school or participate in physical activities.
Which dimension of Hauora is most directly affected?
Taha tinana — physical well-being. Malaria affects the child's physical health and ability to function.
A child lives in a household where the family cannot afford nutritious food. The child experiences poor growth and becomes more susceptible to illness.
Identify the determinant of health and explain one effect on the child's wellbeing.
Economic determinant — poverty. Limited household income reduces access to nutritious food, which can contribute to malnutrition, impaired growth and increased vulnerability to illness.
A health organisation runs a campaign encouraging individuals to use mosquito nets and remove standing water around their homes to reduce malaria transmission.
Which health promotion approach is most clearly demonstrated?
Behaviour change. The intervention encourages individuals to change specific behaviours that can reduce their risk of malaria.
A community experiences repeated outbreaks of waterborne diseases because families have no reliable access to clean drinking water. Many households rely on contaminated rivers for drinking, cooking and washing.
Which determinant of health is most directly contributing to this issue?
Environmental determinant — access to clean water and adequate sanitation. Contaminated water increases the risk of infectious diseases and negatively affects physical wellbeing.
Question:
An international organisation develops a programme that helps communities understand the causes of malaria and supports them in taking action to reduce mosquito breeding sites.
Which underlying health concept is demonstrated by helping people and communities take action to improve their health?
Health promotion. Health promotion involves enabling people and communities to increase control over and improve their health.
A teenager living with a chronic infectious disease experiences anxiety about their future and worries about how others will react if they disclose their condition.
Which dimension of Hauora is most directly affected?
Taha hinengaro — mental and emotional well-being. The teenager experiences anxiety, worry and emotional distress.
A community has limited access to healthcare because its nearest clinic is several hours away. Many people cannot afford transport, so they delay seeking treatment for preventable illnesses.
Identify TWO determinants of health that interact in this scenario.
Economic determinant: Limited income makes transport unaffordable.
Political determinant: Government decisions about the location, funding, and distribution of healthcare services can limit rural communities' access to clinics.
A community programme provides residents with the knowledge, resources and confidence to identify local health priorities and develop their own solutions.
Which health promotion approach is demonstrated?
Self-empowerment. The programme supports people to develop the knowledge, skills and confidence to make informed decisions and take control of their health.
Identify the determinant:
A government decides to reduce funding for rural health clinics. Consequently, some communities lose access to local healthcare services, and people must travel long distances to receive treatment.
Identify the most relevant determinant of health and explain how it contributes to the health issue.
Political determinant — government policy and funding decisions. Reduced funding limits the availability of healthcare services, creating barriers to diagnosis and treatment and potentially worsening health outcomes.
Question:
A country has high rates of preventable infectious disease. Some individuals have limited knowledge about prevention, local communities lack adequate sanitation, and the government has not invested sufficiently in public health infrastructure.
Which underlying concept helps explain how influences at individual, interpersonal, community and societal levels contribute to the health issue?
The socio-ecological perspective. It recognises that health is influenced by interacting factors at multiple levels, rather than by individual choices alone.
A family is displaced by a natural disaster. They are separated from their extended family and community, losing important relationships and sources of emotional support.
Which dimension of Hauora is particularly affected?
Taha whānau — social and family well-being. Separation disrupts family relationships, social connections and support networks.
A lack of safe drinking water contributes to repeated diarrhoeal illness in a community. Children miss school, parents worry about their families' health, and household finances are stretched by medical costs.
Explain how this issue can affect TWO dimensions of Hauora.
Taha tinana: Repeated illness can cause dehydration, weakness and other physical health problems.
Taha hinengaro: Ongoing concern about illness and financial pressures can contribute to stress and anxiety.
Other acceptable answer: Taha whānau, if students explain how caring responsibilities, missed work or family stress affect relationships and family wellbeing.
Residents, community leaders, healthcare professionals and local organisations work together to campaign for improved sanitation and better access to clean water.
Which health promotion approach is most clearly demonstrated?
Collective action. Different groups work together to address a shared health issue and create improvements for the community.
Identify two determinants
n a country experiencing high rates of childhood malnutrition, many families live in poverty. Healthy food is expensive, and some communities have experienced prolonged droughts that have reduced agricultural production.
Identify TWO different determinants of health and explain how each contributes to childhood malnutrition.
Economic determinant — poverty or low income. Families may be unable to afford sufficient nutritious food.
Environmental determinant — drought and food availability. Drought reduces agricultural production, limiting the availability of food and potentially increasing food prices.
In a community affected by HIV, some people believe that individuals living with HIV should be excluded from community activities. This leads to discrimination and discourages some people from seeking testing or treatment.
Which underlying concept helps explain how people's beliefs and judgments can influence health-related behaviour and the wellbeing of others?
Attitudes and values. Beliefs, judgments and values can influence how people behave towards others and how they make health-related decisions. Stigmatising attitudes can contribute to discrimination and barriers to healthcare.
An Indigenous community is affected by an international health crisis. Restrictions and displacement prevent community members from practising important cultural traditions and connecting with places of spiritual significance.
Which dimension of Hauora is particularly affected, and why?
Taha wairua — spiritual well-being. The community's ability to maintain important cultural and spiritual connections is disrupted.
Acceptable extension: Taha whānau may also be affected if displacement disrupts family and community connections.
A country experiences high rates of malaria. Some individuals have limited knowledge about prevention, households cannot afford mosquito nets, communities have poor waste management, and national funding for prevention programmes is limited.
Identify THREE levels of influence from the socio-ecological perspective and give an example of each
Individual: Limited knowledge about malaria prevention.
Interpersonal or household: Families cannot afford mosquito nets or lack the resources to protect household members.
Community: Poor waste management creates conditions that may support mosquito breeding.
Societal: Limited government funding restricts prevention programmes.
A country experiences high rates of preventable illness because many rural communities lack access to clean drinking water. The government is considering two strategies:
Strategy A: Run a campaign encouraging individuals to boil their drinking water.
Strategy B: Invest in reliable community water infrastructure.
Which strategy more directly addresses the underlying determinant described, and why?
Strategy B — investing in reliable community water infrastructure. This directly addresses the environmental determinant of access to safe drinking water and can benefit the wider community over time.
Strategy A may provide a useful short-term measure, but it places responsibility on individuals and may be difficult to implement consistently where fuel or other resources are limited.
Students may argue that a combination of both strategies is appropriate if they justify the value of short-term prevention alongside long-term infrastructure improvements.
An international health organisation investigates a high rate of tuberculosis in an urban community. Its findings reveal that many residents live in overcrowded housing, have insecure employment and cannot afford transport to healthcare facilities. Some residents also avoid seeking treatment because they fear discrimination.
Identify THREE determinants of health and explain how they interact to contribute to the tuberculosis problem.
Environmental determinant — overcrowded housing. Close living conditions increase opportunities for tuberculosis to spread.
Economic determinant — insecure employment and financial hardship. Residents may struggle to afford transport or may be unable to take time off work to attend appointments.
Social determinant — discrimination and stigma. Fear of negative treatment may discourage people from seeking testing or accessing healthcare.
An international organisation works with local communities to reduce maternal deaths. Instead of simply providing medical information, it involves community leaders, healthcare professionals and families in developing culturally appropriate services. The programme recognises that physical health, mental wellbeing, family relationships and cultural connections all matter.
Identify TWO underlying concepts demonstrated in this scenario and explain how each is relevant.
Health promotion. The programme enables communities to participate in improving health outcomes and supports collective action.
Hauora. The programme recognises that maternal health involves interconnected dimensions of wellbeing, not just physical health.
Other acceptable connection: The socio-ecological perspective is relevant because the programme involves individuals, families, community leaders and healthcare systems.
An outbreak of a preventable disease affects a rural community. People who become ill experience physical symptoms, anxiety about their recovery, separation from family members during treatment and disruption to important cultural practices.
Identify THREE dimensions of Hauora and explain how each is affected.
Taha tinana: Physical illness and symptoms negatively affect physical well-being.
Taha hinengaro: Uncertainty and concern about recovery can create anxiety and emotional distress.
Taha whānau: Separation from family can disrupt relationships and reduce access to emotional support.
An international health issue affects a low-income country where many people have limited access to education. Healthcare information is not consistently available in local languages, and some communities distrust health services because of previous discriminatory treatment.
Explain how THREE determinants of health may interact to influence health outcomes.
Economic determinant: Poverty can limit people's ability to access education, transport and healthcare services.
Political determinant: Government decisions about education, healthcare funding and the provision of services in local languages can influence people's ability to access appropriate healthcare.
Social determinant: Previous experiences of discrimination can create mistrust of healthcare providers, discouraging people from seeking medical advice or treatment.
An international health organisation wants to reduce tuberculosis in a community experiencing overcrowded housing, poverty, limited access to healthcare and stigma towards people with the disease.
Recommend TWO complementary health promotion strategies. Explain how each strategy could address the issue and improve health outcomes.
Strategy 1: Improve access to testing and treatment.
Provide accessible community-based testing and treatment services.
This addresses barriers associated with healthcare access, transport and financial hardship.
Earlier diagnosis and treatment can improve individual outcomes and help reduce transmission.
Strategy 2: Develop a community-led anti-stigma and education programme.
Work with trusted community leaders and healthcare professionals to provide accurate information and challenge discriminatory attitudes.
This can improve understanding of tuberculosis, reduce stigma and encourage people to seek testing and treatment.
Further development: Students could also recommend improving housing conditions to address overcrowding, a wider environmental determinant. Strong answers should explain how the strategies complement one another rather than simply list interventions.