QCAA Health cheat sheet

WHO (1948) defines health as a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Nutbeam's three levels of health literacy are functional (basic reading and comprehension of health information), interactive (applying information and interacting with others) and critical (analysing information to take action and exert control).

Health literacy is a set of cognitive and social skills rather than a synonym for general literacy, so it can be developed through education and changes across the life course.

The social view of health holds that health is produced by social, economic, cultural, political and environmental conditions, with individual lifestyle only one factor among many.

The biomedical model focuses on pathology, diagnosis, treatment and cure of individuals; the social model focuses on determinants, prevention and population-level action.

Ottawa Charter prerequisites for health: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity.

A lifestyle-only explanation of health risks is criticised as 'victim blaming' because it attributes outcomes to individual choice while ignoring structural constraints on that choice.

Decision rule: if an explanation cites income, housing, education, employment, culture or policy, it is using a social framing; if it cites pathogens, genes or clinical treatment only, it is biomedical.

Low health literacy is associated with less use of preventive services, more hospital admissions and higher mortality, and it is distributed along a social gradient rather than randomly.

Determinants of health fall into biological and genetic, behavioural, social, economic, cultural and environmental categories, and they interact rather than acting independently.

Dahlgren and Whitehead's rainbow model layers influences outward from age, sex and hereditary factors, through individual lifestyle, social and community networks, living and working conditions, to general socioeconomic, cultural and environmental conditions.

Distal (upstream) determinants such as income inequality, education policy and housing supply shape proximal (downstream) determinants such as diet quality, smoking and housing condition.

Health inequality means any measurable difference in health between groups; health inequity means a difference that is avoidable, unjust and unfair.

Equality allocates the same resource to everyone; equity allocates resources according to need so that avoidable disadvantage is reduced.

The social gradient means health improves progressively with each step up the socioeconomic scale, and it appears in all countries regardless of national wealth.

Rate ratio = rate in the disadvantaged group divided by rate in the comparison group; a value of 2.0 means twice the rate. Rate difference = rate in group A minus rate in group B.

Intersectionality describes how combined characteristics such as Indigenous status, remote location, disability and low income produce inequities larger than any single factor alone.

Aboriginal and Torres Strait Islander Australians experience earlier onset of chronic disease and shorter life expectancy, reflecting colonisation, dispossession and ongoing structural disadvantage rather than biological difference.

WHO defines health promotion as the process of enabling people to increase control over, and to improve, their health.

Ottawa Charter (1986) five action areas: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient health services.

Ottawa Charter three basic strategies: advocate for health, enable people to achieve their health potential, and mediate between sectors with conflicting interests.

Three levels of prevention: primary acts before disease occurs, secondary detects and treats existing asymptomatic disease early, tertiary reduces the impact of established long-term disease.

Settings-based approaches act through schools, workplaces, cities and hospitals so that populations are reached where they live, work and learn.

The Jakarta Declaration (1997) set priorities including investing in health development, expanding partnerships across sectors, and securing infrastructure for health promotion.

Health in All Policies requires non-health sectors such as transport, housing and education to consider health impacts, because most determinants sit outside the health system.

Decision rule: a strategy that changes policy, funding or the physical environment is upstream; one that changes individual knowledge, attitudes or skills is downstream.

A health promotion program is judged effective only against its stated objective, measured against baseline data, with attention to unintended harms and to whether the benefit reached the groups most in need.

Validity is the extent to which a study or instrument measures what it claims to measure; reliability is the consistency of repeated measurements. A reliable tool can still be invalid, but a valid tool must also be reasonably reliable.

Experimental designs (randomised controlled trials) use random allocation and a control group to support causal claims; quasi-experiments lack randomisation; observational and correlational designs identify associations only.

Prevalence = existing cases divided by the population at risk at a point in time. Incidence = new cases divided by the population at risk over a specified period.

Common sampling methods are random, stratified, cluster and convenience; convenience samples are quick but introduce selection bias and limit generalisability.

Bias types include selection, measurement, recall, response and publication bias, and each reduces the validity of conclusions drawn.

Ethical requirements: informed consent, voluntary participation, confidentiality or anonymity, minimisation of harm, and ethics committee approval; research with Aboriginal and Torres Strait Islander peoples additionally requires cultural safety and community control.

Evaluation levels: formative (design and pilot phase), process (implementation fidelity and reach), impact (short-term change in knowledge, attitudes or behaviour) and outcome (long-term change in health status).

The RE-AIM framework assesses Reach, Effectiveness, Adoption, Implementation and Maintenance of a program.

Objectives are written as SMART: specific, measurable, achievable, relevant and time-bound.