SACE Stage 2 Health and Wellbeing cheat sheet

Determinants of health fall into five broad groups: biological/genetic, behavioural, social, economic, and environmental; each group can act at individual, community, and population levels.

The Dahlgren-Whitehead rainbow model layers influences from innermost (age, sex, constitutional factors) outward through individual lifestyle, social and community networks, living and working conditions, and general socioeconomic, cultural, and environmental conditions.

The social gradient in health describes the stepwise relationship between socioeconomic position and health outcomes: health improves as income, education, and occupational status rise, with no threshold above which gains stop.

The Ottawa Charter (1986) identifies five health promotion prerequisites: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity.

Risk factors are cumulative: exposure to multiple adverse factors (e.g., low income plus poor housing plus social isolation) produces more than additive harm, so cumulative risk scores predict outcomes better than single factors.

The biopsychosocial model treats health as the interaction of biological, psychological, and social factors; it contrasts with the purely biomedical model, which locates illness in biological pathology alone.

Protective factors (social support, secure attachment, health literacy, stable employment) buffer the effect of risk factors; resilience is the capacity to maintain or regain wellbeing under stress, not the absence of risk.

Health literacy is the ability to obtain, understand, and use health information to make decisions; low health literacy is independently associated with poorer self-management and higher hospitalisation.

Intersectionality holds that overlapping social identities (e.g., gender, ethnicity, disability, class) combine to produce health disadvantage that cannot be explained by any single identity alone.

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

Indigenous health models such as the Aboriginal and Torres Strait Islander social and emotional wellbeing framework are holistic, encompassing connection to land, culture, spirituality, ancestry, family, and community.

Epidemiological measures used to compare contexts: incidence (new cases per population per time), prevalence (all existing cases at a point), mortality rate, morbidity rate, and life expectancy at birth.

The Demographic and Epidemiological Transitions describe the shift from high birth and death rates with infectious disease to low birth and death rates with chronic, non-communicable disease as societies develop.

Health inequities are avoidable, unjust differences between groups; health inequalities are any observed differences, which may or may not be unjust. This distinction is a key exam decision rule.

The social determinants of health, per WHO, are the conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels.

Rural and remote contexts typically show lower access to services, longer travel times, and workforce shortages; urban contexts show higher population density, pollution exposure, and service concentration.

Global burden of disease metrics: DALY (disability-adjusted life year) = YLL (years of life lost) + YLD (years lived with disability); one DALY equals one lost year of healthy life.

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

Health promotion is the process of enabling people to increase control over and improve their health; it is distinct from health education, which is one strategy within it.

The Health Belief Model predicts behaviour from perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy.

The Transtheoretical (Stages of Change) Model: precontemplation, contemplation, preparation, action, maintenance (and termination); interventions should match the stage rather than assume readiness.

The social-ecological model targets change at five levels: intrapersonal, interpersonal, organisational, community, and public policy; effective programs intervene at multiple levels.

Upstream approaches modify the environment or policy so healthy choices become the default (e.g., fluoridation, plain packaging); downstream approaches target individual behaviour after risk is established.

Community development is a bottom-up approach that builds local capacity and participation; it contrasts with top-down needs-based provision, which may reduce ownership and sustainability.

Primary prevention acts before disease onset; secondary prevention detects disease early (screening); tertiary prevention limits disability and promotes rehabilitation after disease is established.

Health impact assessment predicts the health consequences of a proposed policy, program, or project before implementation, and is used to embed health into non-health sectors.

The UN Sustainable Development Goals (2015, 17 goals, 169 targets) include SDG 3 (good health and wellbeing), which has targets for maternal and child mortality, communicable and non-communicable disease, and universal health coverage.

Universal health coverage (UHC) means all people receive quality health services without financial hardship; it is measured by service coverage and catastrophic out-of-pocket spending indicators.

The WHO Framework Convention on Tobacco Control (2003) is the first international treaty negotiated under WHO and obliges parties to implement price, advertising, and smoke-free measures.

The International Health Regulations (2005) require states to detect, assess, report, and respond to public health events and define the Public Health Emergency of International Concern (PHEIC) mechanism.

The epidemiological triad of agent, host, and environment explains infectious disease causation; control can target any leg, e.g., vaccination (host), sanitation (environment), or treatment (agent).

Antimicrobial resistance is driven by overuse and misuse of antibiotics in human and animal health; it is a One Health issue requiring coordinated human, animal, and environmental action.

Globalisation spreads health risks (pandemics, tobacco and alcohol marketing, obesogenic food environments) and health resources (knowledge, medicines, workforce), so effects are bidirectional.

The inverse care law states that the availability of good medical care tends to vary inversely with the need of the population served, a pattern visible both within and between countries.

Aid effectiveness principles (Paris Declaration, 2005) include country ownership, alignment, harmonisation, managing for results, and mutual accountability; vertical programs can undermine health system integration.