NCEA L1 Health Studies cheat sheet

Te Whare Tapa Whā (Mason Durie, 1984) models wellbeing as four walls - taha wairua (spiritual), taha hinengaro (mental/emotional), taha tinana (physical), taha whānau (family/social) - resting on a whenua (land/roots) foundation; a weakened wall weakens the whole whare.

Fonofale (Sione Tu'itahi, 1985) uses a Pacific model: the foundation is family, the three pillars are spiritual, physical and mental wellbeing, the roof is shelter, and the surrounding fluid is culture, environment, time and context.

Meihana model (Mason Durie) adds migration, colonisation and racism as determinants affecting Māori health, alongside the four walls of Te Whare Tapa Whā.

Te Pae Mahutonga (Southern Cross) names six community wellbeing tasks: mauriora (cultural identity), waiora (physical environment), toiora (healthy lifestyles), te oranga (participation in society), ngā manukura (community leadership) and te mana whakahaere (autonomy).

Hauora is holistic wellbeing, not merely the absence of disease; the WHO definition is 'a state of complete physical, mental and social wellbeing' - a contested ideal because no one is ever 'complete'.

Wellbeing is dynamic: an individual's state shifts with time, context and life stage, so a snapshot measure (e.g. a single survey) cannot capture a whole life.

Whānau wellbeing is collective and intergenerational; an individual's health affects and is affected by the whānau, so interventions targeting one person ripple outward.

Determinants cluster: physical (genes, diet, exercise, sleep), mental/emotional (stress, coping), social (family, peers, belonging), spiritual (values, purpose) and environmental (housing, safety, access).

Determinants of health are the conditions in which people are born, grow, live, work and age - grouped as biological, behavioural, social, economic, environmental and cultural.

The Dahlgren–Whitehead rainbow model layers influences: individual (age, sex, genes), lifestyle, social/community networks, living and working conditions, and general socioeconomic, cultural and environmental conditions.

Social determinants include income, education, employment, housing quality, food security, transport and social support; they are often more powerful than health-care access.

Socioeconomic gradient: health improves stepwise with income and status - the gap matters, not just absolute poverty, so relative inequality predicts health outcomes.

Deprivation indices (e.g. NZDep) rank small areas by income, employment, qualifications, housing, communication and transport, and are used to target services; they measure areas, not individuals.

The Ottawa Charter (1986) names five health-promotion actions: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services.

Behaviours (smoking, alcohol, diet, physical activity, unsafe sex) are shaped by environments and marketing; a behavioural explanation alone can blame individuals and hide structural causes.

Cultural factors include colonisation, racism, language and identity; these are documented determinants of inequity for Māori and Pacific peoples in Aotearoa New Zealand.

Intersectionality: overlapping factors (e.g. low income + disability + rural location) compound disadvantage rather than simply adding up.

Inquiry cycle: identify the issue → ask a focused question → gather and evaluate evidence → interpret findings → decide and act → evaluate the action.

SMART goals: Specific, Measurable, Achievable, Relevant, Time-bound - used to turn a health issue into a testable action plan.

PICO structures a health question: Population, Intervention, Comparison, Outcome; a good question names all four and is answerable with available evidence.

Evidence hierarchy (general guide): systematic reviews/meta-analyses > randomised controlled trials > cohort studies > case-control studies > case reports/opinion; strength depends on design and quality, not just type.

Correlation ≠ causation; check for confounding variables, reverse causation and selection bias before concluding one factor causes another.

Reliability = consistency of repeated measurement; validity = whether a tool measures what it claims. A scale can be reliable but invalid.

Ethics in health inquiry: informed consent, confidentiality/anonymity, cultural safety, avoiding harm, and the right to withdraw - especially for vulnerable groups.

Decision-making models: rational (compare options against criteria), bounded rationality (limited time/information), and shared decision-making (client + clinician + whānau).

Evaluate an action with process (was it delivered as planned?), impact (did outcomes change?) and outcome measures; use both quantitative and qualitative data.