How Healthy Are Australians?

This topic is the first content group of the focus area Health in an Australian and global context. The HSC exam gives the two focus areas roughly equal weight. Section II (56 marks) has 9–12 short-answer items, at least three of them worth 6–8 marks, and Section III has two 12-mark extended responses, one on each focus area. Expect data questions and at least one longer analysis question from this topic.

• Health status of Australians: reading reports, tables and graphs (especially the AIHW's _Australia's health_ reports); major causes of morbidity and mortality; life expectancy for males, females and the whole population; the sociological causes of risky behaviours.
• Groups experiencing health inequities: Aboriginal and Torres Strait Islander Peoples, plus ONE other group (for example socioeconomically disadvantaged people, people in rural and remote areas, or people with disability). You need data, how the determinants interact, the underlying causes and the actions to improve health.
• International comparison: how Australia ranks among OECD countries, why, and what Australia could learn.
• Major conditions: cardiovascular disease (CVD), cancer and ONE other condition: mortality, morbidity, prevalence, incidence, risk and protective factors, and which groups' rates are changing.
• An ageing population: data, healthy ageing, opportunities and challenges, and current and future strategies.

Key terms

• Mortality: deaths in a population. Usually shown as a rate per 100 000 people.
• Morbidity: illness, disease and injury in a population (hospital separations, GP visits, people living with a condition).
• Prevalence: the number or proportion of people who have a condition at a point in time (old and new cases).
• Incidence: the number or rate of new cases in a period, usually a year.
• Life expectancy: the average number of years a person could expect to live if current age-specific death rates stayed the same.
• Burden of disease: the impact of illness and death, measured in DALYs (disability-adjusted life years). One DALY is one year of healthy life lost. DALY = YLL (years of life lost to premature death) + YLD (years lived with illness or disability).
• Age-standardised rate: a rate adjusted to remove the effect of differences in age structure. Use it when comparing populations or years, because an older population will naturally have more deaths and more chronic disease.

Worked example: rates and change

A region of 250 000 people recorded 375 deaths from stroke in one year. Ten years earlier, the rate was 210 per 100 000.

The fall from 210 to 150 per 100 000 is $\frac{60}{210}\times 100\approx 28.6\%$ A good answer then explains the trend (better blood pressure control, less smoking, faster stroke treatment) rather than just restating it.

Data skills the exam rewards

• Quote the numbers with units and the year ("in 2024, dementia caused about 9.4% of deaths").
• Describe the trend (rising, falling, stable), the comparison (which group is higher, and by how much) and any anomaly.
• Then explain: link the pattern to determinants or interventions.

These figures were current in late 2026. Check the date when you quote any statistic.

• Life expectancy is among the highest in the world: about 81 years for males and 85 years for females born in 2021–2023 (ABS).
• Leading causes of death: in 2024 dementia (including Alzheimer's disease) was the leading cause of death overall, ahead of coronary heart disease (ABS, released November 2025). Coronary heart disease remains the leading cause for males; dementia has been the leading cause for females since 2016. Other leading causes include stroke, lung cancer and chronic lower respiratory diseases such as chronic obstructive pulmonary disease (COPD).
• Burden of disease: chronic conditions cause most of the burden. Cancer, musculoskeletal conditions (such as back pain and arthritis), mental and substance use disorders and CVD are the largest groups. About a third of the total burden could be prevented by reducing risk factors, with tobacco use, overweight and obesity, and dietary risks the biggest contributors.
• Risky behaviours: smoking rates have fallen a long way, but vaping has risen among young people; about two in three adults are overweight or obese; most adults and adolescents don't meet physical activity guidelines.

Sociological causes of risky behaviour

Sociological (sociocultural) factors are the social influences around people: peers, family, media, culture and community norms. For example, peer and social-media norms can make binge drinking or vaping seem normal; parents who smoke model smoking; advertising and the easy local availability of alcohol and fast food shape choices. Examiners want you to explain why people behave as they do, not just list the behaviours.

A health inequity is a difference in health that is unfair and avoidable, because it comes from social, economic or environmental conditions rather than biology.

Aboriginal and Torres Strait Islander Peoples

• Data: in 2020–2022, life expectancy at birth was 71.9 years for Aboriginal and Torres Strait Islander males and 75.6 years for females, a gap of 8.8 and 8.1 years compared with non-Indigenous Australians as published by the ABS. (Subtracting the rounded figures for non-Indigenous Australians, 80.6 and 83.8 years, gives 8.7 and 8.2 years; either is accepted in an exam.) There are also higher rates of chronic disease (diabetes, kidney disease, CVD), infant mortality, suicide and preventable hospitalisations.
• Underlying causes: the ongoing effects of colonisation, dispossession from land, racism and intergenerational trauma from past policies (such as the forced removal of children). These shape the other determinants.
• How the determinants interact: lower income and employment, lower school completion and overcrowded housing increase exposure to infections and risk factors. Remoteness limits access to services. Experiences of racism reduce trust in mainstream services, so care is sought later. Connection to Country, culture and community are protective factors.
• Actions: a strengths-based approach. Examples include Aboriginal Community Controlled Health Organisations (ACCHOs), which are run by local communities and provide holistic, culturally safe care; the National Agreement on Closing the Gap (2020), whose priority reforms include shared decision-making and building the community-controlled sector; Aboriginal health workers; and action on housing, education and employment.

One other group: an example (rural and remote people)

• Data: life expectancy falls and rates of road deaths, suicide, chronic disease and preventable hospitalisation rise as remoteness increases.
• Determinants: distance from GPs, specialists and hospitals (environmental); lower incomes and more hazardous jobs such as farming and mining (socioeconomic); norms of self-reliance that delay help-seeking (sociocultural); higher-speed roads and older vehicles.
• Actions: the Royal Flying Doctor Service, telehealth, incentives for rural doctors, mental health programs for farmers, road safety campaigns.

If you study socioeconomically disadvantaged people or people with disability instead, structure your notes the same way: data → determinants and how they interact → underlying causes → actions.

For each condition, know mortality and morbidity, prevalence and incidence, risk and protective factors, and where and for whom rates are changing.

Why death rates are falling: less smoking (lung cancer and CVD); better detection through national screening programs for bowel, breast and cervical cancer; better treatment (stents, blood pressure and cholesterol medication, stroke units, targeted therapies and immunotherapy).

One other condition. Choose one and learn it in the same detail. Good choices are dementia (now the leading cause of death overall, strongly linked to age; risk factors include physical inactivity, high blood pressure, hearing loss and social isolation), diabetes (mostly type 2, linked to obesity and inactivity) or mental health conditions (the leading cause of burden among young people).

The OECD (Organisation for Economic Co-operation and Development) compares member countries on measures such as life expectancy, infant mortality, risk factors and health spending.

• Where Australia does well: life expectancy is in the top group (behind countries such as Japan and Switzerland); smoking rates are among the lowest in the OECD; cancer survival is high.
• Where it does less well: above-average adult overweight and obesity; high alcohol consumption in some groups; large inequities for Aboriginal and Torres Strait Islander Peoples and remote populations.
• Reasons: universal healthcare (Medicare and the PBS), strong tobacco control (including plain packaging since 2012), high incomes and education; but car-dependent cities, energy-dense diets and geographic spread.
• Lessons: for example, Japan's lower obesity rate reflects diet and walking-friendly cities; Nordic countries' smaller health inequities reflect stronger social support. A good answer turns a difference into a realistic lesson.

About one in six Australians is now aged 65 or over, and the share is rising because of lower birth rates and longer lives.

• Healthy ageing: maintaining physical and mental health, social connection and independence in later life.
• Challenges: more people with several chronic conditions at once (multimorbidity) and with dementia; more demand for hospitals, medicines and aged care; aged-care workforce shortages; a smaller working-age share of the population to fund services.
• Opportunities: older people volunteer, care for partners and grandchildren, mentor and stay in paid work longer; demand drives innovation such as home-based care and telehealth.
• Strategies: falls prevention and strength-and-balance programs, home care packages, dementia-friendly communities, social connection programs, and planning by government and non-government agencies (aged-care providers, not-for-profits such as Dementia Australia).

Some of the content in this topic, such as suicide and intergenerational trauma, can be distressing. If you need to talk to someone, contact Kids Helpline (1800 55 1800) or Lifeline (13 11 14).

• Mixing up prevalence (all existing cases) and incidence (new cases).
• Quoting statistics with no year or source. Data change every year.
• Explaining inequities only through individual behaviour ("they smoke more") instead of underlying causes and determinants.
• Writing about ageing as only a burden. Most questions expect opportunities and challenges.
• Describing CVD and cancer without risk and protective factors, or without saying which groups' rates are changing.

• Command verbs matter. _Describe_ = features; _explain_ = cause and effect; _analyse_ = relationships and implications; _evaluate_, _assess_ and _to what extent_ = a judgement with evidence.
• For data stimulus questions, quote numbers from the stimulus, do any calculation clearly, then explain.
• In an inequities answer, use the chain: data → determinants → how they interact → underlying cause → action that targets it.
• A full-mark 12-mark response has a clear argument from the first sentence, uses accurate dated data, links ideas with phrases such as "as a result" and "this is compounded by", and concludes by answering the question.

• The healthcare system, change and health promotion (HMS-H2): Medicare, the PBS, ACCHOs, telehealth and the SDGs are the actions that respond to the health status and inequities described here.
• Training for improved performance (HMS-T1, HMS-T2): physical activity is a protective factor for CVD, some cancers, diabetes and dementia, and supports healthy ageing.
• Year 11 (Health for individuals and communities): the determinants of health are assumed knowledge.