Beyond the rainbow: Exploring determinants of health in the Australian context

Topic overview Rationale

In your future practice within the workplace, you will treat or work with patients and/or clients who present with a health issue that is shaped by the complex conditions in which they live, work and play. Understanding how these conditions impact the health issue experienced by your patient and/or client means that you will be better prepared and able to support them to achieve authentic improvements in their health and wellbeing.

Task Details

This assessment task requires you to explore a contemporary health issue in Australia and explain what academic evidence says about how this health issue is impacted by underlying determinants of health, specifically by living and working conditions.

Guidelines

1. Choose one of the four health issues as outlined below:

• Mental Health

  • Obesity

  • Skin cancer

  • Cardiovascular disease

(more detail of each provided on page 4 of this document)

1. Choose one determinant from the “living and working conditions” layer of the Dahlgren and Whitehead’s model, to discuss in relation to your chosen health issue:

As shown in the diagram above, the determinants from the “living and working conditions” layer that you can select from are:

• Housing

  • Unemployment

  • Work

  • Healthcare Services

  • Education

  • Agriculture and food production

  • Water and sanitation

(more detail of each provided on page 5 of this document)

1. Find at least two peer-reviewed journal articles (published in the last 10 years) that explains how you chosen determinant in the “living and working conditions” layer impacts on your selected health issue.

Required content and structure

• Introduction: Clearly introduce your chosen health issue and your chosen determinant from the “living and working conditions” layer of Dahlgren and Whitehead’s (1991) Rainbow model. Articulate why this health issue is pertinent in contemporary Australia, using statistics (incidence and prevalence) to illustrate the impact. Finally, outline the key points to be discussed in the report, to build a rationale for investigating your chosen health issue through a public health lens. (approximately 150 words)
• Discuss your chosen determinant from the “living and working conditions” layer in the context of the Dahlgren and Whitehead’s Rainbow model: In this section of your report, describe Dahlgren and Whitehead’s model and use it to explain the link between your chosen determinant from the “living and working conditions” layer and health specifically (direct impacts) as well as more broadly (indirect impacts). (approximately 150 words). For example: Evidence suggests a connection between education and health: higher education levels tend to correspond with better adult health, and vice versa. This link may be direct, as education provides individuals with health knowledge to manage wellness and avoid risks, and indirect, through access to better job prospects, higher income, and reduced stress due to socio-economic advantages associated with education.
• Analyse how you chosen determinant from the “living and working conditions” layer impacts on your selected health issue: Analyse what the academic evidence says about how your chosen determinant from the “living and working conditions” layer can impact your chosen health issue (this can be either positive or negative impacts) and the associated health outcomes of this. (approximately 400 words). For example: Lower health literacy is associated with worse COVID-19 outcomes, due to factors such as non-compliance with public health measures [i.e. wearing a mask; vaccination] which then leads to higher infection rates and more severe illness.
• Conclusion: Provide a conclusion which summarises the main points of your report. (approximately 100 words)

Word count: 800 words (+ or – 10%). The word count includes in-text citations and headings and excludes the reference list.

Referencing and Writing Style: APA-7 Style

Feedback: Written feedback will be available within three (3) weeks of the due date.

Submission: This written assessment must be submitted to the Turnitin submission link as a Word or PDF document. Please include a cover page formatted in-line with APA7 requirements.

Health Issue_Further Details:

Please only select 1 of the five health issues. Some additional information pertaining to each has been provided below.

Mental Health:

Mental health is a pressing public health issue in Australia, affecting over 40% of Australians aged 16 to 85, as reported by the Australian Bureau of Statistics. Conditions like depression and anxiety have profound impacts on individuals, families, and communities, with an estimated $11 billion spent nationally in 2019–20 on mental health-related services. Public health professionals are pivotal in implementing strategies for prevention, early intervention, and improved access to care. Government and community initiatives are crucial to reduce stigma and enhance mental health outcomes.

Obesity:

Obesity, affecting around 67% of Australian adults (approximately 12.5 million people), is a pressing public health issue (Australian Institute of Health and Welfare, 2023). Its significance lies in the widespread availability and affordability of unhealthy food options, particularly in low-income areas. Public health professionals play a pivotal role in researching and implementing strategies to prevent and treat obesity. Collaborating with stakeholders, they work on policies and education programs to enhance access to healthy food, promote physical activity, and curb the consumption of unhealthy options. Tackling obesity is crucial for reducing associated health risks and, consequently, contributes to overall public health improvement in Australia.

Skin cancer:

Skin cancer, encompassing both melanoma and non-melanoma skin cancers, stands as a significant public health issue in Australia, representing the most diagnosed cancers annually, as reported by the Australian Institute of Health and Welfare. The country's heightened exposure to ultraviolet (UV) radiation contributes to elevated skin cancer rates. Recognising the critical link between sun exposure and skin cancer, public health initiatives in Australia focus on comprehensive campaigns promoting sun safety, early detection efforts, and educational programs. Addressing this prevalent health concern is paramount to minimising the impact of skin cancer on the Australian population.

Cardiovascular disease:

Cardiovascular disease (CVD) is a significant public health concern in Australia, with coronary heart disease being the leading cause of disease burden and death, responsible for 11% of all fatalities (Department of Health and Aged Care, 2024). Lifestyle factors

such as poor diet and physical inactivity contribute to CVD prevalence. Public health initiatives focus on awareness, education, and interventions to promote heart-healthy behaviours, aiming to reduce CVD incidence and improve overall heart health in the Australian population.

Determinant of Health_Further Details:

Please only select one determinant of health from the “living and working conditions” layer of the Dahlgren and Whitehead’s model.

Below are examples of key issues specific to each determinant that you could consider in your discussion regarding the impact/s on health outcomes. You are not required to address every point listed, rather those that are relevant to your analysis taking into consideration the academic literature and word counts.

Housing

• Physical Conditions: Quality of construction, ventilation, temperature control, and sanitation.
• Overcrowding: Adequate space and privacy.
• Location and Environment: Access to services, neighbourhood safety, and absence of environmental hazards.
• Affordability and Stability: Economic strain and housing security

Unemployment

• Economic Strain: Loss of income leading to poverty and inability to afford essentials.
• Mental Health: Increased stress, anxiety, and depression.
• Social Isolation: Loss of social networks and reduced social status.
• Access to Health Services: Loss of health insurance and delayed medical care.
• Behavioural Changes: Increase in unhealthy behaviours and reduced physical activity.

Work

• Job Security: Stable employment reduces stress and promotes mental well-being.
• Working Conditions: Safe and healthy environments prevent injuries and illnesses.
• Work Stress: High job demands, and low control can lead to stress and mental health issues.
• Income Level: Adequate wages enable access to health-promoting resources.
• Work-Life Balance: Balancing work and personal life is crucial for overall health.

Australian Healthcare

• Accessibility: Availability of healthcare services in terms of location, affordability, and physical access.
• Quality of Care: The standard of medical care, including the competence of healthcare providers and the quality of facilities and equipment.
• Equity: Fair distribution of healthcare resources across different populations, ensuring all groups have access to necessary services.
• Preventive Services: Availability and uptake of preventive care, such as vaccinations, screenings, and health education.
• Cultural Competence: Provision of healthcare that respects and responds to the cultural needs of diverse populations.

Education

• Educational Attainment: Higher levels of education are linked to better health literacy, healthier lifestyles, and improved access to healthcare services.
• Quality of Education: Access to quality education influences cognitive development, critical thinking, and problem-solving skills, which contribute to better health choices.
• Lifelong Learning: Opportunities for continuous education and skill development throughout life can enhance employability, income, and health outcomes.
• Health Education: Integration of health education in curricula promotes awareness of healthy behaviours and disease prevention.
• Socioeconomic Benefits: Education is associated with higher socioeconomic status, which correlates with better living conditions, reduced stress, and improved overall health.

Agriculture and Food production

• Food Availability: Ensuring a stable supply of food to prevent hunger and malnutrition.
• Food Quality and Safety: Maintaining high standards to avoid foodborne illnesses and contamination.
• Nutritional Value: Promoting the production and consumption of nutritionally rich foods to support overall health.
• Sustainable Practices: Implementing agricultural practices that protect the environment and ensure long-term food security.
• Economic Access: Making healthy food affordable and accessible to all socioeconomic groups to reduce health disparities.

Water and Sanitation

• Water Quality: Ensuring access to clean, safe drinking water across urban, rural, and remote areas to prevent waterborne diseases.
• Sanitation Facilities: Providing adequate sanitation and waste disposal systems to reduce the spread of infectious diseases.
• Hygiene Practices: Promoting good hygiene practices, such as handwashing, to prevent illness.
• Infrastructure Maintenance: Maintaining and improving water supply and sanitation infrastructure to ensure consistent service.
• Access Equality: Ensuring all communities, particularly disadvantaged ones, have equal access to water and sanitation services to reduce health disparities.