HSC Health and Movement Science Focus Area 1: the 2026 guide

What this guide is for

HSC Health and Movement Science Focus Area 1 (Health in an Australian and global context) is the first of two compulsory focus areas in Year 12. It is examined in Section II (short answer) and Section III (extended response) of the 2026 HSC paper. This guide walks through the eight sub-topics, the marker advice from NESA's sample exam materials, and the named Australian and global examples that strong responses use.

The structure of Focus Area 1

Per the NESA Health and Movement Science 11-12 Syllabus (2023), Focus Area 1 covers eight sub-topics:

1. Health status in Australia
2. Health inequalities and priority populations
3. Determinants of health in an Australian context
4. Health in a global context and the Sustainable Development Goals
5. Australian health care system and health services
6. Equity and access to health care
7. Health promotion, prevention and advocacy
8. Technology, digital health and big data

Each is covered in a dedicated dot-point page in the syllabus library; this guide gives the overview and the framing that markers reward.

Measuring health: the core vocabulary

A strong HMS response uses the population-health measures with their denominators and time frames. NESA expects fluent use of:

Life expectancy at birth

Average years a newborn would live at current mortality rates. Australian life expectancy is among the highest in the OECD (approximately 81 years for males, 85 for females per AIHW). The Aboriginal and Torres Strait Islander gap is approximately 8 years for both sexes.

Mortality

Deaths per population per time. Crude rates (all deaths) or cause-specific. Major causes in Australia: ischaemic heart disease, dementia, cerebrovascular disease, lung cancer, COPD.

Morbidity

Total illness. Measured as DALYs (Disability-Adjusted Life Years), combining YLL (Years of Life Lost from premature death) and YLD (Years Lived with Disability).

Burden of disease

Total impact in DALYs broken down by condition. AIHW Burden of Disease Study reports leading causes; cancer, cardiovascular disease, musculoskeletal conditions, mental and substance use disorders, and injuries are consistently top contributors.

Incidence and prevalence

New cases per period vs existing cases at a point. They move differently as treatment changes. Confusing them is a common mid-band error.

The four determinants framework

The four categories interact and cluster. Strong responses use all four together when explaining an inequity:

• Individual (biological). Genetics, sex, age, body composition. Largely non-modifiable.
• Sociocultural. Family, peers, culture, religion, language, media.
• Socioeconomic. Income, employment, education, occupation. Often the single strongest population-level driver.
• Environmental. Geography, housing, infrastructure, pollutants, access to food and physical activity.

A clinic-only or behaviour-only intervention typically fails because the other determinants continue to operate. The Aboriginal Community Controlled Health Services model (NACCHO members) is the canonical Australian example of integrated action.

Priority populations

Australian health policy identifies priority populations as groups experiencing measured health inequities relative to the general population. Targeted action follows. Commonly named:

• Aboriginal and Torres Strait Islander Australians.
• People of low socioeconomic status.
• Rural and remote populations.
• Refugees and migrants.
• LGBTQI+ Australians.
• People with disability.
• Older Australians and children (life-course framing).

Closing the Gap is the most visible federal targeted-action framework, with measurable goals across health, education, employment, justice and housing.

The Australian health-care system

Strong HMS responses know the funding flows and the service categories:

Funding. Commonwealth (Medicare levy and general revenue; MBS; PBS; subsidies to public hospitals via national funding agreements). States (operate public hospitals and community-health services). Private (insurance premiums, out-of-pocket).

Services.

• Acute (public and private hospitals).
• Primary care (GPs, allied health, community-health services).
• Mental health (community, public and private).
• Aboriginal Community Controlled Health (NACCHO members).
• Rural and remote (RFDS, outreach, telehealth).
• Aged care (residential and home).
• Disability (NDIS).

The PBS subsidises approved medicines; PBAC assesses cost-effectiveness before listing. Bulk-billing rates have shifted over time; the 2023 federal tripling of the bulk-billing incentive aimed to support primary care.

The Ottawa Charter

Adopted by WHO in 1986. Five action areas:

1. Build healthy public policy. Tobacco taxation, alcohol restrictions, sugar-tax debates.
2. Create supportive environments. Healthy-canteen policies, active-transport infrastructure, smoke-free public spaces.
3. Strengthen community action. Aboriginal Community Controlled Health, Headspace, community-led mental health programs.
4. Develop personal skills. Health-literacy campaigns, school health education, Quitline.
5. Reorient health services. Shift from acute treatment to prevention and primary care; chronic disease management.

A typical HMS extended response on a health-promotion program applies two or three Ottawa Charter action areas to a specific Australian campaign.

Global health and the SDGs

The Sustainable Development Goals (UN, 2015) are 17 goals with a 2030 target horizon. SDG 3 (Good Health and Well-being) is the health-specific goal, but SDGs 1 (No Poverty), 4 (Quality Education), 5 (Gender Equality), 6 (Clean Water and Sanitation), 10 (Reduced Inequalities) and 13 (Climate Action) all intersect with health outcomes. Health workforce density (doctors, nurses, midwives per 1,000 population) is a key SDG 3 indicator.

Equity and access

Equity means resources distributed according to need so all groups achieve good health outcomes. Equality (everyone gets the same) is not the same thing. Barriers to access:

• Geographic (rural, remote, outer suburbs without nearby services).
• Financial (out-of-pocket cost, gap fees, transport cost).
• Cultural (services not culturally safe; communication and trust gaps).
• Language (limited interpreter access).
• Time (work and caring responsibilities).
• Digital (telehealth requires connectivity; the digital divide is now an access issue).

Strategies (the matched policy responses):

• Bulk-billing incentives (financial).
• RFDS, outreach, telehealth (geographic).
• Aboriginal and Torres Strait Islander Health Workers / Practitioners (cultural).
• Refugee Health Services (cultural and language).
• LGBTQI+-specific health services (ACON, Thorne Harbour Health).
• Targeted funding for rural and remote workforce (Modified Monash Model).

Health promotion, prevention and advocacy

Prevention levels

Primary (preventing disease occurring at all; immunisation, smoke-free policy). Secondary (early detection; cancer screening). Tertiary (managing established disease to limit impact; chronic disease care).

Advocacy

Policy change vs awareness. Long-running advocacy campaigns: plain packaging for tobacco (2012); seat-belt laws; alcohol marketing restrictions; obesity-related sugar tax debates.

Named programs

Cancer Council tobacco control, Heart Foundation salt-reduction, beyondblue mental health, BreastScreen Australia, National Bowel Cancer Screening, National Cervical Screening, Tackling Indigenous Smoking, Quitline, Headspace, DrinkWise.

Technology and big data

My Health Record (Australian Digital Health Agency); MBS telehealth items (expanded substantially from 2020 during the COVID-19 pandemic and retained as ongoing items); continuous glucose monitors; wearable HR / sleep trackers; AI in diagnostics (still emerging, evaluations ongoing); the Australian Atlas of Healthcare Variation (Australian Commission on Safety and Quality in Health Care). Equity issues: digital divide; data privacy; uneven uptake across populations.

Marker advice for Focus Area 1 responses

Per NESA's general HSC marking pattern (the HMS 2026 marking guidelines have not yet been published):

• Use the technical vocabulary accurately (DALYs, YLL, YLD, incidence, prevalence).
• Apply the determinants framework systematically rather than listing categories.
• Name specific Australian programs (NACCHO, Cancer Council, Closing the Gap, beyondblue) rather than generic claims.
• Use named priority populations with specific data points where available.
• Apply Ottawa Charter action areas explicitly to a chosen program.
• Acknowledge equity considerations and the limits of single-component interventions.

Connections to Focus Area 2

Focus Area 1 (Health) and Focus Area 2 (Training for improved performance) connect at several points: the priority-populations framing applies to physical activity and sports access; the Ottawa Charter "create supportive environments" action area covers active-transport infrastructure; digital health tools (wearables) overlap with training-monitoring technology. Integrated questions across the two focus areas are likely in Section III.