Priority health conditions in Australia: HSC Health and Movement Science Focus Area 1
“Investigate priority health conditions in Australia (including cardiovascular disease, cancer and Type 2 diabetes) in terms of mortality and morbidity, prevalence and incidence, risk and protective factors, and the population groups and places in which these conditions are changing”
Cardiovascular disease, cancer and Type 2 diabetes are Australia's priority health conditions because they carry the largest disease burden (cancer about 18% and CVD about 13% of DALYs, 2023), share a small set of modifiable risk factors (tobacco, overweight, inactivity, diet, blood pressure), and fall unevenly on Aboriginal and Torres Strait Islander people, lower socioeconomic groups and remote Australians. Strong answers distinguish mortality/morbidity and incidence/prevalence, quote dated AIHW-style figures, and weigh burden, preventability and equity to justify the "priority" label rather than describing each disease.
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What this sub-topic is asking
NESA wants you to investigate Australia's priority health conditions - cardiovascular disease, cancer and Type 2 diabetes - using the standard population-health measures (mortality and morbidity, prevalence and incidence), identify their risk and protective factors, and describe which population groups and places these conditions affect and how they are changing.
The answer
A priority health condition is one that carries a large enough burden, and is preventable enough, to warrant targeted national attention and investment. In Australia the most commonly studied are cardiovascular disease (CVD), cancer and Type 2 diabetes. They are grouped together because they share a small set of modifiable risk factors, carry the largest share of the disease burden, and fall unevenly on particular groups and places.
The standard measures, applied to the three conditions
Cardiovascular disease (CVD). An umbrella term for diseases of the heart and blood vessels - coronary (ischaemic) heart disease, stroke (cerebrovascular disease), heart failure and peripheral vascular disease.
- Mortality. CVD, and coronary heart disease in particular, is one of Australia's leading causes of death. Age-standardised CVD death rates have fallen markedly - the coronary heart disease death rate is down roughly 80% since the late 1960s-1980s (AIHW; indicative) - thanks to falling smoking, better blood-pressure and cholesterol control and improved acute care.
- Morbidity / prevalence. Around 1.3 million Australians reported living with one or more heart, stroke or vascular conditions (ABS National Health Survey, 2022; indicative); survivors live longer, so the management load stays high.
- Incidence. New heart attacks and strokes still number in the tens of thousands each year, though incidence rates are trending down.
Cancer. A group of diseases in which abnormal cells grow uncontrollably. The most common in Australia include prostate, breast, melanoma, bowel (colorectal) and lung cancers.
- Mortality. Cancer is a leading cause of death, with lung cancer the leading cause of cancer death. Overall cancer survival has improved: five-year relative survival has risen across recent decades (AIHW; indicative).
- Morbidity / burden. Cancer is the single largest contributor to total disease burden (about 18% of DALYs, 2023; illustrative).
- Incidence and screening. Cancer incidence is influenced by screening: the National Bowel Cancer Screening Program, BreastScreen Australia and the National Cervical Screening Program lift early detection (raising recorded incidence short-term) while lowering mortality.
Type 2 diabetes. A chronic condition in which the body becomes resistant to insulin and/or does not produce enough, raising blood glucose. It accounts for the large majority of all diabetes.
- Prevalence (rising). About 1.3 million Australians live with diagnosed diabetes (mostly Type 2), and prevalence is rising as the population ages and overweight and obesity persist (AIHW, 2023-24; indicative). Many more are undiagnosed.
- Morbidity. Type 2 diabetes is a major source of morbidity through complications: cardiovascular disease, chronic kidney disease, vision loss and lower-limb amputation. It is itself a powerful risk factor for CVD.
- Mortality. Lower than CVD or cancer as an underlying cause, but it contributes to many deaths as an associated cause.
Risk and protective factors
The three conditions are bound together by a shared set of modifiable risk factors and protective factors. This shared causation is the heart of why they are treated as a single prevention priority.
Modifiable risk factors (the prevention targets): tobacco smoking, overweight and obesity, physical inactivity, poor diet (low vegetables/fibre, high salt, processed meat), high blood pressure, high cholesterol and harmful alcohol use. Each acts across more than one condition - for example, obesity drives insulin resistance (diabetes), raises blood pressure and cholesterol (CVD) and is linked to several cancers.
Non-modifiable risk factors: age, family history / genetics and biological sex. These cannot be changed but help identify higher-risk people for screening.
Protective factors: regular physical activity, a healthy diet, maintaining a healthy weight, not smoking, limiting alcohol, and participation in cancer screening. Because the protective factors mirror the risk factors, a single healthy-lifestyle message lowers risk across all three conditions at once.
Who and where: how the conditions are changing
The burden of these conditions is not evenly shared. The same groups recur because the risk factors cluster with the social determinants of health.
- Aboriginal and Torres Strait Islander Australians carry markedly higher rates of CVD and Type 2 diabetes (diabetes around 3 to 4 times the non-Indigenous rate; AIHW) and poorer outcomes overall.
- Lower socioeconomic groups show higher rates of all three conditions and their risk factors, following the social gradient.
- Regional and remote Australians have higher CVD and diabetes rates and lower cancer survival than people in major cities, partly through reduced access to screening and specialist care.
- Over time: CVD mortality is falling (better treatment, less smoking) but prevalence stays high; cancer survival is improving while incidence of some cancers shifts with screening and risk-factor change; Type 2 diabetes prevalence is rising with ageing and obesity.
The three conditions, the measures and the headline numbers (with years). The priority conditions are cardiovascular disease, cancer and Type 2 diabetes. Hold the measures as two pairs plus the factors: mortality / morbidity (death versus illness; morbidity in DALYs = YLL + YLD) and incidence / prevalence (new cases per year versus total existing cases). The numbers worth quoting, each with a year: cancer about 18% and CVD about 13% of total disease burden (AIHW, 2023; illustrative); the coronary heart disease death rate down about 80% in age-standardised terms since the late 1960s-1980s; about 1.3 million Australians living with diagnosed diabetes and a similar number with heart/stroke/vascular conditions (early 2020s); Type 2 diabetes around 3 to 4 times higher among Aboriginal and Torres Strait Islander people. Risk factors are shared and modifiable (tobacco, obesity, inactivity, diet, blood pressure, alcohol), so prevention is efficient.
Worked example 1 - a data/stimulus response (5 marks)
Question. A described dataset gives the approximate share of total disease burden in 2023: cancer about 18%, musculoskeletal about 13%, mental health and substance use about 13%, cardiovascular disease about 12%, injuries about 7%. Describe what the data shows and explain why cancer and cardiovascular disease are prevention priorities.
Model answer. Cancer carries the single largest share of total disease burden at about 18%, followed by cardiovascular disease, musculoskeletal conditions and mental health and substance use, each at about 13%, with injuries lower at about 7%. Cancer and cardiovascular disease together account for roughly 31% - close to a third - of all burden, and rank first and second. They are prevention priorities for three linked reasons: their burden is the largest, so reducing it yields the biggest population gain; a substantial part of that burden is attributable to MODIFIABLE risk factors (tobacco, overweight, physical inactivity, high blood pressure), which prevention can target; and acting upstream avoids the heavy downstream cost of treating heart attacks, strokes and cancers. The size of the burden and its preventability together justify the priority label.
Marker's note: about 2 marks for an accurate description with figures and rank order, about 3 marks for the explanation linking burden SIZE to PREVENTABILITY (modifiable risk) and to cost. A description with no "why", or "prevention is good" with no data, caps at 3.
Worked example 2 - a short-answer response (6 marks)
Question. Explain how Type 2 diabetes is changing in Australia, and identify which groups and places are most affected, referring to risk factors.
Model answer. The prevalence of Type 2 diabetes is rising: about 1.3 million Australians live with diagnosed diabetes (mostly Type 2) in the early 2020s, and the AIHW projects continued growth as the population ages and overweight and obesity persist (2023-24; indicative). The condition falls unevenly: it is around 3 to 4 times more common among Aboriginal and Torres Strait Islander Australians, higher in lower socioeconomic areas, and higher in regional and remote Australia than in major cities. This pattern tracks the distribution of the modifiable risk factors - overweight and obesity, physical inactivity and poor diet - which themselves cluster with socioeconomic and environmental determinants such as income and food access. The higher rates in disadvantaged and remote groups are therefore largely structural rather than a matter of individual choice.
Marker's note: markers reward the rising trend WITH a figure and year, named groups AND places, and the explicit link from risk factors to the social pattern. A trend with no groups, or groups with no risk-factor link, stays mid-band.
Worked example 3 - an extended-response paragraph (analyse)
Question (paragraph only). Analyse why cardiovascular disease, cancer and Type 2 diabetes are designated priority conditions. Write one body paragraph on inequity in who is affected.
Model paragraph. A decisive reason these three are grouped as national priorities is that their burden is not shared evenly - it concentrates in the same disadvantaged groups, which makes acting on them an equity issue, not only an efficiency one. Aboriginal and Torres Strait Islander Australians carry Type 2 diabetes at around 3 to 4 times the non-Indigenous rate and markedly higher cardiovascular disease (AIHW), and the social gradient runs through all three conditions: rates climb as socioeconomic position falls and as remoteness increases, while cancer survival is lower in remote and disadvantaged areas where screening and specialist care are harder to reach. This is not coincidence: the shared modifiable risk factors - smoking, overweight, inactivity and poor diet - cluster with the socioeconomic and environmental determinants of health, so the conditions pile up precisely where disadvantage piles up. Designating them as priorities therefore directs prevention and treatment to where the burden, and the unfairness, are greatest - which is why a single, structurally aware prevention effort (tobacco control, food policy, accessible screening) is the appropriate response rather than three disconnected clinical fixes.
Marker's note: markers reward a thesis that ANALYSES (weighs the equity case to justify the priority label) rather than describing each disease; named groups and places; CURRENT data with a year (the 3 to 4 times diabetes figure); explicit clustering of risk factors with determinants; and a calibrated judgement. A single-condition description, or data with no year, cannot reach the top band.
Confusing mortality with morbidity, or incidence with prevalence. Mortality is death; morbidity is illness (DALYs). Incidence is new cases per year; prevalence is total existing cases. A condition can have falling mortality and rising prevalence at the same time (better survival).
Describing the three conditions separately instead of analysing the priority label. An "analyse" question wants you to weigh burden, preventability and equity to explain WHY they are priorities - not three mini-essays on what each disease is.
- Quoting statistics with no year (or inventing precise figures)
- Markers reward dated, sourced figures (about 18% of burden, 2023). Use approximate, AIHW-style numbers and flag them as indicative rather than fabricating exact ones.
- Listing only individual risk factors and ignoring who is affected
- The "groups and places" strand is examinable: name Aboriginal and Torres Strait Islander Australians, lower socioeconomic groups and remote populations, and link the pattern to clustered determinants.
- Treating Type 2 diabetes as a death condition
- Its priority status rests mainly on rising prevalence and heavy MORBIDITY (kidney, eye, limb, and as a driver of CVD), not on a high direct death rate.
- Match the command word to the depth
- "Identify/outline" wants the conditions, measures or factors named; "describe/explain" wants the pattern and its causes (risk factors, determinants); "analyse/assess/evaluate" wants you to WEIGH burden, preventability and equity to justify the "priority" judgement. Describing three diseases for an "analyse" caps your band.
- Use the measures as a checklist
- For each condition, be ready with mortality, morbidity, prevalence and incidence in a sentence each. The fastest marks come from correctly distinguishing the pairs (death vs illness; new vs total).
- Anchor every claim with a dated, sourced figure
- Replace "lots of people have diabetes" with "about 1.3 million Australians live with diagnosed diabetes (AIHW, 2023-24)". A figure WITH a year and an AIHW/ABS source earns marks a vague claim cannot - and flag a figure as indicative if you are unsure of the exact value.
- Always name who and where
- Add the equity strand: Aboriginal and Torres Strait Islander Australians, lower socioeconomic groups, regional and remote populations. Then make the analytical move - the risk factors CLUSTER with the determinants, so the burden concentrates where disadvantage does.
- Read a burden chart like a scientist
- For a data item, first DESCRIBE (rank order and the figures), then EXPLAIN (why those conditions lead - common AND fatal/disabling), then say what it IMPLIES (the largest, most preventable burden is the rational prevention target).
Think of the country's health like a town with a few big potholes that wreck the most cars. Cardiovascular disease (heart and blood-vessel problems), cancer and Type 2 diabetes are those big potholes - they damage more lives than almost anything else, so the council puts them at the top of the repair list. That is what "priority condition" means. Now, two handy ways to measure a pothole: how many cars it writes off completely (that is mortality - deaths) and how many it leaves limping along needing repairs (that is morbidity - ongoing illness). And two ways to count: how many cars hit it for the first time this year (incidence, new cases) versus how many cars are in the garage because of it right now (prevalence, total cases). Here is the clever part: these three potholes were mostly made by the SAME few things - smoking, carrying too much weight, sitting around too much and eating badly. So fixing those few habits, and the conditions that make them hard to avoid, patches all three potholes at once. That is why health authorities lump them together. And the potholes are not spread evenly across town: they are deepest in the streets with the least money, the furthest-out suburbs and country areas, and they hit Aboriginal and Torres Strait Islander communities hardest - because the things that cause them tend to pile up in the same places. So "just choose to be healthier" misses the point: you also have to fix the road.
Practice questions
Original practice questions graded from foundation to exam level, each with a full worked solution. Try them before revealing the solution.
foundation3 marksDistinguish between the incidence and the prevalence of a priority health condition, using cardiovascular disease as your example.Show worked solution →
A 3-mark distinguish needs both terms defined and contrasted with a fitting example.
- Incidence (1 mark)
- The number of NEW cases of a condition arising in a population over a set period - usually one year. Example: the number of Australians who have a first heart attack this year.
- Prevalence (1 mark)
- The TOTAL number of existing cases (new and ongoing) in the population at a point in time. Example: roughly 1.3 million Australians reported living with one or more heart, stroke or vascular conditions (ABS National Health Survey, 2022; treat as indicative).
- The contrast (1 mark)
- Incidence counts only fresh cases and tracks how fast a condition is appearing (useful for judging prevention); prevalence counts everyone living with it and tracks the current load on services (useful for planning). They can move in opposite directions: better survival after a heart attack lowers mortality but RAISES prevalence because more people live on with the condition.
Full marks need both definitions plus the explicit new-versus-total contrast.
foundation4 marksIdentify two modifiable risk factors and two protective factors shared across cardiovascular disease, cancer and Type 2 diabetes, and state briefly how each acts.Show worked solution →
Award 1 mark per correct factor with a brief mechanism (cap at 4). Risk and protective factors that recur across all three conditions score best.
Modifiable risk factors.
- Tobacco smoking (1 mark). Damages blood-vessel walls and is carcinogenic; raises risk of coronary heart disease, many cancers (lung, head and neck, bladder) and worsens diabetes complications.
- Overweight and obesity / poor diet (1 mark). Excess adiposity drives insulin resistance (Type 2 diabetes), raises blood pressure and cholesterol (cardiovascular disease) and is linked to several cancers (bowel, breast).
Protective factors.
- Regular physical activity (1 mark). Improves insulin sensitivity, blood pressure and body composition, lowering risk across all three.
- A healthy diet high in vegetables, fibre and unsaturated fats / low in salt and processed meat (1 mark). Lowers blood pressure and cholesterol and reduces bowel-cancer and diabetes risk.
Other acceptable answers: risk - high blood pressure, high cholesterol, harmful alcohol use, physical inactivity; protective - not smoking, limiting alcohol, maintaining a healthy weight, cancer screening participation. Naming a NON-modifiable factor (age, family history, sex) does not earn a "modifiable" mark.
foundation3 marksDefine 'burden of disease' and explain why cancer and cardiovascular disease are described as Australia's leading contributors to it.Show worked solution →
Definition (1 mark). Burden of disease is the total impact of illness, disability and premature death on a population, measured in DALYs (Disability-Adjusted Life Years), which combine YLL (years of life lost to early death) and YLD (years lived with disability).
Why these two lead (2 marks). Cancer and cardiovascular disease each cause a large share of premature death (high YLL) and substantial ongoing illness (YLD): the AIHW Australian Burden of Disease Study (2024, using 2023 estimates) consistently reports cancer and cardiovascular disease among the leading disease-group contributors to total burden. Because they are both common AND frequently fatal or disabling, they dominate the DALY count - which is why they are named "priority" conditions for prevention and treatment investment.
A complete answer defines DALYs (YLL + YLD) and links the "leading" status to both the deaths and the disability these conditions cause.
core5 marksA dataset (ExamExplained, modelled on AIHW figures) gives the approximate share of total disease burden (DALYs) carried by Australia's leading condition groups in 2023: cancer about 18%, musculoskeletal about 13%, mental health and substance use about 13%, cardiovascular disease about 12%, injuries about 7%. Describe what the data shows, and explain why prevention targeting cardiovascular disease and cancer is a public-health priority.Show worked solution →
A 5-mark "describe and explain" rewards an accurate reading of the figures plus reasoned explanation, not a restatement.
Describe the data (about 2 marks). Cancer carries the single largest share of total burden at about 18%, ahead of musculoskeletal conditions and mental health and substance use (each about 13%) and cardiovascular disease (about 12%, now ranking around fourth among the disease groups); injuries are smaller at about 7%. Together, cancer and cardiovascular disease account for roughly 30% - close to a third - of all disease burden. Quote at least the top two figures and their rank order.
Explain the priority (about 3 marks). These conditions are prioritised because (i) they carry the most burden, so reducing them yields the largest population-level gain; (ii) a large fraction of that burden is attributable to MODIFIABLE risk factors (tobacco, overweight, physical inactivity, diet, high blood pressure), which prevention can target; and (iii) acting upstream avoids the high downstream cost of treating heart attacks, strokes and cancers. Linking the size of the burden to its preventability is what lifts this past description.
Marking spine: accurate description with figures and rank (2), the burden-size argument (1), the modifiable-risk/preventability argument (1), the cost/upstream argument (1). Description with no "why", or a generic "prevention is good" with no data, caps at 3. (Figures are an ExamExplained dataset modelled on AIHW Burden of Disease shares, 2023; treat as illustrative.)
core6 marksExplain how the prevalence of Type 2 diabetes is changing in Australia, and identify which population groups and places are most affected. Refer to risk factors in your answer.Show worked solution →
A 6-mark "explain... and identify" needs the trend, the groups/places, and the risk-factor link tied together.
- The trend (about 2 marks)
- The prevalence of Type 2 diabetes is rising. Around 1.3 million Australians were estimated to be living with diagnosed diabetes (the great majority Type 2) in the early 2020s, and the AIHW projects continued growth as the population ages and overweight and obesity persist (AIHW, 2023-24; treat figures as indicative). Rising prevalence reflects both more new cases AND people living longer with the condition.
- Groups and places most affected (about 2-3 marks)
- Type 2 diabetes is markedly higher among Aboriginal and Torres Strait Islander Australians (around 3 to 4 times the rate of non-Indigenous Australians; AIHW), among people in lower socioeconomic areas, and in regional and remote Australia compared with major cities. Some culturally and linguistically diverse communities also carry higher risk.
- Risk-factor link (about 1-2 marks)
- The pattern tracks the distribution of modifiable risk factors - overweight and obesity, physical inactivity, and diet - which themselves cluster with socioeconomic and environmental determinants (food access, income), so the higher rates in disadvantaged and remote populations are largely structural, not a matter of individual choice alone.
Marking spine: the rising trend with a figure and year (2), the affected groups/places named (2), the risk factors linked to the pattern (2). A trend with no groups, or groups with no risk-factor explanation, stays mid-band.
core5 marksCardiovascular disease mortality has fallen sharply since the 1980s, yet it remains a priority condition. Explain how both of these statements can be true.Show worked solution →
A 5-mark "explain" rewards reconciling the falling death rate with the continuing priority status.
The fall in mortality (about 2 marks). Age-standardised cardiovascular (and coronary heart disease) death rates have fallen substantially - by roughly 80% for coronary heart disease since the late 1960s-1980s in age-standardised terms (AIHW; treat as indicative) - driven by falling smoking rates, better blood-pressure and cholesterol management, and improved acute treatment of heart attack and stroke.
Why it is still a priority (about 3 marks). Despite the falling RATE: (i) cardiovascular disease is still a leading cause of death and of total burden (about 12% of DALYs, 2023, illustrative); (ii) prevalence remains high - more survivors live on with chronic heart disease, raising the management load; (iii) the gains are unevenly shared, with persistently higher rates among Aboriginal and Torres Strait Islander people, lower socioeconomic groups and remote populations; and (iv) the ageing population means absolute case numbers stay large even as the age-standardised rate falls.
Marking spine: the mechanisms of the mortality fall (2), and at least two reasons it remains a priority - high prevalence, inequity, ageing, still-leading burden (3). Noting the difference between a falling RATE and falling NUMBERS is a strong move.
exam12 marksAnalyse why cardiovascular disease, cancer and Type 2 diabetes are designated priority health conditions in Australia. In your answer, refer to mortality and morbidity, prevalence and incidence, risk and protective factors, and the population groups and places in which these conditions are changing. Support your answer with current data.Show worked solution →
A 12-mark "analyse" extended response needs a sustained argument that shows WHY these three are prioritised - weighing burden, preventability and inequity - using all the named measures and current data, not three separate descriptions.
Band 6 PLAN.
Thesis: These three conditions are designated priorities not by any single measure but because they sit at the intersection of high burden (mortality AND morbidity), high and rising prevalence, a large share of burden attributable to MODIFIABLE risk factors, and steep inequities in who is affected - so targeted prevention promises the largest, fairest population gain.
Argument 1 - they carry the most burden (mortality and morbidity). Evidence: cancer (about 18% of DALYs) and cardiovascular disease (about 12%) remain leading contributors to total burden in 2023 (AIHW, illustrative); cardiovascular disease and cancer are leading causes of death; Type 2 diabetes adds large morbidity (YLD) and drives complications (kidney, eye, limb). Mechanism: because they are both common and fatal or disabling, they dominate the DALY count.
Argument 2 - prevalence and incidence show a shifting, growing load. Evidence: about 1.3 million Australians live with one or more heart/stroke/vascular conditions and about 1.3 million with diagnosed diabetes (early 2020s, indicative); cardiovascular MORTALITY has fallen (about 80% drop in coronary heart disease death rate, age-standardised) yet PREVALENCE stays high as survivors live on; Type 2 diabetes prevalence is rising. Mechanism: falling mortality with steady or rising prevalence shifts the task from preventing death to managing chronic survivorship.
Argument 3 - much of the burden is modifiable, which is why prevention is prioritised. Evidence: shared risk factors (tobacco, overweight and obesity, physical inactivity, poor diet, high blood pressure, harmful alcohol) drive all three; protective factors (physical activity, healthy diet, not smoking, screening) cut across them. Mechanism: a few common upstream factors explain a large slice of three conditions, so one prevention effort yields triple benefit.
Argument 4 - the burden is inequitably distributed (the equity case). Evidence: Aboriginal and Torres Strait Islander Australians have markedly higher rates of cardiovascular disease and Type 2 diabetes (diabetes about 3 to 4 times higher; AIHW); rates rise with socioeconomic disadvantage and with remoteness; cancer survival is lower in remote and disadvantaged areas. Mechanism: the risk factors cluster with the social determinants, so the conditions concentrate where disadvantage concentrates.
Judgement: prioritising these conditions is justified because no other group of conditions combines this scale of burden, this degree of preventability and this depth of inequity - so investment here is both the most efficient and the most equitable.
Model paragraph (Argument 3). The strongest reason these three conditions are grouped as priorities is that they share a small set of modifiable risk factors, so a single prevention effort pays off three times over. Tobacco smoking damages blood vessels (cardiovascular disease), is directly carcinogenic (cancer) and worsens diabetic complications; overweight and obesity drive insulin resistance (Type 2 diabetes), raise blood pressure and cholesterol (cardiovascular disease) and are linked to bowel and breast cancer; physical inactivity and poor diet compound all three. The protective side mirrors this: regular physical activity, a diet high in vegetables and fibre and low in salt and processed meat, not smoking and limiting alcohol lower risk across the board. Because these upstream factors explain a large, overlapping share of three of the country's biggest disease burdens, acting on them - through tobacco control, the Health Star Rating, physical-activity policy and screening - is far more efficient than treating each condition separately downstream. That shared, modifiable causation is precisely what makes the three a coherent prevention "priority" rather than three unrelated diseases.
Marker's note: markers reward a sustained thesis that genuinely ANALYSES (weighs burden, preventability and equity to explain the priority label) rather than describing each condition; correct use of every named measure (mortality and morbidity, prevalence and incidence, risk and protective factors); CURRENT data carrying a year (the about 18%/12% burden shares, 2023; the about 80% coronary mortality fall; the about 3 to 4 times diabetes rate in First Nations people); named groups and places where the conditions are changing; and a calibrated judgement. Three separate "description of a disease" sections, or data with no year, cannot reach the top band.