HSC PDHPE Core 1 Health Priorities in Australia: deep-dive (legacy syllabus)
Core 1 rewards the explicit use of frameworks. Identify priorities using the five criteria, measure health status with epidemiology (mortality, morbidity, life expectancy, DALYs), know CVD and mental health in depth, and apply all five Ottawa Charter action areas to one priority issue with named Australian examples. Funding sits with Medicare plus private and complementary care.
Jump to a section
- How Core 1 fits into HSC PDHPE
- Identifying priority health issues
- Measuring health status: epidemiology
- Two priority issues in depth
- The Ottawa Charter for Health Promotion
- The role of health care in Australia
- Worked example 1: a 12-mark evaluate response
- Worked example 2: a 6-mark structured response
- Check your knowledge
- Related guides
Legacy syllabus. This page covers the former PDHPE Stage 6 syllabus (listed by NESA as PDHPE Stage 6 (2012)). The last PDHPE HSC exam was held in 2025. From the 2026 HSC, students sit Health and Movement Science 11-12 (2023) instead: see our HSC Health and Movement Science hub. Use this page only as background or for older revision material.
How Core 1 fits into HSC PDHPE
Core 1, Health Priorities in Australia, is the public-health half of the course. It asks four big questions: how priorities are identified, what the priority issues are, what role health care plays, and what actions promote better health. Both cores appear in Sections I and II of the HSC exam, and Core 1 content also underpins the Equity and Health and Health of Young People options.
The single most important thing to understand about Core 1 is that it is framework-driven. Markers reward the explicit use of the syllabus scaffolding, the social justice principles, the five priority criteria, the epidemiological measures, and above all the Ottawa Charter, populated with specific Australian examples. This guide walks each framework and then shows model extended-response answers and a practice set.
Identifying priority health issues
Australia does not simply target the diseases that kill the most people. The syllabus names five criteria the health system applies when deciding where to direct attention and money.
The five criteria
- Social justice principles. The three principles are equity, diversity, and supportive environments. They shift the question from "what kills the most Australians" to "what creates unfair health outcomes for some Australians". Equity means like need should receive like care. Diversity means different groups have different needs. Supportive environments means health is partly created by the place a person lives.
- Priority population groups. Aboriginal and Torres Strait Islander peoples, people in low socioeconomic groups, people in rural and remote areas, overseas-born people, the elderly, and people with disability. A health issue becomes a priority when it affects one of these groups disproportionately.
- Prevalence of condition. How widespread the condition is. Prevalence tells governments whether the problem is large enough to justify population-level intervention. Cardiovascular disease affects roughly 1 in 6 Australians; mental and behavioural conditions affect roughly 1 in 5 in any given year.
- Potential for prevention and early intervention. Whether something can actually be done. Smoking is the canonical example: sustained taxation, plain packaging, advertising bans and quit programs have driven adult smoking down over decades.
- Costs to the individual and community. Direct costs are the dollars spent on treatment. Indirect costs are lost productivity, premature death, caring burden, and reduced quality of life.
How the criteria combine
A condition does not need to score high on every criterion to become a priority. Cardiovascular disease wins on prevalence, cost and prevention potential. Aboriginal and Torres Strait Islander health wins on social justice and priority groups. Mental health wins on prevalence, costs, and the social justice lens. In an extended response, the strongest answers name the criterion explicitly, give the Australian data point, and identify the priority that follows.
Social justice principles are the three values (equity, diversity, supportive environments) used to identify health issues that produce unfair outcomes for particular groups. They are the lens, not a list of programs.
Measuring health status: epidemiology
Epidemiology is the study of patterns and causes of health and disease in populations. It does not study individuals; it studies groups. The Australian Institute of Health and Welfare (AIHW) is the main federal agency for this work, and the Australian Bureau of Statistics (ABS) produces the underlying population and death data.
The syllabus expects you to know these measures, what each tells you, and what each misses.
- Mortality is the death rate, usually expressed as deaths per 100,000 population per year. Strength: hard, registered data, comparable across years and countries. Weakness: it captures who dies, not who suffers, so it misses non-fatal priorities like depression.
- Infant mortality is deaths of children under 1 year per 1000 live births. It is a very sensitive measure of overall population health and the quality of maternal and child care. The Aboriginal and Torres Strait Islander infant mortality rate is roughly double the non-Indigenous rate, which is itself a priority signal.
- Morbidity is illness and disease in a population. It splits into incidence (the rate of new cases in a period) and prevalence (the proportion with a condition at a point in time). Morbidity catches conditions that reduce quality of life without killing quickly.
- Life expectancy at birth is the average years a person born today is expected to live at current mortality rates. The gap between Indigenous and non-Indigenous life expectancy is a priority identification on its own.
- DALYs (Disability-Adjusted Life Years) combine years of life lost from premature death (YLL) with years lived with disability (YLD). One DALY equals one lost year of healthy life. DALYs let you compare conditions that kill against conditions that disable. Mental and substance use disorders rank among the top burdens despite low direct mortality.
A priority emerges when the data agrees across several measures. Cardiovascular disease ranks high on mortality, morbidity and DALYs, which is the triangulation that justifies it as a National Health Priority Area. Mental health is invisible on mortality alone but enormous on morbidity and DALYs, which is what surfaced it as a priority in 1996.
Do not write that "epidemiology is statistics about disease" and stop there. Markers want you to name a specific measure, attach a data point or named source (ABS, AIHW), and then link it to the priority it identifies. The link is the marks.
Two priority issues in depth
Cardiovascular disease (CVD)
CVD is a collective term for diseases of the heart and blood vessels and is Australia's single leading cause of death. The syllabus expects the nature, extent and risk factors.
- Nature. Coronary heart disease is the narrowing or blockage of the arteries supplying the heart muscle, usually from atherosclerosis; a full blockage causes a heart attack. Stroke is the death of brain tissue from a blocked or burst brain artery. Heart failure is the chronic inability of the heart to pump effectively.
- Extent. Around 1 in 6 Australians live with one or more cardiovascular conditions, prevalence rising sharply with age. CVD accounts for roughly 10 percent of total health system expenditure and roughly 10 percent of total disease burden.
- Risk factors. Modifiable: smoking, high blood pressure, high cholesterol, physical inactivity, overweight and obesity, poor diet, harmful alcohol use, and diabetes. Non-modifiable: age, sex, family history, and Aboriginal or Torres Strait Islander status.
There is one trend worth knowing: age-adjusted CVD mortality has fallen sharply since the 1970s through smoking decline, better acute treatment and statin uptake, even as the absolute number of Australians living with CVD rises because the population is growing and ageing. CVD is simultaneously a public health success story and an ongoing priority.
Mental health
Mental health became a National Health Priority Area in 1996. It scores on prevalence (roughly 1 in 5 Australians in any year), on the social justice lens (higher rates among young men, rural Australians, and Aboriginal and Torres Strait Islander people), and on costs through enormous indirect productivity loss. Because mortality data understates it, mental health is the standard counter-example used to argue that prevalence and DALYs, not mortality alone, must drive priority decisions.
The Ottawa Charter for Health Promotion
The Ottawa Charter, adopted by the World Health Organization in 1986, is the central framework for Core 1. Almost every extended response asks you to apply it to a priority issue. The five action areas are:
- Developing personal skills. Building individual knowledge and capacity. Examples: school PDHPE, Heart Foundation Walking groups, Quitline, and online cognitive behavioural programs such as those offered by Beyond Blue.
- Creating supportive environments. Making the healthy choice the easy choice. Examples: the Health Star Rating on packaged food, smoke-free public spaces, and active urban design such as separated cycling infrastructure.
- Strengthening community action. Empowering communities to identify and act on their own priorities. The strongest Australian example is the Aboriginal Community Controlled Health Organisations (ACCHOs), primary care owned and run by and for community.
- Reorienting health services. Shifting from acute treatment toward prevention and integration. Examples: Medicare Chronic Disease Management Plans, the 715 Aboriginal and Torres Strait Islander Health Check, and the National Bowel Cancer Screening Program.
- Building healthy public policy. Government policy that makes health a consideration in every sector. Examples: tobacco plain packaging (a world-first in 2012), tobacco excise, mandatory bicycle helmet laws, and the National Preventive Health Strategy.
The single largest mark-improver in PDHPE extended responses is naming a specific Australian program (Heart Foundation Walking, plain packaging, the 715 check, ACCHOs) rather than describing the action area in the abstract.
The role of health care in Australia
The syllabus also expects you to understand how care is delivered and funded.
- Medicare is the universal public scheme, funded mainly through the Medicare levy plus general taxation. It covers free public hospital treatment, subsidised GP and specialist visits, and subsidised medicines through the Pharmaceutical Benefits Scheme (PBS).
- Private health insurance sits alongside Medicare, giving choice of doctor and shorter elective waiting times, encouraged by the government through the rebate and the Lifetime Health Cover loading.
- Complementary and alternative health care (chiropractic, naturopathy, acupuncture and similar) is widely used; the syllabus asks you to weigh its growing use against the need for evidence and regulation.
- Health care responsibility is shared across individuals, communities and governments (federal, state and local), each with different levers.
Worked example 1: a 12-mark evaluate response
Prompt: "Evaluate the effectiveness of the Ottawa Charter for Health Promotion as a framework for addressing a priority health issue in Australia." (12 marks)
- Thesis
- The Ottawa Charter remains the most effective single framework for addressing cardiovascular disease because it forces simultaneous action across structural and individual levers, and the sustained decline in age-adjusted CVD mortality is the clearest evidence of its value, although mental health shows the framework is necessary but not always sufficient.
- Developing personal skills
- Heart Foundation Walking, GP lifestyle advice and school PDHPE build individual capacity. Reasonably effective, but limited on its own because the environment pushes people back toward unhealthy choices.
- Creating supportive environments
- The Health Star Rating, smoke-free public spaces and active urban design make the healthy choice easier. Effectiveness on smoking has been strong; on obesity, weaker.
- Strengthening community action
- Heart Foundation advocacy and community-led Indigenous screening empower communities. Strong on awareness, more variable on direct outcomes.
- Reorienting health services
- Medicare Chronic Disease Management Plans, statin guidelines based on absolute risk, and integrated GP care. Strong evidence, since acute treatment and statin uptake are part of the sustained CVD mortality decline.
- Building healthy public policy
- Plain packaging, tobacco excise and food-labelling agreements. The strongest evidence base of any action area, because policy shifts the default behaviour for everyone.
- Judgement
- The Charter is effective for CVD precisely because all five areas operate together; no single area would have produced the decline. Mental health is the qualifier: the Charter has been applied but population outcomes have not improved as clearly, suggesting structural change beyond the Charter is sometimes required. The framework is therefore highly effective but not a guarantee.
Worked example 2: a 6-mark structured response
Prompt: "Explain how the principles of social justice are used to identify priority health issues in Australia." (6 marks)
The principles of social justice, equity, diversity and supportive environments, are the lens governments use to spot health issues that disproportionately affect specific groups.
Equity is fairness in access and outcomes, not equality of resources. Equity identifies issues where some groups receive worse care than others despite greater need. The life expectancy gap between Aboriginal and Torres Strait Islander people and other Australians is identified as a priority precisely because equity is being violated.
Diversity recognises that different groups have different needs. It identifies issues for groups whose needs are not met by mainstream services, such as the under-utilisation of mental health services by culturally and linguistically diverse communities.
Supportive environments means physical, social and political settings that protect health. Identifying environments where health is undermined, such as limited safe physical-activity options in low-socioeconomic areas, frames the priority as environmental rather than individual.
In combination, the three principles direct attention away from raw disease counts and toward unfair outcomes, which is why Aboriginal and Torres Strait Islander health and mental health are priorities even where other measures alone would not flag them.
When a question says "evaluate" or "assess", you must make a judgement. When it says "explain", you must give reasons and links. When it says "describe", you must give detailed features. Match your verb to the question's verb, every time.
Check your knowledge
A mix of definitional, short-answer and extended-response questions covering Core 1. Answer under timed conditions, then check against the solutions block.
- List the five criteria used to identify priority health issues in Australia. (3 marks)
- Define epidemiology and explain why mortality alone is an insufficient measure for identifying priorities. (4 marks)
- Distinguish between incidence and prevalence, giving one example of each. (3 marks)
- Explain what a DALY measures and why mental health ranks highly on DALYs despite low direct mortality. (4 marks)
- Outline the nature of cardiovascular disease, distinguishing coronary heart disease, stroke and heart failure. (4 marks)
- Identify three modifiable and two non-modifiable risk factors for CVD, and explain how addressing one modifiable factor reduces CVD impact. (5 marks)
- Apply all five Ottawa Charter action areas to mental health as a priority issue, with one Australian example per area. (10 marks)
- Explain how Medicare is funded and outline two ways private health insurance complements it. (4 marks)
- Q1
- (1) Social justice principles (equity, diversity, supportive environments); (2) priority population groups; (3) prevalence of the condition; (4) potential for prevention and early intervention; (5) costs to the individual and community.
- Q2
- Epidemiology is the study of patterns and causes of health and disease in populations. Mortality alone is insufficient because it captures only who dies, not who suffers. High-burden, low-mortality conditions such as depression and musculoskeletal disorders would be invisible if only mortality were used, so morbidity and DALYs must be included to surface non-fatal priorities.
- Q3
- Incidence is the rate of new cases of a disease in a defined period, for example new cancer diagnoses per year. Prevalence is the proportion of a population with a condition at a point in time, for example the proportion of Australians living with diabetes. Incidence measures the flow of new cases; prevalence measures the existing pool.
- Q4
- A DALY is one lost year of healthy life, the sum of years of life lost to premature death (YLL) and years lived with disability (YLD). Mental health ranks highly because, although it causes few direct deaths (low YLL), it causes large amounts of time lived in poor health, often over many years (high YLD), which produces a large total DALY burden.
- Q5
- Coronary heart disease is the narrowing or blockage of the coronary arteries supplying the heart muscle, usually from atherosclerosis, which can cause angina or a heart attack. Stroke is the death of brain tissue caused by a blocked (ischaemic) or burst (haemorrhagic) brain artery. Heart failure is a chronic condition in which the heart cannot pump effectively to meet the body's demands, often following years of CVD damage.
- Q6
- Modifiable: smoking, high blood pressure, physical inactivity (any three of these or obesity, poor diet, harmful alcohol use). Non-modifiable: age and sex (or family history, Aboriginal or Torres Strait Islander status). Addressing smoking reduces CVD impact because smoking accelerates atherosclerosis and raises blood pressure; population tobacco control through taxation and plain packaging lowers smoking rates, which contributes to the long-term decline in age-adjusted CVD mortality.
- Q7
- Developing personal skills: online cognitive behavioural programs and school mental-health education build coping capacity. Creating supportive environments: workplace mental-health policies and reduced stigma make help-seeking easier. Strengthening community action: R U OK? Day and community suicide-prevention coalitions empower local action. Reorienting health services: Medicare-subsidised psychology sessions and GP mental-health plans shift care toward early intervention. Building healthy public policy: national mental-health strategies and funding for Primary Health Networks embed mental health in policy. Judgement-style answers note the Charter has been applied widely but population outcomes have improved less clearly than for CVD.
- Q8
- Medicare is funded mainly through the Medicare levy, a percentage of taxable income, supplemented by general taxation. Private health insurance complements it by (1) giving members a choice of doctor and access to private hospitals with shorter elective waiting times, and (2) covering services Medicare does not fully cover, such as some dental, optical and allied health, reducing pressure on the public system.