HSC PDHPE Core 1 Health Priorities in Australia: deep-dive 2026 guide

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

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

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.

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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 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

Worked example 2: a 6-mark structured response

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.

1. List the five criteria used to identify priority health issues in Australia. (3 marks)
2. Define epidemiology and explain why mortality alone is an insufficient measure for identifying priorities. (4 marks)
3. Distinguish between incidence and prevalence, giving one example of each. (3 marks)
4. Explain what a DALY measures and why mental health ranks highly on DALYs despite low direct mortality. (4 marks)
5. Outline the nature of cardiovascular disease, distinguishing coronary heart disease, stroke and heart failure. (4 marks)
6. Identify three modifiable and two non-modifiable risk factors for CVD, and explain how addressing one modifiable factor reduces CVD impact. (5 marks)
7. Apply all five Ottawa Charter action areas to mental health as a priority issue, with one Australian example per area. (10 marks)
8. Explain how Medicare is funded and outline two ways private health insurance complements it. (4 marks)

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