VCE Health and Human Development 2025

Question 8 (6 marks): Medicare, sustainability and equity

Based on Question 8 (6 marks). Analyse how Medicare promotes health outcomes, dealing with both sustainability and equity.

Model answer.

1. Role. Medicare is Australia's universal health insurance scheme, funded partly through the Medicare levy. It pays all or part of the scheduled fee for clinically necessary care, such as GP consultations, pathology tests, x-rays and free treatment as a public patient in public hospitals.
2. Sustainability. Medicare subsidises only care that is clinically necessary, and it covers screening and diagnostic services that find disease early. That keeps its cost manageable, so the scheme can keep funding care now and into the future. For example, a person with cardiovascular disease can keep accessing tests and public hospital treatment over many years. Earlier detection and continued treatment lower the risk of a fatal heart attack, which reduces mortality from cardiovascular disease.
3. Equity. Equity means giving more help to people with greater need or fewer resources, not the same thing to everyone. The Medicare Safety Net does this. Once a person's out-of-pocket costs for Medicare services pass a yearly threshold, further services are cheaper. Someone managing a chronic condition such as type 2 diabetes, who needs frequent appointments and tests, can afford to keep attending. That reduces financial stress, which improves their mental health and wellbeing, and better-managed diabetes lowers morbidity from its complications. Bulk billing and Mental Health Treatment Plans are other equity features you could use.

Marker's note: This question was marked holistically. High-scoring answers gave an accurate account of Medicare's role, one detailed example each for sustainability and equity, and a link from each example to a health outcome (health status or a dimension of health and wellbeing). The report says the average was 1.9 of 6. The biggest problem was treating equity as equality ("everyone can access Medicare"). Using the Medicare Levy Surcharge as an equity example earned nothing, because it is a tax measure that encourages private insurance and does not change anyone's access to Medicare services.

Question 6 (5 marks): Social sustainability and human development

Based on Question 6 (1 + 4 marks). Name the dimension of sustainability that best fits an equitable society, sustainable birth rates and access to education, then use two examples to explain how it promotes human development.

Model answer.

• (a) Social sustainability.
• (b) Example 1, access to education. If all children can attend school now and into the future, more of them gain literacy, numeracy and vocational skills. That expands their choices: they can enter paid work, earn an income and afford a decent standard of living (food, housing and health care). This is human development, because people are reaching their full potential and living productive, creative lives.
• (b) Example 2, gender equality. If women have the same opportunities as men in this generation and in future ones, they can have a say in decisions affecting their lives, such as whether and when they marry, and can enter paid work. More women participate in decisions affecting their lives and reach their full potential, which promotes human development.

Final answer: (a) social sustainability. (b) Two examples, each showing that it continues over time and linked to a specific human development idea.

Marker's note: The report accepted "social" or "social sustainability" for part (a) (average 0.7 of 1). Part (b) averaged only 1.2 of 4. High-scoring answers showed the ongoing nature of sustainability with phrases such as "now and into the future", and explained what the human development concept meant for the people involved. Answers that listed human development terms without showing what they meant did not score well.

Question 10b (6 marks): Mass migration and health outcomes

Based on Question 10b (6 marks). Analyse what mass migration could mean for the health outcomes of the people who migrate.

Model answer.

1. Crowded temporary accommodation leads to infectious disease. People moving in large numbers often end up in crowded camps or temporary shelters without enough clean water or sanitation. Pathogens spread quickly in close quarters, so the incidence of infectious diseases such as influenza and diarrhoeal disease rises. That increases morbidity, and for young children mortality, among those migrating.
2. Loss of income and food insecurity. Migrants often leave jobs behind and may be unable to work legally when they arrive. Without an income, they struggle to pay for nutritious food and shelter. This causes ongoing stress and anxiety, which lowers mental health and wellbeing. Poor diet also weakens immune function and adds to physical ill health.
3. Loss of connection to place and culture. Being forced from home and community can reduce a sense of belonging and of hope for the future, which lowers spiritual health and wellbeing. Language barriers and racism in the new location can make people more isolated.
4. Barriers to health care. Without legal status, money or a shared language, migrants may not get treatment. Conditions go undiagnosed and get worse, which raises morbidity.

Marker's note: The rubric rewarded detailed analysis of at least two implications, each clearly linked to a specific dimension of health and wellbeing or a health status measure, saying whether it rises or falls. The average was 2.7 of 6. The report criticised vague statements such as "impacts health status", links to human development instead of health outcomes, and writing about the causes of migration (such as war) instead of its implications. For part (a), "fighting" was too vague; conflict, war, climate change, natural disasters, persecution or famine were accepted.

Question 12 (6 marks): Ottawa Charter and youth physical activity

Based on Question 12 (6 marks). Most 15 to 17 year olds do not meet the daily physical activity guideline. Discuss how two Ottawa Charter action areas could be used in health promotion to address this.

Model answer.

• Action area 1, create supportive environments. Change the physical environment so that activity is easier and safer. For example, local councils could build lit walking and cycling paths, skate parks and outdoor courts near schools and housing. With free places to be active close to home, young people are more likely to walk, ride or play sport after school, so more of them reach 60 minutes a day.
• Action area 2, strengthen community action. Communities work together to set and deliver their own solutions. For example, local government, schools and sporting clubs could run free weekly activity sessions designed with and for teenagers, such as social sport or dance. Because young people help shape the sessions and attend with friends, they are more likely to enjoy them and keep coming, which raises activity levels over time.

Marker's note: Average 3.1 of 6. High-scoring answers named two correct action areas, gave a specific health promotion example of each and clearly linked it to increased physical activity among young people. Answers lost marks by describing what an individual could do rather than how the action area works as health promotion, or by not linking the action to physical activity. Other valid action areas are develop personal skills, build healthy public policy and reorient health services.

Question 11b (3 marks): Why partner with multilateral organisations

Based on Question 11b (3 marks). Using the GPE stimulus, justify why the Australian Government works with multilateral organisations on a project like this.

Model answer.

• A multilateral organisation pools funding and expertise from many governments and agencies. The GPE brings together bilateral and multilateral donors, partner countries, civil society and the private sector.
• That lets Australia's contribution (570 million dollars since 2007) reach far more children than Australia could reach alone. The GPE works in 70 partner countries and has supported 160 million more children to be in school.
• The partnership also provides specialist knowledge of running education systems at global scale, including in the fragile and conflict-affected states the stimulus lists among its priorities. So Australian funding is used more effectively and has a larger, longer-lasting impact on education.

Marker's note: This part had one of the lowest averages on the paper, 0.9 of 3, with 46% scoring zero. The report's main criticism was that many answers showed no understanding of what a multilateral organisation is. Acceptable justifications included greater reach or scale, greater influence, shared and specialist expertise, greater access to resources and funding, and the ability to deliver programs in more than one country. Tie the justification to the GPE facts in the stimulus.

Section B Question 1 (10 marks): Water, sanitation, SDG 6 and SDG 3

Based on Section B Question 1 (10 marks). Using all four sources and your own knowledge, discuss (1) how characteristics of high- and low-income countries affect access to safe water and sanitation, (2) how that access contributes to differences in health status, and (3) how achieving SDG 6 contributes to key features of SDG 3.

Model answer (paragraph plan, organised by the three dot points, not by source).

1. Characteristics affect access. Low-income countries have lower average incomes and Gross National Income per capita, so governments raise less tax to build and maintain water treatment, pipes and toilets. Source 4 describes too few public water fountains in Bambari. They also tend to have more conflict: Milène risks attack by armed men if she collects water in the bush. High-income countries have well-developed infrastructure and stable governments. Source 1 shows the share of people using safely managed drinking water staying above 90% in high-income countries from 2000 to 2022, while in low-income countries it rose only from under 20% to under 30%. Source 2 shows a similar gap for safely managed sanitation (above 80% against under 25%).
2. Access affects health status. Without safe water, people drink water contaminated with pathogens, so low-income countries have higher morbidity from water-borne diseases such as cholera and diarrhoeal disease. In Source 4, people who fetched dirty water "fell ill" and some died. Without safe sanitation, open defecation spreads diarrhoeal disease. Source 3 cites nearly 1.7 billion cases of childhood diarrhoeal disease a year, which pushes under-5 mortality far higher in low-income countries than in high-income ones. Carrying three 20-litre jerrycans (Source 4) adds musculoskeletal conditions, raising morbidity among women in low-income countries.
3. SDG 6 contributes to SDG 3. Safe and affordable drinking water and better water quality (SDG 6) reduce water-borne disease, which helps end epidemics of communicable diseases (SDG 3). Ending open defecation and giving everyone access to sanitation and hygiene (WASH) cut childhood diarrhoea, which helps end preventable deaths of children under 5. Clean water for safe births and hygiene also helps reduce maternal mortality. Source 3 puts the scale at 2.2 billion people without safely managed water and 3.5 billion without safely managed sanitation.

Marker's note: Average 3.7 of 10. The rubric rewarded synthesis of all four sources, several characteristics of high- and low-income countries, a comparative analysis of health status, and specific SDG 6 to SDG 3 links. Answers that did not use the sources could not reach the higher marks. The report advised structuring around the three dot points rather than going source by source, which tended to restate the stimulus. It also said to signpost each source you use. Using "low access to water" as a characteristic that explains low access to water was circular and did not address the question. No formal introduction or conclusion is expected.