Similarities and differences in health status and human development in low-, middle- and high-income countries, including Australia, for VCE Health and Human Development Unit 4 AoS 1

What this dot point is asking

The 2025 study design key knowledge is "similarities and differences in health status and human development in low-, middle- and high-income countries, including Australia". The matching key skills are to evaluate data to analyse similarities and differences between countries, and to compare health data and other information to analyse reasons for health inequalities within and between countries.

So this page is about using the data. The companion pages cover the pieces you need to explain it:

• Characteristics of low-, middle- and high-income countries: how countries are classified and what they typically look like.
• The Human Development Index: the concept of human development and the measure.
• Factors affecting global health: safe water, sanitation, poverty and discrimination, the factors that explain the gaps.

The data: health status by income group and Australia

Source: World Bank, World Development Indicators (accessed September 2026).

How to read it. Move left to right and almost every indicator improves. The gaps are largest for the indicators that measure deaths of mothers and young children:

• Maternal mortality is about 35 times higher in low-income countries than in high-income countries (346 compared with 10 per 100,000 live births), and 173 times higher than in Australia (2).
• Under-5 mortality in low-income countries (68.8) is 19 times Australia's rate (3.6).
• Life expectancy differs by 15.2 years between the low- and high-income groups, and by almost 18 years between the low-income group and Australia.
• Adolescent births, a marker of early marriage, limited education and limited access to contraception, run at 90.7 per 1,000 girls aged 15 to 19 in low-income countries compared with 6.4 in Australia.

The data: human development by HDI group

The UNDP's HDI groups do not line up exactly with World Bank income groups (the HDI adds health and education to income), but the pattern is the same.

Source: UNDP, Human Development Report 2025, statistical annex table 1 (released May 2025). The HDR and World Bank use slightly different life expectancy estimates for Australia (83.9 for 2023 and 83.1 for 2024), so quote the figure from whichever source the question gives you.

What stands out:

• Adults in low human development countries have on average 4.0 years of schooling, against 12.5 in very high human development countries. A child starting school can expect 8.9 years of education, against 16.4.
• Average income (GNI per capita) in the very high group is about 18 times the low group's.
• Australia's HDI (0.958) is above the very high group average because of its long life expectancy and its expected years of schooling (20.7, one of the highest in the world).

These gaps matter for human development because they limit people's choices and freedoms: fewer years of schooling mean less access to knowledge and fewer job options; low income limits a decent standard of living; shorter lives cut off the chance to reach full potential.

Differences: what people die from

The biggest difference is not only how many people die but what they die from. The WHO groups causes of death into three categories: communicable (infectious and parasitic diseases plus maternal, perinatal and nutritional conditions), non-communicable (chronic) and injuries.

Source: WHO, "The top 10 causes of death" fact sheet, 7 August 2024.

This is the epidemiological transition in action: as countries grow richer, deaths shift from infectious disease in childhood to chronic disease in old age. Many middle-income countries sit in the middle with a double burden: they still have to fight infectious disease and undernutrition while treating rising heart disease, diabetes and cancer, often with limited health budgets.

Our region: Australia and its neighbours

Source: World Bank, World Development Indicators (accessed September 2026). Mortality rates are per 1,000 live births (under-5) and per 100,000 live births (maternal); n/a means no safely managed estimate is published.

Two lessons from this table:

1. Countries in the same income group can differ widely. India, Timor-Leste, Papua New Guinea and Nigeria are all lower-middle-income, yet Nigeria's under-5 mortality is more than four times India's and its maternal mortality is over 12 times higher. Income group is a starting point, not an explanation.
2. Australia's nearest neighbours are much closer to the low-income profile than Australia is. Only about one in six people in Papua New Guinea uses safely managed sanitation. This is one reason Australia's aid program concentrates on the Pacific and South-East Asia (see Australia's aid program).

Similarities between income groups

Questions sometimes ask for a similarity, and students often cannot think of one. Good similarities:

• Non-communicable diseases are rising everywhere. NCDs killed at least 43 million people in 2021, equivalent to 75 per cent of non-pandemic deaths. 73 per cent of NCD deaths and 82 per cent of premature NCD deaths (before age 70) occur in low- and middle-income countries (WHO, September 2025). Cardiovascular disease is the leading NCD killer (at least 19 million deaths in 2021).
• Overweight and obesity are global. In 2022, 1 in 8 people worldwide were living with obesity and 2.5 billion adults were overweight (WHO, December 2025). This is not only a high-income problem: obesity has spread as countries gain food security and adopt more processed diets.
• Every group has improved over time. The UN's 2026 SDG report found 134 countries have met the SDG target for child mortality, and new HIV infections and AIDS-related deaths have each fallen by roughly a third since 2015. Low-income countries' HIV/AIDS deaths fell 63 per cent between 2000 and 2021 (WHO).
• Lower respiratory infections appear in the top 10 causes of death in low-, upper-middle- and high-income countries alike (WHO, 2021 data), although they are the leading killer only in low-income countries.
• Inequalities exist within every country. In Australia, life expectancy for Aboriginal and Torres Strait Islander people was 71.9 years for males and 75.6 years for females in 2020-2022, gaps of 8.8 and 8.1 years (see Closing the Gap). In low- and middle-income countries, rural, poorer and conflict-affected communities fall well below national averages.

Australia in the global picture

As a high-income country with very high human development, Australia shows the typical high-income profile:

• Long lives and very low child and maternal mortality: life expectancy 83.1 years, under-5 mortality 3.6 per 1,000 live births, neonatal mortality 2.3, maternal mortality 2 per 100,000 (World Bank).
• A chronic disease burden: Australia lost 5.8 million years of healthy life (DALYs) in 2024. Living with illness or injury caused 54 per cent of the burden and premature death 46 per cent. Cancer (16 per cent), mental health and substance use disorders (15 per cent), musculoskeletal conditions (13 per cent) and cardiovascular diseases (12 per cent) were the leading disease groups (AIHW, Australian Burden of Disease Study 2024).
• Near-universal infrastructure: 95.8 per cent of Australians use safely managed sanitation, and water, electricity and internet access are close to universal.
• Universal health coverage through Medicare and the PBS, which keeps out-of-pocket costs lower than in low- and middle-income countries.

Australia also shares features with lower-income countries: persistent inequalities (between First Nations and non-Indigenous Australians, and between cities and remote areas), rising obesity, and a growing burden from mental ill health.

Explaining the differences

A description of the data earns a mark or two. The analysis marks come from explaining why the differences exist. The study design's factors (safe water, sanitation, poverty, discrimination) and the characteristics of each income group do that work.

Command terms for this dot point

• Identify (1 mark): name a difference or similarity, for example "under-5 mortality is higher in low-income countries".
• Describe (2 marks): give the characteristics with data: "68.8 per 1,000 live births compared with 5.1 in high-income countries".
• Outline the relationship (2 marks): show a pattern across all the data points, with figures (2022 VCAA Q1b). A relationship between two variables, not a comparison of two countries.
• Compare (2 to 4 marks): state both similarities and differences, using linking words such as "whereas" and "similarly".
• Analyse (4 to 6 marks): break the data into parts and explain the reasons, linking factors to health status indicators.
• Evaluate data (key skill): judge what the data do and do not show, for example that a national average hides inequalities, or that estimates for low-income countries are often modelled.

How this dot point appears in the VCE exam

• Short answer with a table or graph (2 to 4 marks): outline a relationship, describe a difference, or explain a characteristic's impact on health status (2022 Q1b, 2024 Q8b).
• Stimulus comparisons (4 to 6 marks): data for a low-income country and Australia, with a request to analyse the difference and its causes.
• Section B extended response (10 marks): 2023 used Afghanistan and Australia (female life expectancy 67.6 compared with 85.8 years; maternal mortality 638 compared with 6 per 100 000 live births; HDI 0.478 compared with 0.951) and 2025 used safe water and sanitation data for low- and high-income countries. Both required students to use the data to show differences in health status before explaining them.