Global health challenges and inequities: WACE Year 12 Health Studies Unit 4
“Analyse how globalisation and the social determinants of health create inequities between and within populations, and evaluate approaches that address them”
Globalisation, the growing interconnection of trade, travel, technology and culture, shapes health both positively (faster spread of medicine, knowledge and aid) and negatively (spread of disease, marketing of unhealthy products, and widening gaps). The social determinants of health explain why inequities persist between rich and poor countries and between groups within a country, and effective approaches must remove the structural barriers that keep groups from better health.
What this dot point is asking
WACE wants you to analyse how global forces and social determinants combine to produce health inequities, then judge the approaches used to address them. A strong answer balances the positive and negative effects of globalisation, links determinants to specific inequities, and evaluates whether an approach actually reduces the barrier. Marks reward analysis and judgement, not description.
How globalisation influences health
Globalisation brings benefits to health. The rapid exchange of medical knowledge, technology and trained workers speeds up diagnosis and treatment. International aid, coordinated disease surveillance and shared vaccine development help control outbreaks across borders. Communication technology spreads health information and connects communities to services.
Globalisation also creates risks. Increased travel and trade let infectious diseases spread quickly across the world. The global marketing of tobacco, alcohol, and energy-dense processed foods promotes unhealthy consumption, especially in lower-income countries with weaker regulation. Economic globalisation can concentrate wealth and widen the gap between those who benefit from global markets and those left behind.
The same global system that delivers vaccines, aid and knowledge to a community can also deliver aggressive marketing of unhealthy products and accelerate the spread of disease. A high-scoring answer weighs both the positive and negative health effects for the population in the stimulus rather than arguing globalisation is simply good or bad.
Social determinants and global inequities
The social determinants of health, including income, education, employment, living and working conditions, and access to services, are distributed unevenly both between and within countries. Between countries, lower-income nations often face weaker health systems, poorer sanitation, less education and limited access to medicines, producing lower life expectancy and a heavier burden of preventable disease. Within countries, the same determinants separate advantaged from disadvantaged groups, so inequities exist even in wealthy nations. This is why two communities exposed to the same global trend can experience very different outcomes: their underlying determinants differ.
Approaches that address barriers
Approaches to reduce inequities work by removing the structural barriers that block better health. Building healthy public policy, such as regulating the marketing of harmful products and funding universal services, tackles barriers at scale. Strengthening health systems and reorienting them toward prevention improves access. Community participation ensures solutions fit local needs and are sustained. International cooperation and aid can build capacity where resources are scarce. Evaluating an approach means asking whether it reaches the most disadvantaged, addresses the determinant causing the inequity, and produces lasting change rather than a short-term fix.
How this maps to the exam
Expect a stimulus comparing health outcomes between or within populations, often with data. You may be asked to analyse the role of globalisation, link determinants to the inequity, or evaluate an approach. Address both the benefits and risks of globalisation and judge approaches against whether they remove the underlying barrier.
When a stimulus compares health between or within populations, the marks come from analysis and a judged approach, not description of the gap.
State the inequity from the data
Read the stimulus precisely: for example, life expectancy is markedly lower and infant mortality much higher in a low-income country than in a high-income one. Quantify the gap rather than just saying "worse".
Analyse the combined causes
Show globalisation both ways: aid and vaccines reach the country, but weak regulation also lets unhealthy products in. Then link the determinants: weak health systems, poor sanitation, low education and limited access to medicines explain why the gap persists. The interaction is the analysis.
Evaluate a named approach
Choose an approach (such as a global immunisation initiative or health-system strengthening) and judge it: does it reach the most disadvantaged, address the determinant, and last? Name a strength and a limit.
Conclude with a conditional verdict
End by stating the approach reduces the inequity when it builds local capacity and is sustained, but achieves little if it is short-term or bypasses the underlying determinants. A balanced, evidence-linked judgement is the top-band response.
Students often describe the gap between groups, quoting figures, without explaining why it exists or judging the response. The dot point asks you to analyse and evaluate, so connect the inequity to specific social determinants and global forces, then assess whether the named approach actually addresses that cause for the disadvantaged group.
Exam-style questions
Questions in the style of SCSA exam questions on this dot point, each with a worked answer. They are written by ExamExplained unless tagged "Past paper"; the year shows the paper a question is modelled on.
WACE 2022-style8 marksAnalyse how globalisation and the social determinants of health combine to create health inequities between high-income and low-income countries, and evaluate one approach used to address them.Show worked answer →
An 8 mark analyse-and-evaluate response needs both sides of globalisation, the determinant link, and a judged approach.
- Analyse globalisation (both ways)
- Positive: faster spread of vaccines, knowledge, aid and disease surveillance. Negative: rapid spread of infectious disease through travel and trade, and global marketing of tobacco, alcohol and processed food into low-income countries with weaker regulation.
- Link to determinants
- Lower-income countries face weaker health systems, poorer sanitation, less education and limited access to medicines, so the same global trends produce far worse outcomes there. The determinants explain why the gap persists.
- Evaluate an approach
- International cooperation and aid (for example funding immunisation and health-system capacity) can build capacity where resources are scarce; judge it by whether it reaches the most disadvantaged, addresses the determinant and lasts, rather than being a short-term fix.
Markers reward a balanced view of globalisation, determinant analysis, and a conditional judgement of the approach.
WACE 2023-style4 marksExplain how the social determinants of health can produce inequities within a single high-income country.Show worked answer →
A 4 mark response needs the uneven distribution and a within-country mechanism.
Uneven distribution. Even in a wealthy country, income, education, employment, living conditions and access to services are distributed unevenly across groups.
Mechanism. Disadvantaged groups (low income, remote, some cultural communities) face worse access and less supportive environments, so they carry higher rates of preventable disease despite the country's overall wealth. The gap is structural, not chance.
Markers reward the within-country focus and a link from unevenly distributed determinants to unequal outcomes.