Factor type Description Examples that I need to know

The physical -Housing

surroundings in -Work environment
Topic 4 Notes which we live, -Urban design and
work and play. infrastructure
Environmenta Environmental -Climate and climate change
l factors factors include
Population groups:
Indigenous and non-indigenous workplaces,
Male and female housing, roads
High and low socioeconomic and
status (SES) geographical
The social and -Socioeconomic status (SES)
Within and outside of Australia's cultural -Access to health care
major cities (rural vs non-rural) conditions into -Early life experience
which people -Food security
Sociocultural are born, grow, -Cultural influences
Influences:
factors live, work and -Social isolation
Biological influences
Sociocultural influences age. These -Social exclusion
Environmental influences conditions -Unemployment
include
socioeconomic
Factors relating -Genetics including sex,
to the body predisposition to disease and
that impact on hormones
health status, -Birth weight
Biological such as -Body weight
factors genetics, body -Blood cholesterol
weight, blood -Glucose regulation
pressure, -Blood pressure
cholesterol
levels, birth
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 identify a relevant (bio, socio, eviro) factor

 discuss how this factor contributes to ill health
 link to health status terms such as morbidity, mortality, etc.

Biological factors -factors relating to the body that impact on health and wellbeing, such as
genetics, body weight, blood pressure, cholesterol levels, birth weight

Body weight/high body mass can contribute significantly to

variations in health status between individuals and population
groups. It can impact cause other concerns listed, such as the
chances of developing high blood pressure, high blood cholesterol
and impaired glucose regulation (which are also biological
factors).

Other health concerns associated with high body mass include:

  cardiovascular disease
 some cancers (including colorectal cancer)
 respiratory problems
 type 2 diabetes
 arthritis
 self-esteem issues and depression
 social exclusion.

A person with high blood pressure has hypertension, a common

health concern throughout the world. The blood of a person with
hypertension does not flow through the blood vessels as easily as
that of someone with normal blood pressure. This may mean that
their heart and kidneys, which regulate blood pressure and filter
the blood, have to work harder, and blood flow may be restricted.

Individuals and population groups that display higher rates of

these risk factors are more likely to experience hypertension,
which in turn increases their risk of associated health concerns
such as cardiovascular disease and kidney failure. These risk
factors often occur in conjunction with each other, which further
increases the risk among some individuals and population groups.

A range of factors can increase the risk of high blood cholesterol,

including:

 excessive alcohol intake

 smoking
 a diet high in saturated fat and/or trans fats
 a lack of exercise
 high body mass index
 genetic predisposition.
Too much LDL cholesterol is a key risk factor for cardiovascular
disease, particularly heart attack and stroke

A range of factors can impact on this mechanism and contribute

to the cells becoming resistant to the action of insulin, preventing
glucose from being absorbed into the cells.
This is known as impaired glucose regulation (or insulin
resistance). Impaired glucose regulation is seen as a precursor to
type 2 diabetes.

Impaired glucose regulation can occur as a result of:

 genetic predisposition
 stress
 pregnancy
 lack of exercise
 smoking
 high body mass (particularly if excess weight is stored
around the abdomen)
 a diet high in fat, particularly trans fat
 excessive alcohol consumption
 high LDL cholesterol
 high blood pressure.

Individuals and population groups who display the risk factors

associated with impaired glucose regulation experience higher
rates of cardiovascular disease and type 2 diabetes. These
conditions can contribute to significant differences in health
status, such as higher rates of heart attack, stroke, kidney
disease and premature death

Babies born with a low birth weight (less than 2.5 kilograms)
are more likely to have an underdeveloped immune system,
making them more susceptible to infections. They are also more
likely to suffer from premature death and significant disabilities
such as speech and learning disabilities.

The genetic material contained in body cells controls many

aspects of life that influence health status, such as sex, body
type, hormone production and aspects of personality
Certain conditions are either exclusive to males or females or are
more common in one of the sexes due to the biological
differences
Males have a different combination of hormones to females,
which could contribute to some of the differences in health
concerns experienced by the two sexes. Of particular note are the
hormones oestrogen and testosterone.
When a woman enters menopause, the levels of oestrogen
decline. This decline leads to a loss of bone mass from the
skeletal system, which can contribute to osteoporosis

Sociocultural factors- the social and cultural conditions into which people are born, grow,
live, work and age. These conditions include socioeconomic status, social connections,
family and cultural norms, food security, early life experiences, and access to affordable,
culturally appropriate healthcare

Socioeconomic status (SES) refers to a person’s position in society relative to other people
based on three factors: income, occupation and education (see FIGURE 4.10). People who
are more socioeconomically disadvantaged have poorer health status across most countries
and cultures

Income can influence people’s ability to access resources such as

adequate housing, food, healthcare (including private health
insurance), recreation, transport and education.
The occupation a person has also influences health status. Some
occupations (including many trades) involve manual labour, which
can increase the risk of soft tissue injuries and back pain
As well as influencing income and occupation, education impacts
health status in a number of ways. Can relate to heath literacy

Unemployment
‘the unemployed have a higher chance of dying and [suffer from]
more illnesses than those of similar age who are employed
Being socially connected has been associated with lower
morbidity and increased life expectancy

Social exclusion can be caused by, or contribute to, a range of

characteristics, including:

 increased risk-taking behaviours, such as alcohol and drug

misuse
 poor physical and mental health and wellbeing, including
increased risk of mental disorders
 disability
 inability to access services such as healthcare, education,
employment and social security
 family breakdown
 homelessness
 discrimination, including racism
 low income.

Social isolation refers to not being in regular contact with

others. Geographical barriers can prevent people from being able
to interact with others and is an issue particularly for many
people in remote areas. Disability, disease, lack of transport and
communication barriers can also prevent people from socialising
and contribute to social isolation
In times of difficulty, people who are socially isolated can feel
they have no-one to turn to, and this can contribute to a range of
mental health problems such as depression and stress.
Cultural norms relate to customs, ideas, values and traditions of a
particular society that are passed through generations

The quality, availability and affordability of the food supply all

affect what people eat. A shortage of such products (called food
insecurity) can lead to deficiency diseases and other health
complications

Every person is, in part, a product of their past experiences

Having optimal growth and strong emotional attachment in the
early years can assist physical, social, emotional, mental and
spiritual health and wellbeing in adulthood. Infants who have
experienced positive emotional stimulation are better prepared to
take on the challenges of formal education and to exhibit positive
behaviour, and are less likely to be socially excluded in adulthood.
Infants who have had the best possible health and wellbeing are
also more likely to have been exposed to healthy lifestyle choices
such as a healthy food intake, a non-smoking environment and
physical activity.
On the other hand, abuse or neglect during the early years affects
brain function and development, and contributes to emotional
and behavioural problems later in life

Healthcare services refers to services that promote and preserve

health and wellbeing. These services diagnose, treat and/or
manage disease and injury. Sometimes services can’t be
accessed due to location, culture, or lack of health literacy.

Environmental factors- the physical surroundings in which we

live, work and play. Environmental factors include workplaces,
housing, roads and geographical access to resources such as
healthcare.

The relationship between the physical environment and health

status is complex, but there is growing evidence to suggest that
the way people interact with the physical environment can
increase or decrease the risk of negative health outcomes.
Housing

Some of the specific concerns of the home environment that

contribute to variations in health status include:
Ventilation and hygiene (disease)
Design and safety (injury)
Sleeping conditions (sleep is important)
Security (peace of mind, no anxiety)
Access to water (Water is essential)

Workplace
Examples of how the physical environment of the workplace can
impact on health status include:

UV exposure (cancer due to UV radiation)

Dangerous working conditions and hazardous substances (injury)

Urban design and infrastructure summarised below

Geographical location of resources

Having access to goods and services can increase the ability of
many people to access resources required for good health and
wellbeing
Having adequate infrastructure, such as sealed roads, public
transport systems, information and communication technologies,
and recreation facilities, assists in promoting health status
Climate
Australia is the driest inhabited continent on Earth, and is more
susceptible to bushfires than many other countries as a result
(deaths, loss of infrastructure)
Ultraviolet (UV) radiation levels are also comparatively high in
Australia, contributing to Australia having the highest rates of skin
cancer in the world
Climate change
There is increasing concern of climate change. It can result in
extreme temperatures, rising sea levels, and increases in the
occurrence of natural disasters (bushfires and floods) and the
spread of diseases such as dengue fever and Ross River fever

Indigenous and non-indigenous

Biological factors:

Higher rates of BMI which increases the risk of suffering from

chronic conditions such as cardiovascular disease, type 2 diabetes
and osteoarthritis

High blood pressure / hypertension which is a risk factor for stroke

and heart disease.
Higher rates of impared glucose regulation, which contributes to
the higher rates of diabetes and kidney disease experienced.

Aboriginal and Torres Strait Islander mothers are almost twice as

likely to give birth to a baby with low birth weight (infections due
to poor immune system)

Sociocultural factors such as socioeconomic status,

unemployment, social exclusion including discrimination and
homelessness, food insecurity, early life experiences and cultural
norms.

Environmental factors

Housing -The absence of affordable, secure and appropriate

housing can result in a number of negative consequences

Poorer water and sanitation access

Less access to health services -Indigenous Australians have lower

levels of access to, and use of, health services and resources such
as Medicare-funded services, the Pharmaceutical Benefits Scheme
(or PBS, which subsidises medication) and private GPs. This could
mean that conditions may go undiagnosed or untreated.

Poorer infrastructure -increase the risk of injuries and deaths

related to roads.

Males vs females

Biological:

High BMI: more prevalent in males than females, causing higher

rates of hypertension, cardiovascular disease and type 2 diabetes
among males.

Blood pressure: mainly a problem for males but older women tend
to have higher blood pressure than older men (cardiovascular
disease)
Glucose regulation: males experienced significantly higher rates
than females, which contributes to the higher rates of type 2
diabetes and kidney disease

Genetics: Menopause (osteoporosis due to lack of estrogen to

promote bone adaptivity), differing fat storages (male around
abdomen), testosterone (risk taking)

Sociocultural:

Unemployment: more men unemployed, has negative effects

SES: Men earn more and that’s why they have better SES and
lower levels of mental and behavioural problems and
psychological distress than women

Cultural norms: A range of gender stereotypes in Australia

contribute to variations in health status. Relates to who is the
carer, type of job, playing sport, appearance expectations (eating
disorders)

Environmental factors:

Men work in more laborious and hazardous workplaces (also more

likely to work outside with UV rays) which contributes to injury
(and cancer).

High vs low SES

Biological factors

BMI: higher for those in low socioeconomic status groups.

contributes to lower life expectancy largely due to the increased
rates of death from conditions such as cardiovascular disease and
type 2 diabetes.
Blood pressure/hypertension: higher for low SES, causes
cardiovascular disease effecting life expectancy also.

Glucose regulation: Rates of impaired glucose regulation are

higher among low socioeconomic status groups. This contributes
to the higher burden experienced in relation to conditions such as
type 2 diabetes and kidney disease

Birth weight is pretty much irrelevant

Sociocultural factors:

Education and income: People in low socioeconomic status groups

have lower educational attainment, lower incomes and jobs with
lower social status, which can lead to numerous negative
outcomes.

Unemployment: People experiencing socioeconomic disadvantage

are more likely to be unemployed. As already explored, those who
are unemployed are also more likely to experience poor health
status

Social exclusion: Socioeconomic disadvantage can also lead to

social exclusion as individuals are less likely to gain education,
meaningful employment and access community resources

Food security: Less common for low SES. Higher rates of obesity
and lower rates of fruit and vegetable consumption are often the
product of food insecurity

Early life experiences: More issues related to low SES, which can
be related to more negative experience for children growing up
but varies heaps.

Access to healthcare: Low SES is less likely to access healthcare

due to cost or lack of facilities, and this can result in conditions
being undiagnosed
Neighbourhood safety: Less safe in low SES meaning less sense of
comfort and more anxiety

Environmental factors

Geographic location: Low SES may naturally have less access to

healthy things like food outlets.

Housing: People of low socioeconomic status are less likely to be

able to afford high quality housing (more exposed to environment
and disease and more anxiety

Work environment: People living in socioeconomic disadvantage

are more likely to work in jobs that have dangerous working
environments, such as factories and manufacturing plants, and
involve exposure to toxic substances and heavy machinery. This
may contribute to higher rates of illness, injury, respiratory
conditions and some cancers.

Rural vs non rural

Biological factors

Body weight: high body mass index are higher among those living
outside of major cities (higher chance of cardiovascular disease
and type 2 diabetes

Blood cholesterol: For some reason rural people have a higher risk
of high blood cholesterol, which contributes to the higher rates of
cardiovascular disease, including hypertension

Glucose regulation: People living outside of major cities are more

likely to experience impaired glucose regulation than those in
major cities. This raises the risk of conditions such as type 2
diabetes and kidney disease.

Birth weight: Higher rate of low birth weight in remote areas.

Blood pressure: More hypertension for remote areas

Sociocultural factors

Socioeconomic status: Rural tends to be lower SES, which

contributes to less opportunities and poorer health later on

Unemployment: People living outside Australia’s major cities

experience higher rates of unemployment compared with those in
major cities, which causes numerous impacts

Food security: Less likely to be food secure when living remotely,

largely due to high costs and lack of access. This can lead to the
consumption of more processed food items with a long shelf life.
These foods often have high salt content which can lead to CV
disease.

Social isolation: obviously more prevalent in remote locations,

and results from a lack of contact with other people such as
family, neighbours and friends. Contributes to higher rates of
mental health disorders and suicide

Environmental factors

Infrastructure: In rural and remote areas, roads and other

infrastructure are generally in poorer condition which can cause
injuries and other health issues

Geographic location: access to hospital services decreased (royal

flying doctor needed) which can enhance the negative impact of
health concerns

Climate and climate change: People living in rural and remote

areas may experience greater hardship in regard to climate.
Droughts, floods and fires can disrupt farmers and lead to
unstable income which can cause stress. A greater risk of natural
disasters means more injury and death

Work environment: Many jobs in rural and remote areas are

based outdoors, which can increase UV exposure and the
incidence of skin cancer. They are also often industries with
associated hazardous risks.