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Applying knowledge of determinants of health – Level 8

Intended outcomes

Students will:

  • critically examine the interrelationships between socio-economic status and other determinants of health in given contexts (8A1, 8A4)
  • evaluate the contribution of policies and practices at local and national levels to achieving equitable health outcomes for population groups (7D3, 8D1)
  • establish and justify priorities for action to enhance the well-being of communities (8D2)
  • critically analyse the influence of the media on public perceptions of health issues (8A4, 8D1)

Links to NCEA Achievement Standards

This activity will help to prepare students for assessment against achievement standards:

Key area of learning

  • Mental Health
  • Sexuality education

Key concepts

  • Socio-ecological perspective – Critically analysing relevant determinants of health in specific contexts

Background information

It is expected that students will already have a comprehensive understanding of determinants of health and will be aware of how these relate to the socio-ecological perspective that is part of health education. In these activities, students are required to use research skills to access relevant data and apply their knowledge of determinants of health to local and national health issues and situations. They analyse the compounding effects of different determinants; this will help them to recognise that broad-based, comprehensive approaches are most effective for improving the health status of populations.

Examples of the kinds of media material that can be used are suggested. Teachers should select material that is relevant to their students and to the contexts they are working within. It is recommended that, before commencing these activities, teachers read 'Social, Cultural and Economic Determinants of Health', a background paper prepared for the National Health Committee (Howden-Chapman and Cram, 1998), which is available from the National Health Committee (Ministry of Health). The National Health Committee's report The Social, Cultural and Economic Determinants of Health in New Zealand: Action to Improve Health is available through the National Health Committee's website http://nhc.health.govt.nz/ by clicking on the following link: http://nhc.health.govt.nz/publications/nhc-publications-pre-2011/social-cultural-and-economic-determinants-health-new-zealand.

Activities

Below are two possible learning activities provided for this learning experience.

Activity 1: Effects of socio-economic factors on the health of a society

Give your students copies of an article from The Press newspaper, entitled ' In sickness and inequity (PDF, 47 KB) '.

As a class, discuss the opinions expressed and issues raised by Professor Kawachi in the newspaper article. Use the following questions and instructions to focus the discussion.

  • Describe an egalitarian society
  • To what extent do you think New Zealand is an egalitarian or a non-egalitarian society?
  • How does Kawachi explain the term 'social capital'?
  • Use your understandings about determinants of health to explain some implications of the term 'social capital'.
  • What are the advantages and disadvantages of an egalitarian society?

As a class, discuss the opinions expressed and issues raised by Professor Kawachi in the newspaper article. Use the following questions and instructions to focus the discussion.

  • Describe an egalitarian society
  • To what extent do you think New Zealand is an egalitarian or a non-egalitarian society?
  • How does Kawachi explain the term 'social capital'?
  • Use your understandings about determinants of health to explain some implications of the term 'social capital'.

What are the advantages and disadvantages of an egalitarian society?

Nutbeam (1998) says that the degree of 'social capital' in a community is the degree of social cohesion that exists in that community. It includes the processes that people use to establish networks, norms, and social trust and to facilitate co-ordination and co-operation for their mutual benefit.

''

Social capital is created from the myriad of everyday interactions between people, and is embedded in such structures as civic and religious groups, and family membership...The stronger these networks and bonds, the more likely it is that members of a community will co-operate for mutual benefit.

''

Nutbeam, 1998, page 19

Students could use statistics to compare the relative incomes of New Zealanders over the last three decades with the prevalence of infectious diseases in the same period in order to establish whether Professor Kawachi's opinions about New Zealand have a sound factual basis. What other evidence might be needed to check the accuracy of his statements? (For answers, students could refer to the following government websites:

Give your students copies of the following extract from a New Zealand  Listener abstract (PDF, 5 KB) to read and discuss.

Teachers' note on Listener extract

Introduce this extract sensitively, acknowledging that there are a number of socio-economic areas in New Zealand where people experience health problems like those described in South Auckland. You may prefer to find an alternative extract.

Students access relevant data for a selected population in an area of New Zealand. (They could examine information relating to their local region, for example, by accessing information from regional websites. 

They then consider their data in relation to each determinant of health listed below and go on to synthesise the information to explain how the socio-economic status of people living in the chosen area influences their health. They will need to think about the effects of each determinant individually, and go on to critically examine the interrelationships of the determinants.

Relevant determinants of health include:

  • unemployment
  • housing (for example, overcrowding and lack of heating)
  • cultural expectations
  • stress levels
  • addiction (including gambling)
  • access to transport
  • nutrition
  • levels of immunisation
  • access to medical services

Students engage in research to identify ways in which these issues are currently being addressed at both local and national levels. Ask them to find out whether there has been any change in the health statistics for their selected population over the last decade and to suggest reasons for any changes.

Students go on to look at health issues that affect the population of New Zealand in general. They identify issues that relate to three determinants - food, exercise, and access to medical services.

Ask your students:

  • In what ways are people in financially disadvantaged situations benefited or disadvantaged in terms of food, exercise, and access to medical care?
  • In what ways are people in financially advantaged situations benefited or disadvantaged in terms of food, exercise, and access to medical care?

A sense of social justice is identified as an important value in Health and Physical Education in the New Zealand Curriculum (1999) (page 34). Students could debate and discuss:

  • What supports the growth of social justice in New Zealand?
  • What actions are being taken in New Zealand that are leading to more social justice?
  • Factors that might be barriers to social justice in New Zealand

Students could establish and justify priorities for action to benefit a specific community, and they could go on to take action by undertaking a health promotion initiative. For example, students could work in the area of early childhood, using the action competence learning process to carry out health promotion activities related to healthy eating choices.

Activity 2. Fact or fiction, myth or reality?

Give students copies of articles with a health focus from current newspapers, television, or other media sources. The  Health articles extracts (PDF, 45 KB) contains examples of suitable quotations from four newspaper articles.

In small groups, students identify and record key issues in the articles. Then, as a class, they discuss the issues raised, using questions and instructions such as the following:

  • What determinants of health could be influencing the key issues in the story?
  • Which of these determinants are discussed in the article, and which are omitted? Do any inclusions or omissions affect the balance of the story?
  • Could the style of reporting influence the way people perceive the issues? If so, how?
  • How could people's perceptions of the issues influence the well-being of the people involved in the story?
  • Who benefits from the way in which the story is reported? How do they benefit? Why was the story reported in this way?
  • Who is disadvantaged by the manner of reporting the story? How are they disadvantaged?
  • Describe any actions that may be needed to ensure that news stories are reported in ways that are socially just.
  • What rights do people have in relation to media reports about them?
  • What code of ethics do journalists follow in reporting news?

Students could also debate the issues presented in the media report, or they could explore people's different perspectives by participating in role plays, taking on the roles of the various stakeholders in the story.


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