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PUBH6000 Social Determinants of Health Case Study Sample


The social determinants of health play a major role toward disease, health and wellbeing of the community. This assessment is aimed at consolidating students understanding of how the social determinants of health affect the health outcomes of a population. The assessment gives you an opportunity to demonstrate your understanding of the fundamentals of public health practice and apply theoretical and conceptual health intervention frameworks to analyse the health of a population. This assessment task is also designed to further develop your ability to reflect on your practice. As a public health practitioner, it is important to develop your ability to reflect on personal experiences, feedback and assess your own capabilities. This practice of reflexivity supports personal and professional growth.

Task Summary

In this assessment you are required to read a case scenario provided by your Learning Facilitator, using critical thinking skills develop a report demonstrating your ability to apply theory into practice. Your report should be 1500 words (+/- 10%) in length. In addition to submitting assessment 2 Part A, you are required to provide another 200 words of learning journal demonstrating your ability to reflect on personal experiences and challenges working to complete Assessment 2 Part A . Use the assessment template provided to develop this assessment.

The scenario will be provided separately.

Please refer to the Instructions for details on how to complete this task.


1. Read carefully over the given scenario provided by your Learning Facilitator.

2. Research health issues and relevant social determinants of health that would influence health outcomes of the population in the given scenario

3. Use the Ecological Model to analyse factors relevant to the scenario that influence health behaviours and health outcomes of the population in the following perspectives.

• Intrapersonal level

• Interpersonal level

• Community level

4. Reflect on your thoughts/activities and challenges in preparing the assessment in the Learning Journal such as information provided to complete the assessment, class activities, searches for further information and references.



The key focus of the assignment is on the disability system in Australia and the impact of relevant social determinants on the health outcome of the Australian population. Accourding to The Assignment Helpline, The case study of a disabled Leo has been used to refer to the various challenges disabled people in Australia might go through although the theoretical perspective is mostly generalized health system. The ecological model consisting of intrapersonal, interpersonal and community level factors have been used to determine the influence on health behaviours and health outcomes. Reflective summary of the experience regarding the assignment has also been provided as learning journal at the end.

Context of Potential Health Issue Among The Population

The survey report of Disability, Ageing and Carers in 2009 revealed that 18.5% of the Australian population or about 4 million people are disabled. In addition to this, another 21% is affected by long-term health condition but is not restricted from everyday activities. 87% of the people with reported disability suffer from specific limitation that restricts them from performing mobility, communication and self-care activities("About People with Disability in Australia | Department of Social Services, Australian Government", 2021). Although there are other health issues that is covered under the entire healthcare system of Australia, the key focus in the case study scenario is disabled people with Leo being one of them. It is quite difficult to define disability but from a general perspective it can be referred to the condition that can hinder a person from their ability to carry out day to day activities (Emerson & Hatton, 2014). However, there are varied degrees to which the disability can hinder a person ranging from mild like needing to wear reading glasses to severe where there is brain injury. According to the Report on Government Services 2002 the three core activities that form the basis of disability includes self-care, mobility and communication. Based on these activities, the ABS Survey of Disability, Ageing and Carers defines 4 levels of disability namely mild, moderate, severe and profound.

There are several issues that people with disabilities have to face and are more likely to experience than people without any disability. Issues like social isolation and fewer opportunities to participate in community life are more probable for disabled people ("Face the facts: Disability Rights | Australian Human Rights Commission", 2021). Moreover, such people are also more subject to living in poor quality, experience poverty, acquire low levels of education and obtain insecure housing. Studies show that some of the greatest causes of disability include mental illness and mental health problems which also diminishes their quality of life and reduce productivity levels. In the Australian population, workforce participation of disabled people is only 54% as compared to 83% of non-disable people ("Disability Support and Services in Australia – Parliament of Australia", 2021). Also, among the OECD countries, Australia has the lowest rank for the relative income of disabled people. Although the Australian government has planned on making all public transport accessible to disable people by 2022, reports show that about 1.2 million disabled people are still struggling to use them properly ("About People with Disability in Australia | Department of Social Services, Australian Government", 2021). Young people with disabilities like cognitive impairment in Australia are six times likely to end up in prison as compared to their non-disable counterpart. On the other hand, 90% of women with intellectual disabilities are subject to sexual abuse where more than a quarter of all disabled people are sexually assaulted in Australia("About People with Disability in Australia | Department of Social Services, Australian Government", 2021).

Social Determinants of Health

The social determinants of health issue refer to the disadvantages that contribute to their poor health and disabled people and their carers are the most disadvantageous group in Australia. The ecological model has been used for critical analysis of the multiple levels of influence on health behaviours of the disabled people in Australia. These include intrapersonal or individual factors, interpersonal factors and community factors ("Ecological Models - Rural Health Promotion and Disease Prevention Toolkit", 2021).

Intrapersonal/ Individual Factors:

The intrapersonal factors influence behaviour such as personality, beliefs, knowledge and attitude and are directly impactful on the individual with the disability. The social determinant that impact on an intrapersonal level is education. The more people participate in the workforce, they acquire higher levels of education and as a result of this achieve better health. Regardless of the impairment types, people with disability have on average lower levels of education as compared to other non-disabled population. Only 24% of the disabled people have completed year 12 or equivalent in terms of educational qualification which quite low than non-disabled people with 46% completing the same educational level ("Social Determinants of Health - Integrated care", 2021).

The National Disability Insurance Scheme (NDIS) provided support through local provider in town for Leo as part of their mission “no one is left behind” which includes 430,000 disabled Australians ("Social Determinants of Health - Integrated care", 2021). Leo lived on his own with the help of the services received from the local provider and was meant to be learning skills that help him live a more independent life. However, the behavioural concerns and continence issues prevented Leo from acquiring the learning skills which has impacted him on an intrapersonal level.

Interpersonal Factors:

The interpersonal factors include social support acquired from interaction with other people or create limitations in enhancing interpersonal growth that can lead to healthy behaviour. Employment can be considered as such a factor that offers opportunity for social support. Both people with disabilities and their carers have lower employment levels which lead to lower incomes and higher rates of poverty. In addition to this, enrolling in the workforce also involve social inclusion, decision-making and autonomy for the disabled person. Disabled people in Australia are almost 50% less likely to be employed which is also well below the OECD recommended 60% (Carey et al., 2017). Even more, disabled women are less likely to be in the workforce as compared to men which further limits their chances of social inclusion.

In the case study, as Leo received services from the NDIS, he lived on his own but was still unemployed as he failed to acquire the learning skills. Moreover, the notice from the service provider to cease all support further worsened the long-standing behavioural and incontinence issues of Leo and his family was quite insecure about his future. It was the complex disability of Leo affecting his cognition, emotional regulation and ability to perform daily task that prevented him from getting employed in the first place.

Community Factors:

These factors include the formal and informal social norms that can limit or enhance healthy behaviours of disabled people through interaction among individuals, groups and organizations. Housing is one such factor and is also linked to health of the disabled individual. Affordable, secure and suitable housing for the disabled is rarely available which makes them vulnerable in the Australian housing market. Instead of residing in cared accommodation establishments, almost 95% of disabled people in Australia live in regular households ("Social determinants of health - Australian Institute of Health and Welfare", 2021). As a result of this, people with disability might often fall out of home ownership and become rental tenants.

The reason the chief executive of Leo’s provider stated of withdrawing the services is the unhygienic condition due to the mess made by Leo. This was considered as an unacceptable risk for everyone and might also compromise the safety and well-being of Leo and the staff members. However, as Leo was suffering from continence issues, a regular household instead of cared accommodation would result in such mess and unhygienic conditions.

Influence of The Key Determinants on Health Behaviours and Health Outcomes

The social determinants from all three levels of the ecological model influence the health behaviours and health outcomes of the disable Australian populace. The lowered rate of employment leads to lower income and increased poverty for the disabled people. As compared to other OECD countries, Australian disabled people live in much worse conditions. As a result of this, the median personal income for disabled people was $225 per week while the non-disabled people had $480 ("SHUT OUT: The Experience of People with Disabilities and their Families in Australia | Department of Social Services, Australian Government", 2021). The intrapersonal factor of education is also linked to this outcome as there is existing income inequality for disabled people regardless of their educational qualification. The higher poverty rates in turn make it eve harder for disabled people to acquire care services which affects them on a community level as well. For this reason, government backed general resources, support and services provided by NDIS helps disabled people overcome the health outcomes caused by the key social determinants (Kavanagh, 2020). Disabled people like Leo and others can live an independent life on their own without worrying about employment and income.


It is evident from the assignment that as compared to other OECD nations, Australia currently is ranked lower in terms of services provided as well as well-being of the disabled people. The critically discussed social determinants from all three levels of the ecological model indicate that Australian population of disabled people are far more likely to suffer from unemployment, poverty and homelessness as compared to non-disabled populace.

Learning Journal



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