June 2026
The 2025 VCE Health and Human Development exam made one thing clear about Australia’s health system and health promotion: definitions were not enough.
Students needed to apply the social model of health, Medicare and the Ottawa Charter to the specific issue in the question. The report shows that many students could recognise the broad concept, but lost marks when they did not connect it to smoking and vaping, equity, sustainability, health outcomes or physical activity.
This is a major lesson for future students.
Health promotion questions are not asking students to recite models.
They are asking students to use models.
How does this initiative reflect the social model of health?
How could it reduce smoking or vaping?
How does Medicare promote health outcomes through equity and sustainability?
How could Ottawa Charter action areas address low physical activity among young Australians?
How does a change in health act as a resource for individuals and the nation?
These questions require applied reasoning.
Smoking and vaping responses needed specific health outcomes
Question 4a asked students to explain two ways smoking or vaping may affect health outcomes in Australia.
The report noted that generic responses were a common issue.
Statements such as “smoking increases morbidity” or “smoking increases incidence” were not specific enough. Students needed to identify the condition or outcome, such as increased morbidity from lung cancer, increased incidence of cardiovascular disease, increased mortality from heart attack, or decreased life expectancy.
This is important because health outcomes are not vague consequences.
They refer to measurable effects on health status or dimensions of health and wellbeing.
A strong response could explain that cigarettes and e-cigarettes may contain carcinogens, which can damage cells and increase the likelihood of tumours developing. This can increase the prevalence of lung cancer in Australia.
Another strong response could explain that chemicals in cigarettes and e-cigarettes can contribute to plaque build-up in arteries, increasing the risk of cardiovascular disease and therefore increasing mortality from heart attacks.
The pattern is:
smoking or vaping → mechanism → specific condition → health outcome.
Without the specific condition or direction of change, the answer remains too broad.
Students needed to state direction
The report also noted that students sometimes referred to an impact on a health status measure without stating whether it increased or decreased.
For example:
Smoking impacts life expectancy.
This is not enough.
A stronger version would be:
Smoking can decrease life expectancy because it increases the risk of fatal conditions such as lung cancer and cardiovascular disease.
The same applies to morbidity, mortality, incidence and prevalence.
Students should write:
increase mortality from lung cancer
increase morbidity from COPD
increase incidence of cardiovascular disease
decrease life expectancy
increase burden of disease due to smoking-related illness
The direction matters because it shows the student understands the health outcome.
The social model of health needed to be visible
Question 4b asked students to describe one initiative based on the social model of health and outline how it could reduce rates of smoking or vaping.
The report noted that students needed to show a deep understanding of how the initiative reflected the social model of health.
This is where many responses became too general.
A student might name the Quit program, a vaping education campaign, plain packaging, social media awareness, school-based education or government restrictions. But naming an initiative was not enough. The student needed to show why it was based on the social model of health.
The social model of health may be reflected through:
health promotion and prevention
education and policy
targeting whole populations
addressing broader determinants of health
reducing inequities
empowering individuals and communities
using Ottawa Charter action areas
A strong response might explain that Quit reflects the social model of health because it focuses on health promotion and prevention by providing education, resources and support before smoking-related disease develops. It may help people develop personal skills to manage cravings and access support, increasing the likelihood that they quit smoking or vaping.
The initiative should not sit separately from the model.
The answer must make the model visible.
The Ottawa Charter could support the social model
The report noted that the Ottawa Charter acts as an example of the social model of health in action.
This is a useful exam connection.
For smoking and vaping, an initiative could reflect develop personal skills if it teaches people strategies to quit, manage cravings, understand risks and seek support.
It could reflect build healthy public policy if governments introduce laws restricting advertising, banning vaping products for minors, increasing taxes on tobacco or regulating smoke-free areas.
It could reflect create supportive environments if schools, workplaces and public spaces become smoke-free or vape-free.
It could reflect strengthen community action if local communities, schools or youth groups develop campaigns to reduce vaping.
It could reflect reorient health services if health professionals focus more on prevention and quitting support rather than only treating smoking-related disease.
Students do not always need to name an Ottawa Charter action area unless the question asks for it. But using one can make the link to the social model clearer.
Reducing smoking and vaping as a resource required a practical chain
Question 4c asked students to explain how reducing rates of smoking or vaping may act as a resource, both individually and nationally.
This question was not asking students to repeat that smoking is harmful.
It asked how reducing smoking or vaping becomes a resource.
For individuals, reducing smoking or vaping may reduce the risk of respiratory illness, lung cancer or cardiovascular disease. This can allow people to attend school or work more consistently, earn income, concentrate better and afford resources such as nutritious food, housing and health care.
For the nation, reduced smoking or vaping may decrease hospitalisations and treatment costs for smoking-related illnesses. This can reduce strain on the health system and allow government money to be redirected to other priorities such as infrastructure, education, medical research or preventative health programs.
The key is the chain:
reduced smoking or vaping → reduced disease or hospitalisation → greater capacity or savings → resource for individual or nation.
A response that only says “people are healthier” does not fully answer the resource part.
Individual and national resources were different
The report separated the question into individually and nationally, and students needed to respect that distinction.
An individual resource might be:
income
ability to work
ability to study
reduced medical expenses
energy for social participation
capacity to care for family
money for food, shelter and health care
A national resource might be:
reduced health system costs
lower pressure on hospitals
greater workforce productivity
more tax revenue
government funds redirected to education or infrastructure
reduced burden on the Pharmaceutical Benefits Scheme
Students should not write the same answer twice.
Individual resources concern the person’s capacity to live well. National resources concern the country’s capacity to support systems, services and development.
Medicare questions required more than description
Question 8 asked students to analyse the role of Medicare in promoting health outcomes in terms of sustainability and equity.
This was a higher-level question.
Students needed to discuss Medicare, health outcomes, sustainability and equity.
A basic description of Medicare as Australia’s universal health insurance scheme was not enough. Students needed to analyse how Medicare promotes health outcomes and how this relates to equity and sustainability.
For equity, Medicare promotes access by reducing financial barriers to essential health services. This means people on lower incomes can still access doctors, diagnosis and treatment. This may reduce morbidity and mortality from treatable conditions and improve health outcomes across population groups.
For sustainability, Medicare can support early intervention and preventative care. If people access health services earlier, illnesses may be managed before they become severe, reducing avoidable hospitalisations and helping the health system remain more sustainable over time.
The word analyse meant students needed to break down Medicare’s role through the specified concepts.
Equity meant fair access, not identical outcomes
In Medicare responses, students needed to understand equity.
Equity does not mean everyone has the same health outcome or uses the same service. It means resources and services are distributed in a way that supports fairness and addresses need.
Medicare promotes equity because it reduces financial barriers to health care. Bulk billing, subsidised consultations and the Medicare Safety Net can help people access care even when they may otherwise struggle to pay.
This can promote health outcomes by supporting earlier diagnosis, treatment and disease management.
For example, a person with symptoms of diabetes may be more likely to visit a general practitioner if cost is not a barrier. Early diagnosis and management can reduce complications, lowering morbidity and improving physical health and wellbeing.
That is an equity chain.
Sustainability needed a long-term lens
Students also needed to address sustainability.
In health system terms, sustainability refers to the ability of the system to meet current needs while remaining able to meet future needs.
Medicare can promote sustainability when it supports early intervention, preventative care and access to primary health care. This may reduce the need for more expensive hospital care later.
However, stronger analysis could also acknowledge tension. Medicare requires ongoing government funding, and demand may increase due to an ageing population, chronic disease and rising health costs. Therefore, maintaining Medicare’s sustainability depends on funding, workforce planning and efficient use of services.
This kind of analysis shows depth.
It does not just state that Medicare is sustainable.
It considers how Medicare supports sustainability and what pressures may exist.
Health outcomes had to remain central
In Question 8, students could not simply discuss Medicare’s principles.
They needed to connect Medicare to health outcomes.
Health outcomes might include:
reduced morbidity from chronic disease
reduced mortality from treatable conditions
increased life expectancy
reduced burden of disease
improved physical health and wellbeing
improved mental health and wellbeing due to reduced stress about health care costs
earlier diagnosis and treatment
greater access to preventative services
A strong sentence might be:
By reducing financial barriers to general practitioner visits, Medicare can support earlier diagnosis and treatment of conditions such as cardiovascular disease, reducing morbidity and mortality and promoting improved health outcomes.
This keeps the answer focused on what the question asked.
Ottawa Charter questions required applied action areas
Question 12 asked students to refer to two Ottawa Charter action areas and discuss how health promotion could address low levels of physical activity among young Australians.
The stimulus stated that at least 60 minutes of moderate to vigorous physical activity per day is recommended for children aged 5–17, yet 83% of young people aged 15–17 did not meet this guideline in 2022.
This stimulus made the issue clear.
Students needed to apply two Ottawa Charter action areas to low physical activity.
A response that simply defined develop personal skills or create supportive environments would not be enough.
The answer had to show how the action area could increase physical activity.
Build healthy public policy could address school activity
Build healthy public policy could be applied through government or school policies that require daily physical activity, active transport programs or minimum physical education time.
For example:
Governments could introduce a policy requiring secondary schools to provide structured physical activity opportunities each day. This could increase the chance that young people aged 15–17 meet the recommended 60 minutes of moderate to vigorous physical activity, improving physical health and wellbeing and reducing the risk of obesity or cardiovascular disease later in life.
This response works because it links:
action area → policy example → low physical activity → health outcome.
The action area is not just named.
It is used.
Create supportive environments could address access and safety
Create supportive environments could involve building or improving safe parks, bike paths, walking tracks, sports facilities, shaded outdoor areas or low-cost recreation spaces.
A strong response might write:
Creating supportive environments could involve local councils developing safe bike paths, well-lit parks and accessible sports facilities. This can make it easier and safer for young people to be active before or after school, helping them increase daily physical activity and promoting physical health and wellbeing.
This is a strong application because it recognises that behaviour is shaped by environment.
Young people may be more physically active when safe, accessible spaces exist.
Develop personal skills could address knowledge and confidence
Develop personal skills could involve education programs that teach young people how much physical activity they need, how to plan exercise into their week, how to use gym or sporting equipment safely, or how to choose activities they enjoy.
This could be especially useful for students who are inactive because they lack confidence, knowledge or motivation.
A strong response might explain that school-based programs could teach students how to set physical activity goals and track their progress, increasing confidence and motivation to be active. This may help more young people meet the 60-minute guideline.
The focus is on skills, knowledge and empowerment.
Strengthen community action could involve local groups
Strengthen community action could involve communities, schools, sporting clubs, youth centres and families working together to create physical activity programs.
For example, a local council could partner with community sporting clubs to run free after-school activities for teenagers. This could increase social support and opportunities for young Australians to be active.
This action area is especially useful when the response discusses participation, community ownership and local needs.
It should not be confused with government policy alone.
Community action means the community is involved in planning or delivering the health promotion.
Reorient health services could shift focus to prevention
Reorient health services could involve health professionals placing greater emphasis on physical activity promotion and prevention.
For example, general practitioners, nurses or allied health professionals could screen young people for low physical activity and refer them to local exercise programs. Health services could work with schools to provide preventative education rather than only treating health conditions once they develop.
This action area is often less popular, but it can be powerful when applied well.
It shows that health services can move beyond treatment and contribute to prevention.
Students needed to discuss, not just name
Question 12 used the command term discuss.
This meant students needed to explain how the action areas could address the issue. Naming two action areas was not enough.
A strong response should include:
the action area
a specific health promotion strategy
how it would increase physical activity
how this could improve health and wellbeing or health outcomes
For example:
Develop personal skills could be used through school programs that teach students how to create realistic exercise plans and understand the benefits of moderate to vigorous physical activity. This may increase motivation and confidence, helping more young people meet the recommended 60 minutes per day and reducing the risk of poor physical health outcomes.
This is a complete discussion.
Health promotion responses needed to avoid generic prevention language
A weak health promotion response might write:
This will educate people and make them healthier.
That is too broad.
The strongest responses specify:
who is being targeted
what the initiative does
which behaviour it changes
how the change affects health
which model or action area it reflects
For smoking and vaping, that might mean teaching young people strategies to resist vaping, reducing nicotine addiction and lowering the risk of respiratory illness.
For physical activity, that might mean creating safe places to exercise, increasing activity levels and reducing risk factors for cardiovascular disease.
Specificity is what turns a general prevention statement into a high-scoring answer.
The social model, Medicare and Ottawa Charter were connected
Although these appear in different parts of the course, the 2025 exam showed how connected they are.
The social model of health focuses on health promotion, prevention, broader determinants and community-level action.
The Ottawa Charter provides action areas that operationalise health promotion.
Medicare is part of Australia’s health system and can promote equity and sustainability through access to services, early intervention and financial protection.
All three involve more than treating illness after it occurs.
They reflect different ways of improving health outcomes at population level.
Students who understand these links can write more flexible answers.
Why health promotion marks were lost
Marks were likely lost when students:
- gave generic health outcome statements
- did not specify the disease or condition affected by smoking or vaping
- failed to state whether a health outcome increased or decreased
- named an initiative without linking it to the social model of health
- described Medicare without analysing equity and sustainability
- defined Ottawa Charter action areas without applying them to physical activity
- wrote about individual behaviour without considering environments, policies or communities
- failed to link reduced smoking or vaping to resources for individuals or the nation
These mistakes usually came from stopping too early.
The content was there, but the application was incomplete.
What future Health and Human Development students should learn from 2025
The 2025 VCE Health and Human Development exam shows that health promotion and Medicare preparation should focus on applied frameworks.
Students should practise:
- linking smoking and vaping to specific health outcomes
- stating the direction of health outcome changes
- explaining biological or behavioural pathways
- connecting initiatives to features of the social model of health
- using Ottawa Charter action areas to explain health promotion
- distinguishing individual and national resources
- analysing Medicare through equity and sustainability
- linking Medicare to health outcomes, not just access
- applying Ottawa Charter action areas to specific issues
- avoiding generic prevention language
- building clear cause-and-effect chains
These skills make health system and health promotion answers more precise.
The 2025 report confirms that knowing the model is only the first step.
Students need to apply it.
How ATAR STAR teaches health promotion and Medicare in Health and Human Development
At ATAR STAR, health promotion and Australia’s health system are taught through applied exam reasoning.
Students learn the social model of health, Ottawa Charter action areas and Medicare, but they practise applying these frameworks to specific issues such as smoking, vaping, physical activity, equity, sustainability and health outcomes. They are trained to move from model to initiative to effect.
The 2025 Examination Report confirms why this matters. High-scoring students did not simply define the frameworks.
They used them to answer the question.