Determinants Of Health

This report analyzes the different health hazards related to poorly-constructed and overcrowded inner-city apartments in Melbourne. It discusses the impact of these hazards on health and provides recommendations for risk management. The report also includes a communication plan for these recommendations.

Running Head: Determinants Of Health
DETERMINANTS OF HEALTH

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Determinants Of Health
Executive summary
In this report, different environmental hazard that is impacting on the health of Melbourne
house dwellers is analyzed. Hazards like infections and fire are evaluated that are common in
the overcrowded apartments of this city of Australia. Impact of these hazards on health of
humans is analyzed and mechanism of impact is described in a detailed way. Moreover,
overall assessment of the level of health risk is done in this report by the help of different
frameworks. Risk management plan is done by providing some recommendations to public,
government and other stakeholders like construction companies. In addition, communication
plan of these recommendations is also discussed in this report.

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Table of Contents
Introduction................................................................................................................................4
Findings and analysis.................................................................................................................4
1. Identification and description of two health hazards related to inner-city apartments that
are poorly-constructed and overcrowded...............................................................................4
2. Impact of identified hazards on health...............................................................................6
3. Identification of the overall level of risk............................................................................8
4. Recommendations and communication plan....................................................................13
Conclusion................................................................................................................................15
References................................................................................................................................16
Appendices...............................................................................................................................20

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Introduction
Health determinants refer to factors that affect the health of a population or individuals. Poor
living conditions of Melbourne inner city apartments have poor living conditions that cause
different health hazards. Recent fire incident in Lacrosse tower is the biggest evidence of this
problem. In this report, discussion about health hazards and identification of overall risk has
been done. Recommendations are given that can help to eliminate these risks in future.
Findings and analysis
1. Identification and description of two health hazards related to inner-city apartments
that are poorly-constructed and overcrowded
People, who lived in poorly constructed and overcrowded housing apartment, often face
health hazards and these hazards impact on their health. Infection and fire risks are two
common health hazards that arise in poor living conditions. In Melbourne, illegal rooming
practice is increasing day by day and this condition is leading to emergence of these kinds of
health hazards. According to World Health Organization (WHO), interaction between health
determinants influences distribution of public health issues (Who.int, 2019). These
determinants of health include social environment, physical environment, economic
environment and characteristics as well as behavior of individuals. Workers and Asian
students are reaching Melbourne and living in unhealthy over-crowded apartments
(Health.wa.gov.au, 2006). This situation is giving birth to health hazards such as infection
and fire risks.
Infection hazards arise from living in poorly constructed and overcrowded housing
complexes (Whiley et al. 2018). In Melbourne, this kind of housing apartments is being
developed for allowing a large number of people to live. However, these people are facing

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infection risks due to poor physical environment. As opined by Dow (2015), different persons
are using a single bed at different time of the day. More than 15 students are living in 2BHK
apartments for living at cheaper expense in Melbourne. This kind of practice is leading to
rising of infection risks and this risk has a high impact on the health of human beings. Living
in this physical environment allow spreading of communicable disease and infections. Due to
poor economic conditions, Asian students and workers are choosing this kind of living
practice without understanding impact of infection risk on their wellbeing. On the other hand,
Cunningham & Fox Koob (2019) have mentioned that approximately 10 beds are being
placed in two-room flats and this overcrowded environment may influence rising of infection
risks. Apparently, infections are spreading in the entire population of Melbourne due to this
unhealthy living practice. In addition, family members of these students and workers can be
infected when they return to their home.
Overcrowding and poor construction of housing apartments give rise to fire risk and this risk
has a high impact on health of people. Real estate companies are building unhealthy
apartments for gaining maximum financial advantages. They are trying to fit maximum
people within small area for their own benefits. Most of the real estate companies are using
flammable housing claddings to ensure attractive outlook of their buildings. As mentioned by
Clay (2015), leading architects have agreed that poor construction of housing apartment is
taking place in Melbourne and this aspect is harmful to both individuals and society. Many
cases of fire accidents have taken place and most of the cases have taken place in poorly
constructed as well as overcrowded houses. Fire incident of lacrosse apartment tower has
been in the limelight in 2015 (Vedelago & Houston, 2015). After this incident, proper
investigation has been done and it has been found that a large number of people were living
awfully in that apartment and poor construction of this overcrowded apartment have
influenced the occurrence of fire incident. It has been found that reason behind fire was

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discarding cigarette at balcony, where combustible materials were stored. This incident has
shed light on interaction between two health determinants such as education and physical
environment. As contradicted by Giles-Corti, Ryan & Foster (2012), people living in this
kind of unhealthy conditions are unable to maintain healthy physical environment despite
being educated enough.
2. Impact of identified hazards on health
Infection hazard has significant impact on health, which spreads due to overcrowding.
Infections in overcrowded locations like inner city of Melbourne spread through the
mechanism of direct or indirect contact. As stated by Cunningham & Fox Koob (2019), 10
beds are adjusted in a two bedroom apartment. This assessment process can be done by a
framework that contains three elements, which includes screening, scoping and assessment.
Screening of infectious hazard can help to find the probable impacts it has on the health of
humans. Communicable disease and infection spread through sneezing, coughing and through
contact with blood. In an overcrowded area, waste disposal and water supply are inadequate.
This acts as a mechanism in spreading viral fevers. In the high rises of Melbourne, beds are
used in shifts by different overseas students and migrant workers (Dow, 2015). This is
increasing the risk of different infectious hazards. Different agents like mosquitoes spread
this infectious virus among humans that impact on the health (Krieger & Higgins, 2002).
Scoping is another element of the selected framework that can help to identify the boundary
of this hazard. People with poor economic background like workers and migrants generally
live on those overcrowded regions and gets affected by infectious diseases. Assessment is
another essential part of the selected framework. Different health determinants like poor
social support, nutrition and health services act as a mechanism to spread virus infections that
causes impact on health of poor or backward people. Different infectious diseases like

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smallpox, measles, influenza, chicken pox cause in these congested areas that impact on
general health, especially children. Impact on both mental and physical growth is seen and
this also impacts on their immunity level. Diet and proper planning by government can help
to mitigate the hazard and minimize impacts on people living close to the source of the
hazard. Low physical environment on these congested areas of Melbourne is increasing the
problem and this is helping the agents of infectious virus-like mosquitoes to increase. Several
health impacts like kidney damages due to viral fever and other chronic diseases can be seen.
Fire hazard also causes different health impacts on people. The massive fire incident on
Lacrosse tower of Melbourne has taken the lives of overseas students who live in these
towers in a poor condition (Clay, 2017). These buildings in Melbourne contains highly
flammable polyethylene cladding, which increases the risk of fire incident. It was estimated
that around 10000 Australian high and medium rise buildings have these claddings on
exterior. Fire hazard can have a direct impact on health taking life of a person. Moreover, it
can cause burns on the skin. This mechanism of health impact is fatal and high grade of burns
can take away lives of people.
Fire hazard can also indirectly impact on health causing heart and lungs diseases like asthma
(Rauh et al. 2008). Moreover, children and pregnant woman get affected by this hazard as
different particulate matter impact on development of respiratory system of children.
Interactivity of different health determinants like social status, income and education are
responsible to increase the risk of this hazard. According to the report of the age, mainly
workers and overseas students overcrowd the inner city high rise of Melbourne (Vedelago &
Houston, 2015). These workers and students have low income and they receive poor facilities
from government and other stakeholders. This increases their risk level and is more prone to
be affected due to fire hazard. These group of low-income people suffers the worst health
impact of fire hazard as they receive poor health support. Other stakeholders like building

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authorities are preparing to build by not maintaining construction codes of Australia.
Flammable cladding in majority building is increasing the risk of health impacts on the
inhabitants. Hence, regular monitoring on construction of buildings and providing proper
social support to inhabitants is necessary to intervene the risk.
3. Identification of the overall level of risk
Severity of risk can be measured by considering the impact of risk and likelihood of
occurrence of that particular risk.
Analysis of overall health risk from infection hazard
The environmental health risk consequence and impact rating guide is being considered
effective framework for analyzing health risk due to infection hazard. This framework has
mentioned characteristics of impact of risks to wellbeing and human safety (Health.gov.au,
2012). It can be stated that health risk from infection hazard has moderate impact (Score:
3) by considering this framework. If infection spread from one resident to other roommates,
medical attention required to be provided. However, Corburn & Sverdlik (2019) have
mentioned that this health risk is not very serious in nature as hospitalization is not required
in most of the cases of infection. In addition, it has been found that infection risks can be
mitigated by treatment and it has no long term effect on human health. Infection hazards are
potential cause temporary disabilities, but can not be a cause of death. Hence, based on these
characteristics of health risks associated with infection hazards, it can be stated that this risk
has moderate impact on wellbeing. [Referred to Appendix 1]
Risk likelihood guide can be used as framework for assessing likelihood of risk. As per this
framework, health risk associated with infection hazards is likely to occur and 4 can be
considered a score for this likelihood (Health.gov.au, 2012). Chance of occurring of this
risk is between 50-74%. This risk can take place in most of the circumstances and it can

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impact on factors that are not under the control of local government such as, health condition
of people (Ali, Foster & Hall, 2018). [Referred to Appendix 2]
Risk matrix
Risk= Likelihood x Consequence or impact
Health risk of infection hazard= 4 x 3= 12
Likelihood
(L)
1
2
3 Risk=12
4
5
Impact (C) 1 2 3 4 5
Risk score
Score Description
1-5 Low
6-12 Medium
13-19 High
20-25 Catastrophic
Evaluation of health risk from infection hazard
Environmenta
l health
practice and
intervention
Social Political Ethical Economical Ecological Risk
assessment

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Framing
proper
guidelines for
tenant and
landlord
Cooperatio
n from
people
living in
overcrowde
d houses is
required.
Reputation
of local
governme
nt can be
hampered.
They can
help by
providing
legal
advice
(Kazeroon
i et al.
2016).
People
who
avoid
living in
this kind
of
situation
can be
affected.
Their
support
is
required
as well.
Local
government
may invest
in framing
the
guidelines.
Healthy
human
habitat can
maintain
ecological
balance in
Melbourne
Medium
Analysis of overall health risk from fire hazard
Considering The environmental health risk consequence and impact rating guide as
framework for risk assessment, it can be stated that health risk associated with fire hazard
has extreme impact (Score: 5) on people, who live in overcrowded as well as poorly
constructed buildings in Melbourne. As mentioned by Ighani et al. (2019), this risk is potent
enough to be the main cause of multiple death. Fire incidents on Lacrosse Tower can be
considered as an evidence of extreme impact fire hazard on health. This kind of accidents
often causes multiple fatalities. Hence, this risk has extreme impact on wellbeing of
Melbourne people, who live in unhealthy housing apartments. [Referred to Appendix 1]

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Risk likelihood guide is being used as a framework for assessing likelihood of health risk
associated with fire hazard (Health.gov.au, 2012). As per this framework, fire hazard can
take place almost certain and its likelihood score is 5. It means that health risk related to
fire hazard can occur in greater than 75% of circumstances. This risk affects factors such as,
incident of multiple fatalities that is not under control of local government. [Referred to
Appendix 2]
Risk matrix
Risk= Likelihood x Consequence or impact
Health risk of fire hazard= 5 x 5= 25
Likelihood
(L)
1 Risk=25
2
3
4
5
Impact (C) 1 2 3 4 5
Risk score
Score Description
1-5 Low
6-12 Medium
13-19 High
20-25 Catastrophic
Evaluation of health risk from fire hazard

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Environmenta
l health
practice and
intervention
Social Political Ethical Economical Ecological Risk
assessment
Improving
infrastructure
Social
life will
be
improve
d and
society
must
cooperat
e
(Turner
et al.
2017).
Local
governmen
t may play
an
important
role in
improving
infrastruct
ure by
providing
funds.
Ethics of
participa
nts can
boost the
process.
Local
government
and
landlords
can arrange
funds.
Climate
condition
must be
considered
while
planning.
Catastrophi
c
Education and
social
awareness
Cooperat
ion from
society
is
required.
Local
governmen
t can
arrange
campaigns.
Ethics of
educated
people of
Melbour
ne can
help in
this
regard
Local
government
can arrange
funds.
Ecological
condition
will be
improved.
Catastrophi
c

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(Atiyeh,
& Gunn,
2017).
4. Recommendations and communication plan
The City of Melbourne can incorporate some recommendations that can help them to
minimize environmental hazards like infectious diseases and fire hazard.
Framing proper guidelines for tenants and landlords: It can be seen that 10 beds were
adjusted in a two-bedroom apartment. Moreover, overseas workers and students sleep in
these apartments in shifts (Cunningham & Fox Koob, 2019). This overcrowding is increasing
the risk of environmental hazards. On the other hand, it has been found that beds were used in
these apartments of Melbourne by different people, which is increasing the treatment of
infectious diseases. Hence, government and building inspectors need to frame proper
regulations for these tenants. Minimum number of tenants in a room and building must be
fixed by the government, which can help landlords during the process of renting. Moreover,
the report of The Age states that landlords treat their tenants in a bad way (Dow, 2015).
These maltreatments increases vulnerability of tenants to environmental hazards. Hence,
framing proper policies for guiding both tenants and landlords are necessary.
Improving infrastructure of high rise apartments in Melbourne: In this report, it was
found that majority of high and medium rise buildings are poorly constructed and national
construction rules are not followed. Use of highly flammable materials for construction of
buildings has increased environmental hazards like fire. Moreover, different social benefits
like health service in locality, proper waste disposal management, and water supply need to

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be maintained. These services can help to maintain hygiene in these apartments and
intervention to environmental hazards can be obtained (Planning.vic.gov.au, 2016).
Increasing education and social awareness: This is another essential recommendation that
can be adopted by local government and housing authorities to increase awareness of both
tenants and landlords. Awareness regarding maintenance of government guidelines, personal
hygiene can help to eliminate the risk of environmental hazards like infections and fire. Local
authority of Melbourne can perform this task with the help of NGOs.
Communication plan
The findings and recommendations can be communicated to the public through synchronous
communication. As opined by Ziegler (2016), if all the related parties are engaged at the
same time, then synchronous communication can be adapted. Different tools of this
communication like group emails, blogs and texting can be done. This can help to increase
their awareness regarding this matter.
For communicating these findings and recommendations to the government and other
stakeholders like housing authority of Melbourne and construction companies a plan needs to
be followed. This includes identification of stakeholders, to whom the message will be
forwarded. After this, different expectations of those stakeholders need to be analyzed and
message must be prepared according to that. Time frames must be adjusted according to
their preferences and proper tools need to be selected. This includes live conference, emails
or texts. After this step, final processing of the documents needs to be done that contains
findings and recommendations regarding environmental hazards in Melbourne housings.
Conclusion
Different environmental health hazards spread due to inappropriate development of
construction and improper services from key stakeholders like government. The fire incident

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of Lacrosse building in Melbourne and infectious diseases are caused due to overcrowding
and lack of policies. Framing of proper policies and increasing awareness among local people
can help to improve the condition.

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References
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Atiyeh, B. S., & Gunn, S. W. A. (2017). Refugee camps, fire disasters, and burn injuries.
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Clay, C. (2017). 'Someone will be burnt to death': Senate demands ban on flammable
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Corburn, J., & Sverdlik, A. (2019). Informal settlements and human health. In Integrating
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Retrieved from: https://link.springer.com/chapter/10.1007/978-3-319-74983-9_9
Cunningham, M., & Fox Koob, S. (2019). Ten beds found crammed inside some apartments
in fire-ravaged tower, The Age, 5 February Retrieved on 15th June 2019, from
https://www.theage.com.au/national/victoria/residents-of-spencer-street-tower-that-
caught-fire-will-be-locked-out-for-days-20190205-p50vtf.html

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Dow, A. (2015). Slum squeeze: overseas students taking turns to sleep in overcrowded
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Appendices
Appendix 1: Environmental health risk consequence and impact rating guide
(Source: Health.gov.au, 2012)

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Appendix 2: Risk likelihood guide
(Source: Health.gov.au, 2012)