DSE Health Management And Social Care Practice Paper: Health, Nutrition And Community Care (12 Questions, 50 Marks, 75 Minutes)

DSE Health Management and Social Care Practice Paper: Health, Nutrition and Community Care (12 Questions, 50 Marks, 75 Minutes)

2026-11-02

DSE Health Management and Social Care

DSE Health Management and Social Care: 12 original questions, 50 marks, 75 minutes on BMI, diet, screening, dependency ratios and carer support. Full solutions included.

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Paper details　Level: S6 | Subject: Health Management and Social Care | Time: 75 minutes | Marks: 50 | Questions: 12

Section A: Short Questions (4 marks each)

Formulae and reference data (you must still substitute the values yourself)

BMI = weight (kg) / height squared (m^2). Hong Kong adult classification: below 18.5 underweight, 18.5 to 22.9 normal, 23.0 to 24.9 overweight, 25.0 or above obese. Fat supplies 9 kcal per gram; carbohydrate and protein supply 4 kcal per gram. Total dependency ratio = (population aged below 15 plus population aged 65 or above) / population aged 15 to 64 x 100%. Old-age dependency ratio = population aged 65 or above / population aged 15 to 64 x 100%. Eight-hour equivalent continuous noise level: LEX,8h = 10 log10[sum of (Ti/8) x 10^(Li/10)]. Positive predictive value = number of true positives / number of people who screened positive x 100%. In every answer, state the formula or definition first, then substitute the data, and finish with the unit and a clear conclusion.

Answer all questions. For calculations, show the formula, the substitution and the units.

#	Question	Answer and marking notes
1	Mr Chan is 1.62 m tall and weighs 63.5 kg. (a) Calculate his body mass index (BMI) and state his weight category using the Hong Kong adult classification. (b) Suggest one practical weight-management measure and briefly explain why it works. (4 marks)	(a) BMI = weight (kg) / height squared (m^2) = 63.5 / 1.62^2 = 63.5 / 2.6244 = 24.2. Under the Hong Kong adult classification a BMI of 23.0 to 24.9 is overweight, so Mr Chan is overweight. (b) He could accumulate 150 minutes of moderate-intensity aerobic activity a week, for example 30 minutes of brisk walking five times a week, and replace sugary drinks with water. Moderate activity raises energy expenditure and improves insulin sensitivity, so together with dietary control it can bring his BMI below 23 and lower his risk of type 2 diabetes and hypertension.
2	Miss Lee takes in 2150 kcal a day, of which 78 g comes from fat. (a) Calculate the percentage of total energy supplied by fat. (b) Compare this with the recommendation that fat should supply 20% to 30% of energy, identify the problem in her diet and suggest two improvements. (4 marks)	(a) Energy from fat = 78 x 9 = 702 kcal; percentage of total energy = 702 / 2150 x 100% = 32.7%. (b) This is above the recommended upper limit of 30%, exceeding it by 2.7 percentage points, and over time raises the risk of obesity and cardiovascular disease. Improvements: steam or poach food instead of frying; choose low-fat milk instead of whole milk and cut down on processed meat and baked goods.
3	The daily smoking prevalence among people aged 15 or above in a district fell from 12.0% in 2010 to 9.1% in 2023. (a) Calculate the relative decrease over these 13 years as a percentage, to one decimal place. (b) State two limitations to consider when interpreting this figure. (4 marks)	(a) Relative decrease = (12.0 – 9.1) / 12.0 x 100% = 2.9 / 12.0 x 100% = 24.2%, a fall of 2.9 percentage points. (b) Limitations: the definition of smoking may change, for example whether e-cigarettes and heated tobacco are included; changes in the age structure affect crude rates, so age-standardised rates should be compared; the figures rely on self-reporting and are subject to under-reporting.
4	The population of a city is: 60 x 10^4 aged below 15, 395 x 10^4 aged 15 to 64, and 145 x 10^4 aged 65 or above. (a) Calculate the total dependency ratio. (b) Calculate the old-age dependency ratio. (c) State two effects of a rising old-age dependency ratio on health and social services. (4 marks)	(a) Total dependency ratio = (60 + 145) / 395 x 100% = 205 / 395 x 100% = 51.9%. (b) Old-age dependency ratio = 145 / 395 x 100% = 36.7%. (c) Effects: demand for chronic disease care and long-term care rises, lengthening waits for public hospitals and community care services; the tax base of the working population shrinks relative to the number of dependants, increasing fiscal pressure on health care and social security.
5	A printing worker works 8 hours a day, spending 4 hours exposed to 85 dB(A) and 4 hours exposed to 95 dB(A) of noise. (a) Calculate his 8-hour equivalent continuous noise level (LEX,8h). (b) Decide whether the exposure limit of 90 dB(A) is exceeded and suggest two noise control measures. (4 marks)	(a) LEX,8h = 10 log10[(4/8) x 10^8.5 + (4/8) x 10^9.5] = 92.4 dB(A). (b) This exceeds 90 dB(A), a level at which action is required. Controls: reduce noise at source with acoustic enclosures and anti-vibration mounts; apply engineering controls or reorganise work to shorten exposure to the loud period; where the limit cannot be met, provide suitable hearing protectors and arrange regular audiometric testing.
6	Mrs Wong used private outpatient services 4 times in a year at 480 dollars per visit, and stayed in hospital for 3 days at 5,200 dollars per day. Her medical insurance pays 80% of eligible charges. (a) Calculate her total medical expenditure. (b) Calculate the amount she pays herself and its percentage of total expenditure. (4 marks)	(a) Outpatient cost = 4 x 480 = 1,920 dollars; hospital cost = 3 x 5,200 = 15,600 dollars; total = 1,920 + 15,600 = 17,520 dollars. (b) The insurer pays 80%, so she pays 20%: 17,520 x 20% = 3,504 dollars, which is 20% of the total. If the policy has a deductible or excludes some items, the real share paid by the patient will be higher.

Section B: Application Questions (4 marks each)

Answer all questions. Quote the given data and explain in complete sentences.

#	Question	Answer and marking notes
7	A community screening programme screened 400 people aged 65 or above for depressive symptoms; 68 tested positive, and 51 of them were later diagnosed with depression after medical assessment. (a) Calculate the positive screening rate. (b) Calculate the positive predictive value. (c) Explain what a low positive predictive value implies for running the programme. (4 marks)	(a) Positive rate = 68 / 400 x 100% = 17.0%. (b) Positive predictive value = 51 / 68 x 100% = 75.0%, so about one in four people who screened positive does not actually have depression. (c) A low positive predictive value means unnecessary anxiety, follow-up visits and further tests, which consume health care resources. The programme therefore needs confirmatory assessment, counselling and clear explanation of results, and mass screening should be used cautiously in groups with low prevalence.
8	A family of three has a monthly income of 11,500 dollars and monthly expenses of 6,800 dollars on rent, 4,200 on food, 900 on transport, 700 on children school supplies and 400 on medical care. (a) Calculate the total monthly expenditure and the monthly deficit. (b) Calculate the deficit as a percentage of total expenditure. (c) Name one social security scheme the family may apply for and state its function. (4 marks)	(a) Total expenditure = 6,800 + 4,200 + 900 + 700 + 400 = 13,000 dollars; deficit = 13,000 – 11,500 = 1,500 dollars a month, so the family spends more than it earns. (b) Deficit as a percentage of expenditure = 1,500 / 13,000 x 100% = 11.5%. (c) The family may apply for the Comprehensive Social Security Assistance scheme, which tops up income to meet basic needs and may provide a rent allowance, medical fee waivers and special grants, so that a basic standard of living is maintained.
9	Mr Cheung works as a delivery driver and has slept 5.4 hours a night on average over the past week. Health authorities recommend 7 to 9 hours of sleep a night for adults. (a) Using the lower recommendation, calculate how many hours of sleep he loses each night and each week. (b) State two effects of sleep deprivation on health and work safety, and suggest one improvement. (4 marks)	(a) Sleep lost each night = 7.0 – 5.4 = 1.6 hours; each week = 1.6 x 7 = 11.2 hours. (b) Effects: chronic sleep deprivation raises the risk of hypertension, obesity and mood problems; daytime alertness and reaction time fall, increasing the chance of a traffic accident while driving. Improvement: keep a regular sleep schedule, stop using screens an hour before bed, and negotiate a reasonable shift pattern with the employer to avoid very long consecutive duties.

Section C: Long Questions (14 marks in total)

Answer long questions in points, giving a reason or example for each point.

#	Question	Answer and marking notes
10	Explain how socioeconomic status affects health through three mechanisms, then identify one policy that can narrow health inequalities and briefly explain how it works. (4 marks)	Three mechanisms: (1) Material resources. People with lower incomes live in crowded housing and have poorer access to nutritious food and health care, which directly affects health. (2) Psychosocial stress. Sustained financial and work stress produces a chronic stress response with raised cortisol and blood pressure, increasing cardiovascular risk. (3) Behaviour and knowledge. Education shapes health literacy, smoking, exercise habits and timely help-seeking. Policy: develop primary care, for example district health centres offering preventive screening, chronic disease management and community rehabilitation, so that people of all socioeconomic positions can obtain early care locally and are less likely to delay treatment because of cost.
11	Design a workplace health promotion programme for a logistics company with 300 employees. State (a) one priority health problem with justification, (b) two activities, and (c) two outcome indicators for evaluation. (4 marks)	(a) Priority problem: lower back strain and occupational injury. Justification: logistics work involves repeated lifting and long hours of driving, making it a high-risk industry for musculoskeletal disorders, which cause absence and staff turnover. (b) Activities: run workshops on manual handling techniques and warm-up exercises; provide height-adjustable trolleys and lifting aids, and post lifting-posture reminders in the warehouse. (c) Indicators: staff participation rate, rate of reported back pain, number of injury cases and days lost to musculoskeletal absence; indicators should be compared before and after the programme to judge effectiveness.
12	Mr Chan has limited mobility after a stroke and is cared for single-handedly by his 68-year-old wife. She has recently had insomnia, low mood and back strain, and gave up her part-time job because of caring duties. (a) Identify three sources of carer stress. (b) Propose one inter-professional support plan naming at least three professions or services. (c) Day care with home care support costs 8,400 dollars a month and residential care costs 18,000 dollars a month; calculate the annual difference in cost, and state two factors other than cost that should be considered when deciding on the placement. (6 marks)	(a) Sources of stress: caregiving runs around the clock with no proper rest; she carries the burden alone without help from other family members, and there is financial strain because she gave up her part-time job; she lacks knowledge about stroke rehabilitation and nursing, which produces helplessness and anxiety. (b) Inter-professional support: a social worker coordinates the case and arranges day care or respite service so the carer can rest; a community nurse visits to assess needs and teach nursing skills; a physiotherapist and an occupational therapist provide rehabilitation training and advice on home modification; a clinical psychologist addresses emotional distress; and referral is made to a carer support centre and to financial assistance. (c) Difference = (18,000 – 8,400) x 12 = 9,600 x 12 = 115,200 dollars. Besides cost, consider Mr Chan’s mobility and level of nursing need, the wishes of Mr Chan and his wife, whether the home can be modified, waiting time and quality of the residential home, and the carer’s own physical and mental health.

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A TutorZone practice paper; original questions and passages, not publisher material.