2025 CCEA AS-Level Health and Social Care 0003 Practice Paper with Answers

Prejudice is a preconceived judgement, opinion or attitude that a person holds about an individual or a group of people, formed without adequate knowledge, thought or experience of them; it is often based on stereotypes or assumptions about characteristics such as race, disability or mental health, and typically results in an unfairly negative view of the person or group before they are known as individuals. Prejudice is a matter of attitude or belief, and it is distinct from discrimination, which refers to the actual actions or behaviours that result from prejudiced views. Final answer: prejudice is a preconceived, often negative, attitude or opinion about a person or group, formed without proper knowledge or experience of them.

[1] basic definition (e.g. 'a negative opinion about someone'); [2] adequate definition referring to a preconceived attitude/judgement; [3] competent definition that also notes it is based on assumptions/stereotypes rather than knowledge or experience, and/or distinguishes it from discriminatory action. All other valid responses will be given credit.

Discrimination is the actual unfair or unjust treatment of an individual or group of people, based on characteristics such as their race, beliefs, gender, disability, cognitive ability, mental health or sexuality, which results in them being treated less favourably than others, or being denied opportunities, services or rights that others receive. While prejudice refers to an underlying attitude, discrimination refers to the behaviour or action that puts that attitude into practice, for example refusing someone a service, excluding them from an activity, or treating them with less respect because of who they are. Final answer: discrimination is the unfair, unjust treatment of a person or group based on a personal characteristic, putting them at a disadvantage compared with others; it is prejudice translated into action.

[1] basic definition (e.g. 'treating someone unfairly'); [2] adequate definition referring to unfair/unjust treatment linked to a personal characteristic; [3] competent definition that also links discrimination to disadvantage/less favourable treatment and/or distinguishes it as prejudice acted upon. All other valid responses will be given credit.

Example of discrimination relevant to disability: a health or social care setting, such as a GP surgery or day centre, might be housed in a building that is only accessible via a flight of steps with no ramp or lift, meaning a service user who uses a wheelchair is unable to physically access appointments or activities that other, non-disabled service users can access without difficulty; this is indirect discrimination, since the barrier disadvantages disabled service users even though it may not be intentional. Example of anti-discriminatory practice: the setting could address this by installing a ramp and an accessible entrance, ensuring doorways and corridors are wide enough for wheelchair access, and providing disability awareness training for staff so that service users with disabilities are supported to participate fully and are not excluded from any aspect of the service. Final answer: discrimination example - physical inaccessibility (e.g. steps with no ramp) excluding a wheelchair user; anti-discriminatory practice example - making the environment accessible (ramps, wide doorways) and staff training to support disabled service users.

[1] basic example of discrimination relevant to disability; [2] adequate/developed example of discrimination relevant to disability; [1] basic example of anti-discriminatory practice; [2] adequate/developed example of anti-discriminatory practice. All other valid responses will be given credit.

Example of discrimination relevant to mental health: a member of staff in a health or social care setting might assume that a service user with a diagnosed mental health condition, such as depression or schizophrenia, is not capable of making decisions about their own care or daily life, and so exclude them from care-planning meetings or make decisions on their behalf without consulting them; this reflects a common but unfounded stereotype that mental illness always means a lack of capacity, and denies the individual their right to be involved in decisions about their own care. Example of anti-discriminatory practice: staff can challenge this by working in a person-centred way, ensuring the service user is fully involved in decisions about their own care wherever they have capacity to be, and by receiving training that challenges stigma and misconceptions about mental health, so that assumptions are not made about a person's abilities based on their diagnosis alone. Final answer: discrimination example - excluding a service user with a mental health condition from decisions about their own care based on stereotyped assumptions; anti-discriminatory practice example - person-centred involvement in care planning, supported by staff training that challenges stigma.

[1] basic example of discrimination relevant to mental health; [2] adequate/developed example; [1] basic example of anti-discriminatory practice; [2] adequate/developed example. All other valid responses will be given credit.

Example of discrimination relevant to race: a hospital or care setting might fail to provide translated written information or access to professional interpreters for patients or service users whose first language is not English, meaning they cannot fully understand their diagnosis, treatment options or care plan, and may be unable to give properly informed consent; this indirectly disadvantages service users from certain ethnic or cultural backgrounds compared with English-speaking service users. Example of anti-discriminatory practice: the setting could address this by providing professional interpreting services (rather than relying on family members) and translated versions of key information leaflets and consent forms, and by training staff in culturally sensitive communication, so that all service users, regardless of race or first language, can access and understand their care equally. Final answer: discrimination example - lack of interpreter/translated information disadvantaging non-English-speaking patients; anti-discriminatory practice example - providing professional interpreters, translated materials and culturally sensitive staff training.

[1] basic example of discrimination relevant to race; [2] adequate/developed example; [1] basic example of anti-discriminatory practice; [2] adequate/developed example. All other valid responses will be given credit.

Example of discrimination relevant to gender: in an early years setting, a male practitioner might be prevented by colleagues or management from carrying out certain intimate care tasks, such as changing nappies or supervising toileting, based on the unfounded assumption that men are less suitable or more risky for such roles simply because of their gender; this denies the individual equal treatment and professional responsibilities compared with female colleagues in the same role. Example of anti-discriminatory practice: the setting could implement a clear equal-opportunities policy that allocates caring duties based on a worker's role, qualifications and appropriate safeguarding checks (such as an enhanced AccessNI check) rather than their gender, and provide training and clear guidance that challenges gender-based stereotypes among staff and management, ensuring male and female practitioners are treated equally. Final answer: discrimination example - excluding a male practitioner from intimate care tasks based on gender stereotypes; anti-discriminatory practice example - equal-opportunities policy allocating duties by role/qualification rather than gender, supported by staff training challenging stereotypes.

[1] basic example of discrimination relevant to gender; [2] adequate/developed example; [1] basic example of anti-discriminatory practice; [2] adequate/developed example. All other valid responses will be given credit.

Impact of discriminatory practice - physical: if the day centre or its staff discriminate against Fatima, for example by not adapting activities or equipment to accommodate her wheelchair, she may be excluded from physical activities or physiotherapy sessions that could help maintain her strength, mobility and independence following her spinal injury; over time, this lack of appropriate physical support could lead to muscle weakness, pressure sores from prolonged immobility, or a general decline in her physical condition. Impact of discriminatory practice - social: if staff or other service users make assumptions about Fatima based on her disability or her visible religious identity (wearing a hijab), for example by excluding her from group activities or making her feel unwelcome, she may become socially isolated, lose confidence in engaging with others, and withdraw from social opportunities at the centre, reducing her wider social network and sense of belonging. Impact of discriminatory practice - psychological: experiencing discrimination, whether related to her disability or her religion/culture, can significantly damage Fatima's self-esteem and sense of identity; she may feel undervalued, anxious about attending the centre, or develop symptoms of depression as a result of feeling excluded or judged, compounding the psychological adjustment she is already making after her spinal injury. Impact of anti-discriminatory practice - physical: if the day centre instead practises anti-discriminatory care, for example by ensuring the building and all activities are fully wheelchair-accessible and by involving Fatima in an individual care/activity plan tailored to her physical needs, she is more likely to maintain and even improve her physical function, mobility and independence over time. Impact of anti-discriminatory practice - social: a centre that actively includes Fatima, respects her religious and cultural needs (for example providing a private space for prayer, or appropriate food options), and challenges any discriminatory attitudes among staff or other service users, will support Fatima to build social relationships, participate fully in group activities, and feel a genuine sense of belonging and community. Impact of anti-discriminatory practice - psychological: being treated with dignity, respect and equality, and having her disability and religious identity accommodated and valued rather than seen as a problem, is likely to protect and improve Fatima's self-esteem, sense of control over her own life, and overall psychological well-being, helping her to adjust positively to her changed circumstances since her spinal injury. Overall, the quality of care Fatima receives, whether discriminatory or anti-discriminatory, has the potential to significantly shape her physical recovery, her social inclusion, and her psychological adjustment and self-worth. Final answer: discriminatory practice risks harming Fatima's physical function, social inclusion and psychological well-being, whereas anti-discriminatory practice (accessible, person-centred, culturally respectful care) can protect and promote all three domains of her health and well-being.

Level 1 (1-4): basic knowledge of discrimination/anti-discriminatory practice with limited or no clear application to Fatima's case; limited coverage of the required domains (physical, social, psychological); QWC basic. Level 2 (5-8): adequate knowledge and application to Fatima's case, addressing at least two of the three required domains (physical, social, psychological) with reasonable development; candidates addressing only one domain cannot achieve beyond Level 1; QWC adequate. Level 3 (9-12): competent, well-developed analysis with full coverage of all three domains (physical, social and psychological), clearly and specifically applied to Fatima's circumstances (her spinal injury, wheelchair use, religious/cultural identity), considering both discriminatory and anti-discriminatory practice; high standard of QWC and confident use of specialist vocabulary. All other valid responses will be given credit.

A socio-economic factor is an aspect of an individual's social position and economic circumstances, such as their income, occupation, education, housing or social class, which can influence their access to resources, opportunities and services, and in turn affect their physical, social and psychological health and well-being. Examples relevant to this specification include gender, social class, housing, and culture and ethnicity. Final answer: a socio-economic factor is a social or economic circumstance (e.g. social class, housing, gender) that can influence a person's health and well-being.

[1] basic definition (e.g. 'something to do with money or society'); [2] adequate definition referring to social/economic circumstances affecting health; [3] competent definition with a valid, correctly identified example (e.g. social class, housing, gender, culture/ethnicity). All other valid responses will be given credit.

An occupational hazard is a risk or danger to a person's physical or psychological health and safety that arises specifically from the nature of their job, workplace or working conditions. Examples include exposure to hazardous substances or noise, physical injury from repeated manual handling, musculoskeletal problems from poor posture or repetitive movements, or stress arising from a demanding working environment. Final answer: an occupational hazard is a risk to health or safety arising from a person's job or workplace, e.g. injury from manual handling or exposure to harmful substances.

[1] basic definition (e.g. 'something dangerous at work'); [2] adequate definition referring to a risk arising from a job/workplace; [3] competent definition with a valid, correctly identified example (e.g. manual handling injury, exposure to hazardous substances). All other valid responses will be given credit.

A behavioural factor is an aspect of a person's own lifestyle, habits or choices that can positively or negatively affect their physical, social and psychological health and well-being over time. Examples relevant to this specification include the amount of exercise a person takes, the quality of their diet, whether they smoke, whether they misuse alcohol, and whether they use illegal drugs. Final answer: a behavioural factor is a lifestyle choice or habit (e.g. smoking, diet, exercise) that can affect a person's health and well-being.

[1] basic definition (e.g. 'something a person does that affects their health'); [2] adequate definition referring to lifestyle choices/habits; [3] competent definition with a valid, correctly identified example (e.g. smoking, diet, exercise, alcohol, drug use). All other valid responses will be given credit.

Physical impact: housing that is damp, cold, poorly ventilated or in a state of disrepair can contribute to physical health problems, such as respiratory conditions (for example asthma or bronchitis) worsened by damp and mould, and increased risk of accidents or injury where housing is poorly maintained; overcrowded housing can also increase the risk of infections spreading between household members. Social impact: living in poor-quality or overcrowded housing can affect an individual's social life, for example a person may feel embarrassed to invite friends or family to visit, overcrowding can create tension and conflict within the household, and a lack of safe outdoor or communal space can limit opportunities for social interaction with neighbours or the wider community. Psychological impact: poor housing conditions are strongly associated with increased stress, anxiety and low self-esteem, as individuals may feel a lack of control over their living environment, worry about the cost of heating a cold or poorly insulated home, or experience a sense of shame or reduced dignity linked to their housing situation; children and young people in particular may also experience disrupted sleep or study environments, affecting their wider psychological development. Final answer: poor-quality housing can cause physical harm (e.g. respiratory illness from damp), social harm (e.g. isolation, embarrassment, overcrowding-related conflict) and psychological harm (e.g. stress, anxiety, low self-esteem).

[1]-[2] basic description of impact on one or two domains; [3]-[4] adequate description covering at least two domains (physical, social, psychological) with some development; candidates addressing only one domain cannot achieve beyond [2]; [5] competent description covering all three domains (physical, social and psychological) with clear, accurate detail for each. All other valid responses will be given credit.

Physical impact: type 2 diabetes affects the body's ability to regulate blood glucose levels, and if not well managed can lead to symptoms such as fatigue and, over time, more serious complications including damage to the eyes (retinopathy), nerves (neuropathy), kidneys, and an increased risk of cardiovascular disease such as heart attack or stroke, since consistently high blood glucose can damage blood vessels over time. Social impact: living with type 2 diabetes often requires ongoing lifestyle adjustments, such as changes to diet and regular blood glucose monitoring or medical appointments, which can affect a person's social life, for example needing to plan around meals at social events, or in some cases reducing participation in certain activities if energy levels are affected; family and social relationships can also be affected if others need to provide support or show understanding around dietary needs. Psychological impact: individuals may experience anxiety or worry about the long-term complications of diabetes, or feel a psychological burden from the ongoing self-management required (monitoring diet, blood glucose, medication), which can affect their overall sense of well-being; some individuals may also experience frustration or reduced self-esteem if they feel their condition limits their independence or the activities they can enjoy. Final answer: type 2 diabetes can cause physical harm (e.g. fatigue, nerve/cardiovascular complications), social effects (e.g. adapting routines, reduced participation) and psychological effects (e.g. anxiety, burden of self-management).

[1]-[2] basic description of impact on one or two domains; [3]-[4] adequate description covering at least two domains with some development; candidates addressing only one domain cannot achieve beyond [2]; [5] competent description covering all three domains (physical, social and psychological) with clear, accurate detail for each. All other valid responses will be given credit.

Physical impact: smoking is strongly linked to a wide range of serious physical health conditions, including lung cancer and other cancers, chronic obstructive pulmonary disease (COPD) and other respiratory conditions, and cardiovascular disease such as heart attack and stroke, as the chemicals in tobacco smoke damage the lungs, airways and blood vessels over time. Social impact: the significant financial cost of regularly buying cigarettes can reduce the money available to a smoker for other social activities, and restrictions on smoking in many public places and workplaces can affect how and where a smoker socialises, sometimes leading to smokers stepping outside separately from non-smoking friends or colleagues; smoking can also affect relationships, for example if family members are concerned about second-hand smoke exposure to children. Psychological impact: nicotine is highly addictive, and many smokers experience a psychological, as well as physical, dependence on cigarettes, which can create stress and anxiety when trying to cut down or quit; at the same time, some individuals use smoking as a coping mechanism for existing stress or anxiety, meaning smoking and psychological well-being are closely, and often negatively, intertwined over the longer term. Final answer: smoking can cause physical harm (e.g. respiratory and cardiovascular disease, cancer risk), social effects (e.g. financial cost, restricted socialising) and psychological effects (e.g. addiction/dependence, stress around quitting).

[1]-[2] basic description of impact on one or two domains; [3]-[4] adequate description covering at least two domains with some development; candidates addressing only one domain cannot achieve beyond [2]; [5] competent description covering all three domains (physical, social and psychological) with clear, accurate detail for each. All other valid responses will be given credit.

Socio-economic factor - housing: Michael's poor-quality, damp rented housing is likely to negatively affect his physical health, for example by aggravating any respiratory symptoms or increasing the risk of respiratory infections, which is a particular concern given he already smokes heavily; socially, poor housing conditions may limit his willingness to invite others into his home, and psychologically, living in substandard housing that he may have limited control over (as a renter) can contribute to ongoing stress and a reduced sense of well-being. Environmental/occupational factor - manual lifting: Michael's warehouse job involving heavy manual lifting is an occupational hazard that increases his risk of musculoskeletal injury, such as back strain, and this physical strain may be compounded by the fatigue that can accompany poorly controlled type 2 diabetes, potentially increasing his risk of injury at work; socially, if he becomes injured or excessively fatigued, this could affect his ability to work and therefore his income and social contact with colleagues, and psychologically, concern about his physical capacity to continue heavy manual work as he ages and manages a long-term condition could cause anxiety about his job security and future. Behavioural factor - smoking: Michael's long history of smoking significantly increases his risk of cardiovascular disease, and this risk is compounded by his type 2 diabetes, since both conditions independently damage blood vessels, meaning the combination substantially raises his risk of serious complications such as heart attack or stroke; the ongoing financial cost of smoking may also affect his social and leisure activities, and psychologically, he may experience the stress of nicotine dependence alongside the burden of managing a new diabetes diagnosis, potentially compounding his overall psychological strain. Interaction of factors: importantly, these factors do not act in isolation - Michael's smoking and diabetes both increase cardiovascular risk, his housing may worsen respiratory health already put at risk by smoking, and the physical demands of his job may become harder to manage as his diabetes and any related fatigue or complications progress, meaning the combined effect of these socio-economic, environmental and behavioural factors is likely to be significantly greater than any one factor considered alone. Overall, without positive changes or support (such as smoking cessation support, improved housing, or workplace adjustments), Michael's combination of risk factors is likely to lead to a substantial decline in his physical health over time, increasing restrictions on his social participation (e.g. through reduced capacity for work or leisure), and rising psychological stress associated with managing multiple, interacting health challenges. Final answer: Michael's poor housing, occupational manual lifting, and long-term smoking interact with his new type 2 diabetes diagnosis to compound risks across all three domains - physically (respiratory and cardiovascular risk, injury risk), socially (reduced work capacity, financial strain, social activity) and psychologically (stress, anxiety about his health, job and future), with the combined effect of these factors likely to be greater than any single factor alone.

Level 1 (1-4): basic knowledge with limited or no clear application to Michael's specific circumstances; addresses at most one category of factor (socio-economic/environmental/behavioural) or one domain (physical/social/psychological); QWC basic. Level 2 (5-9): adequate knowledge and application to Michael's case, addressing at least two of the three categories of factor AND at least two of the three domains; candidates addressing only one category of factor or only one domain cannot achieve beyond Level 1; QWC adequate. Level 3 (10-14): competent, well-developed analysis with full coverage of all three categories of factor (socio-economic, environmental, behavioural) and all three domains (physical, social, psychological), clearly and specifically applied to Michael's circumstances, ideally including recognition of how the factors interact/compound one another; high standard of QWC and confident use of specialist vocabulary. All other valid responses will be given credit.

The medical approach to health promotion is led by health professionals and focuses on preventing, diagnosing or treating disease through clinical intervention, often aiming to reduce ill health at a population level through professionally delivered programmes; an example is a national vaccination programme, such as the childhood immunisation schedule or an annual flu vaccination programme for older adults, which directly prevents specific diseases through medical intervention. The social change approach to health promotion aims to improve health and well-being by changing the wider social, economic, legal or physical environment in which people live, making healthier choices easier or the unhealthy choice harder or more costly, rather than relying solely on individuals changing their own behaviour; an example is the introduction of smoke-free legislation banning smoking in enclosed public places and workplaces in Northern Ireland, which changed the environment to reduce exposure to second-hand smoke and support smokers in cutting down, or the 'sugar tax' (Soft Drinks Industry Levy) on high-sugar drinks, intended to encourage manufacturers to reduce sugar content and discourage high consumption. Final answer: medical approach - professionally led clinical intervention to prevent/treat illness, e.g. vaccination programmes; social change approach - changing the wider environment/policy to make healthy choices easier, e.g. smoke-free legislation or the sugar tax.

[1]-[2] basic description of one approach, with or without an example; [3]-[5] adequate description of both approaches, with at least one valid example; [6]-[7] competent description of both approaches, each with a clear, accurate, relevant example correctly linked to the approach. All other valid responses will be given credit.

Way 1 - lifestyle choices: individuals can take responsibility for their own health and well-being by making positive lifestyle choices in their day-to-day lives, such as eating a balanced diet, taking regular physical exercise, not smoking, moderating their alcohol intake, and avoiding illegal drug use; making these choices reduces the individual's own risk of developing preventable conditions such as cardiovascular disease, type 2 diabetes or certain cancers, and is within the individual's own control to a significant degree. Way 2 - accessing health and social care services: individuals can also take responsibility for their health by proactively engaging with the health and social care services available to them, for example registering with and regularly visiting a GP, attending recommended health screenings (such as cervical or bowel cancer screening) and vaccination appointments, and seeking professional help promptly when symptoms first appear rather than delaying, which supports earlier diagnosis and more effective treatment of any health problems. A further valid way is self-advocacy, where individuals actively seek out information about their health, ask questions, and assert their own needs and preferences when engaging with health and social care professionals, ensuring their care is appropriate to them as an individual. Final answer: individuals can take responsibility for their own health through positive lifestyle choices (e.g. diet, exercise, not smoking) and by proactively accessing health and social care services (e.g. screening, early help-seeking); self-advocacy is a further valid way.

[1]-[2] basic description of one way; [3]-[4] adequate description of one way, or basic description of two ways; [5]-[6] adequate description of two distinct ways; [7] competent, well-developed description of two distinct ways (e.g. lifestyle choices and accessing services, or self-advocacy), each with clear, accurate supporting detail. All other valid responses will be given credit.

The behaviour change approach focuses on directly supporting and encouraging individuals to change unhealthy behaviours, often through structured programmes such as NHS Stop Smoking Services, which can offer one-to-one or group support, behavioural counselling, and access to nicotine replacement therapy or other stop-smoking medication. This approach can be effective because it addresses the physical addiction to nicotine as well as the psychological habit of smoking, provides ongoing, personalised support over a period of weeks, and evidence generally shows that structured stop-smoking support significantly increases a smoker's chances of quitting successfully compared with trying to quit unaided. However, its effectiveness depends heavily on the individual's own motivation to engage with and stick to the programme, and access to and uptake of such services can vary, meaning it may be less effective for individuals who are not yet ready or willing to seek support. The fear arousal approach uses images, information or messages designed to provoke a fear response about the negative health consequences of smoking, such as graphic warning images of diseased lungs on cigarette packaging, or television and online adverts showing the serious effects of smoking-related illness. This approach can be effective in raising awareness of the real risks of smoking and may prompt some individuals to seriously consider quitting, particularly if the message feels personally relevant to them. However, fear arousal approaches are generally considered less effective on their own for achieving long-term behaviour change, since if the fear provoked is too extreme or not accompanied by a clear, achievable way to act on it (such as signposting to support services), individuals may respond by avoiding or ignoring the message altogether, becoming desensitised to repeated warnings over time, or feeling that quitting is too difficult to attempt, rather than being motivated to actually change their behaviour. Overall evaluation: the behaviour change approach is generally more effective for achieving sustained smoking cessation, since it provides practical, ongoing support that helps individuals overcome both the physical and psychological aspects of addiction, whereas the fear arousal approach is more effective as a tool for raising initial awareness and prompting individuals to consider quitting, but is less reliable in producing lasting change if used in isolation; in practice, the two approaches are often most effective when combined, for example using fear arousal messaging (such as pack warnings) to prompt smokers to seek out behaviour change support services, which then provide the structured help needed to quit successfully. Final answer: the behaviour change approach is generally more effective for achieving lasting smoking cessation due to its ongoing, practical support, while the fear arousal approach is useful for raising awareness but less reliable alone for sustained change; combining both approaches is likely to be most effective overall.

Level 1 (1-4): basic knowledge of one or both approaches with limited or no evaluation, and/or limited application to smoking cessation; QWC basic. Level 2 (5-9): adequate knowledge and some evaluation of both approaches, with some application to smoking cessation, but discussion may be unbalanced or a clear overall judgement may be missing; candidates addressing only one approach cannot achieve beyond Level 1; QWC adequate. Level 3 (10-14): competent, well-developed evaluation of both approaches, with accurate, specific application to smoking cessation (e.g. named examples such as NHS Stop Smoking Services, nicotine replacement therapy, graphic pack warnings), a balanced consideration of strengths and limitations of each, and a clear, well-substantiated overall judgement; high standard of QWC and confident use of specialist vocabulary. All other valid responses will be given credit.