Page 3299 - Week 08 - Tuesday, 16 August 2011
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The Health lies in wealth report, based on 2008 data, made some very stark findings. I would like to read out just a few of them. Firstly, it found that if people in the most disadvantaged areas had the same death rate as those in advantaged areas, then up to two-thirds of premature deaths would be prevented. Secondly, it found that those people who are most disadvantaged are at least twice as likely to have a long-term health condition, and in some cases up to four or five times more likely.
If we look at young women in public housing specifically, the report found that 39 per cent of women aged 25 to 44 years are obese, in comparison to 12 per cent of people who own their own home. Smoking is also more common in younger women living in public housing than in any other group, with two-thirds of young women in public housing being smokers. This is in contrast to 15 per cent of young women with tertiary education.
The Australian Institute of Health and Welfare also released some alarming statistics in December last year. They showed that with regard to premature deaths in people under the age of 75, men from low income suburbs were twice as likely to die prematurely as a result of chronic disease than men from high income suburbs. For women, that statistic was 60 per cent higher.
ACTCOSS states in its fact sheets about the social determinants of health that Australians who experience social and economic disadvantage report higher levels of diabetes, diseases of the circulatory system, arthritis, mental health problems and respiratory disease. They are more likely to visit doctors and hospitals and are less likely to use preventative health services, including dental health care.
It is also important to recognise that there is a gradient when it comes to the social determinants of health, as referred to by the World Health Organisation. The debate about the social determinants of health is not just about the haves and have-nots. There is a gradient in between. For example, studies have found that children of people in the second highest quintile have higher mortality than the children of people in the highest quintile.
The ACT population generally benefits from some of the best health outcomes in Australia because of our high levels of income and education. Such averages mask the experiences of those people in the ACT who rely on subsidised income, such as the disability pension. Given that average wealth is high, they cannot compete when it comes to housing or access to a GP. The rate of bulk-billing in the ACT is low and, for people who do work but are low skilled and on hourly wages, this means they may have to forgo earning a wage to access necessary health care.
In December last year, the ACT Health Council expressed its concern that if more is not done to reverse the trends in obesity, the ACT was likely to see a decrease in life expectancies. We know that obesity is more likely to affect people on lower incomes with poorer levels of education, which does make this a social justice issue. We need a much more informed debate on healthcare delivery which is not just about acute care, particularly hospitals, but also looks at issues of social justice. Catholic Health Australia’s CEO Martin Laverty said after issuing the Health lies in wealth report:
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