Groups Experiencing Inequities

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The environmental determinants of health comprise of geographic location, access to health services and technology. A report done by NATSEM at the University of Canberra, identifies that there are certain geographical locations that are more vulnerable and disadvantaged5. For example, the spatial distribution of children are more prone to poverty and mostly cover regions outside of capital cities5. Additionally, the report outlines that the prevalence rates of child social exclusion are second and third highest in the Northern Territory (33.5%) and South Australia (28.8%)5. Social exclusion negatively impacts their health and well-being, as does a lack of resources, opportunity, participation and skills. Thus making it incredibly difficult for those children to improve their socioeconomic status over their lifespan. Furthermore, those of low SES have poorer access to health services and technology. For example, they are less likely to use preventative measures such as immunisation, and are unable to afford some services ultimately placing their health at risk1. NATSEM figures outlines that Australians of low SES in rural and remote areas are twice as likely to suffer from a long term health condition and have less accessible health care, than those least disadvantaged5. The AIHW report on ‘the geography of disability and economic disadvantage in Australian capital cities’

Roles of Individuals, Communities and Governments In Addressing the Health Inequities

Individuals, communities and governments all have a role in addressing the health inequities. To provide an intersectoral approach to the health of socioeconomically disadvantaged people, all three must work collaboratively. Thus, the best suited approach to the health inequities in this group is intersectoral collaboration, as it is used to promote and achieve goals in a number of areas throughout Australia.

Individuals hold their own personal responsibility, as they are primarily responsible to promote their own health and the health of others. Fundamentally, they are the ones who can make good decisions about their own behaviour, reduce risky behaviours and increase protective behaviours. For example, an individual remaining in school and pursuing further study because a higher education will reap the benefits of health literacy and they will be educated in making informed decisions about their own health. Individuals could take actions such as pursuing a higher education level (university) improve their SES, thus providing themselves with additional information to facilitate informed choices about their health and health care used. In doing this, the individual is developing their health literacy and accessing skills that will promote good health throughout their lifetime, thus creating a sense of future1. Statistically, individuals of low SES are more likely to be smokers, participate in risky alcohol consumption, be overweight or obese and be physically inactive1. Individuals can oppose this by promoting health in their family and friends by supporting good health choices. For example, an individual could resist peer pressure when their friends may be smoking or consuming excessive alcohol. Moreover, individuals of low SES would benefit from developing resilience and coping skills. In doing this, their ability to cope with the ups and downs in their life will directly influence their level of health1. This resilience is improved in situations when an individual responds to situations on a more positive way. The risk factors of health are reduced through all of these strategies, consequently helping to address the health inequities in individuals of low SES.

Communities play an important role in reducing health inequities of the socioeconomically disadvantaged through providing relevant health care services and support networks. Communities need to break the stigmas of socioeconomically disadvantaged people through addressing the health inequities within this group. According to the ‘Outcomes 2 Personal Development, Health and Education HSC Course’ textbook, approximately 45% of low SES people are overweight or obese1. The Australian Government has funded a community program, ‘Active After-school Communities’, that has been established to help reduce this health inequity. It is the responsibility of the community to utilise this as it provides Australian families the opportunity of convenient and practical support to the healthy development of their primary school aged children through after-school physical activity[8]. This is an example of intersectoral collaboration. Additionally, communities have a responsibility to fundraise for health promotion programs and initiatives. For example, ‘Jump Rope for Heart’ is a physical activity for schools keeping children physically active and healthy, whilst raising funds to fight heart disease[9]. This program assists in reducing the high prevalence of heart disease death rates in lower socioeconomic groups1. A further example is ‘Life Education’. Life Education is the largest non-government provider of drug and health education operating in all States and Territories. They have been empowering children and young people to make safer and healthier choices through specific programs relevant to young Australians everyday[10]. For example, ‘Healthy Harold’ is one of their programs designed to educate students with strategies and the skills required to avoid the harms associated with an unhealthy lifestyle. Conclusively, communities should take on the responsibility of reducing the health inequities prevalent within low SES people to help them obtain a healthier lifestyle and more beyond their status.

The Australian Government addresses the health inequities widely spread throughout Australian within low SES people. They carry this out through supporting many community programs, creating policies and providing funding for free or reduced cost to health care. For example, the Australian Government supports the ‘Active After-school Communities’ program through funding, as mentioned above. Medicare provides access to a range of medical services, lower cost prescriptions and free health care as a public patient in a public hospital for Australian citizens[11]. Additionally, it provides subsidised medicine through the Pharmaceutical Benefits Scheme (PBS). The objective of this scheme is to provide all Australians with adequate and affordable health care regardless of their SES. The Australian Government also provides housing support to those in need of affordable housing and homelessness services through the Department of Social Services[12]. This substantially helps those of low SES as housing is a great cost and struggle to afford due to their environmental and socioeconomic determinants. ATSI people make up