Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

6.2 Inequities in health

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Australians' concern with fairness in relation to preventative health, together with their concern for the suffering of others, demands actions to support equity of access to the means to lead a healthy life. This suggests, for instance, policies that promote access for all to nutritious food, physical activity, clean water and adequate housing. It also supports the provision of culturally relevant and accessible preventative health services (including minimal co-payments) that discriminate in favour of high-risk groups and those in poorer health.

At the system level, providing equity of access is the major argument for funding primary and community care according to a needs-adjusted capitation formula. A predominant fee-for-service payment system results in highest Medicare Benefits Schedule spend in regions with the highest SES and higher levels of health. It is also an argument for strengthening universal health cover and reconsidering policies not consistent with equity.

We know that health is a major indicator of inequity. If you want to judge how affluent a suburb is, you could check its tax returns – or you could look at its medical records. Rates of diabetes, of heart disease, early deaths, infant mortality, how many teeth a person has left – all are clear markers of socio-economic status. …In three areas – prevention, workforce, and the provision of health services by both public and private providers – a confused combination of government regulation and badly designed markets can hamper our ability to deliver the healthcare that people deserve. Which means health inequalities are becoming entrenched in our community.[26]

In formulating its recommendations, the Taskforce has been particularly concerned with the need to address the unequal distribution of health and risk in Australia. In this, the Taskforce’s views are firmly in alignment with other contemporary developments in Australia and internationally, including:

  • The NHHRC, which identified ‘Facing inequities: recognise and tackle the causes and impacts of health inequities’ as one of four major themes in its Interim Report
  • The targets and priorities set out under the COAG ‘Close the Gap’ objective to address Indigenous disadvantage, which include both health, such as life expectancy and child mortality, and ‘social determinants’ targets, such as education and employment
  • The Australian Government’s Social Inclusion Agenda, and similar initiatives introduced at the state level (such as South Australia’s Social Inclusion initiative)
  • The Report of the WHO Commission on the Social Determinants of Health

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