John Glover Director, PHIDU Torrens University Australia

Transcription

1 John Glover Director, PHIDU Torrens University Australia

2 March 1987, the Australian Health Ministers Advisory Council established the Health Targets and Implementation (Health for All) Committee Purpose was to develop and set of health goals and targets for Australia for the year 2000 Usual terms of reference

3 But, of greatest interest in the report of the Committee was that: Two underlying principles have directed the Committee's work throughout the preparation of this report: increasing the health status of all Australians and decreasing the inequalities in health status between population sub-groups.

4 It was as a result of this report and associated activities in SA that the first SA and Australian SHAs were produced, with an aim to monitor inequalities (differences) in health and wellbeing. And that has kept me in a job over nearly 30 years. The other bit of history is that for the past 18 years the Australian Government Department of Health has funded this work. I was thinking about this presentation when I heard that former Goldman Sachs chairman Jim O'Neill pointed out at a recent business summit the impossibility of the long-running rise of the global profit share continuing at the expense of wages, and noted that "the next phase of globalisation" could become more problematic unless something was done to boost basic wages people need money to buy things. And Brian Loughnane, previously the Federal Director of the Liberal Party of Australia, spoke of the need to deal with populism, and the associated issues of wage inequality and growing poverty. It seemed to me that I was hearing the word inequality a lot more, and from beyond the welfare and health people. But what about health inequality? First, a look at changes in inequality under one measure, and then a look at a few of the SDH/ SDHe over time.

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6 Year Gini coefficient

7 Footnote(s): (a) Equivalised Disposable Household Income Source(s): Graph data Survey of Income and Households

8 Gini for wealth equivalised net worth

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18 Low birth weight babies

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25 Rate Health inequality in South Australia, 1987 to 2013 (based on premature mortality) Rate ratio Absolute difference (lhs) Relative difference (rhs)

26 Most advantaged Most disadvantaged Numbers Rate Numbers Rate

27 There have been improvements in some of the SDH for the population overall. For example, full-time participation of 16 year olds in secondary education and school leavers getting a university place; none, or not much improvement in others, e.g., AEDC, youth unemployment; and growing numbers of the long-term unemployed.

28 In some cases the gap between those most disadvantaged and most advantaged has - Narrowed: AEDC, full-time participation of 16 year olds in secondary education and school leavers getting a university place - Widened: long-term unemployment (and a very large gap) - Stayed the same, or widened slightly: youth unemployment (and a very large gap).

29 Looking at health outcomes and risk factors, overall - the proportion of low birth weight babes has decreased slightly (from 7.0% to 6.7% in Adelaide and from 7.0% to 6.1% in the Rest of State areas) - premature mortality rates have declined markedly, down by 45.1% for males over the twenty three years from to , and by 38.5% for females.

30 The gap between those most disadvantaged and most advantaged has - Narrowed: for low birth weight babies (Adelaide), for women smoking during pregnancy (although the latter still has a very large gap) and for premature mortality for females (outside of Adelaide) - Widened: for low birth weight babies (outside of Adelaide) and for premature mortality for males and females (Adelaide) for males, from a rate ratio of 1.39 to 2.17 (39% gap to more than double); and for females an even more substantial increase, from a rate ratio of 1.23 to Stayed the same: premature mortality for males (outside of Adelaide).

31 So, where to from here? Inequality in health status and outcomes exists, and although there have been improvements in some areas, in others it has worsened. I hope that what I have shared today gives those of you with roles in working for better health an added impetus to address inequalities in your own organisations and roles. PHIDU john.glover@tua.edu.au website: Mobile: