An expert’s tips for getting health inequalities onto the agenda

Continuing the Croakey series on health inequalities (previous articles here and here), today we’ve asked a health communications expert for some tips on how to get the issue onto the public, policy, political and professional agenda.

Dr Mark Ragg, director of Ragg Ahmed, writes:

“We’ve all seen, and many of us would have exploited at various times in our careers, the 6pm chemo kids. Those cute pale pre-schoolers, parents beside them, whose telegenic faces scream ‘GIVE THIS HOSPITAL MORE MONEY FOR LEUKAEMIA RESEARCH’.

That child has suffered one injury – cancer. And there’s one response – give money. In terms of marketing an idea – and that’s what a lot of efforts to change policy and practice are about – that’s pretty straightforward. Not for the parents, not for the child, but for the hospital.

But how do you deal with the child who’s so obese her diabetes is already knocking on the door and who’s dad says Macca’s is cheap and whose mum said see you later and who lives in a flat and there’s no park nearby and the school’s on the slide and the buses don’t run on weekends and on top of everything else whose genes are singing the opening bars of bipolar disorder and dodgy arteries?

What’s the problem? What can you do?

That’s how it is with health inequalities. They’re not an event, or an injury, or a one-off anything at all really. Cancer is waterboarding, but health inequalities are a slow drip, a Chinese water torture, of the lucky dip of birth, early random events, entrenched disadvantage, labour market policy, cramped horizons, government views on redistribution of wealth, haphazard illness, social attitudes, planning policies, educational inequalities, health system access and attitudes … the drips go on. Eventually, they wear you away.

What exactly is the problem? What can you do?

It’s all complex, but persistence works. It’s worked with smoking, it’s worked with heart disease and it’s worked with SIDS. This is harder, because it’s more nebulous, but persistence will out.

We need to continue to try to make the invisible visible. Apply the inequality filter at every step. Use buzzwords – connectedness, social capital, networking, superclinics – and ask whether they will reduce health inequalities. Look at health literacy – a vehicle for reducing inequalities if ever there was one – and keep pressing the responsibilities of providers of health information, health services and health care to work to reduce inequalities.

Use clarity, repetition, persuasiveness, making the case over and over again, reminding people.

There’s nothing that can’t be done, with time, effort and persistence. Who’d have thought, five years ago, that a federal government would commit $100 million to trying to reduce smoking among Indigenous peoples?

There is a way. It just takes the will.”