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Can we build back fairer? Health promotion panel calls for more action to reduce inequalities

Introduction by Croakey: Health promotion and public health practitioners heard a resounding call to advocate for more equitable policies at a webinar hosted by the Australian Health Promotion Association last month.

The event titled ‘Putting equity and the social determinants of health at the heart of prevention‘ included discussions from Professor and world renowned epidemiologist Sir Michael Marmot and a panel of Australian health promotion and public health practitioners chaired by Professor Fran Baum AO.

Kate Ditchburn, Engagement Coordinator at the Victorian Healthcare Association and member of AHPA’s Student and Early Career Practitioner committee, reports below from the event.


Kate Ditchburn writes:

Health advocates in Australia have been urged to keep agitating for more equitable policy – pushing on as many different doors as it will take to advance action on the social determinants of health and health equity.

Speaking at a recent Australian Health Promotion Association (AHPA) event, world renowned epidemiologist Professor Sir Michael Marmot urged Australian colleagues to advocate for healthy public policy, including tackling discrimination.

Marmot, who is also director at the UCL Institute of Health Equity, encouraged colleagues to engage with different avenues of influence like local governments, international audiences, and anyone else who will listen.

“I push on a door, if it doesn’t open, I don’t bang my head against the door, I go and push on a different door,” he said.

Marmot presented research showing a “slow down” in positive health outcomes and growing inequities in England, including declining life expectancy for the poorest populations. The proportion of excess deaths in England in 2019 is also greater in most deprived areas than least deprived.

Image: Excess deaths in each decile of area deprivations, based on the Index of Multiple Deprivation 2019, by sex, England. Source: Institute of Health Equity

Marmot called out poor public policy and reduced public spending in England as a driver for increased inequities, urging Australians to seek a more equitable trajectory.

He outlined principles for healthy public policy including healthy standards of living, education and lifelong learning, environmental sustainability, healthy communities, and tackling discrimination.

In response to Marmot’s presentation, a panel of Australian public health experts echoed calls for strong social policy to reduce inequities.

Epidemiologist Dr Kalinda Griffiths spoke about the value of data to identify critical areas in the health of Aboriginal and Torres Strait Islander people.

“The way we measure things provides important information on who needs what and where”, she said.

For example, Aboriginal people in New South Wales are twice as likely to die from lung cancer than non-Aboriginal people. However, Aboriginal people in outer regional and remote areas are eight times more likely to die of lung cancer, but Aboriginal people in metropolitan areas have the same outcomes as non-Aboriginal people. Data like this provides valuable insight for policy making.

Edwina Macdonald, Co-Deputy CEO of the Australian Council of Social Services (ACOSS), presented a report showing income, employment, and socioeconomic status as strong indicators of health.

Some key findings include that 50 percent of people under 65 whose main source of income is government support reported mental health issues compared to 18 percent of the general population. In addition, 60 percent of people on higher incomes report good health compared to 32 percent of people with lower incomes.

Image: findings from the ACOSS report

Communications critical

During the webinar I presented on the influence of strategic communications in maximising the impact of public health advocacy. Effective communications can create public interest, persuade decision makers, and support those who are affected by inequities.

I encouraged people to avoid framing health inequalities using medical messaging, and instead share strong personal narratives and the social values behind inequalities to motivate for change.

Moderated by Professor Fran Baum AO, the panel discussed putting social determinants and inequalities on the agenda of the new Australian Government.

Despite the concerning trends of increased inequity and growing social disadvantage, the panel remained optimistic that there is now good momentum for targeting inequities and advancing public health.

There is a shift towards greater understanding of social determinants and inequities in politics, but the next challenge is moving knowledge into effective policy that can reduce inequities and improve health outcomes for all.

Marmot encouraged the panel and attendees to continue pushing for more equitable policy.

About the author

Kate Ditchburn is a public health professional from Melbourne. She is currently the Engagement Coordinator at the Victorian Healthcare Association and works with other not-for-profit organisations including Women with Disabilities Victoria and The Water Well Project. She holds a Bachelor of Journalism and Master of Health Promotion and enjoys combining her interests in communications and health. Kate is driven by the desire to reduce health inequities and has particular interest in women’s health. Kate is a member of the Australian Health Promotion Association’s Student and Early Career Practitioner committee. Fellow AHPA member Alyssa Monte asssited her in writing this article.

From Twitter


See Croakey’s extensive archive of articles on health inequity.

 

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