A new group advocating for action on the social determinants of health has been established in Tasmania.
In the article below, Miriam Herzfeld, Facilitator of the Tasmanian Social Determinants of Health Advocacy Network, and Gavin Mooney, a health economist and a member of the new network, argue that all members of the community can contribute to the creation of a healthier society.
They also pose a challenge: will we see similar groups set up in other jurisdictions?
An invitation to Tasmanians who’d like a healthier State
Miriam Herzfeld and Gavin Mooney write:
In Hobart, a new body was recently born – the Tasmanian Social Determinants of Health Advocacy Network (SDHAN). The purpose of the Network is to get Tasmanians working together to leverage action on the social determinants of health so as to improve health and wellbeing outcomes for all Tasmanians.
The vision of the Network is:
All Tasmanians have the opportunity to live a long, healthy life regardless of their income, education, employment, gender, sexuality, capabilities, cultural background, who they are or where they live.
Membership of the Network is open to all Tasmanians who share in this vision. Membership is free of charge.
The starting point of the SDHAN is to get the whole of Tasmania and all of Tasmanians to address the questions: How do we get health at the centre of our lives? How can we build a healthier Tasmania?
The answer to these questions are probably going to be driven by people’s line of work, their qualifications and their working life experiences. So if a Tasmanian is a nurse, public health worker, an allied health professional, a medical researcher, a health promoter or a general practitioner, he or she probably would say, ‘yes of course health is my core business – I do it every day – I help people get better, I’m researching a treatment for cancer, I educate the community about preventing diabetes’ (or whatever the case may be)’.
The real push of the SDHAN is to get recognition that this really needs a whole of community effort.
Thus if someone is an architect or a plumber in the building industry; a lawyer or a policewoman or a court attendant in the justice system; or a teacher or a school janitor or university cleaner in the education system; or a merchant banker or a bank clerk in the financial sector; or a retired or unemployed person with time on their hands, then each of these in their different ways can contribute to the health not only of themselves but also the health of the broader community.
The SDHAN emphasises the need for action at a state level but also in local communities, indeed especially the latter. The seeming cliché that health is everyone’s business is in principle and practice the driving force behind the Network.
Through the Network what we are trying to do is get all of these different people to realise that working at a community level we can all make a contribution.
The building industry: we know that people who live in inadequate housing are more likely to suffer from respiratory conditions. The Network seeks greater recognition among those in the building industry that good housing is good for health.
The justice system: we know that mental health issues can contribute to crime and violence. Acknowledging that can bring greater understanding to the way in which the justice system operates and treats offenders.
The education system: the more educated live longer and healthier lives. Is it not the role of those in the education sector to use this as a stimulus to try that bit harder to guide and support students to do the best they can? But the Network also wants to see more recognition of the importance of literacy and numeracy in day-to-day life. Lack of literacy can be a serious barrier to health.
The financial sector: many bankers (and others in society) are wealthy and as a result healthy. The Network seeks to persuade the better off that they have a role to support those who are less fortunate.
For those familiar with the literature on the SDH, there is nothing really new here. But in Tasmania our Network wants action and we want that action to be genuinely social. The social determinants of health can work. The evidence is there. Our Network wants to make a practical difference, hence the ‘advocacy ‘ in our title.
Tasmania is a relatively poor state. Poverty breeds ill-health. But it is also a small state where we tend to think that we know everyone and everyone knows us! Not true of course but more true than most other parts of Australia. And that is an advantage in trying to build on the SDH.
As a coherent and cohesive state on most fronts, we can all start doing more to share in the responsibility for maintaining the health and wellbeing of our communities.
Our health services, excellent though they are, struggle to cope with the demands made on them. The message for our Network is: ‘Let’s not leave it all to the formal health service. What can the Tasmanian community do to make health our core business?’
There are two other arguments that the Network is using to build support. One is that the gap between the rich and the poor is widening and we know that inequalities are bad for health. Such inequalities are a global phenomenon from which Tasmanians are not sheltered. We know people on lower incomes generally have worse health outcomes. If we don’t act to close this gap, we will see increasing inequities in health outcomes. This will have enormous ramifications across Tasmanian society.
Secondly, the financial resources in health care are under stress. There needs to be action to keep people well. That is best done by investing in changing the social conditions of health and wellbeing – in education, jobs, work conditions, food, transport and all those social factors that contribute to health. This clearly makes health everyone’s business.
The Federal Health Minister, Tanya Plibersek, has given our hard-pressed health care services a lifeline by way of a bail out package. Tasmanians are grateful. It seems that quite a lot of this money will go to promoting health outside hospitals.
Part of the role of the new SDHA Network will be to advocate for a sizeable chunk of this money to go on the social determinants. In that way the Network believes we can promote not only better health but also take some of the strain off the health services.
But we wonder. Are other states or territories setting up such networks? This ideally needs to be an Australia-wide initiative. So let’s make it that! What Tasmania does today ….