Introduction by Croakey: The Federal Government has released details of the 146 participants expected at its two-day Jobs and Skills Summit, which begins in Canberra today, as well as the agenda.
Topics up for discussion include equal opportunities and pay for women, workforce opportunities from clean energy and tackling climate change, addressing discrimination and boosting workforce participation.
Clearly, the discussions have wide-ranging implications for population health, as well as the specific considerations for the health and aged care workforces (as we’ve covered here, here and here).
Below, public health researcher Dr Miriam Vandenberg shows how health equity considerations can be incorporated within the Summit’s five broad themes of maintaining full employment and growing productivity, boosting job security and wages, lifting participation, delivering a high-quality labour force, and maximising opportunities in the industries of the future.
Miriam Vandenberg writes:
The Jobs and Skills Summit in Canberra this week presents an important opportunity to progress a policy agenda that recognises the link between employment and health equity. Ignoring health in the debate will stifle economic productivity in the long term.
It is pleasing to see that among the listed delegates, there are some who could bring a health equity approach to the table. Here’s why we need to bring a health equity perspective to problem-solve a social issue such as jobs and skills.
Broadly speaking, jobs, employment, skill development and working conditions are intimately linked to health and wellbeing. Back in 2007, as part of the WHO’s Commission on the Social Determinants of Health, a network of researchers articulated how political power relations interact with labour market and welfare state policies to shape employment and working conditions, and impact health and health equity.
In a nutshell, a job can be good or bad for health depending on the combined effect of employment conditions (for example, secure/ongoing vs precarious work), working conditions (such as exposures and risks in the workplace) and other life circumstances (for example, socio-economic factors, access to healthcare, social and family networks, health behaviours etc).
Gradually, recognition of the relationship between work and health is trickling into the public policy fora, beyond the more traditional ‘tick a box’ approach to occupational health and safety.
For example, recently the Senate Select Committee on Job Insecurity 2022 recognised the impact of job insecurity on psychological wellbeing, and, among other things, called for increases to Australia’s JobSeeker payments to better support unemployed Australians.
In an article about COVID-19 and vulnerable societies, Professor Michael Quinlan highlighted the “rare public condemnation of precarious work” by a politician (Victorian Premier, Daniel Andrews), who referred to the “toxicity” of insecure work. And the Western Australian Government has been commended for leading the way in recognising insecure work as a health hazard.
The Jobs and Skills Summit presents an opportunity to expand on this type of ‘health in all policies’ approach.
Inequities in the labour market
More specifically, an important reason why health experts should be at the Jobs and Skills Summit table is because unfairness in the labour market impacts upon some Australians much more than others and is likely to directly and indirectly affect health.
It may take the form of job insecurity, wage theft, informal jobs, discrimination and racism, low participation rates or underemployment, inequalities in opportunities related to wages, superannuation and leadership.
A startling example of inequity in the labour market is evident in the Fair Work Ombudsman’s recent announcement of the recovery of a record $532 million in unpaid wages and entitlements from more than 384,00 workers in 2021-22. Since wage theft is largely dealt with in a reactive fashion this is almost certainly the tip of an iceberg, with underpayment also arising from other practices like unpaid traineeships/internships.
Among those most at risk of wage theft are temporary migrants, who make up 11 percent of the Australian labour market. A report on the findings of the National Temporary Migrant Work Survey found that temporary migrants experience multiple forms of exploitation and criminal forced labour, experiences which are likely to exacerbate the already poor health outcomes associated with their visa insecurity status.
That more than half of the wage theft recoveries came from large corporate employers, speaks to the danger of the neoliberal inspired ideology that puts ‘profits before people’ and that appears to be well established in Australia.
Aboriginal and Torres Strait Islander peoples are far less likely to participate in the labour market than non-Aboriginal people – 49 percent compared to 75 percent. Aboriginal and Torres Strait Island peoples are also under-represented as professionals and managers relative to the working age non-Aboriginal population (15 percent versus 24 percent), and “experience widespread socioeconomic disadvantage and health inequality“.
Structural and interpersonal racism and a lack of cultural safety in diverse settings affects Aboriginal and Torres Strait Islander peoples’ health and wellbeing in many ways, including through reduced opportunities in work, education and training.
While there is little evidence at the time of writing that the Health Minister’s interest in the Summit extends much beyond the pressing problem of health workforce shortages, it is heartening to see the disproportionate impact of unacceptable forms of work and lack of employment and skill development opportunities for some population groups recognised in the Summit Issues Paper.
If policy action can reduce barriers to employment for “younger and older people, First Nations people, women, people with disability, unpaid carers, Culturally and Linguistically Diverse People, and those living in certain regional and remoter areas” (p.6), associated health gains and reductions in health inequities are genuine possibilities. That’s in addition to enhanced productivity and reduced healthcare costs.
Equity in the frame
Pre-summit media reports suggest that the Treasurer does support an equity-focused agenda.
In an interview on Radio National, Dr Jim Chalmers is quoted: “…too many Australians are going backwards even in times where we’ve seen strong business profits. … we want to reattach the link between national economic success and people’s ability to earn enough to feed themselves and provide for the people that they love. That’s our objective.”
The voice of the worker is a central to achieving this and health equity advocates would support the Summit’s focus on collective bargaining.
It is obvious that some industry advocates are primarily interested in securing cheap labour in the interests of advancing economic productivity but what this view fails to recognise is that decent jobs create healthier workers and healthier workers are an economic asset that will feed the economy ten times over, through productivity and reduced health care costs. Researchers have shown that countries with collective bargaining have higher life expectancy and lower infant mortality rates (Reeves 2021).
Health knowledge can also bring an understanding of the complexity of social determinants of health to the Summit table. For example, much of the discussion in the lead up to the Summit has been to do with migration.
But as the Grattan Institute points out, this won’t necessarily address skills shortages, not to mention the interaction with other health determinants, including housing. Where will additional permanent migrant workers live, given Australia’s current housing crisis? Another example is provided by those working within an Aboriginal Community Controlled Health Organisation model, who have much to contribute to understanding and solving complex, socially-determined health challenges.
On the Summit’s agenda are several opportunities to improve population health and health equity, including the prospect of maximising employment opportunities in the renewable energy and climate change sectors, and revitalising local manufacturing.
Climate change is a public health emergency and the notion of creating employment opportunities, while advancing planetary health are welcome from a health equity perspective.
Keynesian scholars have long advocated the benefits associated with “homespun goods.” By purchasing imported clothing, for example, Australians often inadvertently support slave labour.
Australia’s over-reliance on overseas goods is causing major disruptions in the construction, machinery and electronics sectors, particularly in the face the COVID-19 pandemic, war and environmental disasters. Such threats are only likely to increase into the future, highlighting the urgency around growing local manufacturing (and the skill development that need to accompany this).
But we need to use the word ‘productivity’ with caution. Not only in the interest of sustainable development, but also with respect to worker wellbeing.
Productivity shouldn’t mean ‘working harder.’ Researchers investigating the concept of the four-day-week, for example, report on multiple benefits related to wellbeing, welfare, social inequalities and social cohesion (Chung 2022).
Five brave ways forward
The Government is to be commended for organising the Jobs and Skills Summit with its aim of finding common ground to create opportunities for more Australians, at a very challenging time in history.
Global and local challenges are likely to become increasingly threatening and complex, so now is the time for well-informed and brave actions in relation to the five Summit themes:
1. Maintaining full employment and growing productivity by recognising population health and planetary health as productive goods and economic assets, and advancing an agenda of sustainable production and consumption.
2. Boosting job security and wages by coming down hard on industries that advance unacceptable forms of work (as defined by the International Labor Organisation), strengthening workers’ voices, addressing power imbalances in the workplace and ensuring minimum labour standards are vigorously enforced.
3. Lifting participation and reducing barriers to employment using an equity approach to remove barriers to labour force participation experienced by younger and older people, First Nations people, women, people with disability, unpaid carers, Culturally and Linguistically Diverse People, and those living in certain regional and remoter areas.
4. Delivering a high-quality labour force through skills, training and migration by understanding the complexity of social challenges when making political, economic and resource distribution decisions and addressing associated issues such as housing, social inclusion, transport and welfare support.
5. Maximising opportunities in the industries of the future through on-shoring and future proofing Australia for the impacts of climate change, disease pandemics and natural disasters.
Dr Miriam Vandenberg is based in lutruwita/ Tasmania, and is a researcher at Adelaide University and the University of Tasmania, and a public health consultant. She has a strong interest in health equity and the social determinants of health, and has research expertise in understanding the health impacts of informal employment in Australia.
Croakey thanks and acknowledges donors to our public interest journalism funding pool who have helped support this article.
Previous Croakey coverage of the Summit
The physio will see you now. Why health workers need to broaden their roles to fix the workforce crisis: By Professor Henry Cutler
Five ways the Jobs and Skills Summit can help address our healthcare needs: By Kylie Woolcock
Why the aged care workforce crisis is beyond scope for the Jobs and Skills Summit: By Charles Maskell-Knight
From Twitter
