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Tackling poverty, food insecurity and “a cruel welfare system that undermines the wellbeing of people who are unemployed”

The impact of cruel and punitive welfare policies, women’s health inequities, food insecurity, and poverty were among the wide-ranging topics discussed when a Stretton Health Equity team at the University of Adelaide took charge of Croakey’s rotated X/Twitter account, @WePublicHealth during the first week in March.

The tag-team: Professor Fran Baum, Dr Connie Musolino, Dr Julia Anaf, Kim Anastasiou, Dr Joanne Flavel and Dr Toby Freeman.

They covered a seminar on poverty presented by Professor Martin McKee CBE from the London School of Hygiene, and the report below also covers McKee’s calls for the public health community to do a better job at communicating about the upstream determinants of health and at speaking truth to power.

The Stretton team noted that “when we think of poverty, people in Gaza are the poorest in the world right now”.

“They’ve lost their families, friends, food, houses, livelihoods, hospitals, schools, universities.They are facing starvation and more bombing. Total health catastrophe.”

They also cited this Oxfam International report, ‘Richest one percent bag nearly twice as much wealth as the rest of the world put together over the past two years’.

“What do you think – should we put a cap on people’s wealth?” they asked.

“Elon Musk, CEO of Tesla SpaceX, owner of X, is the richest person in the world with a net worth of $215 billion. Perhaps after $100m, then a global tax on wealth of 90 percent tax could be invested in health?”

Punching Above Their Weight

 

Professor Martin McKee is founding director of the European Centre on Health of Societies in Transition, a WHO Collaborating Centre. He is research director of the European Observatory on Health Systems and Policies, and a Commissioner, and Chair of the Scientific Advisory Board, of the Pan European Commission on Health and Sustainable Development, reporting to WHO EURO. To find out more about his work: https://www.lshtm.ac.uk/aboutus/people/mckee.martin.

The Punching Above their Weight (PAW) network examines why some countries do much better or much worse in terms of life expectancy than would be predicted by their economic status.

Most research in this area has focused on the health sector performance, whereas the PAW network examines more closely the political, social, environmental and economic context and processes that drive good or poor performance in promoting population health and health equity.

Workers are more and more on precarious contracts and workplaces, lacking control over their own lives, not able to predict and plan their futures – detrimental to health and well-being.

The deterioration of mental health when you lose your job during a period of austerity in an economic crisis is worse than when a country is not in austerity because there are less social safety nets.

Politics and public health

Listen to the podcast here. [The summary below is provided by Croakey].

In the podcast, McKee discusses the impact of the global financial crisis, the introduction of austerity and in some countries – such as the United States and United Kingdom – a widening of gaps.

He also discusses the impact of commercial determinants of health, and the need to act on the political determinants of health, and to shift the narrative away from individuals being responsible for their health, and for public health to look at its own communications.

“We’ve often retreated into silos and looked downstream rather than upstream, that’s natural because people do specialise in their own areas,” he said, but “we need to see the big picture, so we can communicate it to others”.

“We really do need to speak truth to power. We need to be able to challenge people who are talking complete nonsense. For example, the Murdoch empire is an example of very powerful interests promoting a narrative that undermines health.”

McKee highlights the tension when public health work professionals work within government, and says there is a very strong duty on those in academia and civil society to convey the needed messages publicly.

He says: The worst thing to do is to remain silent. History shows people in public health have not spoken out when they should have done so. We have a real responsibility to the public, whose taxes are often funding us, to be the conscience of the nation. Recognising that politicians have short term goals. But we need to help them and hold them to account.

We also need to communicate much better, with the public, we need to find language that works. In the pandemic, some communicated very well, and some people didn’t.

Young people are our hope but the system often grinds them down. We need to be encouraging them.

Re the future, he says “I’m remarkably pessimistic because we have some existential risks that we’ve failed to address”, and he cites the climate crisis and related environmental changes, and failures in global governance.

“We do not have a sufficient degree of leadership going forward,” he says.

If Trump is elected at the US election, “we could very easily be in enormous global difficulty”, especially given his previous actions while President in undermining climate action.

We have some very dangerous times ahead, and “the worry is whether the global architecture is sufficiently resilient to face up to this”.

McKee also says that that whenever peoples’ health deteriorates when they are left behind, they are fertile ground for non-democratic populist politicians.

Other news shared

In Australia, the @AntiPovertyN_SA and other advocates have lost trust in successive governments who acknowledge with words the struggles of living in poverty but continue to fail to make systematic change backed by evidence and community support; for example, raise all social security income!

Food security matters

Kim Anastasiou covered poverty, equity and food.

The right to food is “realised when every man, woman and child, alone or in community with others, has the physical and economic access at all times to adequate food or means for its procurement.” – General Comment No.3, UN Doc.E/1991/23, Annex III, paragraph 1.

Unfortunately, we’re still a long way off achieving this goal. Barriers to accessing ‘adequate’ food (which I would argue needs to mean quantity and quality – including impacts on health and the environment) are rife, both in Australia and beyond.

This has caused major road-blocks to policy change across the world. Ultimately, if we want to re-orient the food system to support EVERYONE, we need to seriously re-think who holds the power, and who stands to gain from the current policies in our food system.

So what can we do to re-orient the food system to support health and sustainability FOR ALL?

The Healthy, Regenerative and Equitable Food Systems Strategy for Victoria provides some important pointers.

Previous research has emphasised the importance of representative governance – for example, including women and youth on advisory committees. Clear boundaries to protect against undue vested interests is also needed.

UPF sales result in the growth of corporate wealth, and allows large transnational corporations to grow their influence and policy power. This includes lobbying for public-private partnerships and self-regulation over state-led food systems governance.

Further highlighted in this article, ‘Corporate interest groups and their implications for global food governance: mapping and analysing the global corporate influence network of the transnational ultra-processed food industry’.

One industry that has repeatedly targeted low-income earners is the ultra processed food  (UPF) industry. We know that low-SES groups are more likely to have diets high in UPFs.