Introduction by Croakey: The COVID-19 crisis should be seized as an opportunity to address inequities, within countries and globally, according to new briefs issued by the United Nations Department of Economic and Social Affairs (UN DESA).
A recent policy brief examining the role of income redistribution for poverty reduction explored a strategy called “economic growth with equity”. Amid the pandemic and recovery period, countries now have the ability to “consider solutions previously considered too difficult to implement”, it said.
The brief builds on a report released in September, ‘Sustainable Development Outlook 2021: From anguish to determination’, which calls for a whole-of-government approach to address inequality.
The report recommends accelerating COVID vaccination by “making the COVID-19 vaccine a public good”, strengthening access to quality, affordable universal health coverage and ensuring growth is “socially inclusive and environmentally sustainable”.
Growth should focus on building human capital, expanding employment, and investing in education, training, science and technology, and research and development, it said.
“Societies should try to make use of the COVID-19 crisis to overcome political barriers to moving towards a more equitable society,” the report says. Below are some of its key graphics on how the pandemic is exacerbating inequalities.
Meanwhile, in the article below, Master’s student Veronica Martinez Harris (pictured) outlines how systems and institutions can reduce inequities by focusing on the key social determinants that influence health and wellbeing – employment, housing and education.
This is the second and final article published by Croakey from the Public Health Association of Australia’s National Student Think Tank Competition. You can also read Alison Ainsworth’s article on addressing ageism in this series.
Veronica Martinez Harris writes:
The health of our population is largely shaped by social inequities that are deeply embedded in our systems, structures, and institutions. Social inequities are defined as avoidable or unnecessary differences in living and working conditions that unfairly disadvantage certain populations.
They arise when there are inequitable distributions of power, money and resources that favour those who are economically advantaged over those who are not. Opportunities taken for granted by some are simply unattainable for others. This includes opportunities for increased life expectancy and improved health and wellbeing, which are increasingly difficult for certain populations to attain during times of a pandemic.
The United Nations’ Declaration of Human Rights decrees that all humans are entitled to a standard of living adequate for health and wellbeing. This includes having adequate housing, access to clean water, food security, an education, stable employment, and income.
However, as a result of social inequities not all people are afforded these basic rights, a problem that has been exacerbated by the COVID-19 pandemic. For example, the implementation of COVID-19 ‘containment and health’ policies has further reinforced social inequities.
Policies such as restricting the gathering and movement of people, contact tracing and testing, social distancing, regular handwashing and sanitising, and mandating the use of personal protective equipment are very much centred on individual behaviour and assume that health is the responsibility of individuals.
Despite being effective in the short-term, these policies fail to acknowledge the structural barriers that impact on peoples’ ability to adhere to COVID-safe guidelines and are not sustainable in the long term.
A silver lining is that although the COVID-19 pandemic has exacerbated these inequities, it has also provided an opportunity to bring to the fore policy priorities related to social inequity.
Avenues through which we can reduce social inequities include key social determinants that are known to influence health and wellbeing outcomes: employment, housing, and education.
Dilemma for the breadwinner
People in informal or casual employment do not have the same opportunity to follow ‘containment and health’ policies as they are not able to take paid leave for COVID testing, self-isolation and vaccinations. This provides a disincentive for such workers to follow COVID-safe measures as leaving work means sacrificing their income, an impossible task if they are their family’s sole breadwinner.
The introduction of paid leave for those who are in casual employment is essential if we are to address widening inequities. We need to continue to advocate for the support of these populations, particularly as the vaccine becomes more readily available.
Physical and social distancing is difficult for those who live in overcrowded housing or apartment complexes. Such complexes have few, if any, green spaces. This reduces opportunities for engagement in physical activity, impacting both physical and mental health.
Policies should address overcrowding and include careful planning and consideration of the physical environment where people live and work and, in particular, mandate the development of environments that promote physical activity through the inclusion of green spaces or well-lit footpaths.
Supportive learning environment
The education of children is disrupted without a supportive learning environment for school students, such as home access to a stable internet connection and electronic devices. This can have long-term implications for employment and income, which are positively correlated with health.
Inequities in education can be addressed through subsidised access to home learning devices for children who do not own a laptop or other electronic devices.
More funding for public health
As we look to a ‘new normal’ we must address widening inequities so our systems and institutions do not further disadvantage those in already precarious positions.
We can start by acknowledging the social inequities in people’s living and working conditions, including their employment, housing and opportunities for education. This can be achieved through greater investment in public health and health promotion approaches that are evidence-based and community-led.
By providing support to those who need it most – in a way that is feasible, practicable and timely – we can ensure both the short- and long-term health for all members of our population and reduce the widening inequities precipitated by pandemics.
Veronica Martinez Harris is a Master of Public Health student in the School of Public Health at the University of Queensland.
See Croakey’s extensive archive of articles on health inequalities.