The National Rural Health Conference is well known for profiling the diversity, creativity, innovation and resilience of rural and remote communities – as well as highlighting the health gap with metropolitan Australia.
This year the conference – which brings together arts and cultural performances alongside clinical, policy and public health discussions – is being held as part of ‘A World of Rural Health’ that also includes the 14th World Rural Health Conference.
Putting a focus on healthy economies
Melissa Sweet writes:
Policy makers must work to ensure that economic growth is more inclusive and its gains are shared more widely, using such policy levers as progressive taxation, and investments in skills, lifelong learning and high quality education.
They must also work towards mitigating and adapting to climate change, and supporting labor market adjustments to the major structural transformations now underway globally, partly due to technological change.
This advice comes not from the world’s leaders in public health (although it easily could), but from the International Monetary Fund (IMF) in its latest publication, World Economic Outlook, April 2017: Gaining Momentum?
This IMF publication is timely, coming ahead of the 14th National Rural Health Conference, which kicks off on Wednesday on the country of the Traditional Owners and Elders of Cairns, the Gimuy Walubara Yidinji and Yirrganydji peoples.
The economics of rural and remote communities is the theme for the first plenary session on Thursday morning, which will be addressed by Professor Allan Fels AO, Chair of the National Mental Health Commission; Mick Reid, Deputy Chair of the Royal Flying Doctor Service, and Adjunct Associate Professor Lesley Russell, of the Menzies Centre for Health Policy at the University of Sydney.
This theme reflects that the economic agenda is the first of five key advocacy priorities for the National Rural Health Alliance, which published a position statement earlier this year urging government to “commit to unlocking the economic and social value of the 7 million people living in regional and remote Australia by reducing the gap in health and wellbeing outcomes compared with people living in cities”.
This would “dramatically improve participation and productivity, and increase Australia’s economic growth,” it said.
The statement, published in The Australian Journal of Rural Health, states that while agriculture will continue to be the mainstay of the regional and remote economy, finding ways to diversify and expand local economies is vital.
The statement highlights the importance of retaining young adults and older people in local communities and says “the interests of both groups would be served by growing workforce and facilities to support older people, and people in need of community based services, locally”.
“With the ageing of Australia and an increased need for services to support mental health, ageing and disability care, there are growing opportunities in regional and remote communities to generate new jobs to support these changing needs,” it states.
The CEO of the Alliance, David Butt, believes rural health advocates can make a powerful case for policy advances by focusing on the economic toll of health inequalities. He told Croakey:
The case for the social disadvantage and for the higher burden of disease in terms of chronic complex illness has been made pretty well in relation to rural and remote Australia.
Where there could be a stronger argument for change and new policy directions is in relation to economic burden, as well as social burden.
As you move away from metropolitan centres, your access to services gets poorer, and your health gets poorer – which impacts on your ability to participate in employment, and in turn on economic growth.
We are interested in looking to the economic benefits that could flow to Australia by improving the health outcomes in rural and remote communities.”
Butt argues that improving health outcomes in rural areas, through more effective health promotion, addressing the social determinants of health, and primary healthcare, has the potential to have significant economic benefits, in addition to saved healthcare costs.
Equitable access to the internet is another factor vital for the health and development of rural economies and communities, he says.
“To create jobs, to be innovative, you are going to need good access to fast internet,” he says, adding that this is also vital for health service delivery and development.
Meanwhile, conference delegates will hear a strong economic argument for mental health reform from Fels, Chair of the National Mental Health Commission.
“The economic gains from mental health reform dwarf the gains that would be made from most of the conventional microeconomic reforms that are being talked about at the moment, such as tax reform and efficiency gains in a whole lot of sectors of the economy,” he told Croakey.
Efforts to improve mental health through prevention and early intervention, stepped care, better integration of mental and physical healthcare, and attention to critical determinants such as housing and employment had the potential to increase GDP by one per cent, he said.
Rural and remote communities have potentially the most to gain from mental health reform because they are often so poorly served at present, he said.
Fels said there was an urgent need for the current national debates around housing affordability to focus more on the needs of people with mental illness.
“There could be much more done on mental illness and housing,” he said. “The mental health sector and service providers and government all need to take an interest in this. We feel policy is a bit thin in this area so we are trying to get it developed.”
Governments needed to work more closely and effectively with the finance and super funds to stimulate investment in affordable housing, in particular for people with mental illness, he said.
National policy gaps
David Butt hopes the conference will also spotlight the need for a national rural health plan, to help promote a more concerted focus at the national policy level.
He says there is currently no area within the Federal Health Department that is responsible for rural health, and that the National Rural Health Framework that was released in 2011 “has just died”.
“There seems to be a view in a lot of ways that solutions that apply in metro areas will suffice for rural and remote areas,” he says.
The Alliance is also advocating for the Rural Health Commissioner to have a broader remit than its current focus on rural generalist pathways and to extend beyond June 2020.
Watch this interview
Added on 26 May, this interview from the conference with Professor Alan Fels examines the maldistribution of the mental health workforce, and calls for greater use of e-health services.
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