Nursing Online – March 2010

There is no better example of health inequity in Australia than the 17-year gap in life expectancy between white and black Australians. Equity is one of the key principles that is supposed to underpin our health system but we have a long way to go before our health system lives up to this goal.

No ‘fair go’ in health
Fair Society, Healthy Lives
Marmot Review – Strategic Review of Health Inequalities in Britain post – 2010

People with higher socio-economic positions in society have a greater array of life chances and more opportunities to lead a flourishing life. They also have better health. The two are linked: the more favoured people are, socially and economically, the better their health.

This link between social conditions and health is not a footnote to the ‘real’ concerns with health – health care and unhealthy behaviours – it should become the main focus. Consider one measure of social position: education. People with university degrees have better health and longer lives than those without.

‘The more favoured people are, socially and economically, the better their health.’

For people aged 30 and above, if everyone without a degree had their death rate reduced to that of people with degrees, there would be 202,000 fewer premature deaths each year. Surely this is a goal worth striving for.

It is the view of all of the authors associated with this Review that we could go a long way to achieving that remarkable improvement by giving more people the life chances currently enjoyed by the few. The benefits of such efforts would be wider than lives saved.

People in society would be better off in many ways: in the circumstances in which they are born, grow, live, work, and age. People would see improved wellbeing, better mental health and less disability; their children would flourish, and they would live in sustainable, cohesive communities.

www.ucl.ac.uk/gheg/marmotreview/FairSocietyHealthyLivesExecSummary

Australia’s Health 2008
Australian Institute of Health and Welfare

Australia’s Health 2008 is the 11th biennial health report of the Australian Institute of Health and Welfare. It’s the nation’s premier source of statistics and informed commentary on: patterns and determinants of health and illness; health across the life stages; the supply and use of health services, expenditure and workforce; and health sector performance.

This report includes information on how the health of groups in the Australian population varies and detailed analysis of the determinants of health status.

www.aihw.gov.au/publications/index.cfm/title/10585

Michael Marmot on a fairer health system
Life Matters, Radio National, 11 February 2010

Professor Sir Michael Marmot’s ground-breaking studies of British civil servants in the 1960s and 1980s showed that people’s health improved when their wealth improved. Now he has assessed Britain’s health inequalities, and his review, the Marmot Review, will be published on 11 February.

www.abc.net.au/rn/lifematters/stories/2010/2814523.htm

Will today’s health ministers tackle health inequalities
Croakey, 12 February 2010

What does the Marmot Review, which sets out strategies for tackling health inequalities, mean for Australia?

Ben Harris-Roxas, a health equity expert at the University of NSW, gives us some Australian context for the report – and some suggestions for today’s meeting of health ministers.

http://blogs.crikey.com.au/croakey/2010/02/12/will-todays-health-ministers-meeting-tackle-health-inequalities/?source=cmailer

Intensive glare
Melissa Sweet, ABC Unleashed

Rather than enhancing professional and institutional power, the Marmot Review talks of ‘creating new kinds of partnerships in a delivery model based on co-production that encourages genuine public engagement in decision-making, shifting the balance of power towards local people and away from professionals and formal institutions’.

Rather than reinforcing the many silos that constrain the health sector, the Marmot Review stresses the need to integrate planning, transport, housing, environmental and health systems to address the social determinants of health in each locality.

Ultimately, according to Marmot and co, discussions about how to close the health gap are ‘a debate about what sort of society people want’.

Unfortunately in Australia we have not reached that level of deliberation. We remain firmly limited to conversations about hospitals, and whether institutional power should rest with doctors or administrators.

www.fahcsia.gov.au/sa/indigenous/pubs/nter_reports/Pages/closing_the_gap_nter.aspx