The gap in health outcomes for the haves and have-nots is widening

Australians pride themselves on the fact that Medicare provides equal access to affordable healthcare, but there are alarming claims that the gap in health outcomes between the haves and the have-nots is widening.

The University of NSW (UNSW) and the Australian Council of Social Service (ACOSS) released their Work, Income and Health Inequity report on Thursday, which found the COVID-19 pandemic had highlighted that some groups were at greater risk of poorer health outcomes based purely on their income.

The report found that there were clear links between health outcomes and socio-economic status across multiple indicators and that people with higher incomes were more likely to report good health (60 per cent), while people with lower incomes were less likely to report good health (32 per cent).

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It also found that the incidence of certain chronic health conditions, such as asthma, diabetes and heart, stroke or vascular diseases, were more prevalent for people on low incomes and those reliant on government payments for their income.

ACOSS chief executive Dr Cassandra Goldie said she feared that people with the lowest incomes were also the most at risk of missing out during the vaccine rollout.

“The pandemic has exposed the stark inequities that impact our health across the country,” Dr Goldie said. “People on the lowest incomes, and with insecure work and housing have been at greatest risk throughout the COVID crisis. Now, they are the same people who are at risk of missing out in the vaccine rollout.

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“Our report shows that health inequities are built into our society. Our report shows that people on low incomes have the highest levels of psychological distress, and we know that the pandemic is increasing that distress.

“People on lower incomes are also at greater risk of chronic illnesses, which can also make them more at risk to the impacts of the pandemic.”

Professor Evelyne de Leeuw, director of the Centre for Health Equity Training, Research and Evaluation, said the risks COVID-19 posed to lower income groups were higher, largely because of their living conditions or work situations.

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“It’s clear that income and wealth help determine health outcomes in Australia, with our report showing those in the highest income group are more than twice as likely to be in good health than those in the lowest income group,” Prof. de Leeuw said.

“Without urgent government action, the pandemic is only set to widen this inequality, with people on lower incomes already being left behind in the vaccine rollout.

“Many live in insecure, overcrowded housing or work in roles that cannot be carried out from home. Health inequities are not a given; they are a consequence of how our societies work.”

One of the key recommendations of the report is developing a set of metrics to evaluate and monitor the health of the Australian population and the success of the health system, similar to the World Health Organization’s European region policy matrix.

That system measures health indicators across a range of categories, including health status, healthcare and other determinants, and the social and economic causes and consequences of ill-health.

The report found that one of the biggest problems is that Australia lacks the appropriate data to accurately assess health inequity.

Dr Goldie also explained that addressing some of the causes of economic disadvantage in Australia could go a long way to closing the health inequality gap.

“Improving health for all is not only about investing in our health system – it’s also about income support, housing and community services,” she said.

“We must deliver on the basic economic supports and social determinants of health such as adequate and secure incomes and housing, including in lockdowns, so that we can improve health for all and get through the COVID crisis.

“It is inexcusable that we have not tackled preventable health inequalities. Far too many people have poorer health outcomes by reason of preventable economic and social disadvantage.”

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Written by Ben