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Report of the
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Social determinants
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Report of the
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Social determinants
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There is strong and unequivocal evidence, from Australia and other developed countries, that factors such as income, socioeconomic status, employment status and educational attainment are associated with inequalities in health (Berkman et al., 2000; Turrell et al., 2006). The health burden in the Australian population attributable to socioeconomic disadvantage is large and much of this burden is potentially avoidable (Turrell et al., 2006). Socioeconomically disadvantaged groups experienced more ill health, and were more likely to engage in behaviours or have a risk factor profile consistent with their poorer health status (Turrell et al., 2006). These inequalities are important from both social justice and economic perspectives - not only can they be considered 'unfair' and preventable, but they also have high direct and indirect costs on the health system (Sainsbury and Harris, 2001).
The mechanisms - at both individual and community levels - through which social and economic factors influence health, and through which health inequalities perpetuate, are only beginning to be understood. Nonetheless, there is growing interest in identifying opportunities for the health sector to act to reduce health inequalities. In response, the NSW Department of Health has developed a Health and Equity Statement (NSW Department of Health, 2004). As well as setting out priorities for action by NSW Health, the Statement recognises that many of the factors that contribute to health inequalities lie outside the control of the health system. It emphasises the need for strong partnerships among clinicians, community and consumer groups, and other government and non-government organisations to tackle these issues, and provides guidance on how to build these partnerships. It will act as a platform for future planning and decision-making within the NSW health system to reduce 'gaps' in health and health outcomes.
This chapter presents data on social and economic factors that are associated with health. These include indicators of household income, income sources, pensions, unemployment rates, family composition, school retention rates, crime rates and social capital. The indicators are based on data from the Australian Bureau of Statistics; the NSW Population Health Survey; the NSW Department of Education and Training; and the NSW Bureau of Crime Statistics and Research. Further information on the effects of social determinants on health outcomes can be found in the chapter on socioeconomic status.
Low income is one of the main determinants of poverty, which is closely linked to poor health. Average total weekly earnings figures, which are published by the Australian Bureau of Statistics each quarter, provide one measure of income. The averages are calculated based on the total number of employees, not the total population of working age. Changes in the averages may be affected not only by changes in the level of earnings of employees but also by changes in the overall composition of the wage and salary earner segment of the labour force. For example, an increase in the number of part-time employees will generally lower the average.
Over the period from 1985 to 2000, total average weekly earnings in NSW almost doubled, from $356 to $690. Similar trends were seen for both male and female earnings. However, female average earnings were consistently around two-thirds of males. Even when full-time employees only were considered, average female earnings were around 80% of male earnings (ABS, 2000).
Over the same period, the Australian consumer price index (CPI) also almost doubled (ABS, 2002). The CPI reflects changes over time in the the cost of a 'basket' of goods and services of the kind acquired by Australian households, including food, alcohol and tobacco, clothing, housing, transportation, communication, and education.
| For more information: |
Berkman LF, Kawachi I (Editors). Social epidemiology.New York: Oxford University Press, 2000. Turrell G, Stanley L, de Looper M and Oldenburg B. Health Inequalities in Australia: Morbidity, health behaviours, risk factors and health service use. Health Inequalities Monitoring Series No. 2. AIHW Cat. No. PHE 72. Canberra: Queensland University of Technology and the Australian Institute of Health and Welfare, 2006. Available at www.aihw.gov.au/publications/index.cfm/title/10041 Sainsbury P, Harris E. Health inequalities: Something old, something new. N S W Public Health Bull 2001; 12: 117-119. Available at www.health.nsw.gov.au/public-health/phb/phb.html Australian Institute of Health and Welfare website at www.aihw.gov.au Australian Bureau of Statistics website at www.abs.gov.au. Australian Bureau of Statistics. Australian Social Trends 2005. Catalogue no. 4102.0. Canberra: ABS, 2005. Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4102.02005?OpenDocument Draper G, Turrell G, Oldenburg B. Health inequalities in Australia: Mortality. Health Inequalities Monitoring Series No. 1. AIHW Cat. No. PHE 55. Canberra: Queensland University of Technology and the Australian Institute of Health and Welfare, 2004. Available at www.aihw.gov.au/publications/index.cfm/title/10041 |
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| Copyright notice: | This work is copyright NSW Department of Health, 2006. It may be reproduced in whole or in part, subject to the inclusion of an acknowledgement of the source. Commercial usage or sale is prohibited. |
| Suggested citation: | Population Health Division. The health of the people of New South Wales - Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at: http://www.health.nsw.gov.au/public-health/chorep/soc/soc_intro.htm. Accessed (insert date of access). |
| Produced by: | Centre for Epidemiology and Research, Population Health Division, NSW Department of Health. |
| Last updated on: | 16 November 2006 |
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