Hardship set to rise in SA, experts warn

Shopping trolleys containing clothing and personal items in Adelaide's CBD in 2016. Photo: Michael Coghlan CC/Flickr.

The escalating COVID-19 crisis will widen the gulf between people with and without secure income, with experts outlining increasing inequities in health outcomes for South Australians in a wide-ranging new report.

Entitled SA: The Heaps Unfair State: Why have health equities increased in South Australia and how can this trend be reversed?, the report from by the Southgate Institute for Health, Society and Equity at Flinders University and the South Australian Council of Social Service (SACOSS) highlights significant increases in inequities in SA since the 1980s and also recommends how to improve this state’s health outcomes.

Follow the report launch’s Twitter Festival at #SAHeapsUnfair and twitter handles @CroakeyNews @SACOSS @baumfran @RossWomersley @MelissaSweetDr @drtobyfreeman @ConMarguerite @TessRyan1 @mariemcinerney

“The Heaps Unfair report shows that a state which has previously done comparatively well in reducing inequities can quickly slide backwards,” says Southgate Institute director, Flinders University Professor Fran Baum.

“An escalating divide shows an increasing number of South Australians experiencing economic and social exclusion,” she says.

SACOSS CEO Ross Womersley, says: “This research has supplied us with data to support what we see evidenced in people’s lives – if you’re poor economically, you are at an increased risk of poor health outcomes.”

The report’s authors, including academics and leaders from the social service sector, say the rise is best captured in premature mortality rates that differ according to socioeconomic status.

Photo: Getty Images

Recently published longitudinal data from the Social Health Atlas suggests that health inequities have increased Australia wide since the late 1980s, and particularly in SA.

This trend is evident for almost all the health outcomes in the atlas, including: infant deaths, self-reported health, diabetes, respiratory system diseases, asthma, chronic obstructive pulmonary disease, musculoskeletal system diseases, psychological distress, and premature death.

This South Australian case study is taking a mix-methods approach to understand what factors including social, political and economic have contributed to this growth in inequities.

The report draws on publicly available data on health and health inequalities in Australia and data on the social determinants of health to provide quantitative examination of potential underlying factors that might explain the increase in socio-economic health inequalities in South Australia between the late 1980s and the period 2011-2015.

“What seems, at first, to be a health service issue is inexorably tied to a range of other social conditions that arise with a tightening economy, increased income insecurity, lack of stable employment, poor quality housing, insufficient income support and frequently being unable to find enough stable employment,” says Mr Womersley.

“The impact of de-industrialisation on the South Australian economy and manufacturing industries, coupled with worrying trends in employment and income stability has resulted in a sharp rise in the numbers of economically disadvantaged people and children living in poverty.”

Photo: Getty Images

Beyond making a call to the South Australian and Federal Government to revise policy and implement changes, the report’s raft of almost 40 recommendations stretches across the fiscal, education, energy, health, public service, social security, housing, digital, employment, NGO (non-government organisation), rural and regional sectors.

The report signals that a holistic approach, addressing the social determinants of health, is necessary if the existing problems are going to be effectively changed.

“Our work has identified that much more store is put on economic growth and much less on developing community solidarity and on achieving social justice as a policy goal in South Australia,” says Professor Baum.

The recommendations to redress this state’s health inequities, as outlined in the report, require swift action – particularly in such daunting times.

“There are many things we can do to increase health equity. We’ve learnt what not to do – it’s time to learn from those mistakes and embrace the idea of a ‘fair-go’ to extend to our health systems,” says Mr Womersley.

“Our recommendations are made in the hope that they will inform a determination to make South Australia ‘heaps’ more equal, and the recommendations are even more pressing in light of the COVID-19 crisis,” says Professor Baum.

Find the summary, full and statistical reports at the Southgate site, a video summary from experts, and more at the Croakey website

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College of Medicine and Public Health Society and Equity