Below is an article by Robert Douglas which appeared on The Conversation website. A summarised version has been reprinted with permission. The full article is available here.
The largest and longest-running study on maternal crack cocaine use, for instance, surprised everyone earlier this year when it showed that poverty – not cocaine use during pregnancy – was more detrimental to the long-term development of children.
This isn’t the only research to show the insidious impact of social status on social, mental, and physical well-being.
The higher we climb the status ladder, the more autonomy we have and the more comfortable we are participating in social activities and relationships.
Conversely, the lower down the pecking order, the greater are the stresses associated with everyday living, as people do what the system requires rather than enjoy the sense that they are in charge of their lives.
A similar relationship with ill health is clear with poverty.
In 2010, it was estimated that 12.8% of the Australian population were living below this poverty line (after taking housing cost into account). It was also estimated that 17.3% of Australian children were living in poverty.
There is now a large body of research that shows a very consistent gradient for life expectancy with those in the upper echelons living longer and experiencing less illness than those in each of the socioeconomic strata below them.
These gradients have been consistently shown in country after country including Australia.
Poor people have less disposable income for nutrition, health care, safe housing and are less able to avoid risk. Poverty is often associated with single parenthood and dependence on junk food, alcohol, tobacco and illicit drugs. Homelessnes is also more common among people in this group.
What is less clear is how to deal with the health consequences of poverty.
The gap between Australia’s rich and poor is now increasing substantially. And the burden of ill health for those in poverty persists across the nation, especially among indigenous communities.
A public health approach to the health consequences of poverty requires an understanding of cultural and social participation, which begins with education.
According to Richard Wilkinson and Kate Pickett, authors of The Spirit Level, education could have positive social and health ramifications right across the social gradient. They ask about the factors that perpetuate status differences and exclude those in the lower echelons of society from feeling worthwhile and being able to control.
A social-determinants approach recognises the multifocal nature of human stress and its frequent social origin in the status syndrome; the more helpless we feel when facing a difficult situation, the more toxic will be the stress from conventional health risks.
This approach means that we need to pay attention not only to the income, tax and targeted benefits for those currently below the poverty line but should also pay particular attention to education, child care, employment, housing, mobility and transport.
It changes the aim of public policy to fostering autonomy and the capacity to participate meaningfully in a range of social and community activities.
Centralising people rather than organisations, institutions, or ideology to public policy arguments is the Labor way, and it is backed up by the science around what should be a core value for all governments - better health and quality of life outcomes for all people.
Labor policies are formed with the intention of reducing the gap between rich and poor, as highlighted by Labor's move to means test spending such as the health insurance rebate. Labor did look to address the inequitable balance in education funding through its Gonski reforms and through its BER investment. Labor has sought to support lower income earners through its school kids bonus, through its superannuation support for low income earners.
The Abbott government will remove means testing further widening the rich-poor divide, they will strip away financial support for low income earners and as a result will force much poorer health and quality of life outcomes on them.
Clearly Labor's policies they are the right ones for a better standard of living for all Australians. We need to stick with them, and we need to sell them much more convincingly.