(A report back on A/Professor Kylie Valentine - No one left behind? The role of social policy in viral hepatitis - Australasian Viral Hepatitis Conference Day 1 )

What social policy can tell us about viral hepatitis? 

Social Policies are society’s responses to ‘big picture’ questions of how best to distribute resources through taxation, income support, programs and service. 

Social policies tell us  

  • what a society regards as Important and fixable problems  
  • what those problems are thought to be  
  • What isn’t a priority  

 

Social policy research tells us about  

  • How different groups of people are affected by these choices and priorities 
  • How policies and policy domains interact  

Inequality in Australia  

  • The top 20% of households have five times the disposable income of the lowest 20%  
  • The lowest 40 % income group rely mainly on social security or low wages  
  • Australia has higher inequality than most other wealthy nations  
  • The average wealth of a household in the wealthiest 20 % ($ 2.9 million) is 
    • Five times that of the middle 20 % ($ 570,000)  
    • Almost a hundred times that of the lowest 20 % ($30,000)  

Australia’s mental and physical health 

There is a strong evidence of a socioeconomic gradient in the incidence of multimorbidity 

The National Mental Health Survey reported that mental health conditions are more likely in people  

  • Who live outside major cities 
  • In the lowest socioeconomic quintile  
  • Who are not employed  
  • Who live alone and / or  
  • Who have a disability causing a profound or severe limitation 

What can social policy research tell us about living with hepatitis?  

Universal Programs do not equal universal benefit  

Vaccines  

  • Financial constraints are a barrier to achieving higher immunisation coverage, despite being free 
  • The proportion of children in the lowest SES decile who were partly vaccinated and for whom there was no recorded objection, was 20 – 50 % higher than for those living in the most advantaged decile  
  • 16 % of Australians in 2013 did not fill as prescription; skipped a recommended medical test, treatment or follow up; or had a medical problem but did not visit a doctor or clinic in the previous year because of the cost  
  • Refugees are at high risk of being under immunised  

Education  

  • On average of 73 % of selective school students came from the highest quarter of socio – educational advantage in 2016 
  • Socio – educational conditions are having a stronger net impact on school performances than they were before the First Gonski Review  

 

Health and social problems are worse in more unequal countries  

Index includes;  

  • Life expectancy  
  • Maths & Literacy 
  • Infant mortality 
  • Homicides  
  • Imprisonment  
  • Teenage births 
  • Trust 
  • Obesity 
  • Mental illness including drug and alcohol addiction  
  • Social mobility  

In conclusion, more than 50 % of the audience answered that better community services providing social, legal, employment, mental health and family support would make the most difference in improving the lives of people living with hepatitis.  

 

 

Author bio: 

Currently working at Adult Psychiatry and Rehab departments of The Canberra Hospital as a Senior Resident Medical Officer and member of ASHM and RACGP. Interested in Sexual and Reproductive health, including HIV and Viral Hepatitis. Completed HIV and Hepatitis B Prescriber course in 2017 and keen to practice and support diverse communities of remote and rural Australia.