Welcome to Eureka Street

back to site


Whose health matters?

  • 15 May 2018


This year's budget was a missed opportunity to invest in preventative health measures, and to fix health inequalities through policies informed by the social determinants of health.

Each year, the budget is a chance for the federal government to set out their priorities, to say what is important to them and to look towards, at least, the near future. Health spending takes up a significant amount of both federal and state government spending, as well as an increasing amount from individuals.

But what is the reason for this spending? Is it to help keep Australians healthy, or to treat us when we get sick? Do we spend money to prevent people getting ill? How do we respond to future health challenges, such as climate change? How do we make sure that everyone's health gets looked after?

A 2017 report found that Australia spends 1.34 per cent of total health spending on preventative health. Other reports put the figure closer to two per cent. This is far less than comparable countries such as New Zealand, Canada and the UK. But preventing disease is not just about economics and budgets — it's about preventing suffering, pain, illness.

One of the strongest sets of indicators for poor health, and one of the most preventable, are what is known as the social determinants of health. In the 2016 Boyer Lectures, Professor Michael Marmot said that:

'Health and inequalities in health are closely linked to the conditions in which we raise our children, the education we get, the neighbourhoods in which we live, the work we do, whether we have the money to make ends meet, our social relationships, our care for the elderly.' In short, the social conditions we live in influence our health, and inequalities between us also have an impact on the state of our health.

These ideas are not new, or even particularly revolutionary. Put people in crowded, precarious housing, make treatments unaffordable and give them a pittance to survive on and, lo and behold, people get sick, and sicker.


"Health is one of those policy areas where simple, one-off, splashy interventions might grab the headlines, but far more prosaic measures are what actually make a difference long term."


Policy interventions that look at the social determinants of health would include raising the rate of Newstart, making housing more affordable and making sure everyone can get the healthcare they need. None of these got a look in on budget