The COVID-19 and health inequity crises: opportunities for policy reform in Australia
By Christina Zorbas, Alexandra Chung, Associate Professor Kathryn Backholer
Abstract: The impacts of the COVID-19 pandemic are being felt in every aspect of daily life in Australia. The pandemic has created an opportunity for policy actions to improve the social determinants of health for Australians and reduce health inequities across our nation.
As COVID-19 threatens to exacerbate health inequities, we are being reminded of our shared humanity. The COVID-19 crisis has spurred policy actions on the social determinants of health (i.e. the daily living conditions that drive health inequities (1)) with a zeal that has been seldom seen in the post-war era. Here, we summarise how government policy actions can equitably support health and prevent socioeconomic decline in Australia, both now and post-COVID-19 (2).
Australia’s COVID-19 Early Childhood Education and Care Relief Package ensured free childcare for all families (March – July 2020). This provided much-needed savings to families on low incomes and fairer developmental opportunities for all children. Nevertheless, these equity benefits were short-lived. To promote health equity, long-term investments in universal and affordable childcare and education programs are needed throughout childhood (2).
Employment and regular wages have well-established impacts on mental and physical health (3). JobKeeper provides $1500 fortnightly payments to employees via employers (small businesses) experiencing substantial revenue losses (≥30%). As of September, this will be reduced to $1200 fortnightly payments (forecasted to end in March 2021). Whilst wage subsidies are especially important for those with limited savings, policy actions will also be required to generate long-term employment opportunities for all socioeconomic groups.
Social protection: income support
Australians are receiving a $550 COVID-19 supplemental payment fortnightly if they are eligible for income support schemes (i.e. JobSeeker). As with JobKeeper, JobSeeker will only support the socioeconomic wellbeing of our vulnerable citizens in the short-term. From September, the total JobSeeker payment will be reduced from $1100 to $800 fortnightly. Ongoing, adequate social cash transfer schemes are vital to reduce health inequities by ensuring that millions of Australians do not live in poverty (4).
Recognising the importance of affordable housing, the government has banned rent increases and evictions, with one-off $3000 rental grants also provided for low-income households in Victoria. But policy actions should not cease here if we are to tackle health inequities. Indeed, a Senate committee recently recommended investigations into the adequacy of the Rent Relief Program and increased funding for emergency and social housing in Australia (4).
COVID-19 has disrupted the socioeconomic fabric of Australian society. We now have two options – emerge as a more equal, healthier society with a strong backbone of social support, or ‘snap back’ to where we were pre-COVID-19, with persistent and increasing health inequities.
Author contributions: Christina Zorbas and Alexandra Chung led this work with overarching guidance provided by Kathryn Backholer.
- CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
- Saunders M, Barr B, McHale P, Hamelmann C. Key policies for addressing the social determinants of health and health inequities. Copenhagen: WHO Regional Office for Europe; 2017 (Health Evidence Network (HEN) synthesis report 52).
- Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality. Social science & medicine (1982). 2011;72(6):840-54.
- Adequacy of Newstart and related payments and alternative mechanisms to determine the level of income support payments in Australia. The Senate. Community Affairs Reference Committee. Canberra, Australia; 2020.
Christina is a PhD Candidate in the Global Obesity Centre (GLOBE) within the Institute for Health Transformation. Her research aims to identify how policies, namely food pricing policies, can equitably improve population nutrition across all socioeconomic groups.
Alexandra Chung is a PhD candidate, and a visiting researcher at the Institute for Health Transformation’s GLOBE. Alex’s PhD research is investigating ways to reduce socioeconomic inequities in obesity among children in Australia.
Associate Professor Kathryn Backholer is a National Heart Foundation Future Leader Fellow and Associate Director at GLOBE.