It’s clear that Australia is entering a new phase with the COVID-19 pandemic. While most Australians understand that unpredictability and disruption are the hallmarks of this pandemic, there is an increasing feeling that we are no longer in this together.
To avoid a rapid widening of our social, economic and health inequalities, policy makers need to keep people and equity at the heart of every decision made.
The pandemic has already shone a light on the drivers of health inequalities through demonstrating the inextricable links between our health and our resources.
Governments saw the need to deliver substantial social measures such as housing, higher basic welfare, and greater job security, to protect our individual and collective health and economic prosperity. And the National Cabinet was borne to ensure all Australians’ needs were met.
Now, the reduction in the additional income, employment and housing support measures, and inconsistent access to testing, risk the tenuous social contract we had developed. There are already signs that we are moving to an “everyone for themselves” response.
We know how this plays out. Those with greater resources, be they financial, jobs, or housing, will be able to take fewer risks to their health. They can work from home, test themselves and their families more frequently, and choose to not open their businesses to the public.
Equity requires a level playing field. Everyone needs the same opportunity to seek and maintain good health. To achieve this, our policy responses need to be able to address people’s differing needs and experiences.
In the context of the pandemic this means considering the impact of the current crisis, and our responses, on the diverse communities that make up Australia. If we want people experiencing symptoms of a COVID infection to test and isolate, we need to design a system that works for those experiencing the greatest barriers to doing these things – be they time, money, ability, or location.
It is not hard to imagine those in our community who may not be able to access rapid antigen tests (RATs); execute a test’s fiddly instructions; or support a whole family to isolate for 7 days without further job, income or housing protections. The outcomes are not good for these people, nor for the health of those they come in contact with, nor for the businesses forced to close due to this increased spread of COVI-19 and the impacts of isolation.
We know from centuries of public health research that if we can design a system that works for those experiencing the greatest barriers, it will work for everyone else too. How then do we ensure that the diverse needs and experiences of our communities are not just an after-thought?
The principles of equity in health policy demand that in developing policy responses, those Australians experiencing the greatest barriers are front and centre. To do otherwise is neither effective nor efficient, let alone equitable. We need precisely these Australians to advise on what might work for whom.
In a time of rapid change and uncertainty like the pandemic, this means proactively and constantly engaging these views to identify the best response to each new challenge as it emerges. And it means reminding ourselves of those inextricable links between our health and our resources by keeping options such as rent and financial relief, housing, and employment security on the table.
Comprehensive and inclusive social and public health measures are there to make sure that no-one falls behind, through no fault of their own. The alternative is a widening of disparities and the cracks in social, health and economic outcomes that this delivers. Now is the time to invest further in an equitable societal response to the pandemic, not to abandon it.