Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Exploring discourses of equity, social justice and social determinants in Australian health care policy and planning documents

Janette Young A B and Richard McGrath A

A School of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.

B Corresponding author. Email: janette.young@unisa.edu.au

Australian Journal of Primary Health 17(4) 369-377 https://doi.org/10.1071/PY11038
Submitted: 30 March 2011  Accepted: 30 August 2011   Published: 15 November 2011

Abstract

The Australian National Health Reform agenda includes aims to reduce health disadvantages and provide equitable access. However, this reform will be implemented through state and territory governments, and as such will be built on existing conceptualisations of health as a social justice concept (core to understandings of social determinants). A selection of state and territory health policy documents were analysed within a critical discourse framework focussing on their use of terms relating to social determinants. Analysis revealed that the understandings of social justice concepts vary across Australia and are generally apolitical, belying core concerns inherent in a social determinants understanding. Such differentiation bears recognition by reformers seeking to implement national consistency. This paper also considers how health professionals might become aware of their own cultural enmeshment in neo-liberal frameworks of understanding, recognising a social determinants framework as counter-cultural and hence requiring radical thinking.

Additional keywords: health justice, health outcomes, health reforms, new public management.


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