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

Explaining health inequalities in Australia: the contribution of income, wealth and employment

Joanne Flavel https://orcid.org/0000-0003-3228-7192 A B * , Martin McKee C , Fisaha Haile Tesfay D , Connie Musolino A B , Toby Freeman https://orcid.org/0000-0002-2787-8580 A , Helen van Eyk https://orcid.org/0000-0002-8573-4235 A and Fran Baum A
+ Author Affiliations
- Author Affiliations

A Stretton Health Equity, Stretton Institute, University of Adelaide, Adelaide, SA 5005, Australia.

B College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia.

C Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.

D Deakin University, Institute for Health Transformation, Melbourne, Vic. 3125, Australia.

* Correspondence to: joanne.flavel@adelaide.edu.au

Australian Journal of Primary Health 28(6) 474-481 https://doi.org/10.1071/PY21285
Submitted: 2 December 2021  Accepted: 13 June 2022   Published: 13 July 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background: Studies show widespread widening of socioeconomic and health inequalities. Comprehensive primary health care has a focus on equity and to enact this requires more data on drivers of the increase in inequities. Hence, we examined trends in the distribution of income, wealth, employment and health in Australia.

Methods: We analysed data from the Public Health Information Development Unit and Australian Bureau of Statistics. Inequalities were assessed using rate ratios and the slope index of inequality.

Results: We found that the social gradient in health, income, wealth and labour force participation has steepened in Australia, and inequalities widened between the quintile living in the most disadvantaged areas and the quintile living in the least disadvantaged areas.

Conclusion: Widening income, wealth and employment inequalities have been accompanied by increasing health inequalities, and have reinforced and amplified adverse health effects, leading to increased mortality inequality. Effective comprehensive primary health care needs to be informed by an understanding of structural factors driving economic and health inequities.

Keywords: Australia, economic inequality, health equity, health inequalities, social class, social determinants of health, social gradient, socioeconomic factors.


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