Pillar 4: A health system for all

4.1: Reduce health inequities by addressing underlying social and other determinants of health, thereby improving the overall health and well-being of the population in Australia.

Refer to the AMA Social Determinants of Health position statement for more details.
 

• Establishment of a cross portfolio ministerial body to consider and provide advice on policies that may impact on health outcomes equity.

• Establishment of the ministerial body.
• Improvements in policies that impact health outcomes and equity.

• All governments take a proactive role in addressing the social determinants of health through:
  • establishment of a baseline and realistic key performance indicators
  • sophisticated monitoring, reporting and publishing on progress to expose areas of inequality
  • conducting health equity assessments of relevant policies.
     

• National ongoing monitoring, reporting, and publishing on progress in reducing health inequities. 
• Regular health equity assessments of policies.
• Reduction in heath inequities. 

• Improvements in health literacy and education, with a focus on priority groups. 

• Implementation of educational campaigns and programs. 
• Increase in health literacy rates among the population. 

• Improve access to affordable and appropriate housing and nutritious foods, regardless of participation in paid employment, and investment in measures that support retraining and re-employment for those who are affected by underemployment or unemployment.

• Reduction in health issues related to inadequate living standards. 
• Increase in employment participation rates. 

• Recognition of the contribution of the social determinants of health as they apply to harmful product use (such as tobacco, junk foods and gambling), including investment in interventions that seek to reduce their impact as opposed to reliance.

• Implementation of interventions to address root causes of harmful product use. 
• Increase in individuals accessing support services for harmful product use.
• Reduction in harmful product use.

• Undertake revision of the jurisdictional challenges to providing healthcare services to those in custody.
• Highlight the need for continuity of care post-release from prison.
   

• Increase in healthcare services available in custodial settings.
• Reduction in preventable physical and mental illnesses, as well as deaths, among incarcerated individuals.
   

• Meaningful input from Aboriginal and Torres Strait Islander peoples in all policies, service delivery, and evaluations of Aboriginal and Torres Strait Islander health.

• Ongoing incorporation of Aboriginal and Torres Strait Islander perspectives and knowledge into policy development and decision-making processes.

• Aboriginal and Torres Strait Islander peoples are represented across hospital and health service governance and leadership.

• Increase in the number of Aboriginal and Torres Strait Islander peoples in governance and leadership roles.

• Full implementation of the National Agreement on Closing the Gap, the National Aboriginal and Torres Strait Islander Health Plan 2021–2031 and other supporting plans, with a commitment to long term (10+ years) needs-based and coordinated cross-sectional funding by all governments.

• Progress in achieving the priority reforms outlined in the National Agreement on Closing the Gap.
• Progress in achieving the recommendations in the National Aboriginal and Torres Strait Islander Health Plan 2021–2031 and other supporting plans.
• Comparable health outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

• Investment in Aboriginal and Torres Strait Islander-led data development at the local level and uphold the principals of Data Governance and Sovereignty by empowering communities and individuals to access place-based data to design community-driven initiatives.

• Development of local Aboriginal and Torres Strait Islander-led data systems.
• Increase in data accessibility for communities. 

• Development of an Aboriginal and Torres Strait Islander-led research agenda for health and wellbeing, prioritising the acknowledgement of the impacts of systematic racism in all health systems. This should include an investment in knowledge translation and research impact.

• Identification and funding of research priorities by Aboriginal and Torres Strait Islander communities.
• Increase in research projects focused on the impacts of systemic racism.

• Proactive engagement and partnership with Aboriginal and Torres Strait Islander organisations, including the Australian Indigenous Doctors’ Association and the National Aboriginal Community Controlled Health Organisation.

• Increase in collaborative projects with Aboriginal and Torres Strait Islander organisations.
• Positive feedback from Aboriginal and Torres Strait Islander organisations on the effectiveness of partnerships. 

• Improved integration within the broader care sector to facilitate seamless coordination between aged care, disability services, and healthcare, including:  
  • mechanisms to support team-based care, collaboration, and continuity of care
  • technology that facilitates data sharing and interoperability between care settings
  • funding models that support integration and collaboration
  • regular reporting to identify opportunities to improve the delivery of streamlined and patient-centred care.
     

• Increased adoption of team-based care models and continuity of care.
• Increased adoption of technology that facilitates data sharing and interoperability.
• Reduction in duplicated tests and procedures.
• Reduction in medication errors. 
• Ongoing reporting on care coordination and health outcomes. 
• Increase in formalised partnerships or agreements between healthcare settings. 
• Improvements in quality of life for residents in aged-care facilities and people living with disabilities. 

• Improved incentives to encourage healthcare professionals to deliver care in the aged-care and disability sectors, as outlined in the AMA research report Putting health care back into aged care. 

• Increase in healthcare professionals working in aged-care and disability sectors.

• Urgent implementation of the outstanding recommendations from the Royal Commission into Aged Care Quality and Safety.

• Significant progress in implementing recommendations from the Royal Commission into Aged-Care Quality and Safety.

• A tax on sugar-sweetened beverages that raises the retail price by 20 per cent, as recommended by the World Health Organization. See AMA report A sweet deal: the case for taxing sugar-sweetened beverages.

• Implementation of a tax on sugar-sweetened beverages.
• Reduction in the amount of sugar consumed through sugar-sweetened beverages.
• Change in purchasing behaviour towards healthier alternatives. 
• Reduction in obesity rates and related health conditions.
   

• Banning the promotion of junk food products to children through advertising and marketing channels.

• Reduction in exposure of children to junk food advertising.
• Changes in sales of junk food products.
• Improvement in children’s knowledge of healthy eating. 

• World-leading policies to tackle nicotine addiction and prevent new harmful products from entering the market.

• Improvement in children’s knowledge of the long-term health consequences of nicotine addiction.
• Reduction in smoking-related diseases.
• Social disconnection between nicotine containing products and acceptability.
• Improved nicotine cessation tools.

• A complete ban on all online gambling advertising and sponsorship.
• An independent regulator to coordinate a national and consistent regulatory response to protect Australians from the harms of gambling.

• Reduction in exposure to online gambling advertisements.
• Change in online gambling revenue.
• Reduction in problem gambling rates and gambling-related harm indicators (e.g. mental health issues).
• Establishment of an independent regulator.

• Education and awareness on the health impacts of online materials.
• Independent regulation of online materials that present a risk to health. 
   

• Increase in public awareness of the health risks associated with online materials.
• Increase in the number of educational campaigns and programs.
• Changes in online behaviour towards healthier choices.
• Reduction in harmful online behaviours.
   

• Increase fees under the Department of Veterans’ Affairs schedule to ensure continued access to care.
• Improve equity and access to supports for Australia’s veterans.

• Increase in the number of veterans able to receive care without financial barriers.
• Increase in the number of healthcare providers who accept veteran patients. 

• Funding models that support the viability of health services operating in regional, rural, and remote areas.
  • Dedicated funding and resources for rural health services that support the provision of high-quality facilities, access to diagnostic services, and workforce attraction and retention. 

• Reduction in closures of regional, rural, or remote health facilities.
• Increase in services offered by regional, rural, or remote health facilities.
• Increase in healthcare providers recruited or retained in regional, rural, or remote areas.
• Reduction in wait times for appointments or services in regional, rural, or remote areas.

• Develop and evaluate rotational commuting workforce models of service delivery (e.g. fly-in-fly-out) that meet the health needs of rural communities and support healthcare professionals who provide regular services to communities through these models.

• Implementation and evaluation of rotational commuting workforce models of service delivery.
• Increase in the number of healthcare professionals participating in rotational commuting workforce models.
• Increase in the healthcare services provided through rotational commuting workforce models.
• Reduction in healthcare professional burnout or turnover in regional, rural, and remote areas.
   

• Continued improvement of mobile and broadband coverage and performance in rural areas to support new and innovative models of care. 

• Increase in telemedicine and telehealth usage.
• Increase in the number of healthcare facilities with reliable internet access.
   

• Support for rural health services to integrate new technologies and capabilities.

• Increase in adoption of new technologies in regional, rural, and remote healthcare facilities.
• Increase in remote diagnostic capabilities.
• Reduction in patient transfers to urban centres.