Fixing health—why housing and income policy must be part of the mix

Australian Election 2019 — Equity
Tuesday, April 23, 2019

‘All parties must factor equity into their post-election healthcare plans and promises’, Australian Healthcare and Hospitals Association Chief Executive Alison Verhoeven said today.

‘While Medicare, our universal healthcare scheme, is aimed at making healthcare affordable for all, health equity doesn’t get the same attention. And as reported by the Commonwealth Fund in its health performance rankings for 11 major countries, while Australia’s health system is ranked #2 overall, on equity we don’t do so well, ranked #7 after the UK and several European countries.

‘The causes of health inequity lie in the conditions in which people are born, grow, work, live, and age. For example, on the current Newstart allowance less than $40 a day, ability to be housed safely, eat healthy food and thrive is severely compromised and must be addressed. Housing conditions, family dysfunction, water quality and even bureaucratic barriers to useful assistance can also affect health’, Ms Verhoeven said.

‘Fixing social disadvantage makes a difference to health outcomes—for example, in reducing world childhood death rates, the World Health Organization estimates 50% of the reduction has been due to non-health-sector investments.

‘One notable example of people experiencing multiple layers of disadvantage is Aboriginal and Torres Strait Islander end-stage kidney disease (ESKD) patients in remote areas of the Northern Territory (NT).

In an AHHA issues brief released today, Improving access to housing for Aboriginal and Torres Strait Islander renal patients with complex care needs, Deeble Institute Jeff Cheverton Memorial Scholar, Stefanie Puszka outlines why housing and income policy changes needed to improve health outcomes.

‘These patients have ESKD rates 15 times those of non-Indigenous Australians. To obtain lifesaving dialysis treatment and manage other complications, 80% have to relocate from their remote communities to urban areas. But after 8 weeks of temporary accommodation provided by the NT government, patients are expected to make their own arrangements.

‘They then find they have nowhere to stay that’s affordable, accessible and culturally safe. Sometimes they are kept in hospital when accommodation cannot be found, leading to delays for other patients.

‘The waiting time for a one-bedroom public housing unit in Darwin is 8 years—longer than the average survival time for these ESKD patients (6 years). Even with priority access on medical grounds, the wait is still 3–4 years. And public housing demand continues to grow faster than supply.

‘Renal patients are unlikely to be able to work. And it is common for them to wait for up to 6 months, sometimes over a year, to get their applications for the Disability Support Pension approved by Centrelink.

‘With no income and nowhere to stay, these patients and their carers are at severe risk of homelessness and may return to their communities and high risk of an early death.

‘Our Issues Brief makes several practical recommendations for housing and income support which will improve health equity in this situation,’ says Alison Verhoeven.

‘We call on all parties to take a broad view of health as they sharpen their health policies during this election campaign.’

To follow AHHA commentary throughout the election campaign, visit www.ahha.asn.au/election. You can also follow our #AusVotes2019 #AusVotesHealth commentary on Twitter by following @AusHealthcare. The issues brief is available here.

Media enquiries:  Dr Chris Bourke, Strategic Programs Director, AHHA, 0418 869 443