Spring 2018

Income, inequality and health

Having the freedom to lead a life we have reason to value with dignity and respect is very unequally distributed in Australia. Such freedom comes from three basic things: sufficient material resources for a decent life, a sense of control over our lives, and participation in the policy decisions that affect the conditions in which we are born, grow, live, work, age and die.

People’s health and wellbeing are affected by these three things. The fact that they are so unequally distributed really matters for the health of people lower down the social ladder—for people living in poverty, people with disabilities, those living in housing stress, and many Indigenous Australians. We already have a society where the opportunity to live a long and healthy life is unequally distributed. The poorest 20 per cent of the population can still expect to die younger (six years on average) compared to the richest 20 per cent of the population.

Income inequity itself is bad for society and for people’s health and the gap between the poorest and the wealthiest will continue to widen if Newstart levels are not raised. This inequity reduces trust, self-worth, sympathy and community within societies, which gives rise to feelings of social exclusion, insecurity and stress. The health of people living on Newstart will also be affected through the loss of control over their lives that they will experience. This sense of a lack of control is a recognised stressor; it has, for example, been found to increase the risk of coronary heart disease by 50 per cent.

It does not have to be like this. These three things are influenced by public policy and the way in which society chooses to organise its affairs. Now is the time for organising—and organising around a goal—the society that we want. Imagine a time when we have macroeconomic policies that are designed to improve the lot of everyone, and economic growth becomes a means to an end rather than the end itself; a time when conditions of life—education, employment, housing, health care, disability care, aged care—support, nurture and enable everyone to flourish, regardless of their postcode, gender, abilities or colour.

Pursuit of such a vision requires changing the status quo. It requires challenging issues of power and redressing the inequities in income and resources and in people’s daily living conditions. This is not straightforward, given that some people and institutions benefit from the status quo. Harnessing political consciousness around a shared vision is important and can lead to transformative change. People like Martin Luther King and Nelson Mandela have shown how a clear, collective vision and collective hope can lead to emancipation.


Sharon Friel is Professor of Health Equity and Director of the School of Regulation and Global Governance (RegNet) at the Australian National University.

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