Who Gets To Be Healthy? 'Social Determinants Of Health' Can Reduce Inequities, But Many Policies Neglect Them

“Social determinants of health” is a great way to express a simple idea: a person's health depends not only on what they eat or do, but also on social factors.

These include:

• access to education (including early childhood education)
• Your parents entered
• Buy fresh fruits and vegetables
• Access to good housing and health care
• When a child or his family is discriminated against.

Researchers and policy makers increasingly recognize that addressing the social determinants of health is key to ending inequality in Australia.

And in childhood, these factors begin to greatly influence a person's life path.

However, this increased awareness of how social factors affect children's health is not always reflected in policy.

Our research, published by BMC Public Health, includes an analysis of 26 Australian educational health and safety policy strategies. Only 10% responded to social determinants of health.

It's worrying. If the social determinants of health are not addressed, the damage will multiply infinitely.

What did we do and what did we get

Our research includes analysis of 26 national and state strategic policies for health and safety in education:

We selected these policies by reviewing the strategic policies of all federal and provincial/territorial health agencies and selecting key education safety policies written since 2009.

We have chosen policies for Children and Adolescents, Pediatrics and Adolescents, Adolescent Health or Family and Education that include the heading Safety.

We also selected government policies that included a general chapter or section on child and adolescent health issues and health promotion or disease prevention policies.

What we got was disappointing. About 10% of the 26 policies we reviewed addressed social determinants of health.

And while Australian governments widely recognize the need to address the social factors that contribute to health and leave behind certain groups of children, there is a flaw in the acute care system.

In other words, in solving problems after children become ill, we focus on solving the problems rather than looking at what needs to be done to prevent the problems in the first place.

The most vulnerable children are the ones who are brought most often to the emergency room. To solve this problem, we must work on social issues that we know will make conditions fairer for all children.

good news

The good news is that we've seen Australian policymakers pay attention to some social health issues. Example:

Early Childhood and Education: Many interventions focus on the first 1,000 days of a child's life and the various stages of education. This is good news because we know that if children engage early in childcare, kindness, and education, they will have better health outcomes later in life. Several policies also suggested strategies for out-of-school children.

Parents' working conditions: The policies we analyzed recognize that parents' working conditions contribute to children's health. However, there is still work to be done in this area. An often overlooked area is the need for affordable child care.

Strong regulatory framework : A number of policies recommend that we consider child-friendly marketing near schools, playgrounds and daycare centers. This is positive, but we continue to see junk food sold to children across Australia, especially in the sports arena. We see opportunities for more regulation in this area.

Healthy spaces: We see that there are green spaces for children and families to play, and measures are being taken to ensure that cities are walkable and cycling friendly.

Housing: Some policies, especially for young people, are beginning to recognize that housing is essential to health and well-being. This is welcome, but there is also an opportunity to expand this area, because the living space is not suitable for many.

Involving children's voices: We are pleased that different policy areas recognize the importance of hearing the voices of children and youth in the policy-making process. This reflects the obligation enshrined in Article 12 of the United Nations Convention on the Rights of the Child, which clearly states: “Children have the right to have their views taken into account in matters affecting them.”

Mental Health: We welcome the strong link between the Department of Health and Education in the field of mental health. It can be a key component in dealing with the emotional distress experienced by some children and young adults.

Where do you go from here?

Our study is only a snapshot of policy, but provides a starting point for a broader discussion of how Australian policymakers can broaden their interest in social health issues.

We need a healthcare system that balances acute care with prevention . This will help achieve the goal of ensuring good health outcomes and a good start in life for all Australian children.

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Social determinants of health