Reducing Health Inequalities in Riverlands

This report highlights the significance of addressing health inequities in Riverlands, which mirror broader social inequalities. Local authorities can implement benefits schemes to reduce economic disparities, potentially influencing health inequalities. The report reviews various studies and reports on health disparities and their impact on wellbeing.

Running head: HEALTH INEQUALITY AUDIT REPORT 1
Health Inequality Audit Report
Name
Institutional Affiliation

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HEALTH INEQUALITY AUDIT REPORT
Table of Contents
Executive Summary..................................................................................................................................3
Introduction...............................................................................................................................................5
Health Inequalities....................................................................................................................................7
Gender Wellbeing Inequities.......................................................................................................7
Lifestyle Inequalities....................................................................................................................8
Socioeconomic Health Inequalities..............................................................................................9
Geographic Health Inequalities..................................................................................................11
Recommendations...................................................................................................................................12
Conclusion...............................................................................................................................................13
Glossary...................................................................................................................................................14
References...............................................................................................................................................15

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Health Inequality Audit Report
Executive Summary
Health is the ability of a person, family or community to appreciate the motivations and
fulfill the necessities to survive in a given environment. Moreover, health is not only the
nonexistence of a disease but also the state of general psychological, physical and societal well-
being. Factors such as environment, gender, age, economic and lifestyle greatly influence the
general wellbeing, consequently instigating health inequalities.
Health inequalities are the systematic differences in various aspects of health across
population groups that can be defined as social, economic, demographical or geographical.
Social status and income, literacy level and education, employments and working conditions are
some of the social determinants of health. There is compelling evidence that when these social
determinants are properly dealt with, health inequity will be a thing of the past in Victoria.
Health inequalities had probably not been a main concern in the Department of Health.
Nevertheless, the country has acknowledged the importance of reducing the inequities in health;
thus the government is currently undertaking a commendable work through the Ministry of
Public Health and National Health Services (NHS). Therefore, we conducted an audit of health
inequities in various local zones to collect evidence of health inequities in the identified areas.
The main aim of health equality audit conducted was to find out how fairly the health services
and other health-related resources are distributed considering health requirements of different
subzones and people in River lands.
We as resident in Victoria must have a role in encouraging health equity and
discouraging health inequalities with every approach or mechanism available. Notwithstanding
of the methods of measuring health, either by means of usage, need and accessibility of services

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or risk factors or outcome, we find out that specific groups of people are always disadvantaged
regarding health. In the audit, we have found out that there is a healthy relationship between
socioeconomic and health. People in poor socioeconomic status in term of occupation, education,
income are more likely to experience poorer health than those who are slightly in a better
socioeconomic status.
Addressing these socioeconomic, cultural, age, gender, and geographical health
inequalities need a population health process that embraces impacts on the wellbeing as well as
the approach on the techniques that should be undertaken for the improvement of general
wellbeing. The principles of health equity must be adhered to in any kind of actions involved in
with the aim that those activities aid in reducing inequalities in health. The recommended
framework for intervention involves developing and executing approaches in four phases
(VicHealth, 2004). First phase being structural; where the causes of disparities in health such as
social, cultural, economic and historical aspects are tackled. Second phase being Intermediate
paths; where psychosocial, elemental or behavioral aspects which facilitate the effect of a
structural element on healthiness inequalities are put into consideration. Third phase being health
and disability services; where certain activities within disability services and health are
undertaken. Finally, the fourth phase being impact; where the influence of incapacity and ailment
on socioeconomic status is minimized.
Moreover, WHO (2017) encourages an inter-sectorial approach that necessitates a
particular line of action at different phases of policymaking. WHO (2017) works with the
Member States with the aim of building and sustaining their institutional and human capacities.
This allows health inequities to be solved through particular lines of action, comprising of review
of public health policies, facilitation, and training.

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The government of victoria has health policies that address gender, vulnerable groups,
local level governance, and subnational governance. These policies ensure that inequalities in
health are reduced to bare minimum if they are appropriately implemented. The systems will
promote gender equity, improve the health of vulnerable individuals, and strengthens local and
subnational government.
Introduction
Health inequalities are widespread all over the world. This report provides a perfect
synthesis of the health inequality audit carried out in Riverlands that was divided into 15
subzones. According to HM Treasury (2002) about the Cross-Cutting Review on Health
Inequalities, the obligations of the government were stipulated to minimize inequities in the
health sector and recognize that sustainable action on the broader contributing factors of health
inequities is necessitated if the generation cycle of poverty and health is to be shattered.
National policy and strategy indicate a collection of clarifications and interpretations of the
meaning of tackling health inequities (Graham, 2002).
This report discusses four significant determinants of health inequities in Riverlands.
These contributing factors are general socioeconomic and environmental conditions, gender,
ethnic identity, and geographic place of residence. For instance, general socioeconomic and
environmental conditions, that is, the status people have in the society regarding education and
incomes can affect the ability of a person to access health services (HFA, 2000).
In this report, health inequity is conveyed in three ways:
i. Utilization of health services: - where the rehabilitation, prevention and
treatment measures are put into consideration.

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ii. Health outcomes: - where the mortality (life quantity) and morbidity (life
quality) are considered.
iii. Health risks: - where behavioral, biological and environmental factors are
considered.
Taking into consideration the failure to minimize inequalities in the health sector, we
decided to carry out an audit in Riverlands, primarily to identify what more the local government
could ensure to improve the outcome. Our focus was the input the NHS and Department of
Health have made in securing health equity. The following were our terms of reference:
i. Whether the Government, through the Ministry of Health, has met its
public service targets in respect to health inequalities in Riverlands;
ii. The accomplishment of NHS organizations to co-coordinate activities with
local authorities of Riverlands and other relevant organization in handling the issue of
disparities;
iii. The efficiency of the Department of Health in co-coordinating policies and
strategies with the local government departments, in an attempt at minimizing health
inequalities;
iv. The quality and distribution of GP services and their impact on health
inequalities, and how the outcome and quality structure might be applied to reduce
disparities in the health sector;
v. The efficiency of public health services in minimizing health inequalities
by aiming at the leading causes of disparities such as smoking in local areas; and
vi. Whether the Government, through the Ministry of Health, has met its
public service targets in respect to health inequalities in Riverlands.

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Health Inequalities
Health inequities in Riverlands society are documented in several aspects. Health and
other relevant agencies usually collect health statistics, and available in a range of source
documentations which we immensely relied on. There are limitations in the available data
regarding methods of collections, interpretation, and quality. However, regardless of the
restrictions, the information evidently indicates health inequalities across the subzones of
Riverlands in the stated measures: gender, socio-economic status, cultural uniqueness, and
geographical dwelling place.
Gender Wellbeing Inequities
Both gender and sex impact the disparities in health outcomes of women and men. Sex is
the biological differences recognized between women and men, while gender is the social
classification that describes the cultural and social structure of masculinity and femininity in the
social order, indicating the difference in allocating supremacy and resources (Ostlin, 2002).
Gender inequalities cause particular morbidity and mortality suggesting that the
involvements with the aim of minimizing differential wellbeing amongst men should have a
focus distinct from interventions that reduce women health inequalities (Smith et al., n.d.). The
gender health inequalities in outcomes are as a result of differential gender risk factors, for
instance, differential labor exposure segregation both at home and workplace, and the difference
in accessing economic and social resources. The health of both women and men is affected by
gender policies and gender roles. Awareness programs need to be established in Riverlands to
sensitize the influence of roles which expose gender to health hazards, utilization of available
health services and health outcomes.

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Averagely in Riverlands, men have shorter life expectancy than women. Differences in
gender health are illustrated in figure 3 below.
Figure 1: Gender well-being inequalities on SF36 Scales
General Health
Mental Health
Physical Functioning
Role Physical
Role Emotional
Social Functioning
Vitality
Body pain
0
10
20
30
40
50
60
70
80
90
Male
Female
Measures of Gender Health Inequality (SF Scales)
Mean Scale Scores
Source: Australian Medicare Locals Atlas PHIDU (2011)
Lifestyle Inequalities
The lifestyle factors which impact inequalities in health are also referred to as the
‘proximate’ causes of inequalities in health since they are the direct originators of illnesses as
opposed to the ‘broader determinants ‘such as socio-economic factors (Kristenson, 2006). These
factors are smoking, nutrition, exercise, alcohol consumption, drug use, and sexual behavior. In
Riverlands, the statistic shows that higher percentage of men smoke than women.

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Figure 2 indicates the level of smoking among adults in the subzones of Riverlands.
Amongst male adults, daily cigarette smoking varies from an estimate of 22% in Subzone 01 to
45% in Subzone 14. Females recorded the lowest and highest percentage in cigarette smoking;
12% in Subzone 01 and 27% in Subzone 14 respectively.
Figure 2: Percentage of adults smoking in Riverlands
Subzone 01
Subzone 02
Subzone 03
Subzone 04
Subzone 05
Subzone 06
Subzone 07
Subzone 08
Subzone 09
Subzone 10
Subzone 11
Subzone 12
Subzone 13
Subzone 14
Subzone 15
0 5 10 15 20 25 30 35 40 45
Female
Male
Percentage of the Population Smoking (%)
Sub-zones of Riverlands
Source: Australian Medicare Locals Atlas PHIDU (2011)
Socioeconomic Health Inequalities
Health and possibilities of untimely deaths are caused by socioeconomic factors
prevailing throughout the life and across the generation (Davey-Smith et al., 1997). Therefore,
health in the middle or old age is subject to the previous socioeconomic status along with the
current situation. In Riverlands, the subzones have registered a group of people with low level of

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education. This always results in underpaid jobs which are vulnerable and expose them to
chemical and physical menaces, and inadequate housing.
There are several reasons behind the social-economic disadvantaged people in these
zones to less likely embrace the beneficial health demeanors (Marmot & Bell, 2013). First, the
relevant information as a guide on how they should healthily behave is not reaching them.
Moreover, they lack the necessary resources that can enable them to live healthily, furthermore,
the environment (swampy and infested with mosquitoes) where they live negatively affect their
health. It is also apparent that demeanors such as smoking are characterized and more inbuilt in
those people with low socio-economic status.
Figure 3: Unemployment rate per subzone of Riverlands
Subzone 01
Subzone 02
Subzone 03
Subzone 04
Subzone 05
Subzone 06
Subzone 07
Subzone 08
Subzone 09
Subzone 10
Subzone 11
Subzone 12
Subzone 13
Subzone 14
Subzone 15
0
5
10
15
20
25
30
Unemployment Rate in Riverlands
Unemployment Rate (%)
Source: Victorian Department of Health (2012)
Figure 1 above shows the employment rate in Riverlands. Subzone 10 records the lowest
rate of unemployment of 10% among females and 11% among males. Subzone 04 marks the
highest percentage of unemployment of 25% among females and 23% among males. This

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scenario explains the inequalities in health across the subzones which are as a result of
unemployment. In every Subzone, females recorded lower percentage compared to males.
Geographic Health Inequalities
Where people live, place of residence plays a significant role in creating health
inequalities. It is the physical, local and social environments of the people. The acknowledged
characteristics of people’s place of residence that create inequalities in health are (Pearce,
Mitchell, & Shortt, 2015):
 The difficulty in accessing the place for the health services to be provided;
 The difficulty in accessing the place for educational facilities, employment and
societal activities;
 An unavailability of food choices which are healthy and affordable;
 Lack of safety factors on roads, lack of recreational facilities, and the shortage of
public transport systems; and
 Lack of suitability and better quality of the housing stock.
Some zones in Riverlands that are poverty-stricken experience features that make them
unhealthier compared to those who live in wealthier zones. Therefore, life expectancy in
poverty-stricken subzones is lower compared to the life expectancy of those people in wealthier
subzones. Moreover, some subzones in Riverlands are very marshy denying the accessibility of
health services. Subzones within Riverlands have negative perceptions and low level of
cohesiveness with other subzones making it difficult for health services to be provided equally.
Figure 4 indicates that subzone 09 has a longer life expectancy at birth compared to other
subzones. Moreover, females generally have a longer life expectancy at birth than males as
illustrated in figure 4.

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HEALTH INEQUALITY AUDIT REPORT
Figure 4: Life Expectancy at Birth in Subzones of Riverlands
Subzone 01
Subzone 02
Subzone 03
Subzone 04
Subzone 05
Subzone 06
Subzone 07
Subzone 08
Subzone 09
Subzone 10
Subzone 11
Subzone 12
Subzone 13
Subzone 14
Subzone 15
0
10
20
30
40
50
60
70
80
90
Male
Female
Subzones of Riverlands
Life Expectancy at Birth (Years)
Source: Victorian Department of Health (2012)
Recommendations
The Australian government should bring into notice national indicators particularly to
observe and control the progress of minimizing inequalities in health both nationally and locally.
Besides, NHS together with Australian government should assess the geographical spread of
primary care services to make sure that the requirements related to higher deprivations levels are
sufficiently resourced.
Furthermore, the NHS boards and councils should ascertain things that they jointly
employ in reducing inequalities in health sector locally, and work together to make sure that the
targeted resources are those resources with the highest demand. The NHS should as well observe

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and control the usage of hospital services by the diverse group of people, and apply the gotten
information to find out whether a particular line of action is necessary to help a specific group of
people to access health services.
Conclusion
All the evidence indicated an apparent relationship between deprivation of socio-
economic, poverty, and higher levels of morbidity and shorter life expectancy. Health inequities
mirror broader inequalities that result from the social divisions in our societies (Jelfs, 2016).
There are measures that local authorities of Riverlands can take through benefits schemes to aid
in reducing economic disparities which eventually would influence iniquities in health. The
existent of health inequalities in Riverlands is indicated by various indicators of the state of
wellbeing: morbidity, mortality, and life expectancy.

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Glossary
Acronyms and terms used in the report
ABS Australian Bureau of Statistics
GP General Practice
NHS National Health Service
SF36 This is a measure of health status
WHO World Health Organisation

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References
Australian Bureau of Statistics (2011). 3218.0 Regional Population Growth (2001-2010),
Australia.
Davey-Smith G, Hart C, Montgomery S. 1997. Lifetime Socioeconomic Position and
Mortality.Prospective Observational Epidemiology. British Medical Journal 314: 547–52.
Department of Health (2011). The health and wellbeing of Aboriginal Victorians: Victorian
Population Health Survey 2008 Supplementary report, State Government of Victoria,
Melbourne.
Graham, H. (2002) ‘Tackling inequalities in health in England: remedying disadvantage,
narrowing gaps or reducing gradients?’ Internal discussion paper. Health Development
Agency, London.
HFA. (2000). Striking a Better Balance: A Health Funding Authority response to reducing
inequalities in health. Wellington: Health Funding Authority.
HM Treasury (2002) The Cross Cutting Review on Health Inequalities. Summary Report. HM
Treasury, London.
Jelfs, P. (2016). The Australian Bureau of Statistics’ Aboriginal and Torres Strait Islander
enumeration and engagement strategies: challenges and future options. Indigenous Data
Sovereignty. doi:10.22459/caepr38.11.2016.15

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Kristenson, M. (2006). Socio-economic position and health. Social Inequalities in Health, 127-
152. doi:10.1093/acprof:oso/9780198568162.003.0006
Marmot, M., & Bell, R. (2013). Socioeconomically Disadvantaged People. Social Injustice and
Public Health, 21-41. doi:10.1093/med/9780199939220.003.0002
Ostlin P. 2002. Gender perspecitive on socioeconomic inequalities in health. In J Mackenbach,
M Bakker (eds). Reducing Inequalities in Health: A European perspective. London:
Routledge Press.
Pearce, J., Mitchell, R., & Shortt, N. (2015). Place, space, and health inequalities. Health
Inequalities, 192-205. doi:10.1093/acprof:oso/9780198703358.003.0014
Public Health Information Development Unit, Medicare Locals Instant Atlas, University of
Adelaide
Smith, G. D., Hart, C., Upton, M., Hole, D., Gillis, C., Watt, G., & Hawthorne, V. (n.d.). Height
and risk of death among men and women:. Health inequalities, 233-250.
doi:10.2307/j.ctt1t8955q.27
VicHealth (2004). The Health Costs of Violence. Measuring the burden of disease caused by
intimate partner violence. VicHealth, South Carlton.
Victorian Department of Health (2012). Mornington Peninsula (S) and Frankston (C) 2011.
Local Government Area Profiles, Modelling, GIS and Planning Products Unit,
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World Health Organization (2017) ‘Gender, equity and human rights’,
http://www.who.int/genderequity-rights/understanding/gender-definition/en/