The conditions in which people are born, grow, live, work and age, influence their health and wellbeing. In Victoria, the higher your income and education level, the better your health tends to be. People on low incomes, people in rural areas and Aboriginal people, on average, have poorer health, die earlier and receive less health care than other Australians. Therefore VCOSS adopts a social determinants of health approach to health and wellbeing that focuses on creating positive living and working conditions and an environment for good health as well as providing support and services for people with poor health and chronic disease. We advocate against barriers in the health system that lead to people having poorer health, and we work towards equitable access to income, education, secure housing and employment as some of the factors that correlate strongly with good health.
VCOSS provided a submission to the Health 2040 discussion paper that articulates our vision for the future of the health system. We envision a system where health is everyone’s business and the focus is on preventing illness and ensuring all Victorians can achieve and maintain good health. Health policy and planning cannot be confined to the health care system, and particularly not to the medical and acute care system. It must be the business of local government, employers, schools and the whole of government.
The submission also highlights the important but sometimes unrecognised role of the community sector in the health system. The community sector works to engage marginalised communities and individuals, address the social determinants of health, deliver healthcare services directly and build community resilience that protects against and prevents poor health.
The submission suggested the following principles should guide health reform in Victoria:
- ensure equitable access for all Victorians
- address health inequities
- prioritise prevention and early intervention
- encourage place based solutions to local needs
- co-design with consumers, carers and families
- build resilient communities.
The discussion paper identified the following priority areas for reform:
- a person-centred view of healthcare
- preventing and treating chronic disease
- improving people’s health outcomes and experience
- improving the way the system works
- better health for people in rural and regional areas
- valuing and supporting our workforce
As well as making recommendations about these identified priority areas, the VCOSS submission also recommended including a priority area to address health inequity by identifying and targeting measures to improve the health of priority population groups.
Aboriginal and Torres Strait Islander people, people from culturally and linguistically diverse (CALD) backgrounds, lesbian, gay, bisexual, transsexual and intersex people (LGBTI) and other vulnerable population groups, often experience poorer health outcomes and additional barriers to accessing services compared to the general population. Growth and development during a child’s early years has consequences for their wellbeing throughout life. Young children should be included as a priority population.
The health system should be structured so as to promote good health outcomes for all Victorians, regardless of their social or economic circumstances, and to correct health inequities. This requires targeted measures for those people who are the most vulnerable and at-risk, and to decouple the link between poor health, poverty and disadvantage.
VCOSS looks forward to engaging with the Victorian government further as our shared vision for the health system continues to develop.