In my research about
the public health system I have come across some interesting statistics that I
want to share with you and these statistics will help answer my question.
OECD and WHO statistics show us that the bigger the income differences in a society the
bigger the difference between society’s health (Denton, 2003; OECD, 2011; Peacock, Devlin, McGee, 1999; Wilkinson, 2011). For example, in New Zealand the gap between rich and poor
is large and the corresponding statistics on the health of the population is
similarly large.
On the flip side
of these statistics are countries, such as Sweden and Japan, who have
smaller gaps between the rich and poor and as a result the differences in the
health of the population are a lot less noticeable (OECD, 2011; Wilkinson, 2011).
When I first saw
this graph on a TED talk by Richard Wilkinson (2011) I was stunned, New Zealand is fifth
on the graph of countries whose health is worse because of the income
inequities. This was a real surprise for
me. Considering that we have a public
health system that is, in theory, available to all, how can we possibly be in
such a negative position in the statistics.
Why are there
links between the differences in incomes and the differences in the health of
the population? What causes health inequalities?
These are not
simple questions to answer; it is as complex as the private versus public funding
of health. Have I got the scope to
answer this question in this blog? Probably not, but I will try.
One belief about
why there are health inequalities is because “health is generally not high on
the political agenda. Policy and planning are heavily influenced by a few elite
groups who are least affected by health inequalities” (Prinja & Kumar, 2009,
para. 2).
A report written for the Ministry of Social Development tells us that in New Zealand the links between low incomes and poor health are because of
A report written for the Ministry of Social Development tells us that in New Zealand the links between low incomes and poor health are because of
- lack of money for medicines,
- lack of good and healthy food,
- lack of education,
- the neighbourhood you live in,
- poor household conditions – cold and damp houses and
- overcrowding
(Baker et al. 2000; Cheer et al. 2002; Crampton et al. 1997;
Ellaway et al. 2001; Howden-Chapman et al. 2007; Lochner et al. 2003; McCulloch
2001; McNicholas et al.2000; Waldegrave et al. 2004; as cited in Carroll,
Casswell, Huakau, Howden-Chapman & Perry, 2011).
How does the
payment of the health affect lower income families and their children? In New
Zealand, I feel that we measure up pretty well, compared to some countries, however, I think we have a long way to go before we measure up
to countries like Sweden or Japan. The
public health system is accessible to all New Zealanders, no matter their
income, but they must first have the ability to access the services the government
has put in place for them.
My next blog is going to look at current New Zealand child health policies and what governments have done in the past to ensure that children are benefiting from the public health system.
References:
Carroll, P.,
Casswell, S., Huakua, J., Howden-Chapman, P., & Perry, P. (2011). The
widening
gap: Perceptions of poverty and
income inequalities and implications for health and
social outcomes. Social Policy Journal of New Zealand: Te Puna Whakaaro. Retrieved from
Deaton, A.
(2003). Health, Income and Inequalities. Retrieved from
OECD (2011). An
overview of growing income inequalities in OECD countries: Main
Findings. Retrieved from http://www.oecd.org/els/soc/49499779.pdf.
Peacock, D., Devlin, N., & McGee, R.
(1999). The horizontal equity of health care
in
New Zealand. Australian and New Zealand Journal of Public
Health.23.(2).:126-130. Retrieved from
Prinja, S &
Kumar, R. (2009). Reducing health inequalities in a generation: A dream or a
reality? Retrieved from http://www.who.int/bulletin/volumes/87/2/08-062695/en/.
Wilkinson, R. (2011, July). How economic
inequalities harm society. [Video
file]. Retrieved from http://www.ted.com/talks/richard_wilkinson.html.
Angie, another insightful blog post. It was shocking to see how high New Zealand is on the income inequality scale, and the significant impact that this has for child welfare. It would be interesting to compare the income inequalities with government policies to see if these contributed to or reduced the inequalities. I was interested to read that health inequalities may be caused by government policies and education. It seems to me that the current National governments neoliberal approach is trying to put more of the responsibility for education on each institution, so will this cause increasing differences in health care? As a public health system user, i feel that there definitely is a difference in care between public health care and private health care. And the health system works fine when you are able to access it quickly and successfully, however i found that it is on each individual to really fight for their position in the public health system which some people have not got the ability to do. I know i had to push hard to get the public health system to notice me and my condition, so i question the effectiveness for people who do not have the courage to stand up for their health, or feel that it is too hard or not important. Who will stand up for these people in the public health system? And who will stand up the children as well? Sorry for rambling :-) Debra
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