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Getting to the root causes of health problems: some local and international perspectives

As recently mentioned, there will be a health focus to a workshop on climate change in Melbourne this weekend that is being put on by the Green Institute.

One of the speakers is Senator Richard Di Natale, the Greens health spokesperson, who writes below that we need to focus more on the underlying causes of poor health.

On related themes, don’t miss this New York Times article which profiles an organisation working on the social causes of poor healt.  Health Leads trains about 1000 volunteers each year to staff resource desks in the waiting rooms of hospital clinics or health centers in Baltimore, Boston, Chicago, New York, Providence, R.I., and Washington.

At these sites, doctors now regularly “prescribe” a wide range of basic resources — like food assistance, housing improvements, or heating fuel subsidies — which the Health Leads volunteers “fill”, by applying their problem solving skills to identify resources anywhere they may be available.

Health Leads was co-founded by a Harvard University student, Rebecca Onie, in 1996 and up until a year ago, she thought that the organisation’s biggest obstacle would be getting doctors to pay attention to patients’ social needs.  But the organisation now gets so many referrals from doctors that it has waiting lists.

According to the report, Health Leads offers a model of how to develop a workforce to systematically address the social causes of illness.

Looks like an interesting idea with potentially wider application?

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The real crisis in health

Senator Richard Di Natale writes:

Not many people give up a career in medicine to become a politician. However, I still have the same goal: the good health of Australians.

Australia’s health care system isn’t bad. We spend less on health care than many other countries, about 9% of GDP (less than half of that spent in the USA), but most of us get access to high quality care when we need it.

But we are also one of the most hospitalised nations in the world, with more overnight beds per capita than any other OECD country. And even with the relatively high rate of hospitalisation, 60 per cent of our population is overweight, half the teeth of Australians aged 35-44 have some decay and alcohol abuse is costing our economy billions each year and rising.

Australia isn’t having a health crisis. We’re having a preventative health crisis.

The cost of a hospital bed is considerable, but we’re failing to invest in measures that prevent people from needing that bed in the first place.

Dental health is a prime example of the opportunity we have to transform our health system through better preventative measures. Currently, 650,000 Australians are on public dental care waiting lists, and dental admissions are the highest cause of acute preventable hospital admissions. Illness due to untreated dental disease is costing us dearly. Yet less than 20 per cent of dental care is currently funded by the Government, compared to nearly 80 per cent of general medical services.

For alcohol abuse and obesity as well, there are many preventative measures we can take to reduce the enormous costs to our economy each year. In addition to publicly funded dental care, I will be working towards a phase-out of alcohol and junk-food advertising during sports broadcasts, a more rational alcohol taxation system and better food labelling regulations.

It doesn’t take much imagination to see how a small investment in prevention can save us large costs in cure.

And with greater preventative health measures, we have more opportunity to address the social inequalities in health in Australia.

Health isn’t just a physical condition. If you have less income and less education, you are more likely to have poorer health. Beyond genetic make-up, behaviour and access to medical care, social inequality is still a strong determinant of health. This is especially acute when it comes to the health of Indigenous communities.

Climate change is emerging as a major health issue, and once again, those who are more likely to suffer health problems due to climate change are those on the lower end of the socio-economic scale.

During heatwaves and other extreme weather events, we have seen that the poor, the elderly and children are most affected. Already, our changing climate is creating a rise in vector-borne diseases, such as Dengue Fever, Malaria and Ross River Fever, and increasing rates of gastroenteritis will also take a heavier toll on the most vulnerable.

(Editor’s note: a paragraph has been deleted here that was mistakenly left in a draft of the article).

As a doctor, I realised that there wasn’t much point to handing over prescriptions unless I could also give my patients better access to employment, housing, education, strong communities, clean water, preventative health measures and a fair share of Government funding.

As a Senator, I now have the opportunity to improve not just the health of people, but the health of the system that must care for all of us.

• To register for the workshop, see here.

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  • 1
    Geordie
    Posted July 29, 2011 at 9:29 pm | Permalink

    a more rational alcohol taxation system

    This is where you lost me. I was nearly applauding in my loungeroom up until here.
    What does “more rational” mean? I assume it doesn’t mean “lower tax”. Why should I pay more for a sixpack on a Friday afternoon to accompany my reading of Crikey, just because other people are a burden on the tax system?

  • 2
    Posted August 2, 2011 at 12:53 pm | Permalink

    @Geordie I think the reference may be to the differential rates of taxation based on the form the alcohol comes in, e.g. as I understand it a mL of alcohol is taxed at a different level based on whether it comes in spirits, wine or beer.

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