Are we governing for health and wellbeing or are we governing for profit? The answer to that questions over the next few years could determine whether life expectancy, which has steadily gained in Australia for decades, begins to fall, says Professor Fran Baum, Director of Southgate Institute for Health, Society and Equity at Flinders University.
“Health inequities, particularly over the last 25 years, are increasing in Australia and I predict that, for some groups at least, we're likely to have declining life expectancy in the next five years,” she says. ”It's already happened in the US and UK for lower socioeconomic people and I think we won't be far behind.”
While governments and oppositions may haggle over healthcare budgets, that is to miss the point, says Professor Baum.
“Health care is just picking up the bodies at the bottom of the cliff,” she says. “What we're trying to do is take people away from the cliff and give them a good life so they don't ever go near the edge.”
Professor Baum has been studying the social, political and economic determinants of health since the 1980s with international acclaim. This year, Southgate Institute was designated as the World Health Organization Collaborating Centre on Social, Political and Commercial Determinants of Health Equity.
“There's a number of studies that show that standards of health care are not the main contributors to life expectancy. It's what happens in the rest of our lives – how we're employed, the kind of housing we have, our access to education. These are much more powerful determinants of life expectancy than care.”
Estimates suggest the healthcare system contributes about 20% to a person’s life expectancy, genetics a similar amount, but around 60% comes from broader social determinants.
Professor Baum hopes that the COVID-19 pandemic may open people’s eyes to the choices our policymakers make between short-term profit on the one hand and the best wellbeing and health options for the populations.
“I think we're seeing as a result of this pandemic that what's good for health in the long term is also good for the economy,” she says. “Some issues, like opening a coal mine, might benefit us in the very short term.
"But in the long term, there's going to be a lot of health disbenefits of that coal mine.”