Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.
4
2018
Australia’s
health
Chapter 4
4.2 Social determinants
of health
Evidence supports the close relationship between people’s health and the living and working
conditions which form their social environment. Factors such as socioeconomic position,
conditions of employment, power and social support—known collectively as the social
determinants of health—act together to strengthen or undermine the health of individuals
and communities. The World Health Organization (WHO) describes social determinants as:
…the circumstances in which people grow, live, work, and age, and the systems put in
place to deal with illness. The conditions in which people live and die are, in turn, shaped
by political, social, and economic forces (CSDH 2008).
According to the WHO, social inequalities and disadvantage are the main reason for unfair
and avoidable differences in health outcomes and life expectancy across groups in society.
In 2015, the all-cause mortality rate for people in the lowest socioeconomic group was
1.5 times as high as for people in the highest socioeconomic group (see Chapter 5.1
‘Socioeconomic groups’). This is reflected in life expectancy gaps. In 2011, Australian males
and females in the lowest socioeconomic group lived, on average, 5.7 and 3.3 years less
than males and females in the highest socioeconomic group.
This snapshot provides a brief overview of some of the key social determinants of health
in Australia.
Socioeconomic position
Socioeconomic position can be described by indicators such as educational attainment,
income or occupation. In general, every step up the socioeconomic ladder is accompanied
by a benefit for health. The relationship is two-way—poor health can be both a product of,
and contribute to, lower socioeconomic position (see Chapter 5.1 ‘Socioeconomic groups’).
• In 2017, 66% of people aged 20–64 held a non-school qualification, an increase of
8.5percentage points since 2007 (ABS 2017a).
• Around 13% of the Australian population were estimated to be in relative income
poverty in 2013–14, a figure that has changed little over the last 10 years (ACOSS 2016).
• Among major occupation groups, Managers had the highest average weekly total cash
earnings in 2016 ($2,298), and Sales workers, the lowest ($652) (ABS 2017b).
Early life
The foundations of adult health are laid in-utero and during the perinatal and early
childhood periods. The different domains of early childhood development—physical,
social/emotional and language/cognition—strongly influence school success, economic
participation, social citizenship and health.
• One in 10 (10%) mothers who gave birth in 2015 smoked at some time during their
pregnancy, a drop from 15% in 2009. In 2015, smoking rates varied from 3.4% in the
highest socioeconomic group to 18% in the lowest socioeconomic group.
