Academic journal article Rural Society

What Is Health Anyway? Perceptions and Experiences of Health and Health Care from Socio-Economically Disadvantaged Rural Residents

Academic journal article Rural Society

What Is Health Anyway? Perceptions and Experiences of Health and Health Care from Socio-Economically Disadvantaged Rural Residents

Article excerpt


In 2009, Australians were consulted by their federal government on the need to protect and promote human rights. Simultaneously, the government has social inclusion goals that include promoting access to resources, such as employment, education, health and community services and encouraging participation in formal and informal networks (Vinson, 2009a). The preventative health agenda is likewise concerned about the ways citizens can be engaged in lifestyles that support good health (NPHT, 2008). Socio-economic disadvantage has a significant impact on achieving human rights, social inclusion and prevention goals (WHO, 2008).

The divide between rich and poor in Australia is starkly apparent in health status statistics. The poorest Australians have the poorest health (Germov, 2002). Indigenous Australians, rural dwellers and those reliant on government payments for income are significantly affected by health system inequities and health risk factors (AIHW, 2008; Lynch, Due, Muntaner & Smith, 2000; Bhalla & Lapeyre, 1999). While income inequality in Australia has fallen since 2000, poverty (meaning people who live on less than half median incomes) has not fallen and at 12% is above the OECD average (OECD, 2008). Health is Australia's largest industry, consuming 9.5% of gross domestic product in 2003 and growing rapidly (Gray, 2004). Yet its processes and products are unequally distributed across the nation. Australian citizens reliant on income support are also reliant on public sector healthcare. These citizens are more likely to experience mental health problems, chronic disease, social isolation and chaotic personal relationships indicating increased need for supportive and responsive health and community services (Ackerson, 2003; Sands, 1995).

Socio-economic disadvantage and the relationship to health

The relationship between poverty and health is complex. Those on low incomes are more likely to experience poor health (Germov, 2002; Turrell, 1995). However, it is not only access to treatment that influences health consequences. This is conceptualised by the International Federation of Social Workers as health chances and health experience, where:

health chances are a person's chances of being ill or staying well, of living a long life or having their life cut short, are a product of economic, social, political and environmental factors, while health experience is a person's experience of living with and combating illness, is a product of the resources they can access for preventing, treating or alleviating illness and promoting health. (IFSW, 2007)

Health chances highlight the significance of social determinants influencing health status, whereas health experience emphasises the health consumer's perspective of access and availability of treatment, intervention, support and prevention for a country's citizens. Others have written about the social determinants of health, including education, income, housing, access to health services, work places, social inclusion, racism and mastery (Marmot & Wilkinson, 2008). Regardless of approach, there are tangible health benefits of higher income and stable well-paid employment experienced by middle and high income earners, including higher levels of health status, high expectations of health care and reduced health risk factors. This suggests attention to income support and employment is critical to improving health. Family income levels experienced during childhood are the best indicator of adult health status (Lynch et al., 2000; WHO, 2008). Low family income may mean that necessary health care is not obtained for children because of financial barriers even though it is high on the family's priority (Li, McMurray & Stanley, 2008). Thus, health chances and health experiences are intertwined.

Rural health discourse of access and availability

Rural health discourse strongly describes unmet need alongside the impact of centralised and urbanised policy and planning for healthcare delivery that does not understand or care about rural context (e. …

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