Escolar Documentos
Profissional Documentos
Cultura Documentos
For
Addressing
Health Inequalities
2003
The State of Queensland
Copyright protects this publication. However, Queensland Health has no objection to this
material being reproduced with acknowledgment, except for commercial purposes.
Permission to reproduce for commercial purposes should be sought from the Policy and
Quality Officer, Queensland Health, GPO Box 48, Brisbane Q 4001.
Social Indicators for Addressing Health Inequalities Version 1, 2003, prepared by the
Southern Public Health Unit Network, West Moreton Public Health Unit for Public Health
Services, Queensland Health.
This report aims to serve a growing demand for a compilation of a concise but
comprehensive list of social indicators for use by staff of Public Health
Services in assessing the impact of government policies on health and health
inequalities within Queensland. This initial listing contains 60 individual and
clustered social indicators grouped according to their being identified as either
socioeconomic or community capacity factors. It needs to be acknowledged
however, that in some cases the indicator could be relevant to either
dimension. Public Health Services is continuing its efforts with active
collaboration within Queensland Health to extend the set of indicators and
improve their comparability.
The chosen indicators are listed together with their general information on
sources and definitions. Most of the indicators are readily and easily available
and in the majority of cases accessible through the Internet on a regular basis.
John Scott
Manager
Public Health Services
Queensland Health
July 2003
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Contents
Foreword ...................................................................................................................... 1
Overview of the document........................................................................................... 5
PART 1 ............................................................................................................6
AN I NTERPRETATIVE GUIDE................................................................................................... 6
What are social indicators for?.................................................................................... 7
The structure of the indicators .................................................................................... 7
The use of the indicators ............................................................................................. 8
Figure 1: National Health Performance Framework ................................................................... 9
Description of the indicators ..................................................................................... 10
Caution ....................................................................................................................... 10
The future ................................................................................................................... 11
Review process .......................................................................................................... 13
PART 2 ..........................................................................................................14
SOCIAL INDICATORS ........................................................................................................... 14
SOCIOECONOMIC FACTORS ................................................................................................. 15
Benefits....................................................................................................................... 15
1. Dependent children of selected pensioners and beneficiaries as a percentage of
all children aged from 0-15 years by SLA. ................................................................. 15
2 Proportion of people receiving a pension by type of government
pension/allowance (principal and auxillary, full or part) by gender. ............................. 16
3. Proportion of sole parent pensioners as a percentage of all persons aged 15
years and over by gender. ........................................................................................ 16
4. Unemployment benefits by region by sex. ................................................................. 17
Death rates ................................................................................................................. 17
5. Gender differentials in death rates across socioeconomic quintiles for males
and females aged 15 years old and above. ............................................................... 17
Education.................................................................................................................... 18
6. De-enrolment and retention rates in government and non-government schools. ......... 18
7. Proportion of highest level of schooling completed (highest educational
attainment) by age and gender for persons aged 15 years and over. ......................... 18
8. Percentage of year five students achieving the national reading benchmark............... 19
9. Percentage of year five students achieving the national numeracy benchmark. .......... 20
Employment ............................................................................................................... 20
10. Labour force status by gender and age for persons aged 15 years and over. ............. 20
11. Number of unemployed and unemployment rates, States/Territories and
Statistical Local Areas, June Quarter 2001 to June Quarter 2002. ............................. 21
12. Trends in proportion of employed persons by industry by gender and age.................. 22
13. Trends in unemployment rates by gender and age groups......................................... 22
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14. Trends in participation rates by gender and age groups............................................. 23
15. Trends in long-term unemployment as a proportion of total unemployed. ................... 23
16. Trends in proportion of employed persons by gender and age. .................................. 23
17. Underemployment – Populations by State or Territory of usual residence for
September 2000. (Includes underemployed workers by sex). ................................... 24
Health Expenditure..................................................................................................... 25
18. Health expenditure Australia 2000-01. ...................................................................... 25
19. Trends in proportion of adults covered by private health insurance in addition to
Medicare.................................................................................................................. 26
20. Trends in proportion of adults holding a Health Care Card by card type and
gender. .................................................................................................................... 26
Housing Costs............................................................................................................ 26
21. Monthly housing loan repayment: Occupied private dwellings being purchased.......... 27
22. Weekly rent by landlord type: occupied private dwellings being rented. ...................... 27
COMMUNITY CAPACITY ....................................................................................................... 28
Community support services..................................................................................... 28
23. Proportion of children receiving formal and informal care by State. ............................ 28
24. Distribution of health facilities by statistical division.................................................... 29
25. Proportion of surveyed Queensland communities with limited access to healthy
food basket items..................................................................................................... 30
Demography ............................................................................................................... 30
26. Collection of demographic indicators available through Queensland Health................ 30
27. Indigenous population by age, sex and statistical local area (time series)................... 31
28. Indigenous population by age (5yr gaps), sex, statistical local areas and health
service districts ........................................................................................................ 31
29. Age (5 yr gaps) by sex by statistical local area and health service districts, Qld.......... 31
30. Births – selected variables as per Perinatal Annual Report, Qld ................................. 31
31. Proportion of population of postcode in each SLA in Qld (SD, SSD and District
identifiers)................................................................................................................ 31
Ethnicity...................................................................................................................... 32
32. Ancestry by birthplace of parents. ............................................................................. 32
33. Birthplace (countries) by sex..................................................................................... 32
34. Birthplace (regions) by sex. ...................................................................................... 33
35. Distribution of Emerging Communities by Local Government Area............................. 33
36. Humanitarian entrants by birthplace and region of settlement. ................................... 34
37. Language spoken at home by sex. ........................................................................... 34
38. Proficiency in spoken English by year of arrival in Australia. ...................................... 35
Family ......................................................................................................................... 35
39. Family type - families and persons in families in occupied private dwellings
(excluding overseas visitors)..................................................................................... 35
40. Weekly family income by family type: Families in occupied private dwellings.............. 36
Housing needs ........................................................................................................... 36
41. Estimated potential SAAP clients and unmet needs by gender, age and State. .......... 36
42. Dwelling structure - private dwellings and persons in occupied private dwellings. ....... 37
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43. Dwelling structure by tenure type and landlord type: Occupied private dwellings. ....... 37
44. Number of SAAP support periods of accommodation on the 15th of the month,
by month and region, Queensland. ........................................................................... 38
45. Distribution of private dwellings by type of occupancy (rented, being
purchased). ............................................................................................................. 38
46. State government housing assistance by program and type of assistance,
Queensland, 1988-89 to 1997-98. ............................................................................ 39
Income ........................................................................................................................ 39
47. Distribution of weekly individual income by age and gender (persons aged 15
years and over)........................................................................................................ 39
48. Distribution of weekly household income by household type. ..................................... 40
49. Population distribution by index of relative disadvantage Socio Economic
Indexes For Areas (SEIFA)....................................................................................... 40
50. Type of educational institution attending (full-time/part-time). ..................................... 41
Safety .......................................................................................................................... 41
51. Victim of assault in last 12 months. ........................................................................... 42
52. Victim of break-in in last 12 months. ......................................................................... 42
53. Victim of assault or break-in in last 12 months........................................................... 42
54. Victim of domestic violence in the last 12 months (source: Family Services who
funds a domestic violence service for NESB women: the Immigrant Women’s
Emergency Support Service). ................................................................................... 42
55. Feelings of safety at home during day:...................................................................... 42
56. Crime and Safety - Offences reported by police region and type of offence,
Queensland, 1991-92 to 2000-01. ............................................................................ 42
Social supports .......................................................................................................... 43
57. Relationship in household by age by sex – Persons in occupied private
dwellings. ................................................................................................................ 43
58. Religious affiliation by sex. ....................................................................................... 43
59. Social Capital (generalised reciprocity and cohesion; community identity;
generalised trust; tolerance of diversity; civic trust; community involvement;
informal social networks), Queensland...................................................................... 44
Transport .................................................................................................................... 44
60. Method of travel to work by sex: Employed persons (excluding overseas
visitors).................................................................................................................... 45
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OVERVIEW OF THE DOCUMENT
This document has been produced as a tool to aid Public Health Service
(PHS) staff in addressing health inequalities. It comprises two parts: an
Interpretive Guide and a Social Indicators set.
A number of possible uses for the indicators are provided including those
suitable for adoption and reporting on the social conditions of whole-of-
population and various sub-populations of the Queensland community. Equity
is an important component of these factors. As such the indicators help us to
understand the social environment as a consequence of government policy.
Possible future indicators at the macro level are identified which may be
worthwhile for PHS to explore in terms of their impact on health and health
inequalities including activation policies; ecological footprint; healthy
communities index; income inequality; safe communities; and tax burden.
The chosen indicators are by no means exhaustive and have been listed
together with their general information on sources and definitions. Most are
readily available and easily accessible via the Internet. Wherever possible the
actual web address has been provided as the first point of call for the
investigator.
The indicator set selected for inclusion in this document are aligned with, and
complement Queensland Health’s Health Determinants Reports (formerly
known as Zonal Indicator reports). The indicators identified in this report
reflect our best understanding as of June 2003, however, it is anticipated that
this document will be reviewed and updated as the evidence base develops.
1
National Health Performance Committee (2002) National Report on Health Sector
Performance Indicators 2001. A report to the Australian Health Minister’s Conference.
Brisbane: Queensland Heath.
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An Interpretative Guide
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The indicator set contained within this document aligns with and complements
the health indicators reported on within Queensland Health’s zonal indicator
reports2
The structure applied in this document falls well short of being a full-scale
framework for the collection of social statistics but nevertheless reflects the
‘upstream’ social dimensions contained within the framework developed by
the National Health Performance Committee (NHPC) (Figure 1)3.
2
Queensland Health (2001) Health Indicators for Queensland: Southern Zone. Brisbane:
Public Health Services, Queensland Health. Note, reports are also available for the Central
and Northern Zones.
3
National Health Performance Committee (2002) National Report on Health Sector
Performance Indicators 2001. A report to the Australian Health Minister’s Conference.
Brisbane: Queensland Health.
4
Turrell, G.; Oldenburg, B.; McGuffog, I. and Dent, R. (1999) Socioeconomic Determinants of
Health: Towards a National Research Program and a Policy and Intervention Agenda.
Canberra: Queensland University of Technology, School of Public Health; Ausinfo.
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In most cases individual indicators are given and in others a set of indicators
but in all cases they were selected against a range of criteria. It is not
anticipated that each criterion will be met for every indicator, rather the
selection criteria provided guidance only. The criteria included:
• be worth measuring
• be measurable for diverse populations
• be understood by people who need to act
• galvanise action
• be relevant to policy and practice
• measurement over time will reflect results of actions
• be feasible to collect and report
• comply with national processes of data definitions.
CAUTION
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THE FUTURE
There are possibly many alternative social indicators that may better suit the
needs of PHS. In the immediate future perhaps we need to identify what
information is ‘missing’ – for example, on the accessibility of basic social
services, or the quality of housing.
Possible future indicators at the macro level which may be worth exploring for
their impact on health and health inequalities, include
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• your health
• quality of life
• personal background
• beliefs and behaviours
• health conditions and use of services
• employment and income
• community involvement
• voluntary work.
7
Dept of Health and Human Services (1999) First Results of the Healthy Communities Survey
1998. Tasmania: Health and Wellbeing Outcomes Unit, Dept of Health and Human Services.
8
OECD (2001) op cit p. 64.
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6. Tax burden on labour: a measure of the size of the tax burden on labour
involves consideration of the ‘wedge’ between what employers pay for the
labour of an employee, and the consumption a worker can purchase from
this income. Consideration of this ‘wedge’ is important as such taxes
either raise the cost of employing labour, or reduce the financial returns to
working10. It involves calculation of the taxes and contributions paid when
someone is employed at average earnings. A fairer tax burden will help
the less well-off who are in work.
REVIEW PROCESS
9
WHO Collaborating Centre on Community Safety Promotion (2002) Safe Community News,
No 2, 2002, p. 1.
10
OECD (2001) op cit p. 60.
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Part 2 – Social Indicators
SOCIOECONOMIC FACTORS
Research has shown a clear link between socioeconomic position and health
outcomes with people who occupy positions at lower levels of the
socioeconomic hierarchy faring significantly worse in terms of their health.
Specifically, experiencing higher mortality rates for most major causes of
death11. People variously classified as ‘low’ socioeconomic status (SES) have
greater ill-health (both physiological and psychological), and their use of
health care services suggest they are less likely to prevent disease or detect it
at an early stage. In addition, socioeconomic differences in health are evident
for both females and males at every stage of the life-course (birth, infancy,
childhood and adolescence, and adulthood) and the relationship exists
irrespective of how SES and health are measured12.
BENEFITS
For the least well-off members of society it is the benefit system which is the
principal determinant of living standards. Studies of the budgeting
arrangements of poor families have shown that frequently living standards
such as nutrition are compromised when there is insufficient money to go
around and so placing health at risk13.
11
Turrell, G.; Oldenburg, B.; McGuffog, I. and Dent, R. (1999) op cit.
12
National Health Strategy (1992) Enough to Make you Sick: How Income and Environment
Affect Health. Canberra: National Health Strategy.
13
Acheson, D. (1999) Independent Inquiry into Inequalities in Health Report. London: The
Stationary Office, pp. 32-36.
14
Acheson (1999) op cit p. 33.
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15
Kawachi, I.; Kennedy, B. and Wilkinson, R. (eds) (1999) The Society and Population Health
Reader: Income Inequality and Health. New York: The New Press.
16
Acheson (1999) op cit p. 107.
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DEATH RATES
Statistics relating to deaths are easily presented as crude death rates ie the
number of deaths in a year divided by the number of individuals in the
corresponding population.
17
Marmot, M. (1999) The Solid Facts: The Social Determinants of Health. Health Promotion
Journal of Australia, vol. 9, no. 2, pp. 133-139.
18
National Health Strategy (1992) Enough to Make You Sick: How Income and Environment
Affect Health, Canberra: National Health Strategy.
19
Morris, J., Cook, D, and Shaper, A. (1994) Loss of Employment and Mortality. BMJ, vol.
308, no. 6937, pp. 1135-1139.
20
Australian Institute of Health and Welfare (2000) Australia’s Health 2000. Canberra: AIHW
Cat No 19,
21
Queensland Health (2001) Social Determinants of Health – The Role of Public Health
Services. Brisbane: Public Health Services, Queensland Health, pp. 54-55.
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EDUCATION
Generally, people with the worst health status have low education levels.
Education is important as it provides a route out of poverty. A strong
education system offers a significant contribution to society and ensures equal
opportunity for people in disadvantaged groups 22.
22
Queensland Health (2001) op cit p. 26.
23
Speirings, J. (2000) Youth disadvantage: Some key indicators and future policy directions.
In, Massey, D. (ed) New Horizons in Education – The Journal of World Education Fellowship
Australia pp. 25-46.
24
ABS (2002) Australian Social Trends 2002: Education – Educational attainment: Education
and training: International comparisons. Australian Bureau of Statistics.
25
Acheson (1998) Independent Inquiry into Inequalities in Health. Department of Health pp.
35-44.
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26
National Advisory Committee on Health and Disability (1998) The Social, Cultural and
Economic Determinants of Health in New Zealand: Actin to Improve Health. Wellington, New
Zealand: the National Advisory Committee on Health and Disability pp. 28-30.
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EMPLOYMENT
10. Labour force status by gender and age for persons aged 15 years
and over.
Employment, is a primary source of status in industrialised countries
while also significant in providing purpose, social support, structure to
life and a means of participating in society. Unemployment is potentially
a major risk to health for the working age population and their families29
Potential use by PHS: an indicator of community need, program
impact (eg employment initiatives) and basic information for community
profile
Geographic reporting unit: Collected with Census. Available for all
Census geographic areas from Collection District level to total Australia
Last reported: 1996; 2001
27
Estrada, C.; Barnes, V; Collins, C. and Byrd, J. (1999) Health literacy and numeracy.
JAMA, Vol 282 No 6 p. 527.
28
Woloshin, S.; Schwartz, L.; Moncur, M.; Gabriel, S. and Tosteson, A. (2001) Assessing
values for health: Numeracy matters. Medical Decision Making, Vol 21, No 5, pp. 382-90.
29
Acheson, D. (1999) op cit p. 44-50.
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30
Bartley, M., Ferrie, J. and Montgomery, S. (1999) “Living in a High-Unemployment
Economy: Understanding the Health Consequences” in, Marmot, M. and Wilkinson, R. (eds.),
Social Determinants of Health, Oxford: Oxford University Press, pp. 81-104.
31
New South Wales Department of Health (2002) The Health of the People of New South
Wales. Report of the Chief Health Officer, 2002. NSW Department of Health, September, pp.
12.
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32
Theorell, T. (2000) ‘Working conditions and health’. In, Berkman, L. and Kawachi, I. (eds)
Social Epidemiology. Oxford: Oxford University Press, pp. 95-117.
33
Kasl, S. and Jones, B. (2000) ‘The impact of job loss and retirement on health’. In, In,
Berkman, L. and Kawachi, I. (eds) Social Epidemiology. Oxford: Oxford University Press, pp.
118-136.
34
Marmot, M., Siegrist, J., Theorell, T. and Feeney, A. (1999) “Health and the Psychosocial
Environment at Work”, in Marmot, M. and Wilkinson, R. (eds.) Social Determinants of Health.
New York: Oxford University Press.
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35
New South Wales Department of Health (2002) op cit p. 341.
36
New South Wales Department of Health (2002) op cit p. 12.
37
Marmot, M.; Siegrist, J.; Theorell T. and Feeney, A. (1999) op cit pp. 105-131.
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38
ABS (2001) Measuring Wellbeing: Frameworks for Australian Social Statistics. Chapter 6:
Work, p. 6. Canberra: Australian Bureau of Statistics.
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HEALTH EXPENDITURE
Total expenditure on health is the amount spent on health care goods and
services plus capital investment in health care infrastructure. Changes in
health expenditure over time can indicate changes in the level of goods and
services used, either from a population growth perspective or from more
intensive per person use of goods and services 39 and the sources of funding
for health care.
39
AIHW (2002) Health Expenditure Australia 2000-01. Health and Welfare Expenditure
Series no. 14. Cat. no. HWE 20. Canberra: AIHW. p. 58.
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HOUSING COSTS
40
Baum, F. (2001) The New Public Health: An Australian Perspective. New York: Oxford
University Press, pp. 429-430.
41
Acheson (1999) op cit pp. 50-55.
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42
Queensland Health (2001) op cit. p32.
43
Acheson (1999) op cit p. 52.
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COMMUNITY CAPACITY
44
Queensland Health (2001) Social Determinants of Health: The Role of Public Health
Services – Summary Document. Brisbane: Public Health Services, Queensland Health.
45
National Health Performance Committee (2002) National Report on Health Sector
Performance Indicators 2001. A report to the Australian Health Ministers’ Conference, p. 7.
46
Eagar, K.; Garrett, P. and Lin, V. (2001) Health Planning: Australian Perspectives. Crows
Nest: Allen & Unwin, pp. 17-18.
47
ABS (1999) Child Care. Cat No 4402.0, p. 3.
48
Acheson (1999) op cit pp. 67-69.
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DEMOGRAPHY
51
National Health Strategy (1992) op cit. pp. 12-13.
52
Queensland Health (2000) The 2000 Healthy Food Access Basket (HFAB) Survey.
Queensland Health, pp. 18-19.
53
New South Wales Department of Health (2002) op cit p. 4.
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27. Indigenous population by age, sex and statistical local area (time
series)
29. Age (5 yr gaps) by sex by statistical local area and health service
districts, Qld
54
Chapters’ relates to ICD10 Chapters eg Class 1 – Infectious and Parasitic Diseases.
55
Estimated Resident Populations
56
Australian Standard Geographical Classification
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ETHNICITY
57
OECD (2001) op cit, pp. 28.
58
Queensland Health (2001) op cit pp. 43-44
59
Queensland Health (2001) ibid.
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60
Multicultural Affairs Queensland (2002) New and Emerging Communities in Queensland.
MAQ.
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61
OECD (2001) op cit pp. 30.
62
Wilkinson, R. and Marmot, M. (1998) The Social Determinants of Health: The Solid Facts.
WHO: p. 14.
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FAMILY
The immediate family and the wider community are the context for individual
achievement in other areas of social concern. They are the arenas in which
children become socially responsible adults, and individuals gain a sense of
belonging 64.
63
New South Wales Department of Health (2002) op cit p. 100.
64
ABS (2001) Measuring Wellbeing: Frameworks for Australian Social Statistics. Chapter 3:
Family and Community.
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HOUSING NEEDS
In some areas, the health impact of poor quality housing is combined with
neighbourhood problems such as substandard community services, high
levels of unemployment, inadequate public transport and recreational
facilities, environmental hazards and violence66. Homelessness is caused by
structural factors such as poverty, an inadequate supply of affordable housing
and unemployment. People may experience family, community or social
isolation as a consequence of, or a precursor to, homelessness67. In addition,
health problems faced by homeless people are often exacerbated by the
likelihood that health services may not be available to them because they
have no fixed address.
41. Estimated potential SAAP clients and unmet needs by gender, age
and State.
This publication is one of the Series 5 reports on the Supported
Accommodation Assistance Program (SAAP) National Data Collection
1999-2000. The series provides information on people who are
homeless and people who were at risk of being homeless who
accessed the SAAP in 1999-2000. Indicators include:
• support provided in 1999-2000 (provision of services; referral of
services)
• demand for accommodation (demand by clients; demand by
potential clients; meeting the daily demand)
• total assistance provided (daily assistance; one-off assistance)
65
ABS (1999) Australian Social Trends 1999. Income & Expenditure – Income Distribution:
Lower Income Working Families. Australian Bureau of Statistics.
66
Queensland Health (2001) op cit pp.32-33.
67
Commonwealth Advisory Committee on Homelessness (2001) Working Towards a National
Homelessness Strategy. Consultation Paper. CACH, p. 8.
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68
Shaw, M.; Dorling, D. and Davey-Smith, G. (1999) ‘Poverty, social exclusion, and
minorities’. In, Marmot, R. and Wilkinson, R. (eds) Social Determinants of Health. Oxford:
Oxford University Press, pp. 211-239.
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69
AIHW (2001) Demand for SAAP Assistance 1999-2000. A report from the SAAP National
Data Collection. Canberra: AIHW Cat No HOU 60, p. 1.
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INCOME
70
Wilkinson, R. (1999) ‘Putting the picture together: prosperity, redistribution, health, and
welfare’. In, Marmot, M. and Wilkinson, R. (eds) Social Determinants of Health. Oxford:
Oxford University Press, pp. 256-274.
71
National Health Strategy (1992) op cit.
72
Marmot, M. (1999) op cit.
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73
Australian Bureau of Statistics (1998) 1996 Census of Population and Housing.
Socioeconomic Indexes for Areas. ABS Cat No 2039.0. Canberra: ABS.
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SAFETY
Crime influences health. Areas with high crime rates tend to have higher
death rates, indicating that the social origins of crime - including social
disorganisation, income inequality, and low social capital – are causes of ill
health75. Personal violence and assault has direct effects on the physical and
mental health of victims and witnesses. Victims of property crime may suffer
psychological harm. Fear of crime may be a factor that limits enjoyment of
life. Crime and ill-health also share common causes. Indicators available
through the ABS General Social Survey are given below (see Indicators #51-
55).
74
Baum, F. (2001) The New Public Health: An Australian Perspective. South Melbourne:
Oxford University Press, pp. 435-426.
75
Kawachi, I.; Kennedy, B. and Wilkinson, R. (1999) Crime, social disorganization and
relative deprivation. Social Science and Medicine, Vol 48, pp. 719-731.
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56. Crime and Safety - Offences reported by police region and type of
offence, Queensland, 1991-92 to 2000-01.
Areas with high crime rates tend to have higher death rates, indicating
that the social origins of crime including social disorganisation, income
inequality, and low social capital are causes of ill health76.
Potential use by PHS: identification of vulnerable communities
including possible social isolation as a consequence of fear of crime.
Also can indicate safe communities
Geographic reporting unit: Queensland Police regions: Metropolitan
North (Brisbane Central, Brisbane West, North Brisbane and Pine
Rivers districts); Metropolitan South (Oxley, South Brisbane and
Wynnum districts); South Eastern (Gold Coast and Logan districts);
North Coast (Bundaberg, Maryborough, Gympie, Sunshine Coast and
Redcliffe districts); Southern (Charleville, Dalby, Ipswich, Roma,
Toowoomba and Warwick districts); Central (Gladstone, Longreach,
Mackay and Rockhampton districts); Northern (Mt Isa and Townsville
districts); Far Northern (Cairns, Innisfail and Mareeba districts)
Last reported: 1991-92 to 2000-01
Data source: Office of Economic and Statistical Research
http://www.oesr.qld.gov.au/data/tables/compendium/table0290.htm
How could it be collected by PHS staff: not applicable
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SOCIAL SUPPORTS
A strong correlation exists between social supports and health status such
that people with diverse networks of quality, supportive relationships manifest
more robust health than people who are socially isolated77. Unequal societies
tend to be those with the lowest levels of community cohesiveness and loss of
the ‘social glue’ that holds groups together may have adverse consequences
such as violence, sexual exploitation and drug taking78.
76
Kawachi, I.; Kennedy, B. and Wilkinson, R. (1999) op cit
77
Shumaker, S. and Czajkowski, S. (eds) (1993) Social Support and Cardiovascular Disease.
New York: Plenum Press.
78
Wilkinson, R. (1999) Health, hierarchy and social anxiety, Annals of the New York Academy
of Science, No 896, pp. 48-63.
79
Shumaker, S. and Czajkowski, S. (eds) (1994) Social Support and Cardiovascular Disease.
New York: Plenum Press.
80
Wilkinson, R. and Marmot, M. (1998) op cit pp. 20-21.
81
Najman, J. (2001) ‘A General Model of the Social Origins of Health and Well-being’. In,
Eckersley, R.; Dixon, J. and Douglas, B. (eds) The Social Origins of Health and Well-being.
Melbourne: Cambridge University Press, pp. 73-82.
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TRANSPORT
People’s health is directly related to the conditions in which they live. One
factor shaping these conditions is transport, and the way in which it is
organised for people to gain access to goods and services.
82
Queensland Health (2002) Social capital: Interpersonal trust, reciprocity and community
involvement in Queensland (Draft Information Paper). Public Health Services, Queensland
Health, p1.
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Part 2 – Social Indicators
83
Queensland Health (2001) op cit pp. 34-35.
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