Regional barriers to financial inclusion and health - part 1: the desktop research
In February this year, Beacon Strategies Director, Elliot Parkinson attended a Financial Inclusion conference and presented on the regional barriers to financial inclusion and health.
The presentation was developed based on insights recently captured by Beacon Strategies through co-design projects commissioned by South Eastern NSW PHN and South Western Sydney PHN.
The contents of this presentation have now been transformed into the following two-part blog series about financial inclusion and its connection to the concept of health equity. Let’s jump into it.
What do we already know about financial inclusion and health equity?
Financial exclusion is a barrier to good health and wellbeing
We know and have known for a long time that financial exclusion is a barrier to good health and wellbeing — that shows up at an individual level, household level, local community level and at a country level.
We consistently see health status and health outcomes predicted by the socioeconomic gradient — determined by someone’s employment, income, expenses and debts, housing status, suburb and geography.
The three graphs below show premature deaths, diabetes a common chronic health condition, and employment (a known social determinant of health) for people living with a mental health condition. You can see a consistent trend across all three — a link between an adverse outcome and social disadvantage.
The same trend could be shown for several more graphs — physical inactivity, tobacco use, suicide, obesity.
This statement from AIHW on the burden of disease uses a collective measure to the impact of both mortality and morbidity — in terms of population impact, if all Australians had experienced the same burden as people in the highest socioeconomic areas in 2015, the total disease burden could have been reduced by one-fifth (20%).
That’s not just using up more health system resources, but contributes to many more people’s experiences of pain and distress, sometimes of suffering and of loss, and of generally not being able to live their life how they might choose to do so.
Financial inclusion is a component of health equity.
Several key financial and economic factors such as income, employment, housing and service access are both a cause of and consequence of good health and wellbeing.
Particularly in the context of health, when we say financial inclusion here, we don’t just mean paid employment.
Financial inclusion conceptually comes from being involved in one’s community, having agency and independence, knowledge and education, access to services that are affordable and otherwise accessible; being free from financial constraints or pressures.
“Inequities in health systematically put groups of people who are already socially disadvantaged (by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health… health is essential to wellbeing and to overcoming other effects of social disadvantage.”
Source: Braveman P, Gruskin S. Defining equity in health. Journal of Epidemiology & Community Health 2003;57:254-258.
Economic resources and social capital are both a direct cause of and a direct result of an individual’s and a society’s physical and mental health and wellbeing. So we know that these aspects of financial inclusion, having financial resources, housing, community inclusion, affordable services — are linked to good health.
But when we think about what to do about using health equity as a concept, it’s not just about there being differences in health status that shows up along a social gradient — it’s about those differences in opportunity that arise from things that are avoidable, unfair or unjust.
In part two, we’re moving on and sharing some insights about regional barriers to financial inclusion and health from two recently completed co-design projects our team has undertaken. Read about it here.