DRAFT Australian Dietary Guidelines - Eat For Health

Appendix 7. Equity and the social
determinants of health and nutrition
status
A7.1 Introduction
The World Declaration on Nutrition (1992) states that ‘access to nutritionally adequate and safe
food is a basic individual right’ [992]. Australia is fortunate to have an abundant and safe food
supply. Life expectancy and health status are relatively high [12, 26, 44]. Australians are generally
literate and have good access to health and nutrition information and sufficient education to make
informed food choices [993].
However, there are differences in health and wellbeing between groups of Australians. People in
lower socioeconomic groups have shorter life spans and poorer health. They have higher rates of
death and disease, are more likely to be hospitalised and are less likely to use specialist and
preventative health services [994]. As in other countries, there is a socioeconomic gradient
whereby health status generally improves the higher a person is up the socioeconomic ladder [26].
The determinants of health inequities are largely outside the health system and reflect the
distribution of social, economic and cultural resources and opportunities [27, 28, 992, 994].
Employment, income, education, cultural influences, lifestyle, language, sex and other genetic
differences, geographic, social or cultural isolation, age and disability, the security and standard of
accommodation, and the availability of facilities and services, all influence diet, health and
nutritional status [27, 28].
The relationship between these factors and health status is complex and it is often difficult to
determine the nature and direction of causal relationships [27, 28]. For example, those on higher
incomes tend to have greater opportunity to attain higher levels of education and afford housing in
higher socioeconomic areas with better access to goods and services (for example, health
services, transport, shops including food outlets) that support healthy lifestyles. Lower levels of
education and/or an individual’s poor health status can limit opportunities for employment and
therefore income and access to other goods and services, including nutritious food [27, 28].
While higher education can improve health literacy, just because a person can understand healthy
lifestyle and nutrition information does not mean they can or will act on it. For example, one
Australian study of people 16 years and older found that, although 80% and 35% of people knew
the recommended daily intake of fruit and vegetables respectively, only 56% and under 10% met
these respective recommendations [26].
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