Summary - Department of Health and Ageing

Poor health is unequivocally linked to disadvantage. In Australia, people across all age
groups who are at the lower end of the socioeconomic scale experience more ill-health
and early death. Internationally, studies of the relationship between income and health
consistently show that, as income reduces, health deteriorates; a comprehensive UK study
clearly linked health status with inequalities relating to socioeconomic group, ethnicity
and gender. The social environment also influences the health and wellbeing of individuals
and communities, through levels of social support and social cohesion—often described as
social capital. Social exclusion, both formal (as in the detention of asylum seekers) and
informal (such as the labelling of some groups as deviant), adds to the burden for some
sectors of the community.
Some researchers also emphasise the role of cultural influences, and their ability to
exacerbate or moderate the effect of socioeconomic disadvantage. Australian researchers
identify trends such as: consumerism, individualism, the emphasis on economic
considerations, and the replacement of over-arching truths by relativism, ambiguity and
fragmentation; and a general pessimism and uncertainty among young people, even those
from privileged social backgrounds.
Social disadvantage—particularly as reflected in factors such as unemployment,
homelessness or insecure housing and poverty—is clearly linked to health-damaging
behaviours, including the misuse of alcohol and other drugs. Cigarette smoking, for
example, is more common among groups with lower socioeconomic status (SES); people
living in rented dwellings, those without private transport, the unemployed and those
living in crowded accommodation. However, these connections are not straightforward
for all drug types and may work in different ways as drug use patterns move into different
social groups.
Income can work both ways. Recent Australian studies have found that the number of
cigarette packs smoked by schoolchildren was strongly and positively linked to a child’s
income; and people in employment tended to drink more alcohol than those who were
unemployed. International and Australian data show that during economic downturns, less
alcohol is consumed across the population and serious alcohol-related harm is less
common.
Drug use is only one of a range of health risk behaviours that share common social
determinants, risk and protective factors, and outcomes. This clustering of health and
social problems, and risk, is discussed on page 17 of the Summary. However, some people
do better than others in terms of health and social outcomes, even under circumstances of
extreme social disadvantage and material deprivation, and this reflects the complex way in
which the broad social determinants of health interact with individual risk and protective
factors. Where problems exist, some studies have found that treatment is likely to be more
effective where people have family supports and stable relationships.