Social Determinants of Health - 2020
The AMA Position Statement on Social Determinants of Health 2020 was finalised and endorsed by the AMA Federal Council in early 2020, shortly before the novel coronavirus (COVID-19) was declared a global pandemic, and its impacts began to be felt in Australia.
Since then, more than 65 million COVID-19 infections have been diagnosed worldwide, and more than 1.5 million people have died. Australia has done well to control the infections, but we have still had more than 27,000 cases, and more than 900 deaths – largely among our most vulnerable people.
While this Position Statement’s release has been delayed, its recommendations not only remain valid, but have been reinforced by the disproportionate effect that the pandemic is having on the disadvantaged in our community, including those already experiencing poverty, health inequities, disability, and discrimination. The AMA urges Australian governments to consider the additional impacts of COVID-19 on the social determinants of health, and in particular, the financial disadvantages that have been exacerbated by the pandemic. Australia has a new cohort of unemployed people arising from the events of 2020, which impacts communities in other areas including mental ill-health and domestic violence. This year has revealed the essential nature of front-line services in providing support to areas of high need in times of crisis in particular. The AMA will review this Position Statement within 12 months of its publication to account for the impacts of the COVID-19 pandemic on the social determinants of health.
While lockdowns are easing around the nation, the second wave of infections in Victoria and smaller outbreaks in other jurisdictions show that complacency is COVID-19’s best ally, and our worst enemy. The 2020 Federal Budget, while maintaining financial supports, relies heavily on the assumption that an effective and universally available vaccine is in sight, and that our borders and our economy will reopen in coming months. However, it is clear that even if the most optimistic forecasts come true, the ongoing impact of this year’s disruption will have long-lasting effects on those who have lost income and working hours, had their access to education cut off, and are in vulnerable accommodation.
The AMA continues to maintain that social distancing should and will be part of our lives for some time yet, as we do not know how effective the vaccines under development are going to be. Understanding this through the lens of social determinants reminds us that basic housing, hygiene, safety and access to clean water are essential to keeping healthy and COVID-19 free. During the early part of any rollout, the limited available vaccine will need to be prioritised to higher needs groups within the community.
Social determinants of health remind us of the challenges some groups in our community face to access the basic health care they need. The AMA acknowledges those communities will need extra assistance from a responsive health system as we adapt to the necessary changes brought about from COVID-19.
Dr Omar Khorshid