The Social Health Atlas : a policy tool to describe and monitor social inequality and health inequality in Australia

En 1988, como respuesta a la toma de conciencia del papel que las desigualdades sociales juegan en las desigualdades relacionadas con la salud, la Oficina para la Salud Social de la Comisión de Salud de Australia Meridional propuso la adopción de una estrategia en salud social. La estrategia en salud social adoptó una visión, para mejorar la salud de los habitantes de Australia Meridional, basada en el reconocimiento de políticas externas al sector sanitario que pueden tener un impacto importante sobre la salud de la comunidad en general y de los grupos más desfavorecidos en particular. Entre estas políticas externas a la salud destacan la vivienda, la educación y el transporte. En su conjunto, esta visión se conoce como "aproximación social a la salud". Como parte de esta estrategia, la información se percibe como una componente importante al facilitar la descripción de perfiles socioeconómicos y de salud en la población. Los mapas fueron elegidos como el mejor instrumento para presentar y transmitir este tipo de información. Los mapas presentan la información de tal forma que ésta se hace accesible a audiencias heterogéneas, no sólo para aquellas encargadas de establecer políticas e implementar estrategias sino también a los consumidores y a otros actores sociales que podrían tener limitaciones a la hora de manejar información estadística presentada de forma más tradicional. Los mapas del atlas que se presenta describen la distribución geográfica de la población a través de un amplio rango de indicadores socioeconómicos, su estado de salud y el uso que hace de los servicios sanitarios, subrayando, por tanto, las relaciones existentes entre los indicadores de desigualdad social y las condiciones de desigualdad en salud. Ésta es la razón por la el atlas recibe el nombre de "Atlas Socio-sanitario". Durante los catorce años que han transcurrido desde que el primer atlas socio-sanitario fue publicado, la variedad y calidad de las bases de datos existentes a nuestra disposición ha mejorado considerablemente, lo que permite una mejorada comprensión del impacto que las condiciones socioeconómicas ejercen sobre la salud. Esta mejora ha permito, asimismo, analizar tendencias temporales y patrones de distribución espacial. Los atlas representan una iniciativa de gran calado en los esfuerzos por reforzar la información sobre las infraestructuras de salud pública en Australia y constituyen una herramienta de importancia mayor en las políticas dirigidas a problemas relacionados con desigualdades sanitarias cuyo origen se encuentra en la desigualdad social.In 1988, in response to an increasing awareness in Australia of the role of social inequality as a key to health inequality, the Social Health Office within the South Australian Health Commission proposed the adoption of a social health strategy. The social health strategy outlined an approach to improving health for all South Australians through a recognition that policies in areas outside of the health sector, such as housing, education, transport etc. can have substantial impact on the health of the general community, and in particular on disadvantaged groups. This is often referred to as a 'social view of health'. Information was seen as having an important part in this strategy, by describing the socioeconomic and health status profiles of the population. The approach chosen to presenting information was through mapping. Maps present data in a way that is accessible to a wide audience, not only those charged with setting policy and undertaking strategic planning, but to consumers and other community advocates who may have limited skills in handling statistical information presented in more traditional ways. The maps describe the geographic distribution of the population by a range of socioeconomic indicators, together with maps showing their health status and use of health services, thereby highlighting the relationships between the indicators of socioeconomic inequality and inequality in health status. These reports have been titled 'social health atlases'. Over the fourteen years since the first social health atlas was released, the range and quality of datasets has improved, allowing for a better understanding of the impact of socioeconomic influences on health. It has also been possible to address changes in the overall levels, and patterns in the distribution, of socioeconomic status and health status and to assess the extent to which the health divide has been addressed. The atlases represent a major initiative in strengthening the public health information infrastructure in Australia and are a major policy tool with which to address health inequality arising from social inequality

The Social Health Atlas : a policy tool to describe and monitor social inequality and health inequality in Australia

En 1988, como respuesta a la toma de conciencia del papel que las desigualdades sociales juegan en las desigualdades relacionadas con la salud, la Oficina para la Salud Social de la Comisión de Salud de Australia Meridional propuso la adopción de una estrategia en salud social. La estrategia en salud social adoptó una visión, para mejorar la salud de los habitantes de Australia Meridional, basada en el reconocimiento de políticas externas al sector sanitario que pueden tener un impacto importante sobre la salud de la comunidad en general y de los grupos más desfavorecidos en particular. Entre estas políticas externas a la salud destacan la vivienda, la educación y el transporte. En su conjunto, esta visión se conoce como "aproximación social a la salud". Como parte de esta estrategia, la información se percibe como una componente importante al facilitar la descripción de perfiles socioeconómicos y de salud en la población. Los mapas fueron elegidos como el mejor instrumento para presentar y transmitir este tipo de información. Los mapas presentan la información de tal forma que ésta se hace accesible a audiencias heterogéneas, no sólo para aquellas encargadas de establecer políticas e implementar estrategias sino también a los consumidores y a otros actores sociales que podrían tener limitaciones a la hora de manejar información estadística presentada de forma más tradicional. Los mapas del atlas que se presenta describen la distribución geográfica de la población a través de un amplio rango de indicadores socioeconómicos, su estado de salud y el uso que hace de los servicios sanitarios, subrayando, por tanto, las relaciones existentes entre los indicadores de desigualdad social y las condiciones de desigualdad en salud. Ésta es la razón por la el atlas recibe el nombre de "Atlas Socio-sanitario". Durante los catorce años que han transcurrido desde que el primer atlas socio-sanitario fue publicado, la variedad y calidad de las bases de datos existentes a nuestra disposición ha mejorado considerablemente, lo que permite una mejorada comprensión del impacto que las condiciones socioeconómicas ejercen sobre la salud. Esta mejora ha permito, asimismo, analizar tendencias temporales y patrones de distribución espacial. Los atlas representan una iniciativa de gran calado en los esfuerzos por reforzar la información sobre las infraestructuras de salud pública en Australia y constituyen una herramienta de importancia mayor en las políticas dirigidas a problemas relacionados con desigualdades sanitarias cuyo origen se encuentra en la desigualdad social.In 1988, in response to an increasing awareness in Australia of the role of social inequality as a key to health inequality, the Social Health Office within the South Australian Health Commission proposed the adoption of a social health strategy. The social health strategy outlined an approach to improving health for all South Australians through a recognition that policies in areas outside of the health sector, such as housing, education, transport etc. can have substantial impact on the health of the general community, and in particular on disadvantaged groups. This is often referred to as a 'social view of health'. Information was seen as having an important part in this strategy, by describing the socioeconomic and health status profiles of the population. The approach chosen to presenting information was through mapping. Maps present data in a way that is accessible to a wide audience, not only those charged with setting policy and undertaking strategic planning, but to consumers and other community advocates who may have limited skills in handling statistical information presented in more traditional ways. The maps describe the geographic distribution of the population by a range of socioeconomic indicators, together with maps showing their health status and use of health services, thereby highlighting the relationships between the indicators of socioeconomic inequality and inequality in health status. These reports have been titled 'social health atlases'. Over the fourteen years since the first social health atlas was released, the range and quality of datasets has improved, allowing for a better understanding of the impact of socioeconomic influences on health. It has also been possible to address changes in the overall levels, and patterns in the distribution, of socioeconomic status and health status and to assess the extent to which the health divide has been addressed. The atlases represent a major initiative in strengthening the public health information infrastructure in Australia and are a major policy tool with which to address health inequality arising from social inequality

Healthy life gains in South Australia 1999-2008: analysis of a local Burden of Disease series

BACKGROUND: The analysis describes trends in the levels and social distribution of total life expectancy and healthy life expectancy in South Australia from 1999 to 2008. METHODS: South Australian Burden of Disease series for the period 1999-2001 to 2006-2008 and across statistical local areas according to relative socioeconomic disadvantage were analyzed for changes in total life expectancy and healthy life expectancy by sex and area level disadvantage, with further decomposition of healthy life expectancy change by age, cause of death, and illness. RESULTS: Total life expectancy at birth increased in South Australia for both sexes (2.0 years [2.6%] among males; 1.5 years [1.8%] among females). Healthy life expectancy also increased (1.4 years [2.1%] among males; 1.2 years [1.5%] among females). Total life and healthy life expectancy gains were apparent in all socioeconomic groups, with the largest increases in areas of most and least disadvantage. While the least disadvantaged areas consistently had the best health outcomes, they also experienced the largest increase in the amount of life expectancy lived with disease and injury-related illness. CONCLUSIONS: While overall gains in both total life and healthy life expectancy were apparent in South Australia, gains were greater for total life expectancy. Additionally, the proportion of expected life lived with disease and injury-related illness increased as disadvantage decreased. This expansion of morbidity occurred in both sexes and across all socio-economic groups. This analysis outlines the continuing improvements to population health outcomes within South Australia. It also highlights the challenge of reducing population morbidity so that gains to healthy life match those of total life expectancy.David Banham, Tony Woollacott and John Lync

Aboriginal premature mortality within South Australia 1999-2006: a cross-sectional analysis of small area results

<p>Abstract</p> <p>Background</p> <p>This paper initially describes premature mortality by Aboriginality in South Australia during 1999 to 2006. It then examines how these outcomes vary across area level socio-economic disadvantage and geographic remoteness.</p> <p>Methods</p> <p>The retrospective, cross-sectional analysis uses estimated resident population by sex, age and small areas based on the 2006 Census, and Unit Record mortality data. Premature mortality outcomes are measured using years of life lost (YLL). Subsequent intrastate comparisons are based on indirect sex and age adjusted YLL results. A multivariate model uses area level socio-economic disadvantage rank, geographic remoteness, and an interaction between the two variables to predict premature mortality outcomes.</p> <p>Results</p> <p>Aboriginal people experienced 1.1% of total deaths but 2.2% of YLL and Aboriginal premature mortality rates were 2.65 times greater than the South Australian average. Premature mortality for Aboriginal and non-Aboriginal people increased significantly as area disadvantage increased. Among Aboriginal people though, a significant main effect for area remoteness was also observed, together with an interaction between disadvantage and remoteness. The synergistic effect shows the social gradient between area disadvantage and premature mortality increased as remoteness increased.</p> <p>Conclusions</p> <p>While confirming the gap in premature mortality rates between Aboriginal South Australians and the rest of the community, the study also found a heterogeneity of outcomes within the Aboriginal community underlie this difference. The results support the existence of relationship between area level socio-economic deprivation, remoteness and premature mortality in the midst of an affluent society. The study concludes that vertically equitable resourcing according to population need is an important response to the stark mortality gap and its exacerbation by area socio-economic position and remoteness.</p

The Social Health Atlas: a policy tool to describe and monitor social inequality and health inequality in Australia

In 1988, in response to an increasing awareness in Australia of the role of social inequality as a key to health inequality, the Social Health Office within the South Australian Health Commission proposed the adoption of a social health strategy. The social health strategy outlined an approach to improving health for all South Australians through a recognition that policies in areas outside of the health sector, such as housing, education, transport etc. can have substantial impact on the health of the general community, and in particular on disadvantaged groups. This is often referred to as a 'social view of health'. Information was seen as having an important part in this strategy, by describing the socioeconomic and health status profiles of the population. The approach chosen to presenting information was through mapping. Maps present data in a way that is accessible to a wide audience, not only those charged with setting policy and undertaking strategic planning, but to consumers and other community advocates who may have limited skills in handling statistical information presented in more traditional ways. The maps describe the geographic distribution of the population by a range of socioeconomic indicators, together with maps showing their health status and use of health services, thereby highlighting the relationships between the indicators of socioeconomic inequality and inequality in health status. These reports have been titled 'social health atlases'. Over the fourteen years since the first social health atlas was released, the range and quality of datasets has improved, allowing for a better understanding of the impact of socioeconomic influences on health. It has also been possible to address changes in the overall levels, and patterns in the distribution, of socioeconomic status and health status and to assess the extent to which the health divide has been addressed. The atlases represent a major initiative in strengthening the public health information infrastructure in Australia and are a major policy tool with which to address health inequality arising from social inequality.En 1988, como respuesta a la toma de conciencia del papel que las desigualdades sociales juegan en las desigualdades relacionadas con la salud, la Oficina para la Salud Social de la Comisión de Salud de Australia Meridional propuso la adopción de una estrategia en salud social. La estrategia en salud social adoptó una visión, para mejorar la salud de los habitantes de Australia Meridional, basada en el reconocimiento de políticas externas al sector sanitario que pueden tener un impacto importante sobre la salud de la comunidad en general y de los grupos más desfavorecidos en particular. Entre estas políticas externas a la salud destacan la vivienda, la educación y el transporte. En su conjunto, esta visión se conoce como "aproximación social a la salud". Como parte de esta estrategia, la información se percibe como una componente importante al facilitar la descripción de perfiles socioeconómicos y de salud en la población. Los mapas fueron elegidos como el mejor instrumento para presentar y transmitir este tipo de información. Los mapas presentan la información de tal forma que ésta se hace accesible a audiencias heterogéneas, no sólo para aquellas encargadas de establecer políticas e implementar estrategias sino también a los consumidores y a otros actores sociales que podrían tener limitaciones a la hora de manejar información estadística presentada de forma más tradicional. Los mapas del atlas que se presenta describen la distribución geográfica de la población a través de un amplio rango de indicadores socioeconómicos, su estado de salud y el uso que hace de los servicios sanitarios, subrayando, por tanto, las relaciones existentes entre los indicadores de desigualdad social y las condiciones de desigualdad en salud. Ésta es la razón por la el atlas recibe el nombre de "Atlas Socio-sanitario". Durante los catorce años que han transcurrido desde que el primer atlas socio-sanitario fue publicado, la variedad y calidad de las bases de datos existentes a nuestra disposición ha mejorado considerablemente, lo que permite una mejorada comprensión del impacto que las condiciones socioeconómicas ejercen sobre la salud. Esta mejora ha permito, asimismo, analizar tendencias temporales y patrones de distribución espacial. Los atlas representan una iniciativa de gran calado en los esfuerzos por reforzar la información sobre las infraestructuras de salud pública en Australia y constituyen una herramienta de importancia mayor en las políticas dirigidas a problemas relacionados con desigualdades sanitarias cuyo origen se encuentra en la desigualdad social

The Politics of Cold War Culture

Tony Shaw, 'The Politics of Cold War Culture', Journal of Cold War Studies, Vol. 3 (3): 59-76, Fall 2001, doi: 10.1162/152039701750419510 Original article can be found at: http://muse.jhu.edu Copyright by the President and Fellows of Harvard College and the Massachusetts Institute of TechnologyThis article examines the relationship between politics and culture in Great Britain and the United States during the Cold War, with particular emphasis on the period from the late 1940s to the early 1960s. The article critically examines several recent books on British and American Cold War cultural activities, both domestic and external. The review covers theatrical, cinematic, literary, and broadcast propaganda and analyzes the complex network of links between governments and private groups in commerce, education, labor markets, and the mass entertainment media. It points out the fundamental differences between Western countries and the Soviet bloc and provides a warning to those inclined to view Western culture solely through a Cold War prism.Peer reviewe

Domestic violence in South Australia: a population survey of males and females

Abstract Objective: To determine the self‐reported prevalence of domestic violence in South Australian adults and to examine the associated risk factors, demographic factors and related health issues using computer‐aided telephone interviewing (CATI) methodology. Sample: A representative random sample of South Australian adults aged 18 years and over selected from the Electronic White Pages. Overall, 6,004 interviews were completed (73.1% response rate). Results: In total, 17.8% of adults in South Australia reported some form of domestic violence by a current or an ex‐partner. Demographic factors such as low household income, unemployment or part‐time employment and health variables such as poor to fair self‐reported health status and alcohol abuse problems were found to have a significant relationship with domestic violence. Conclusions: Approximately one in five South Australian adults report physical and emotional abuse from current or ex‐partners, of whom the majority are women who are separated, divorced or never married and on lower incomes. Telephone interviewing is a cost‐effective method of identifying prevalence estimates of domestic violence when compared with data collection by way of police reports or hospital emergency statistics. Implications: Domestic violence is a serious public health concern often ‘hidden’ by the lack of appropriate data. This study has shown that domestic violence is frequent and has important social, economic and health consequences

Recognising potential for preventing hospitalisation

To identify the incidence and distribution of public hospital admissions in South Australia that could potentially be prevented with appropriate use of primary care services, analysis was completed of all public hospital separations from July 2006 to June 2008 in SA. This included those classified as potentially preventable using the Australian Institute of Health and Welfare criteria for selected potentially preventable hospitalisations (SPPH), by events and by individual, with statistical local area geocoding and allocation of relative socioeconomic disadvantage quintile. A total of 744 723 public hospital separations were recorded, of which 79 424 (10.7%) were classified as potentially preventable. Of these, 59% were for chronic conditions, and 29% were derived from the bottom socioeconomic status (SES) quintile. Individuals in the lowest SES quintile were 2.5 times more likely to be admitted for a potentially preventable condition than those from the top SES quintile. Older individuals, males, those in the most disadvantaged quintiles, non-metropolitan areas and Indigenous people were more likely to have more than one preventable admission. People living in more disadvantaged areas in SA appear to have poorer utilisation of effective primary care, resulting in preventable hospital admissions, than those in higher SES groups. The SA Health Care Plan, 2007-2016 is aimed at investing in improved access to primary care in those areas of most disadvantage. The inclusion of SPPHs in future routine reporting should identify if this has occurred