Australian COVID-19 policy responses: Good for health equity or a missed opportunity?

Abstract

COVID-19 shines a spotlight on social and health inequities: the already widening inequities in life expectancy, premature death, noncommunicable diseases and mental health issues in Australia will get worse as a consequence of COVID-19 if progressive, long-term multisectoral action is not taken. This report examines the health equity implications of 156 social and economic policy measures introduced by the Australian Federal and State/Territory Governments in response to the pandemic. The wide-ranging and rapid policy responses to COVID-19 risks and impacts is impressive, showing that if there is political will action can happen. A number of positive measures were introduced to address employment, household income, and standard of living. These could go a long way to keeping people well and reducing health inequities. They must however not return to conditions that will keep people in poverty. Policies must ensure a decent standard of living and fair working conditions as we move forward. To prevent an accumulation of disadvantage and health inequities throughout the life course, the temporary supports for childcare should continue and enable access to free childcare for, at the very least, socially disadvantaged households. None of the housing-related measures that were introduced addressed the medium and long term housing precariousness that is prevalent in Australia. Unless this is fixed, social and health inequities will continue to widen. Investment in social housing could help address the gap in housing, job creation and income growth, and reduce homelessness. Policy measures introduced to support aged care, disability services, the arts and family violence are very helpful in the short term. However, there is a need for sustained and adequate funding to these sectors and organisations, particularly going forward when it is likely that these organisations will play a more vital role than ever in helping to rebuild communities. COVID-19 has initiated an enormous intergenerational transfer of debt. The health consequences will be felt for decades, possibly generations. But austerity cannot be the policy response going forward. Long-term investment is vital across the conditions of daily living. Action on the structural drivers of health inequity is essential. Without action on climate change, health inequities will be exacerbated. Good social policy is good climate adaptation policy, and good for health. Climate change mitigation must focus on the consumptagenic system – the institutions, policies, processes, actors, and ideas that embed, facilitate, and normalise the dominance of a system addicted to growth and profits irrespective of the environmental, social, and health costs. ‘Bouncing back better’ from COVID-19 could see a healthier, more equitable and sustainable Australia if political leaders choose to use this unfortunate event to drive positive societal change. We cannot have deregulations in social, health and environment sectors in order to "kickstart the economy", nor the dominance of certain gender, economic and political lenses in the recovery governance processes. Governing going forward requires a new social compact, supported by a national whole of government health equity strategy