Successive Australian governments have failed to tackle the social and economic inequities that result in some people having shorter, unhealthier lives than others, according to a leading public health expert.

Professor Fran Baum, who was a commissioner on the World Health Organisation’s Commission on the Social Determinants of Health, has called on the Federal Government to establish an Australian Health and Equity Commission to work across government to improve the population’s health and to reduce inequities.

“This commission would have a specific brief to look beyond behavioral explanations of health inequities and consider the underlying factors that perpetuate inequity,” she said.

Writing at Croakey today, Baum said the focus of health reform in Australia has been narrowly limited to a discussion of health services rather than how to create a fairer society with a more equitable distribution of good health.

And she warned that government policies such as quarantining of welfare payments were out of step with the evidence, which suggests this policy has considerable potential to do harm.

Baum, professor of public health at Flinders University, said Australia had been slower than some other comparable countries to address the underlying causes of ill health and to act on the social and economic determinants of health.

Her comments followed the recent release in England of the Marmot Review, which was commissioned in response to the Commission on the Social Determinants of Health’s (CDSH) landmark 2008 report.

“What the CSDH report and the Marmot Review do so well is to knock on the head any simplistic idea that our health status reflects our individual determination to be healthy,” said Baum. “They both show that health and its distribution are the result of how we organise our political, economic and society affairs.”

Baum said both major political parties tended to blame the personal lifestyles and habits of the groups that suffer the worst health, rather than looking at the underlying causes.

“There are examples of this from both the last two health ministers’ (Tony Abbott and Nicola Roxon) speeches, that they easily revert to this position and see that chronic disease could be reduced if only people would eat the right food or exercise enough,” she said.

“It is rare for an Australian health minister to give a speech that shows a sophisticated understanding of the underlying determinants of health and health inequities.”

Baum also said that none of the major reports driving health reform in Australia have truly offered “a progressive alternative to business as usual in the health sector but rather suggested some tinkering with the way we currently organise health services in response to illness”.

“Thus, the National Health and Hospital Reform Commission final report A Healthier Future for All Australians just considered reform within hospitals and primary health care and while it contained the odd mention of social determinants of health, did nothing to lay out a comprehensive plan of action for tackling them,” she said.

Baum argues that one reason we’ve been slower than some other countries to address health inequity is that “Australians still like to hang on to the idea that we are a classless society or certainly one where class counts less than in Europe”.

“We are now in an election year and I would love one of the major parties to develop a platform based on tackling the underlying causes of ill-health and health inequities,” she said.