Scoping and complementary economies in closing the gap in health outcomes for Aboriginal people in the Australian desert David Campbell (Desert Knowledge CRC/Centre for Remote Health) 2008 Desert Knowledge Symposium and Business Showcase Alice Springs Thursday 6 th November 2008

Nature of the health gap for Aboriginal people in the Australia desert Conditions important to explaining the gap Chronic disease Intra- and inter-personal harm Factors important to explaining the conditions The social and psychological factors (Psychosocial determinants) are important to explaining these conditions

Scope of government response to closing the gap Healthy homes Safe communities Health services Early childhood Schooling Economic participation Governance & leadership How, within a budgetary constraint should these factors be interlinked?

Economic considerations to a holistic approach Joint outcomes & economies of scope: –these are important to how we cost inputs to closing the gap, eg schooling and governance –They can also be important to where work occurs and Complementarities: –Making sure we get the mix of medical and those other factors affecting the social determinants of health correct.

Human capital- enhanced state /public health Aboriginal health Arts and crafts Environment: biodiversity. biosequestration Joint products in closing the gap through engagement of Aboriginal people in land management

Medical inputs Addressing social determinants Complementarities in the production of health outcomes using social determinants and medical services as inputs A B C Production curve for increasing health/or for closing the gap Iso-quantity curvesHealth production line

In conclusion There are questions regarding whether health outcomes are as good as might be expected? The proposition in this presentation is that this is in part due to not meeting the social determinants of health. Any policy response, however, needs to ensure: – That a full broad-based (holistic) accounting is taken of the costs and benefits of the actions taken, and –Ensure that the mix of inputs is appropriate.

: The research reported here was jointly supported by funding from the Australian Government Cooperative Research Centre Program through the Desert Knowledge CRC and the Centre for Remote Health, funded by the Department of Health and Ageing University Department of Rural Health program. The views expressed herein do not necessarily represent the views of Desert Knowledge CRC, the Centre for Remote Health or its participants. Much of the material discussed here is contained in: Campbell, D. Davies, J. and Wakerman, J. 2008, ‘Facilitating complementary inputs and scoping economies in the joint supply of health and environmental services in Aboriginal central Australia’ Rural and Remote Health Journal ‘ 1080’