1. Alternative ways to improve health
Dr Heather Douglas
Centre for Social Responsibility in Mining
University of Queensland or

2. Health – just one aspect of wellbeing
Wellbeing – a multidimensional condition with personal, social, environmental and economic features providing the foundation for individuals to live a dignified, meaningful life (McGregor, 2010).

3. Wellbeing - sufficient access to
Basic requirements
Meaningful life
Health
Employment, valued activities
Education
Social relationships
Personal safety
Inclusion
Shelter
Personal accomplishments
Social welfare
Natural environment
Income, material goods
Culture and heritage
Stephen Hawking

4. Queensland budget: $55.7bn 2017-18
Health %
Education %
Social welfare/housing/other community services 12.8%
Transport & Communications %
Public order & safety %
Economic services %
Other %

5. Queensland budget: $55.7bn 2017-18
Basic requirements %
Meaningful life
Health
29.4
Education
24.5
Personal safety Public order, safety
9.2
Social welfare Social welfare, community services, housing
(Child safety, disability, communities %)
Shelter (Housing %)
12.8
Employment/valued activities
Social relationships
Inclusion
Personal accomplishments
Natural environment
Culture and heritage
Income Economic services 4.2% - income ??%

6. Improving health: income & education
“Approximately 90% of variation in infant mortality can be explained by a country's per capita income, the distribution of income, the extent of women's education, the level of ethnic fragmentation, and the predominant religion.
Public spending on health has relatively little impact”.
Filmer & Pritchett, World bank report, 1997

7. Improving health: investing in education

8. Improving health: Investing in education

9. Improving health: education
“Education has the potential to bring significant benefits to individuals and society, which go well beyond its contribution to individuals’ employability or income”.

10. OECD: Education benefits
Education improves agency: it enables individuals to
perform better in the economy as employees or entrepreneurs
improves wellbeing, civic engagement, longevity, happiness, health
individuals are more able to make decisions and contain violence.
“By fully recognising the power of education, policy makers could better address diverse societal challenges”.
OECD 2013 EDUCATION INDICATORS FOCUS 01

11. Improving health in disadvantaged populations: educating girls and women
There is a strong link between educating girls and positive outcomes for the health, economic empowerment and social improvement (OECD).
Educating girls helps to make all communities and societies healthier, wealthier and safer (World Bank, 2014).
These effects apply in developing countries and also disadvantaged communities in developed economies.

12. Improving health: educating girls
Educating girls is one of the most important investments for the future of developing countries
Better educated women tend to be healthier, participate more in formal labour markets, marry later, have fewer children
Investing in girls’ primary education has a significant impact on their agency, reducing violence and family size, increasing control over material assets, and increased capacity to engage in economic activities
The lifetime economic return for one year of a girl’s secondary education is an increase of up to 25%
These effects carry from one generation to the next.
(World Bank 2014)

13. Educating women & girls: benefits
For women
For families
For communities
10% increase in female earnings for each year of schooling
A child of a literate mother is 50% more likely to live past 5 years of age
25% increase in agricultural output in Sub-Saharan Africa
Girls with secondary schooling are 6 times less likely to be child brides
Children of mothers with secondary education have better nutrition and brain development
35% higher GDP per capita for each additional year of education
Adapted from Global Partnership for Education 2016; Somani 2017

14. Linking education and health

15. Improving health: income
Children from poor families do not perform as well at school as those of affluent families, and
Rich people have better health than poor people,
So we need to examine income

16. Why do better educated, richer people live longer and in better health than poorer, less well educated people?

17. Improving health: income
Income provides options – to buy services, relocate to better neighbourhoods, eat better, have better housing etc.
All of these affect health and wellbeing

18. Improving health: income
Mortality is positively and significantly correlated with almost all measures of income inequality
Life expectancy widened in many countries after 1980 as income inequality was increasing
(NBER report, 2003)

19. Australia
ACOSS

20. Relative income across Australia

21. Proportion of people at income levels

22. Improving health: Income arguments
Materialist arguments e.g. money buys health-promoting goods and the ability to engage in a social life in ways that enable people to be healthy;
Psychosocial mechanisms e.g. the stress of not having enough
money may affect health;
Behavioural factors – people living in disadvantaged circumstances are more likely to have unhealthy behaviours;
Circular effects - poor health affects education and employment opportunities and these subsequently affect health.

23. Improving health: income
ABS – approximately 40% of the Australian working population has non traditional working arrangements
Part time work
Short term contracts e.g. 1 month – 1 year
Non standard hours
Precarious work (0 hour contracts, infrequent work)
Gig economy

24. Improving health: income
Long term unemployed 22.9% June 2016 cf 12.8% 2009
41% of unemployed 55-64yr olds were long term
2016 employment grew 212,000 but 68.3% was PT
PT work grown 26% (June 2000) to 32% (June 2016)
Precarious work arrangements are difficult to document but
50% of academic employment is non traditional working arrangements, especially tutors and research staff

25. Improving health: income
Nonstandard work = reduced income
Reserve bank is increasingly discussing these effects as ‘low wage growth’

26. So what? We need to consider health as only one aspect of wellbeing
Need to consider budgeting adequately to offer people meaningful lives

27. Consider wellbeing in budget process Fund and measure what matters