1. Health outcomes: Indigenous Victorians  Life expectancy 17 years younger in Victoria than non-Indigenous  Aboriginal youth are four times more likely to die before the age of 25, twice as likely to be obese  13.6% of births to Indigenous mothers had low birthweight compared with 6.8% for non-Indigenous births

2. Health outcomes: New arrivals  4 out of 5 refugee children do not receive comprehensive health care  Higher levels of diabetes, poorer levels of nutrition amongst some new arrival communities

3. Health outcomes: People with disabilities 20% of Victorians report having a disability (ie. 1,033,080 people) 52.25% of people with a disability rate their health as good, very good or excellent, compared with 85.4% of all Victorians

4. Health outcomes: Low income/SES Compared to people on higher incomes, people from low income households:  Experience poorer health  Are more likely to engage in behaviours harmful to health (smoking, sedentary behaviour)  The health of people with limited socioeconomic resources is improving at a much slower rate than higher income earners

5. Influences on health Examples:  Access to employment  Access to education  Housing  Health, social and community infrastructure

6. Employment: Who is left out?  Employment: some migrant groups, Indigenous  People with disabilities

7. Education: Who is left out?  About 40.1% of Indigenous students finish a year 12 education compared with 75.9% of non- Indigenous students (AIHW 2007)  Female school completers from a low socioeconomic background are less likely to go on to university than boys from this background (Nelms 2007)  Labourers, manufacturing workers, retail industry, lowest weekly incomes participate less in furthjer learning, mostly due to being too busy (44%) or not being able to afford training (18%) (ABS 2007).

8. Housing: Who is left out?  There is an over-representation of overseas-born residents in private rental households (AHURI 2007).  2% of housing transactions in 2003 would be affordable to someone on an average income, compared with 13.5% in 1996 (The Age 2007)

9. Community infrastructure: Who is left out? 1

10. Community infrastructure: Who is left out? 2 Disability: any limitation, restriction or impairment which had lasted/will last at least 6 months and restricts everyday activities People with disabilities All Australians

11. The work still to do

12. Health inequalities  “Ensuring equity is about moving beyond equality of access to ensuring equality of opportunity and measuring equality of impacts and outcomes.”

13. Equity triangle lens

14. Equality of access  Cost  Culturally appropriate service delivery  Physical barriers

15. Equity of access: Key questions  Direct costs, but also reflect on service-related costs: uniforms, equipment, child or respite care  Culturally appropriate service delivery: Cultural security = being able to obtain the same level of service even if your values base is different  Physical barriers: Venue layout, do staff understand taxi subsidy support scheme, etc?

16. Equality of opportunity  Employment/income opportunities  Reflect on local place barriers and enablers  Social influences: “linking/bridging capital” and “contact hypothesis”

17. Equity of opportunity: Key questions  Where does the service/program fit on a continuum between unemployment and new work opportunities?  How well do you understand what it is like to live in the local area? Housing stresses, transport access, shopping and recreation

18. Equality of impacts and outcomes  Going beyond throughput measures  Who is using your services/programs?  Can this be built into KPIs/contractual arrangements?

19. Equity of impact and outcome: Key questions  Does service/program use reflect the needs of the local population?  What population demographics are collected on usage?  How do you share successes with the community and participants?

20. Current trial project  Real-life projects: around 20 across before/during/after and project/service/program/policy  Mentors and e-learning network  Leads to validating as an instrument