Better health cannot just be about bigger hospitals

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Victoria’s health system emerged from the COVID-19 pandemic bruised and battered. It was no surprise then that health was the central issue during last year’s state election, with Labor promising close to $10 billion in spending on large health projects, including new hospitals in West Gippsland and Melbourne’s east.

Buttressing the election debate was the belief that good health is reliant on a well-resourced health system.

And that is true. Without access to quality medical care, staying healthy is always going to be a challenge.

But is building more hospitals, buying more equipment, hiring more medical staff a silver bullet to a healthy society?

As The Age’s new State of Our Health series reveals this week, the inherent advantages or disadvantages of their postcode can also have a dramatic impact on people’s health, no matter how close or good a hospital may be.

For the first time, the 2021 census asked Australians to disclose whether they had been diagnosed with health conditions including asthma, cancer, heart disease, diabetes and dementia.

The results have revealed a detailed picture of Victoria, exposing a range of health issue hot spots in cities, towns and regions across the state.

Our series gives a unique insight into where particular health conditions are prevalent and a voice to those afflicted by those ailments. It also talks to a range of experts who expand on the notion that one’s social and environmental circumstances can have an enormous impact on one’s wellbeing.

It’s not a new idea. An extensive study two years ago by the Australian Council of Social Services and the University of New South Wales found that Australians without paid work are almost twice as likely to report mental health issues than those working full-time.

More broadly, those with higher incomes reported good health 60 per cent of the time, while those on lower incomes only 32 per cent of the time.

The Age’s health series, for the first time, gives us a more granular view of Victoria and helps build a more comprehensive picture of what factors may impact our health.

As the series explains, for instance, there are many triggers linked to lower-quality housing that people relying on rental accommodation will find difficult or impossible to avoid such as dampness, gas stoves and poorly ventilated heating. Each one can exacerbate asthma. There is also the rapid spread of fast food outlets in areas such as Melton that experts believe are exacerbating the number of people with diabetes.

Not all things are clear-cut. For example, the series reveals that only 2 to 3 per cent of Tarneit residents state they have a mental health condition compared with a statewide average of 9 per cent.

In explaining such a low number, one Tarneit resident believes high rates of employment and an unwavering drive by the suburb’s many immigrants to create a better life for their children has given residents purpose and boosted their mental health.

At first glance that would seem good news. It’s an area that would be experiencing high levels of mortgage stress and other challenges.

But experts believe the low numbers may also reflect the area’s “poorer health literacy”, which can translate to people being less inclined to want to discuss or publicly reveal mental health issues.

This is not a series that is going to give you definitive answers. What it does, however, is quash the view that one’s health is determined simply by the individual or their access to good healthcare.

While these are important, factors such as age, employment status, cultural norms, income level, social support, housing, food and transport can also play a crucial, and often determining, role.

For governments the lessons are clear. Building more hospitals, while an essential cog in the health system, will not strikingly shift the dial when it comes to health outcomes in certain areas.

That must be a broader discussion that takes into account not just how people are treated when they are afflicted with an ailment, but why, in the first place, they are unwell.

Patrick Elligett sends an exclusive newsletter to subscribers each week. Sign up to receive his Note from the Editor.

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