Opinion article

Low socioeconomic status increases levels of chronic disease

Rosemary Calder examines how geographical location aligns with risk factors for preventable chronic disease. 

Last year, the Australian Health Policy Collaboration, a policy think tank at Victoria University in Melbourne, released Australia’s Health Tracker by Socioeconomic Status, the fourth in the series of curated data reports that tell the story of the health status of Australians in terms of the risk factors for preventable chronic diseases that are present in our population.

The data in this report graphically highlighted the obvious – that people and families in the lower two socio-economic quintiles – that’s 10 million Australians – are at much greater risk of poor health.

These Australians mostly live in geographical communities that reflect their individual circumstances. Australia’s Health Tracker by Area shows the alignment of risk factors for preventable chronic disease within local government areas and with primary health network catchments and emphasises the geography of disadvantage and high levels of risk factors for poor health and chronic diseases.

The risk factors that feature in Australia’s Health by Socioeconomic Status are a suite that are the most significant risk factors contributing to preventable chronic diseases in our population. They include behavioural risk factors such as physical inactivity; alcohol consumption and smoking, and the biomedical risks of high cholesterol; high blood pressure and obesity.

The 40 per cent of Australians in the lower two socioeconomic quintiles – ten million people – are more affected by three health issues diabetes, suicide and premature deaths than are other Australians. These three health issues tell a stark story:

  • People in the most socioeconomically disadvantaged communities are 60 per cent more likely to live with diabetes than those in the most advantaged
  • They are 71 per cent more likely to suicide than those in the most advantaged communities, and suicide is the leading cause of death for 15 – 44 year olds
  • And, for the period 2013 – 2017, there were 49,227 more deaths before the age of 75 in lower socio-economic groups than in other socioeconomic groups.
That’s an extraordinary ‘road toll’ and one that we have little awareness of. Contributing to some of those are the very large socioeconomic differences in the risk factors:

  • People in most disadvantaged communities are 57 per cent more likely to be obese than the most advantaged – and Australia has one of the world’s highest rates of obesity
  • They are 2.5 times more likely to smoke than the most advantaged
  • They are much more likely to be physically inactive than the rest of the population.
The risk factors that occur at higher levels within communities of low socioeconomic status can and do lead to increased levels of chronic disease, and as the data shows, to higher rates of early death from preventable causes. We can identify regions with particularly high risk factors, for example:

  • 83.8 per cent of people in Naracoorte (SA) reported low or no physical activity in the week preceding the Australian Health Survey collection in 2012
  • Bridgewater (Tasmania) has smoking rates of 39 per cent - levels that prevailed in the general population three decades ago but which have come down to 12 – 15 per cent nationally
  • Homebush Bay / Silverwater (NSW, western Sydney) has childhood obesity rates of 20 per cent of their child population.
We have the data that can guide policy and investment to better target the costly impacts of disadvantage that affect individuals, communities, health and other government budgets as well as the national economy. Policies which specifically address the health, education and participation impacts of socioeconomic conditions will significantly improve health and healthier people will contribute socially and economically.

Smart policies will align current investments with increased focus on inequalities and the communities in which they cluster.

CEDA research: Read How unequal? Insights on inequality.

About the authors

Rosemary Calder

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Rosemary Calder is the director of the Australian Health Policy Collaboration, an independent national health policy ‘think tank’ established by Victoria University, Melbourne. Rosemary is a leading health and social policy expert. She has held positions as a senior executive in health policy and administration in both State and Commonwealth Departments of Health and was head of the Office for the Status of Women in the Commonwealth Department of Prime Minister and Cabinet from 2000 to 2003.

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