Social and commercial determinants of health and health equity in Australia

Health inequities in Australia have increased over recent decades, driven by increasingly inequitable distribution of social determinants, including employment, education, healthcare access, welfare, and digital access. Aboriginal and Torres Strait Islander peoples are affected by these inequities, in addition to the denial of their sovereignty, dispossession, and the effects of ongoing colonization. Commercial determinants of health are seen in the domination of neoliberal ideology in Australia’s public policy, leading to increased privatization, a hollowing out and deskilling of the public service, and lack of investment in infrastructure like public housing that would reduce inequities. Climate change is exacerbating the impact of many social and commercial determinants. Australia is slow in transitioning to a renewable energy economy and needs to ensure that fairness is a consideration. A change in direction for Australian public policy towards a more equitable, and just approach that prioritizes population health is essential to reversing health inequities.