Trends in Health Poverty in Australia, 2001-2018

Good health is a fundamental aspect of quality of life. Although there are measures of poverty in several aspects of life, there is no established measure of health poverty. We use data on 30,005 adults from the Household, Income and Labor Dynamics in Australia (HILDA) to track trends in health poverty in Australia over 18 years from 2001 to 2018. We define health poverty as dying within one year or reporting the lowest levels of health in any of the six health domains of the Short-Form Six Dimension (SF-6D). We show how rates of health poverty have changed over time for the population as a whole and for sub-groups of the population defined by gender, age, indigenous status, rurality and State of residence. The proportion of the adult population experiencing health poverty in any one of the dimensions was 41% in 2001, falling to 36% in 2009 and then rising to 42% in 2018. The level of health poverty was higher for women than for men (42% vs. 36%), for older age groups (37% among 15 to 29-year-olds vs. 49% among those aged 60 years and over), for indigenous people (52% vs. 39%) and in South Australia (41% vs. 39%—the average rate of all the other states). The six domains of health are: physical function, role function, social function, pain, mental health, and vitality. Most (51%) people experiencing health poverty reported poverty in more than one of the six dimensions. Poverty in role functioning was the most commonly reported domain. Lack of vitality and role functioning were the domains most commonly reported as the only deficit causing an individual to be in health poverty, by 24% and 39% respectively of individuals experiencing health poverty. These domains were also the main reasons for higher rates of poverty over time and between women and men. Poor mental health and role functioning were the main reasons for higher health poverty amongst Indigenous people. The analysis shows which groups in Australia experience health poverty and in which aspects of their lives. We hope that this framework, together with regular monitoring and evaluation, could be used by Australian Governments to target and minimize health poverty.