ACKNOWLEDGING AND ADDRESSING SOCIAL DETERMINANTS OF HEALTH IN CHRONIC KIDNEY DISEASE: AN ANALYSIS OF HEALTH POLICY RESPONSES ACROSS AUSTRALIAN JURISDICTIONS
Javier Recabarren1,2, ANITA VAN ZWIETEN1,2, AMANDA DOMINELLO1,2, NICOLE SCHOLES-ROBERTSON2,3, ALLISON JAURE1,2, GERMAINE WONG1,2, MARTIN HOWELL1,2 1Sydney School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia2Centre for Kidney Research, The Children’s Hospital at Westmead, Sydney, New South Wales, Australia3Rural and Remote Health, Flinders University, Alice Spring, Northen Territory, Australia
Abstract
Background and Aims: The health of populations and individuals is substantially determined by non-medical factors called social determinants of health (SDH), which are a key driver of health inequities. The aim of this study was to examine the extent to which government health policies that address chronic kidney disease (CKD) acknowledge and address SDH.
Methods: We searched Commonwealth and state/territory health department websites for current policies up to March 2022 that were relevant to provision of healthcare for people with CKD. We examined the extent to which policies capture the evidence for SDH in its written content, with a framework that described whether policies acknowledged, set out aims and/or described specific actions to address SDH. We also examined whether policies addressed structural (e.g. income or cultural factors) or intermediary (e.g. healthcare access or psychological factors) SDH.
Results: 101 policies addressed CKD; 27 Commonwealth, and 74 state or territory-based. In their written content, almost a half (50%) acknowledged SDH, and one-third (33%) suggested aims and actions to address SDH. When we examined the intended consequences of the policy, almost two-thirds (66%) addressed intermediary factors while only one-third (33%) addressed structural determinants. Most of the policies that addressed structural SDH were amongst the 36 health plans.
Conclusions: Only health plans proposed structural actions to tackle the burden of CKD. However, they were aspirational and provide few measurable actions. The rest of the policies focused solely on tackling intermediary determinants. Following the World Health Organization recommendations, more policies addressing structural SDH that include actions with other state departments and social participation are required to address inequities in the burden of CKD in Australia.
Biography
Javier Recabarren Silva is a Research Officer at the Centre for Kidney Research at the School of Public Health at The University of Sydney. Javier was awarded his PhD in 2022 in the field of political economy at the School of Social and Political Sciences at The University of Sydney. His main research areas are the analysis of health policies, the impact of the social determinants of health, and the involvement of patients and caregivers in research.