Federal, State and Territory government responses to health inequities and the social determinants of health in Australia.

ISSUE ADDRESSED: Planned actions by governments can play an important part in addressing the social determinants of health and health inequities. We assess the extent to which Australian health departments are committed to health equity as a core value, and the extent to which strategic directions and policies show evidence of action and achievement in reducing health inequities and attention to the social determinants of health.
METHODS: Key documents guiding each health department since 2000 were sought from a key informant in each jurisdiction (State/Territory/federal). An analysis was made of the content in terms of stated values, strategies, objectives, intended and current initiatives, collaborations, funding, and reporting of achievements in relation to the reduction of health inequities and the attention accorded to the social determinants of health.
RESULTS: All jurisdictions are explicitly or implicitly committed to reducing health inequities and to addressing the social determinants of health to at least a limited extent. The extent of commitment varies from those who make a clear statement of the importance of achieving health equity at both whole-of-government and health department level, to others who have extremely limited commitment. There is also variation in the extent to which directions are transformed into planned initiatives to improve health outcomes or access to health services for disadvantaged groups or areas, and variations in the degree of monitoring and evaluation.
CONCLUSION: Although substantial health inequities exist in Australia there is explicit or implicit recognition of the underlying value of equity within all jurisdictions and some policies designed to increase health equity in all. However, in most jurisdictions health equity could be more explicitly incorporated into core government and health department strategies and initiatives, and there is room for the development of the capacity to monitor change over time in access to services, quality of care, and improved health outcomes.