- + Key points: Socioeconomic status
• In NSW and Australia there are differences between socioeconomic groups in many measures of mortality and morbidity, due to differences in the determinants of health (both social and behavioural) between groups and to inequalities in the health system.
• Life expectancy has increased and rates of premature and potentially avoidable deaths have declined among all socioeconomic groups over the past 20 years in NSW.
• In this period life expectancy has remained consistently higher and premature and potentially avoidable death, ambulatory care sensitive hospital separations, and teenage pregnancy rates consistently lower, in the highest socioeconomic group than in the lowest socioeconomic group.
• Smoking and overweight and obesity show a similar pattern of sustained differences between the highest and lowest socioeconomic groups over time.
• Rates of decline in premature and potentially avoidable death have been greatest in the highest socioeconomic quintile for both males and females, resulting in an increasing relative 'gap' between this group and the rest of the population.
• Relative gaps in teenage pregnancy rates increased between all three socioeconomic groups.
• From 2002 to 2009, the relative gap in the prevalence of overweight and obesity was stable for both sexes, while the relative gap in the prevalence of smoking was stable for females but increased for males.
- + Background: Socioeconomic status
The term "socioeconomic position" means the social and economic factors that influence what position individuals and groups hold within society that may have an influence on their health. Individual-level measures of socioeconomic position include occupation, income, assets and education. Group or area-level measures include occupational, educational and economic structure, housing characteristics and indexes of poverty or deprivation.
This report uses the Index of Relative Socio-Economic Disadvantage (IRSD), one of four Socio-Economic Indexes for Areas (SEIFA) developed by the Australian Bureau of Statistics based on census data, to measure socioeconomic disadvantage in the NSW population. The IRSD includes the main measures of disadvantage (low income, high unemployment, low levels of education and high levels of unskilled occupations) as well as other measures shown to be associated with disadvantage, such as the proportions of Aboriginal people, persons with low English fluency, and multiple families living in the one house in an area. IRSD scores are assigned to geographic areas rather than individuals, weighted to the population of the area, and ranked for the whole of Australia.
Such an approach means that health outcomes can be compared between areas based on the overall socioeconomic status of areas. A disadvantage is that area scores may hide pockets of disadvantage in larger geographic areas. The IRSD also does not consider other socioeconomic measures which may be important, such as wealth, community infrastructure, or cost of living differences (Adhikari 2006).
Further discussion of SEIFA is included under the Methods tab.
The health of all Australians has improved enormously over the 20th century, with the life expectancy of both genders increasing by about 20 years over this time. Despite this, health outcomes remain unequally distributed between different socioeconomic subgroups of the NSW population.
Burden of disease
The socioeconomic gradient in population health is well-documented: as socioeconomic disadvantage increases, there is a simultaneous increase in mortality and morbidity from both avoidable and other causes. The health burden in the Australian population attributable to socioeconomic disadvantage is large and much of this burden is potentially avoidable.
Adhikari P. Socio-economic indexes for areas: Introduction, use and future directions. ABS Catalogue no. 1351.0.55.015. Canberra: ABS, 2006.
- + Interventions: Socioeconomic status
Both absolute and relative changes in indicators of socioeconomic disadvantage are presented in the report as each of these measures provides important information for assessing the success of any initiative aiming to reduce inequality.
Interventions aiming to reduce inequality are embedded in strategies dealing with specific health issues or specific disadvantaged populations.