While the theme of this edition of Health Voices is “Lessons for consumers from COVID-19”, I would argue that most of the lessons we need to learn to help children and young people survive and emerge from this pandemic with the best possible prospects have already been learned. We largely know what needs to be done and why.
For example, ARACY’s evidence-based wellbeing framework for children and young people known as The Nest makes it clear we should take a wholistic view of the child, and their circumstances, and work to address their needs across six key and interlocking areas: Being Valued Loved and Safe; Having Material Basics; Being Healthy; Learning; Participating; and Having a Positive Sense of Identity & Culture.
We know too the importance of the early years in shaping the lifetime health of children. Analysis of global evidence found adult conditions such as coronary heart disease, stroke, diabetes, and cancer are now being linked to pathways that originated prior to or during a child’s first 1000 days.
We know that low levels of income support have a negative impact on children and young people. Our report To Have and To Have Not found that children in jobless families (and therefore dependent upon what was then called Newstart) are more than four times more likely to be homeless than kids in families where an adult works, nearly twice as likely to be bullied or face social exclusion and almost two and a half times more likely to be missing out on learning at home.
We know that stable housing and maternal smoking have a huge impact on children. Modelling by PwC Australia found that for each woman who stops smoking during pregnancy, an estimated saving of $29,000 is projected over her child’s lifetime, 50 per cent of which is due to a reduction in obesity costs. The same report also found that growing up in a home owned by the child’s parents or primary caregiver leads to societal benefits of approximately $36,000 over the lifetime of that child, 94 per cent of which is attributable to increased earning capacity.
We knew before the pandemic that the costs of late and inadequate action to help children, young people and their families were huge. A 2019 report found that every Australian is paying $607 per year ($15.2 billion in total) for services that could have been avoided, had children and families in need been provided with early and appropriate help. Key elements of this cost are physical health ($1.1b) and mental health ($1.3b).
It’s clear that even before the pandemic, we knew what obstacles our young people faced. That said, there is no doubt the pandemic has highlighted these obstacles and, in many cases, made them more severe. For example there are many indicators that children and young people are experiencing higher levels of mental illness brought on by the pandemic, the economic crisis and the strict public health measures.
Given that we already understand the social determinants of health, especially as they effect young people, and given that we know that the pandemic has made these effect stronger, what can we as consumers learn from the pandemic?
First, we must learn and remind ourselves that as citizens we are consumers of government policy, and as consumers we have rights and power. As consumers (and in most cases, taxpaying funders of these services) we should be making clear to governments that we understand the social determinants of health, and that we expect them to act to address these.
We must be making it clear to governments that for the health and wellbeing of our children and the long-term benefit of the nation, we expect that children will not be forced to live in poverty or in unsafe or unstable housing, that we wish to see greater investment in areas like public housing and income support.
We need to make clear to our governments that we expect them to take into consideration the whole child, and the child’s context, when designing and providing services. This would range from macro activities such as establishing a national wellbeing budget process, similar to that of New Zealand, to micro reforms such as ensuring policy makers and service delivery staff are trained to better understand social determinants of health, and look for appropriate non-medical solutions (such as social prescribing and closer working with other non-medical service providers and organisations). These can be achieved through ensuring greater awareness of frameworks such as The Nest and more wholistic ways of working with clients and colleagues such as ARACY’s Common Approach.
In short, I think this pandemic has taught us little, if anything, new. But it has, again, brought into stark relief the very real impacts issues such as poverty, unemployment, isolation and homelessness have upon the health of children and young people across generations. It again reminds us that these effects can last a lifetime. And most importantly, it reminds us that there are steps we can take to address these.
Some, such as building public housing, delivering universal early education (and making more centres family services hubs) come with huge price tags, but which are offset with immediate stimulatory impacts as well as long term health and productivity gains. Others such as thinking of children and families in context and working with new colleagues in different ways may be less expensive but will require time and ongoing effort to become effective.
The main lesson I think we should all take from this pandemic is that we are all consumers, and we ought not be afraid to use our power as consumers, especially at the ballot box.
About the author
Penny Dakin was appointed CEO of ARACY (Australian Research Alliance for Children & Youth) in January 2019 having acted in the role from mid-2018. She has previously worked as General Manager for Policy and Strategic Engagement with ARACY and has worked in a number of roles in organisations including Insight Consulting, the Department of Health, and A Village for Every Child. Penny is passionate about ensuring young Australians, regardless of their background or circumstances, receive every opportunity to reach their potential and is a firm believer in ARACY’s unique role as a driver of collaboration and a leader of alliances to help achieve this.
