David Campbell (Desert Knowledge CRC/Centre for Remote Health)

1. David Campbell (Desert Knowledge CRC/Centre for Remote Health) 2008 Desert Knowledge Symposium and Business Showcase Alice Springs Thursday 6th November 2008 Scoping and complementary economies in closing the gap in health outcomes for Aboriginal people in the Australian desert

2. Nature of the health gap for Aboriginal people in the Australia desert Conditions important to explaining the gap • Chronic disease • Intra- and inter-personal harm Factors important to explaining the conditions • The social and psychological factors (Psychosocial determinants) are important to explaining these conditions

3. Scope of government response to closing the gap • Healthy homes • Safe communities • Health services • Early childhood • Schooling • Economic participation • Governance & leadership How, within a budgetary constraint should these factors be interlinked?

4. Economic considerations to a holistic approach • Joint outcomes & economies of scope: • these are important to how we cost inputs to closing the gap, eg schooling and governance • They can also be important to where work occurs and • Complementarities: • Making sure we get the mix of medical and those other factors affecting the social determinants of health correct.

5. Joint products in closing the gap through engagement of Aboriginal people in land management Aboriginal health Human capital-enhanced state/public health Arts and crafts Environment: biodiversity. biosequestration

6. Complementarities in the production of health outcomes using social determinants and medical services as inputs Iso-quantity curves Health production line B C Addressing social determinants A Production curve for increasing health/or for closing the gap Medical inputs

7. In conclusion • There are questions regarding whether health outcomes are as good as might be expected? • The proposition in this presentation is that this is in part due to not meeting the social determinants of health. • Any policy response, however, needs to ensure: • That a full broad-based (holistic) accounting is taken of the costs and benefits of the actions taken, and • Ensure that the mix of inputs is appropriate.

8. Much of the material discussed here is contained in: Campbell, D. Davies, J. and Wakerman, J. 2008, ‘Facilitating complementary inputs and scoping economies in the joint supply of health and environmental services in Aboriginal central Australia’ Rural and Remote Health Journal ‘www.rrh.org.au/articles/subviewnew.asp?ArticleID=1080’ : The research reported here was jointly supported by funding from the Australian Government Cooperative Research Centre Program through the Desert Knowledge CRC and the Centre for Remote Health, funded by the Department of Health and Ageing University Department of Rural Health program. The views expressed herein do not necessarily represent the views of Desert Knowledge CRC, the Centre for Remote Health or its participants.