Jackson has been homeless for the past five years after losing his job. He has a history of untreated depression that manifests as sadness, lack of motivation, and hopelessness. He also experiences anxiety and panic attacks. He doesn’t have many friends and doesn’t see his family and without a job or savings, he can’t find somewhere to live.
With no income, no savings, and no access to consistent health care, Jackson’s story is not unique. It’s a stark example of how social determinants – like housing, employment, access to health care, and social support – can shape a person’s health and well-being.
While the Australian health care system is one of the best in the world, we recognise some people and communities don’t have the same access to quality health care. As the operator of Western Australia’s three Primary Health Networks, WA Primary Health Alliance has a responsibility to improve access to affordable, quality health care for people and communities most at risk of poor health outcomes.
In Western Australia, some groups are at greater risk of poorer health outcomes including Aboriginal people, people from multicultural communities, LGBTIQA+ people, people experiencing socioeconomic disadvantage and those with limited access to health care.
While not every person in every group has the same experience, some groups are more likely to experience inequities in health and wellbeing associated with social determinants of health. This includes things like lack of local health services where they live, stigma, discrimination and unequal access to resources.
Evidence shows that these people tend to:
- Seek treatment later in the course of an illness.
- Present to hospital EDs more frequently.
- Face challenges in accessing preventative health care.
- Have poor health literacy.
Our under-served communities often face challenges accessing health care, which can be made more difficult when they are impacted by multiple social determinants of health. The needs of each group are diverse and there is no one size fits all approach to improving health equity.
Mapping and understanding under-served communities and the barriers they face is crucial. It helps us to improve the efficiency and effectiveness of primary health care services, particularly for those at risk of poor health outcomes, and allows us to improve the coordination of care to ensure patients receive the right care in the right place at the right time.
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As a commissioner of primary health care services, achieving health equity means more than just funding health services. It’s about ensuring the services we commission reach the right people and are delivered in a way that meets their needs.
Through our commissioned service providers we can better understand the day-to-day struggles some people face in accessing the health care they need. The case studies below were developed by bringing together key elements of real cases about the challenges members of our communities can face in accessing health care.
Melody’s story
Melody, 22, has depression, social anxiety and alcohol use problems. Experiencing childhood trauma, she has limited relationships with family and friends and often uses alcohol to cope. Lately she’s been drinking more often and it’s starting to impact her performance at work.
Melody started seeing a psychologist who worked with her to address her depression, reduce her alcohol use and increase her support network.
After her sessions, Melody experienced an improvement in her mood and wellbeing, she was drinking less and was in touch with her family and friends. She was linked in with community services, including a local GP, to support her ongoing needs.
Sarah’s story
Sarah, 19, grew up in a low-income family in a small rural town. She often missed school to help at home which caused her to fall behind.
Growing up in a disadvantaged environment, Sarah developed severe social anxiety, feeling self-conscious and avoiding social interaction due to fear of judgment. To cope, she turned to social media and online forums, which provided a temporary escape but made her feelings of inadequacy worse.
During a GP visit for regular headaches, Sarah’s doctor noticed signs of anxiety and referred her to a free digital mental health service. Sarah enrolled in therapy to address her anxiety and an online support group, where she found a safe space to connect with others.
With time, Sarah’s anxiety improved, and she became more involved in her community. Inspired by her experience, she hopes to pursue a career in social work.
Jackson’s story
Jackson, 45, has been homeless for the past five years after losing his job. He has a history of untreated depression that manifests as sadness, lack of motivation, and hopelessness. He also experiences anxiety and panic attacks.
He doesn’t have many friends and doesn’t see his family. Without a job or savings, he can’t find somewhere to live.
Through a community outreach program, Jackson was provided short term accommodation at a hostel that provides in reach services.
He began attending therapy sessions and was prescribed antidepressants to help manage his symptoms. Jackson’s depressive symptoms began to improve and he’s feeling more hopeful and motivated to change his situation.
He was eventually placed in a supportive housing program that offers long-term accommodation and access to social services, allowing him to focus on his recovery.
Find out more about under-served communities in Western Australia