Applying an Economic Framework to the Benefits for Aboriginal People of ‘Healthy Country, Healthy People’ and Government Failure in Addressing the Global Noncommunicable Disease Pandemic

Author: David Campbell

Campbell, David, 2017 Applying an Economic Framework to the Benefits for Aboriginal People of ‘Healthy Country, Healthy People’ and Government Failure in Addressing the Global Noncommunicable Disease Pandemic, Flinders University, School of Medicine

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Abstract

Two national policy concerns are the loss of environmental services and the higher level of chronic

or noncommunicable disease born by Aboriginal people relative to non-Indigenous Australians. This

difference in health outcomes is the result of the higher level of psychosocial stress born by the

Aboriginal population, with the socioeconomic determinants of health and loss of control through

invasion and colonization being important additional stressors. These stressors act as

primary-causative agents leading to disruption of the homeostatic system and to risky behavioural

choices.

The initial intention of the thesis is to demonstrate the positive interrelationship between the

above two policy issues according to the nexus between healthy country, healthy people, through

involvement by Aboriginal people in traditional land management, or caring-for- country. This

demonstration was carried out using two quantitative economic analyses of the probable cost savings

in primary health care through involvement in caring-for-country. These analyses were for an

Aboriginal community in tropical west Arnhem Land in the Northern Territory’s ‘top end’, and for an

Aboriginal community in the Northern Territory central Australian desert.

In addition to the private good benefits enjoyed by those participating in caring-for-country, the

analyses shows the possibility of substantial cost savings in primary health care. A number of

other public good social benefits, including biosequestration of greenhouse gases, maintenance of

biodiversity, and mitigation of dust storms, which is a vector of airborne particulate matter and

of disease. Such public good benefits occur as cost free by-products, or externalities. That is,

these public good benefits can occur at no cost to society as a whole. As Aboriginal people receive

minimal benefit from these public goods, they are likely to be under supplied, which might be

corrected through use of appropriate incentives.

Much of government engagement in prevention and mitigation of noncommunicable disease is focused on risky behavioural choices and curative health interventions. While such interventions can be

helpful, they do not address the primary stressors, which have negative health impacts beyond risky

choices. Having a nonmedical origin they can be addressed through the application of nonmedical

primary-preventative health interventions. For Aboriginal people in remote to very remote

Australia, participation in caring-for-country provides an opportunity to assert control over their

lives and the mitigation of those psychosocial stressors, which are primary-causative agents

affecting negative health outcomes.

At a higher level of abstraction, caring-for-country exemplifies a cost-effective nonmedical primary-preventative health intervention, when such preventative actions might be applicable to the mitigation of the global noncommunicable disease pandemic. Nonmedical primary-preventative health interventions are likely to increase disability-free survival, with depressed morbidity leading to reduced health costs, increased social welfare and an extended tax base. Contrary to these benefits, primary- preventative health funding by government appears to be underfunded relative to curative health funding. Such government policy imbalance can constitute government policy failure. The processes by which economically optimal nonmedical primary preventative health interventions might be assessed and applied are considered, according to the likely multidisciplinary and multijurisdictional nature of such interventions.

Keywords: Preventative health, environmental health, Traditional land management,

Subject: Medicine thesis

Thesis type: Doctor of Philosophy
Completed: 2017
School: School of Medicine
Supervisor: MELISSA LINDEMAN