To what extent do Australian child and youth health, and education wellbeing policies, address the social determinants of health and health equity?: a policy analysis study

Abstract
Background: Children and youth are an important population group requiring specific policies to address their
needs. In Australia, most children and youth are doing well, however, certain equity groups are not. To address child
and youth health equity in policy, applying a social determinants of health approach is considered best practice. For
over 10 years governments in Australia have been called upon to address the social determinants of health, however,
there has been limited action. Health and education departments are typically most involved in policy development
for children and youth. To date, there have been limited systematic analyses of Australian child and youth health policies,
and selected education wellbeing policies, with a social determinants of health and health equity focus and this
study aims to contribute to addressing this gap.
Methods: Policy analysis was conducted across 26 Australian child and youth health policies, and selected education
wellbeing policies. We used an existing prior coding framework to understand the extent the social determinants of
health and health equity were addressed. All policies were strategic level and only included if dated 2009 onwards.
Results: Across 26 selected policies only 10% of strategies addressed the social determinants of health, demonstrating
a lack of policy action. However, there is relatively even focus on all developmental stages, and an increased
focus on youth. Equity is acknowledged across most policies with some groups receiving more attention including
Aboriginal and Torres Strait Islander children. The social determinants of health addressed, to some degree, include
early childhood development, education, parental workplace conditions, healthy settings, and housing, those least
mentioned include public transport and regulation.
Conclusion: This study demonstrates a lack of policy action on the social determinants of health within Australian
child and youth health policy, and selected education wellbeing policies. Rather, the application of a siloed, and predominantly
acute care approach. However, there is recognition of equity across all policies; an emphasis on housing
as a determinant of health; and a link between health and education departments through education wellbeing policies,
specifically addressing the issue of mental health.