Sydney Local Health District EquityFest 2018

Every year Sydney Local Health District holds EquityFest, an event that showcases work being done to address health equity within the District and to consider what else needs to be done. The theme of this year’s EquityFest was “investing in the future – leaving no one behind”. It was an impressive showcase of the diversity of the District, and the work that they’re undertaking to respond to their communities’ needs.

More than that though, it provided a clear statement that equity matters to them as an organisation, something that we almost never see in contemporary Australian social institutions.

Key messages

  • There’s a need to invest meaningful time in understanding lived experience, not just giving lip-service to it through a narrow focus on things like patient experience measures.
  • Reflective and interrogative practices are required, personally and organisationally, to identify biases and to think about who’s excluded in, and through, our activities.
  • We need to think about “soft infrastructure” more meaningfully and systematically in planning (referring to services, networks, and community social assets), and sharing this through networks/backbone organisations.
  • There is a groundswell of interest in equity, but the challenge is developing a shared vision of how to achieve it, being accountable for change, and the related challenge of meaningful engagement.

Opening session

There was a welcome from the Chief Executuve Dr Teresa Anderson and a warm welcome to country by Uncle Allen Madden.

Lessons from #EquityFest: People living in public housing, people who are homeless, people with substance use disorders, sex workers, and people in custody all experience extremely high levels levels of social exclusion Click To Tweet

A/Prof Jane Lloyd from the Health Equity Research and Development Unit gave an overview of the importance of social inclusion, and the health harms of exclusion. She spoke about who’s excluded in Australia, based on data from the Brotherhood of St Laurence Social Exclusion Monitor. This highlighted that people living in public housing, people who are homeless, people with substance use disorders, sex workers, and people in custody all experience extremely high levels levels of social exclusion.

Peter Jack from Sydney Local Health District spoke about his experiences of working with people in Redfern and Waterloo about health concerns. In discussion with Jane he reflected on life, growing up as an Aboriginal person and the challenges of working with people who are socially excluded in Sydney and Adelaide. The lessons I took from from Peter were the importance of investing time to develop credibility and trust with excluded people, before we try to do anything else.

Zione Walker-Nthenda spoke about the challenges of inclusiion in justice and domestic violence. She emphasised that self-interrogation is important, both organisationally and institutionally, to identify biases and barriers to inclusion. Essentially, that we need to constantly check that we’re not kidding ourselves about how inclusive we’re being.

Join-In and Speak-Out Sessions

There were a series of presentations showcasing work that’s happening. Highlights included Can Get Health, the Waterloo Neighbourhood Advisory Board, Redlink, and Healthy Homes and Neighhbourhoods.

 

Liz Harris from HERDU presented a framework that emphasised the need to consider place as the dynamic interplay between people and space – meaning the norms, use, services, and culture that make up the bulk of community life. Her critique was that in planning in human services often focuses on “need”, constrained to understanding people in atomised ways, and rarely considers place assets and issues in meaningful ways. She further suggested that more work is required to develop coherent program logic for these activities.

Lessons from #EquityFest: Planning in human services often focuses on “need”, constrained to understanding people in atomised ways, and rarely considers place assets and issues in meaningful ways Click To Tweet

Hal Pawson from the UNSW Faculty of the Built Environment spoke about the factors that drive locational disadvantage. The drivers he emphasised were:

  • pushing people without resources to the fringes, or less accessible parts of cities
  • the diminishing pool of low cost housing in acccessible areas
  • a political unwillingness to use planning powers to reverse these trends.

Pam Garrett, Director of Planning within SLHD, spoke about the scale and pace of development within the inner west, ranging from Green Square, through to Waterloo/Redfern, Parramatta Road, and the Bankstown line. This represents a challenge in general, but also presents specific challenges to the District to make sure that services are responsive and that health inequalities aren’t exacerbated.

Geoff Turnbull from Inner Sydney Voice and REDwatch emphasised the need to get back to genuine community development, and the need to work in genuine partnership with communities. He emphasised the need to create organisations that bring together interests to have a voice in changes that would affect their suburbs and communities.

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