Discriminatory policies are impacting the health of Australians
Discriminatory policies are impacting the health of Australians
Perrhaps we have been too busy worrying about bullying and harassment in our own backyard to take much notice. But in case you missed it, the Federal Government recently effectively endorsed the bullying of non-heterosexual identified or gender-questioning children and young people. In some kind of Orwellian doublespeak, by gutting the Safe Schools Coalition, the government managed to send a clear message to the nation that bullying is bad, but bullying queer people is OK.
Some have argued that Prime Minister Malcolm Turnbull, a known proponent of gay rights in the past, has succumbed to the right-wing bullies in his own party to the extent of handing over his lunch money. But Turnbull is now leading a government that sanctions abuse and discrimination in far too many arenas for doctors to continue to remain silent.
Think of the indefinite detention of asylum seekers, the Border Force Act that prevents doctors advocating for detainees; offshore detention of children; the forced relocation of Aboriginal communities; the endorsement of bullying of LGBTI young people; the pillorying of LGBTI people and their families through the non-binding plebiscite on marriage equality; the weakened response to domestic violence, and the winding back of a range of essential primary support services, including women’s refuges, health and disability funding and Gonski.
As we head towards the July federal election, doctors have the opportunity to seriously consider what these policies are doing to the health of Australians, including the health of doctors. All of these policies are upstream causes of mental and physical illness. And where will that river meet the sea? In primary care, at your desk, where access by those most in need is being made even more difficult thanks to frozen Medicare rebates and reduced funding to community support services.
There are mountains of evidence of the negative impact of stigma, discrimination and social exclusion on health. Recently, the College of Psychiatrists released yet another summary of the evidence in their statement: Recognising and addressing the mental health needs of people identifying as LGBTI’. But the same kind of evidence exists for any other minority you can name.
Marginalisation makes people sick. Medicine cannot fix marginalisation. Only political and social change can do that.
If we truly see ourselves in the business of improving health, we need to seriously think about both the policies we vote for and the biases we bring into our own consulting rooms. Doctors are one of the barriers to marginalised people seeking and receiving effective health care. It’s not simply a matter of treating all patients the same or being colour-blind. This is not about equality. It’s about equity. Some people simply need more resources than others. Not because they are lazy or weak, but because we as a society have endorsed and sustained decisions that make life harder for them.
There is a terrible irony in the need to plead the negative health impacts of discrimination in an attempt to make it stop. But there is a different way.
I was reminded of this over a very nice glass of Mortimer’s chardonnay the other night. The Mortimer family not only makes very good wine, they also play very good rugby league, and are legends to NRL fans.
Recently, they celebrated the wedding of their son and nephew, Matt and his American doctor sweetheart, Jason. Matt and Jason had been legally married in the US before returning to Australia to recommit in front of family and friends and the media.
Of course, even though they are legally married in the US, their marriage is not recognised here because somehow their love for each other and their families’ love for them is damaging to the fabric of our society.
But what is not damaging is the ripple effect the unconditional love of a true-blue, league-loving, rural Australian family for their son and nephew and his soul-mate has had on others.
Over that glass of wine I was told about a woman – a big NRL fan – who had not spoken to her gay son in years. The Mortimer wedding convinced her it was OK to call her son, reconnect and bring him home.
There’s good evidence that phone call will improve both their mental health and reduced the chance that either will be sitting across from you sometime soon.
The power of one is the power we all have to choose what we endorse within the society we create.
Choose wisely. Go with the evidence. Choose health for all.
