Health and welfare links
Australian Institute of Health and Welfare (2023) Health and welfare links, AIHW, Australian Government, accessed 11 December 2023.
Australian Institute of Health and Welfare. (2023). Health and welfare links. Retrieved from https://www.aihw.gov.au/reports/australias-welfare/health-and-welfare-links
Health and welfare links. Australian Institute of Health and Welfare, 07 September 2023, https://www.aihw.gov.au/reports/australias-welfare/health-and-welfare-links
Australian Institute of Health and Welfare. Health and welfare links [Internet]. Canberra: Australian Institute of Health and Welfare, 2023 [cited 2023 Dec. 11]. Available from: https://www.aihw.gov.au/reports/australias-welfare/health-and-welfare-links
Australian Institute of Health and Welfare (AIHW) 2023, Health and welfare links, viewed 11 December 2023, https://www.aihw.gov.au/reports/australias-welfare/health-and-welfare-links
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A person’s health is the result of a complex interplay of their genetics, lifestyle and environment. The World Health Organization defines health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ (WHO 1946). This recognises that health is multi-dimensional, and a person’s health is linked to their wellbeing.
Welfare refers to the wellbeing of individuals, families and the community. The terms welfare and wellbeing are often used interchangeably (see Understanding welfare and wellbeing).
Both physical and mental health are important aspects of health that affect wellbeing. A person’s health status plays a role in their ability to participate in work, education or training and engage with their community and social networks. Health can positively, or negatively, affect a person’s wellbeing. For example, a person may suffer isolation or loneliness because of poor health (see Social isolation and loneliness). Good health may enable a person to earn a sufficient income to support themselves and live independently, placing them at lower risk of poor outcomes such as unsuitable housing conditions, overcrowding and homelessness (see Income and income support and Homelessness and homelessness services).
The circumstances in which a person lives and works can affect their health. A number of social and economic factors act together to strengthen or undermine health. These factors are all strongly related to wellbeing and can include housing, working conditions, social support and participation, education, income and employment. Environmental, structural, cultural, biomedical, commercial and digital factors can also influence health (Department of Health 2021).
See the Australia’s welfare: topic summaries on housing, employment and income, social support and education for more.
Health inequalities (systematic, avoidable and unfair differences in health outcomes across groups in society) arise because of the conditions in which a person lives and works (CSDH 2008).
Social inequalities and disadvantage are closely linked with health inequalities and the dramatic differences in health experienced across groups in society (CSDH 2008).
The health system is one part of a network of systems working to create positive wellbeing for all Australians. It plays a role in the prevention, early intervention and treatment of diseases and other ill health and injury to maintain health. The health system helps people remain as healthy as possible for as long as possible.
The health system is linked with other sectors, especially welfare. An example of the relationship between health and welfare at the service level is the ‘no jab, no pay’ policy. This encourages parents to vaccinate children in order to receive family assistance payments such as the Family Tax Benefit (DSS 2020; Services Australia 2022).
While health and welfare services are generally distinct but complementary, in some settings the boundaries are less clear, with services intersecting both health and welfare. For example:
- The aged care system aims to promote the wellbeing and independence of older people and their carers by enabling them to stay in their own homes or by assisting them in residential care (SCRGSP 2023; see Aged care). While aged care is generally regarded as a ‘welfare’ service, some aged care services may also provide ‘health’ services. For example, recipients of the Commonwealth Home Support Programme may be eligible for nursing care or allied health support services such as physiotherapy, speech pathology and nutritional advice (Department of Health and Aged Care 2023).
- People with permanent and significant disability may access disability support services. Support available for those who are eligible is wide ranging and includes some health-type supports, such as allied health and the provision of aids and equipment (NDIA 2021; see Specialised supports for people with disability).
Many issues involve both health and welfare services, requiring people to navigate multiple systems and providers. Family, domestic and sexual violence (FDSV) is one example of this. FDSV can have a serious impact on a victim’s health, but also on other aspects of their life that determine wellbeing. In 2020–21, there were 5,600 hospitalisations for females and 2,000 hospitalisations for males due to family and domestic violence (AIHW 2022b). In 2021–22, 108,000 people who sought Specialist Homelessness Services had experienced family and domestic violence (AIHW 2022d) and 26,100 people had family and domestic violence Crisis Payment claims granted (AIHW 2022a). Services and initiatives across sectors work to support the wide reach of FDSV. For example, around 1 in 7 (15%) women who experienced violence from their current partner and were working during the period when the violence was occurring, took time off work as a result of the violence (ABS 2020). This can lead to less income or loss of employment. In February 2023, government initiatives came into effect so all employees of non-small businesses have access to paid family and domestic violence leave (Australian Government 2022).
The COVID-19 pandemic is another example that demonstrates the relationship between health and welfare. The pandemic had direct effects on health for individuals who contracted the virus, as well as many indirect effects on the broader community associated with the interventions put in place to contain the spread of the disease. These include impacts on social, economic and environment factors, and adverse effects on income, education, employment, housing and social connections (AIHW 2022a). See for example Social isolation and loneliness, Higher education, vocational education and training and chapters 3 and 4 ‘Employment and income support following the COVID-19 pandemic’ and ‘Homelessness and housing affordability in Australia’ in Australia’s welfare 2023: data insights.
While there are limited data available, it is estimated around 5–10% of COVID-19 cases in Australia result in the development of long COVID (AIHW 2022c). A significant proportion of people with long COVID (defined as ongoing symptoms 12 weeks or longer after infection) report they have limitations on their daily activities and a reduced quality of life. Persisting symptoms can impact on workforce participation, including delays in return to work, and ongoing residual difficulties that impact the ability to perform the same duties or limit working hours (Gualano et al. 2022).
AIHW has developed a COVID-19 register and linked data set to provide new insights into the health outcomes for people who have been diagnosed with the disease, and the effect that COVID-19 has had on the health system and broader community. It will also offer researchers the opportunity to explore a range of issues associated with the pandemic. For more, see COVID-19 register and linked data set.
The development and collection of health and welfare data is hugely valuable and represents an important investment by public and private organisations. When used well, these data can provide reliable information on the quality of people’s lives and how this is changing over time and location within and across different population groups. Data can also inform about the impact of policy and programs, enabling better decision making and improved outcomes for Australians across a range of areas including health, housing, education and skills, employment and income, social support, and justice and safety.
Data linkage (a process combining information from different data collections while preserving privacy) is increasingly being used to analyse the links across health and welfare data sets. Data linkage has the potential to provide new and important insights into people’s health and wellbeing by:
- exploring how early events in someone’s life can impact subsequent events
- comparing groups so that outcomes for people who do and do not use a particular program can be evaluated
- understanding how service systems operate and observing the way in which people use multiple services.
An important example of this type of work is the development of the National Disability Data Asset (disability data asset), which is a large-scale data integration project that brings together de-identified Commonwealth and state and territory government data in an effort to gain a better understanding of people with disability’s life experiences across time, location and population group. The disability data asset is led by the Australian Government Department of Social services and is overseen by the Disability Reform Ministers Council. To deliver an enduring disability data asset, the Australian Bureau of Statistics (ABS) and the AIHW are working with the states and territories to implement the Australian National Data Integration Infrastructure (ANDII). The development of systems such as the ANDII has the potential to facilitate data linkage across sectors to get a better understanding of how people use services across different policy areas. See ’Chapter 5 Use of mainstream services and outcomes achieved for people with disability’ for findings from the recent disability data asset pilot phase.
Another data linkage example is the National Integrated Health Services Information Analysis Asset (NIHSI AA), which brings together multi-year de-identified data on:
- hospital admissions
- Medicare Benefits Schedule
- Pharmaceutical Benefits Scheme
- aged care
- mortality data.
The NIHSI AA has been used to gain new insights about the operation of the health system including analysis of service use in the last year of life and on the extent to which people receive appropriate medications once they leave hospital. None of this analysis would have been possible with existing data on individual services.
The ABS’ Multi-Agency Data Integration Project (MADIP) is a secure data asset that links data on education, employment, health, income and taxation, government payments and demographic information, over time. It allows for exploration for different population groups in Australia and their interactions with and between various services like health and education over time. For example, the MADIP was recently used to better understand the ex-serving Australian Defence Force population following their separation from service, providing new insights; see ‘Chapter 1 The future of data’ in Australia’s welfare 2023: data insights for more information on the use of MADIP for veterans, and for more information on welfare data and the impact of COVID-19. Also see ‘Chapter 7 Relative influence of different markers of socioeconomic status on university participation’ for analysis drawing on data from the MADIP to investigate the relative importance of various markers of socioeconomic status for accessing university.
For more information see:
ABS (Australian Bureau of Statistics) (2020) Partner violence - in focus: crime and justice statistics, ABS, Australian Government, accessed 27 March 2023.
Australian Government (2022) Fair Work Amendment (Paid Family and Domestic Violence Leave) Act 2022, No.50, 2022, Australian Government, accessed 16 March 2023.
AIHW (Australian Institute of Health and Welfare) (2022a) Australia’s health 2022: data insights, AIHW, Australian Government, accessed 27 March 2023. doi:10.25816/ggvz-vr80
AIHW (2022b) Family, domestic and sexual violence data in Australia, AIHW, Australian Government, accessed 27 March 2023.
AIHW (2022c) Long COVID in Australia – a review of the literature, AIHW, Australian Government, accessed 28 March 2023.
AIHW (2022d) Specialist homelessness services annual report 2021–22, AIHW, Australian Government, accessed 16 March 2023.
CSDH (Commission on Social Determinants of Health) (2008) Closing the gap in a generation: health equity through action on the social determinants of health - Final report of the commission on social determinants of health, World Health Organization, accessed 6 April 2021.
Department of Health (2021) National Preventive Health Strategy 2021–2030, Department of Health, Australian Government, accessed 4 March 2022.
Department of Health and Aged Care (2023) Commonwealth Home Support Programme, Program Manual 2022–2023, Department of Health and Aged Care, Australian Government, accessed 12 May 2023.
DSS (Department of Social Services) (2020) Immunisation and Health Check requirements for Family Tax Benefit, DSS, Australian Government, accessed 13 April 2023.
Gualano MR, Rossi MF, Borrelli I, Santoro PE, Amantea C, Daniele A, Tumminello A and Moscato U (2022) 'Returning to work and the impact of post COVID-19 condition: a systematic review', Work, doi:10.3233/wor-220103.
NDIA (National Disability Insurance Agency) (2021) Supports funded by the NDIS, NDIA, Australian Government, accessed 16 March 2023.
SCRGSP (Steering Committee for Review of Government Service Provision) (2023) Report on government services 2023 Part F, Section 14, Productivity Commission, Australian Government, accessed 16 March 2023.
Services Australia (2022) Immunisation requirements, Services Australia, Australian Government, accessed 13 April 2023.
WHO (World Health Organization) (1946) Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946. New York: WHO.