In Australia the health of the general public, at  a population level, is in the hands of the federal government. They make decisions on the level of welfare payments, minimum pay, and legislation that affects job security and conditions. These directly affect the well-being of most of us through the very direct relationship between our socio-economic status and our health (Marmot, WHO). The wealthier we are and the higher our social status, the better our health. It is a  direct relationship – people who are a little poorer will be a little less healthy, people who are a lot poorer will be a lot less healthy. The evidence for this is now beyond dispute.

The federal government controls just how poor the poorest are and therefore just how poor their health will be, as a population. Similar relationships govern how much control we have over our life circumstances, how socially connected we are  and  how much stress we experience. Contrary to myth, the wealthiest  Executive  Officers have less stress than the rest of us (Marmot, McEwan).

The commonest symptoms of poverty; lack of control, high stress and less social connection, have clear and familiar symptoms. These symptoms are substance use, unemployment, less education, and crime. If you don’t have money you can’t pay your car registration, that’s a crime. You sneak some margarine through the self check-out, that’s a crime. You can’t afford school uniforms or books and your children get teased, then bullied, then excluded. Your relationship suffers, conflict increases, your relationship breaks down. These trajectories should be familiar and obvious but as a society we tend to take the view that all these are the responsibility of the individual. Well, they would be if the individual had the resources to address them.

The consequences of these types  of outcomes of poverty land on our state governments. The states pay for our overcrowded prisons, for our Emergency Departments and hospitals and they host the disenfranchised suburbs and towns where people on the lowest incomes must live.

Federal government neglect of minimum wages, and welfare benefit levels directly contributes to the expenses born by states for prisons and hospitals. Both the major parties from time to time, when in government federally, bear responsibilities for this and in the interests  of ‘the Australian people’, to whom they frequently refer, responsibility to address this. When they hold a state government  both  major parties should be motivated, to pressure the federal government. They should not pressure for more money, but for more responsibility and accountability for the damage and expense they hand on to the states. More responsibility and accountability for the damage they do to us.