AUSTRALIAN ATTITUDES TO UNEMPLOYMENT AND UNEMPLOYED PEOPLE

Social security policy towards unemployed people in Australia has become increasingly conditional on their demonstrating ever greater job search effort. The evidence from attitudinal survey data on whether this policy shift accords with public opinion is ambiguous. Although, by international standards, Australians take a relatively hard line on the responsibilities of unemployed people lo actively seek work, there is little information about views on the detail of activity testing. While a majority oppose greater public expenditure on unemployment, they still see an important role, for government in addressing unemployment and supporting unemployed people.     

INTENSIVE ASSESSMENT FOR “INTENSIVE ASSISTANCE”: UNEMPLOYMENT,MENTAL HEALTH AND THE NEED FOR HOLISTIC ASSESSMENT OF LONG‐TERM UNEMPLOYED PEOPLE

This article will comment on recently announced changes to the Intensive Assistance (IA) program and to the Community Support Program (CSP) as they relate to the assessment of mental health and similar issues in recipients of unemployment benefits. It will be argued that proposed resources to be spent on assessment of IA clients and increased funding and numbers for the CSP are much needed alterations and should be welcomed. It will be argued that agencies assisting IA clients risk significant underestimation of mental‐health and related issues in their clients if they rely only on Centrelink's Job Seeker Classification Instrument (JSCI) as a screening tool and do not expend resources on additional professional assessment. The reasons behind failure of such issues to be easily identified in the current system include difficulty in administration of the JSCI, fear of disclosure by the client, client ignorance of their condition and its relevance to work‐ability, the lack of mental‐health expertise in private sector employment agencies and the current high cost. of purchasing professional assessment. Recently announced changes to IA and the CSP appear to allow for considerable improvements in identifying and managing these issues.     

UNEMPLOYMENT BENEFITS AND UNEMPLOYMENT IN AUSTRALIA, 1950–89

Although the incidence of unemployment in Australia is well established, the causes of unemployment remain controversial. Various putative causes for unemployment exist, including the unemployment benefits system. The present study sought to estimate the impact of the generosity of Australian unemployment benefits on the measured unemployment rate of three recipient groups, single adult males over 21, married males, and married males with two children, for the period 1950 to 1989 inclusive. The results of this statistical exercise are largely consistent with similar work done in Australia and elsewhere; namely, that while unemployment benefits did increase the measured rate for unemployment during the period 1950 to 1989 to a statistically significant degree, other stronger influences on unemployment were evident.     

PUBLIC ATTITUDES TOWARDS GOVERNMENT SPENDING ON HEALTH CARE

One of the most vigorously debated topics in the area of health care is the proportion of health care costs that should be borne by the government, rather than by the individual. Using nationally representative data, the views of Australian citizens on this issue are explored. The findings suggest that the majority of Australians favour increased spending on health by the government. Multiple regression analyses indicate that in addition to various sociodemographic factors, political partisanship and political efficacy are strong, significant predictors of attitudes towards health spending by the government. The policy implications of these findings are discussed.     

COMMUNITY CARE AND HEALTH

Community Care: A Reader By JOANNA BORNAT, CHARMAINE PEREIRA, DAVID PILGRIM AND FIONA WILLIAMS (EDS.)
Working Together for Better Community Care By RANDALL SMITH, LUCY GASTER, LYN HARRISON, LINDA MARTIN, ROBIN MEANS AND PETER THISTLETHWAITE
Health, Welfare and Practice: Reflecting on Roles and Relationships By JAN WALMSLEY, JILL REYNOLDS, PAM SHAKESPEARE (EDS.)
Health and Wellbeing: A Reader By ALAN BEATTIE, MARJORIE GOTT, LINDA JONES AND MOYRA SIDELL (EDS.)
Health Policy in Britain By CHRISTOPHER HAM
The NHS Transformed By IAN HOLLIDAY     

AIDS KNOWLEDGE AND ATTITUDES AMONG CANBERRA SECONDARY SCHOOL STUDENTS

This paper reports findings from a study of 1,014 Canberra secondary school students in 15 government and private schools. Open-ended responses concerning students' understanding of AIDS, and their views regarding prevention, are presented and discussed. Data on source of AIDS information are also investigated. In general, students understand AIDS as sex-linked, that it involves transmission through the blood, and that there is no cure for it. They espouse more research and education as the main preventive measures, although males also propose homophobic solutions. Teachers and television are the primary sources of AIDS information. Differences by sex of respondent and school type are reported and implications for school-based AIDS education policies are suggested.     

HEALTH RISK ANALYSIS AND SOCIOMEDICAL TECHNOLOGIES OF THE SELF: PRIVATE HEALTH INSURANCE GETS INTO HEALTH PROMOTION

In October 1994 the then Australian Federal Minister for Health, Dr. Carmen Lawrence, announced that Medicare, the Australian universal national healthcare fund was considering introducing Healthtrac a computerised health promotion program. The change of government in 1995 put paid to this plan, however, lifestyle based health promotion programs, including computerised programs, are an increasing trend in contemporary health care. Research from the United States indicates a growing interest by private insurers and Health Maintenance Organisations (HMOs) in funding and encouraging members, particularly older members and retirees, to engage in healthy lifestyle programs, some of which provide written reports, periodic up-dates and checks to members as well as summary advice to employers and insurers. In this article we argue that while many of these programs are well researched programs that take cognisance of the contradictions surrounding scientific research related to lifestyle behaviours, disease and disability, they take a narrow approach to health promotion. Further, in the hands of private insurers and HMOs these programs have the potential to become sociomedical techniques (Stone 1989) of dominance, arising out of risk analysis that informs and refines techniques of governance of the self (Burchell 1993; Rose 1993). Consistent with Stevensen and Burke (1991) we see health promotion not as a new social movement, but as a political strategy of the state and capitalism to deal with among other things, escalating health care budgets. Given this, health promotion strategies that overly focus on risk analysis for the individual citizen reinforce techniques of self-governance by linking lifestyle behaviour to immorality as well as potentially creating a culture of anxiety - surely a public health problem in itself.     

DISABILITY AND PRODUCTIVE EMPLOYMENT: A PREDICTION OF FAILURE AND A PROPOSAL FOR CHANGE

This article will argue that recent disability services legislation has selectively interpreted the concepts of normalisation and integration to focus on employment for people with an intellectual disability as a major policy goal. It will be contended that the nature of the contemporary labour market is such that this goal cannot be fulfilled and therefore that the aim of enhancing quality of life cannot be achieved. The article recommends an approach to the reorientation of policy which is based upon a critical analysis of the cultural position of people with disabilities. In this regard, the notion of cultural productivity is introduced as a framework within which some solutions may be found.     

ANCILLARY AND SPECIALIST HEALTH SERVICES: THE RELATIONSHIP BETWEEN INCOME,USER RATES AND EQUITY OF ACCESS

Australia's public health system currently provides substantial funding to, amongst its other objectives, ensure access to hospital, medical and pharmaceutical services by all families irrespective of income (McClelland, 1991, p. 6). However most ancillary services are not similarly subsidised and there is some evidence that income presents a barrier to the use of these services. There is also evidence that low income might also reduce access to specialist medical practitioner services which, while funded through Medicare, are less likely to be bulk billed than general practitioner services, and which therefore attract higher out-of pocket costs. In this study, the 1989–90 National Health Survey is used to examine whether there are indicators that low income reduces access to a range of ancillary services such as physiotherapy, optician services, chiropractic and dental services and to specialist medical practitioner services.     

INDIVIDUALS WITH INTELLECTUAL DISABILITY AND MENTAL ILLNESS: A LITERATURE REVIEW

This review highlights the urgency for a seamless and co‐ordinated approach to service delivery for people with intellectual disability and mental illness. There is emerging evidence of the high prevalence of mental illness in persons with intellectual disability. The notion that people with intellectual disability can have mental illness has only been recently acknowledged. Furthermore, people with intellectual disability also experience a wide range of psychiatric disorders often seen in the general population. Despite of recent developments in treatment options for these people, many of them continue to experience barriers in accessing mental health services.     

YOUNG REFUGEES TALK ABOUT WELL‐BEING: A QUALITATIVE ANALYSIS OF REFUGEE YOUTH MENTAL HEALTH FROM THREE STATES

Young people from refugee backgrounds face enormous challenges in the settlement process within Australia. They must locate themselves within a new social, cultural, geographic and adult space, yet also try to find security within the spaces of their own families and ethnic communities. Traumas of the past can mix with painful experiences of the present. The stressors in the lives of these young people can be both complex and diverse. This paper explores the nature of these stressors among young people from refugee backgrounds living in Australia. It is based on in‐depth interviews with 76 young people from refugee backgrounds now living in Brisbane, Adelaide and Perth. A qualitative analysis of the impact of these stressors as well as the coping strategies employed are discussed. It is argued that trauma exists within a life continuum and that approaches to supporting young people in these circumstances should be wary of limiting their focus to biomedical categories such as Post Traumatic Stress Disorder or Acculturation Stress and instead focus on a wider social context.     

PUBLIC WEALTH,PUBLIC HEALTH,AND PRIVATE STEALTH: EXAMINING THE BLACK MARKET IN CIGARETTES IN AUSTRALIA

Taxes on tobacco provide a significant income for the Australian government — $5.1 billion in 2001. At the same time, health officials are making strenuous efforts to reduce smoking, particularly among teenagers. Some economists suggest that raising taxes on tobacco will produce more revenue while at the same time lowering smoking rates, particularly among youths who have less discretionary spending power than adults. But a by‐product of excise tax in Australia has been the emerging market in “chop‐chop,” tobacco diverted from legal channels by growers who receive considerably higher prices for a part of their yield than they can obtain from legal manufacturers. The article details this situation and suggests that only bold solutions may be able to reduce tensions in tax policies, smoking rates and the “chop‐chop” black market.