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Improving health equity in Australia: practical advice for those ready to act

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A personal checklist for the time-poor clinician

In these times of health reform mired in complexity and politics, I found myself recently wondering where physicians with a particular concern about health inequities for rural and remote Australia, especially public health physicians like me dealing daily with their distribution and determinants, might turn for guidance.

Recalling plaudits in a book review in the Journal,1 I retrieved all three editions of the Oxford handbook of public health practice. The first edition in 2001 of the handbook2 was rightly praised for conceptualising public health practice in a fresh and imaginative way. Its second edition appeared in 2006, and was emphatic in admonishing that “people who dislike decisions should not become public health practitioners”.3 The third and current edition implores the reader “to leave the health of the public in a better state than you found it”.4 Each edition has included a chapter on health inequities — those of the first two were written by Anna Donald, the much-revered Australian-born advocate for evidence-based medicine who died before publication of the third edition.5

Framing the practical actions in each edition is the ability to distinguish…