Health inequality, social exclusion and neighbourhood renewal: Can place-based renewal improve the health of disadvantaged communities?

The overall improvement in the health of Australians over the last decade has concealed a widening gap between the health of the rich and the poor. Orthodox responses to health inequality based on improving access to health services and changing the behaviour of high-risk groups have not led to a more equal distribution of health outcomes. This paper assesses the policy and practice implications of the causal nexus between health inequality, socioeconomic status, social exclusion and locational disadvantage. In addition to more traditional redistributive macroeconomic and social policies, the paper identifies the need for targeted responses to spatial concentrations of inequality. The Victorian Neighbourhood Renewal initiative is introduced as a place-based social model of health that ?joins-up? government and builds inter-sectoral and community partnerships to tackle local sources of health inequality. Neighbourhood Renewal intervenes in key material, psychosocial and behavioural pathways to morbidity and mortality by transforming poor housing, creating employment, improving education, rejuvenating local economies, reducing crime and building community resilience.