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It is well established that social determinants are crucial to health outcomes. However, the link between how social determinants contribute to health inequalities for people with disability has often failed to be acknowledged. For example, Australian disability policy has paid little attention to social determinants of health, despite people with disability faring particularly badly on a range of outcomes. This paper identifies barriers to policy action on the social determinants of health for people with disability in Australia. Data obtained from interviews with key disability policy stakeholders are analysed using a micro, meso, macro level policy analysis framework. Our analysis identifies a “services drift” acting as an important barrier to policy action, where attention is focused on health service access rather than broader social determinants such as housing, employment and education. We also identify issues in how disability policy is made that hinders action on social determinants of health.Points of interestThe environments people live, work and interact in like their housing, employment and education, have been shown to be more important for good health than having access to health services, yet these areas are often neglected in policy for people with disability.Using interviewees with people involved in disability policy in Australia this article aims to explore why these areas are neglected in policy relative to the focus on access to health services.Reasons for focusing more on health services compared to other policy areas include people's attitudes towards disability such as thinking about it as a medical problem rather than a social problem.There are also issues with how disability policy is being made, such as a lack of consultation with people with disability, and a lack of co-ordination between government levels and departments.Identifying these policy barriers is an important step in finding ways to get more policy action on improving the environments people with disability live in. The environments people live, work and interact in like their housing, employment and education, have been shown to be more important for good health than having access to health services, yet these areas are often neglected in policy for people with disability. Using interviewees with people involved in disability policy in Australia this article aims to explore why these areas are neglected in policy relative to the focus on access to health services. Reasons for focusing more on health services compared to other policy areas include people's attitudes towards disability such as thinking about it as a medical problem rather than a social problem. There are also issues with how disability policy is being made, such as a lack of consultation with people with disability, and a lack of co-ordination between government levels and departments. Identifying these policy barriers is an important step in finding ways to get more policy action on improving the environments people with disability live in.

Barriers to policy action on social determinants of health for people with disability in Australia