Written Answers. - Life Expectancy.
Eric J. Byrne
Question:
128
Mr. Byrne
asked the
Minister for Health
if his attention has been drawn to the recent report produced by the British Department of Health which shows that the life expectancy of a woman in Ireland is the worst of 15 developed countries and that the life expectancy for Irish men is fourth worst of the 15 countries surveyed; if he intends to carry out any investigation as to the reasons for this situation; if he intends to take any steps to try to improve life expectancy; and if he will make a statement on the matter.
I recognise that the health statue of Irish people and their life expectancy could be improved. I have, on many occasions, drawn attention to this fact. Indeed it has been the rationale behind many of the intitiatives I have taken in the last few years, particularly in the area of health promotion.
It was in recognition of the fact that we needed greater co-ordination in our efforts to promote the health of our community and, by implication, improve life expectancy, that I reorganised the health promotion structures at national level. As the Deputy is aware, the health promotion framework now has four main elements: a Cabinet subcommittee to ensure that the policies of relevant Government Departments support health, an Advisory Council on Health Promotion to make recommendations to me on priorities in this area, a Health Promotion Unit — the executive and policy formulation function at national level — and, most recently, a chair of health promotion in University College Galway to provide a teaching and research resource in health promotion.
As the Deputy is aware, the major causes of death, including premature deaths, in Ireland, as in many developed countries, are heart disease and cancer. Most recent available statistics show that in 1989 diseases of the heart and circulatory system accounted for 47 per cent of all deaths. Cancer is the second leading cause of death, accounting for 23 per cent of deaths. These diseases can be viewed as major contributors to our unfavourable life expectancy. As a country we compare quite favourably with countries such as Italy, France, Spain and Belgium in terms of the number of deaths from coronary heart disease and stroke in men in the 30-69 year age group, for example. Other countries such as Finland, America and Canada, have achieved significant reductions in coronary heart disease. Some of this reduction is attributed to community-based projects aimed at reducing the risk factors for coronary heart disease — smoking, high blood pressure, high cholesterol levels, alcohol abuse — and encouraging healthy lifestyles.
For this reason the Kilkenny Health Project was initiated as a major pilot project with a brief to develop, implement and evaluate a communitybased health promotion programme to prevent cardiovascular disease. The programme is now being evaluated both in terms of its effect on the lifestyle of the people of County Kilkenny and also in terms of its potential for integration into the health service structures nationwide having regard to such matters as feasibility and cost effectiveness.
Lifestyle behaviours such as smoking are risk factors not only for heart disease and stroke but also for some cancers, most notably lung cancer, and for diseases like bronchitis and emphysema. Other lifestyle factors implicated in the causation of preventable diseases are alcohol abuse, lack of exercise and unhealthy food choices.
The Health Promotion Unit have invested significant funds in the development of a lifewise programme which address these issues. Lifewise is a health education programme for adults which focuses on promoting healthy behaviour and provides the individual with the skills, information and motivation to develop and maintain a healthy lifestyle. An important feature of the programme is its flexibility for use in a variety of settings. The programme is being piloted in the Mid-Western Health Board and because of its success to date a number of other boards,viz. North-East-ern, Midland, Southern and South-Eastern, have asked to be party to the programme. A new training programme was recently arranged involving participants from all the interested boards and also from the Irish Countrywomen's Association. A national structure to oversee the development of the project and ensure its quality is being developed.
In relation to alcohol, a comprehensive national policy on alcohol is currently being developed under the aegis of the Advisory Council on Health Promotion. This policy will examine the broad range of social, cultural, economic, legal and educational issues involved and will pay particular attention to the question of youth and alcohol. A number of initiatives have already been taken in relation to alcohol use by young people — most significantly the launch of the Drink Awareness for Youth Programme aimed at 14-19 year olds to encourage them to make responsible decisions about alcohol use.
Another important feature of the health promotion unit's activities each year is an anti-smoking campaign. A legislative framework which supports health promotion programmes is an important component in a strategy to improve health status. In that regard the anti-smoking legislation which we have introduced should make a significant contribution in the long term to reducing deaths from smoking, of which there are currently 5,000 per year in Ireland. I am also confident that the increase of 10p in the price of a packet of 20 cigarettes introduced by the Government in the January budget will help in this regard.
I have also recently established a Nutrition Advisory Group under the aegis of the Advisory Council on Health Promotion to provide expert advice to my Department and to the general public in the area of nutrition and to combat misinformation. The unit have also developed a nutrition health promotion five-year framework for action, which was launched on 2 July 1991. There is now persuasive evidence to link unhealthy food choices to ill-health. The cornerstone of the framework for action will be the promotion of my Department's healthy eating guidelines among various targeted groups in the community.
The Health Promotion Unit provide financial support to a wide range of voluntary organisations and also have a public information service through which a variety of education materials on health topics are made available free to the public.
I might add that several of the projects carried out by the unit are taking place under the auspices of the Europe against Cancer Programme, which aims to reduce deaths from cancer by 15 per cent in the European region by the year 2000.
The Health Promotion Unit are also liaising with relevant organisations such as the Health and Safety Authority in pursuing the commitment which the Government gave under theProgramme for Economic and Social Progress to utilise the potential offered by the workplace to promote healthy lifestyles.
I am confident that the health promotion measures I have outlined, together with the maintenance of a high quality health service, will lead to improvements in the health status — including life expectancy — of our population in the coming years.
