I appreciate the invitation and welcome the opportunity to talk about the first ten years of the Institute of Public Health in Ireland. I am its chief executive and accompanied by the associate director, Mr. Owen Metcalfe. Both of us have worked in different capacities in the area of mental health. Mr. Metcalfe was a teacher and counsellor and worked in health promotion. I am a doctor and have worked in health promotion and public health.
We appeared before the joint committee in June, when the Chairman was unable to attend, to discuss the issue of fuel poverty. I referred to other areas in which we worked. We have just produced a ten-year report which, I hope, has been circulated to members. I will be pleased to come back, if invited. Again, I thank the committee for inviting us.
I believe the committee has a short paper outlining some of our work. I will briefly summarise some of the key points, if that is appropriate. I will begin by setting out why the institute was set up and will speak about what we have been doing since then. As members know, it is an all-island organisation, so its purpose is to promote co-operation between North and South. It was set up because the two chief medical officers on both sides of the Border had been talking about what could be done together to improve public health. With the support of the Governments, and now the Department of Health and Children and the Department of Health, Social Service and Public Safety, the institute was set up. We work, in particular, in three areas, namely, research and information, capacity building for public health and offering policy advice. I will briefly give the committee some examples of the work we have been doing in these areas. We will then be happy to answer any questions.
I will start with the area of information and research. Our understanding of public health is based on the idea that social, economic and environmental factors are hugely important in shaping people's health. That is why we are particularly pleased to be at this committee because its responsibilities cover so many areas that influence our health.
This understanding of the wider social causes of health underpins all our work and it was emphasised very much in the first major report we did in the institute which looked at all deaths across the island of Ireland. This is a very large report looking at 500,000 deaths against all the major causes of death. What was staggering to us was the huge gap that it showed in the health experience of rich and poor. Obviously, it will not be a surprise to members to know about the way such things as poverty, income and employment affect health. Although I had worked in that area for many years, the difference we found was staggering. We are talking about differences of the order of 100% to 600% between the health experience of rich and poor. This finding has defined the work we have been doing since then.
I will now speak about information. One of the complexities for us in working across the island is the huge differences between North and South in terms of the way the health services are organised, the way they are financed and the priorities that each jurisdiction has. However, one of the things we share is a common concern about high levels of chronic diseases such as heart disease, diabetes, etc.
Until now, there has not been a systematic means of identifying the levels of some of these chronic diseases. For example, we have never really known how much diabetes there is in the country and we have not had a way to forecast that into the future. One of our pieces of work has been to measure that and to forecast what will happen in Ireland over the next decade. I am sure members already know that we are seeing a rise in diseases such as diabetes due to the sharp increase in the incidence of obesity. Perhaps in the next ten years or so, we will be looking at an additional 80,000 people with diabetes. That is appalling for the individuals and their families but it is also a huge cost to the health services and to the wider economy in terms of loss of productivity.
This kind of work is underpinning our idea for a public health observatory across the island. This will form a backbone of interlinked health surveys, not only looking at diseases but at the social factors which impinge on them. We hope this will be a one-stop-shop for people like members of the committee, for political researchers and for practitioners because they will be able to access a huge number of databases from this well.
We also contribute to policy advice across a range of areas, including fuel poverty, which I mentioned, food, smoking and tobacco. Addressing these areas requires co-operation across very many Departments as the committee well knows. All have huge roles to play. Our understanding is that it is absolutely essential that we have this type of cross co-operation if we are to improve health.
Recognising this, we have produced a number of reports looking at the influence of things like transport, the environment and employment on health. Our forthcoming report, which will be issued next week, is on the impact of education on health. My colleague, Mr. Owen Metcalfe, has been leading this work and will be more than happy to give the committee some findings from that report, which is very timely.
We have also been helping people with the idea of health impact assessment. That is a way in which policies can be assessed to see what impact they have on health. We have been undertaking training programmes, leading reviews and working with people in different countries who are also very interested in the whole area of public health.
We have developed a number of research programmes involving different countries and we have also been able to set up within the institute a number of new initiatives addressing issues such as ageing and, I hope in the future, issues associated with palliative care and terminal care. We have devised a leadership programme and we have a number of networks which involve people working in public health across the island on crucial issues such as nutrition, smoking, mental health, etc.
I hope I have been able to give the committee a short flavour of the work we do. There are many public health challenges facing us on the island. A priority for us will continue to be tackling the huge health inequalities that exist. We believe the way in which policies and structures affect the health of the most vulnerable in our community is something we must tackle in a more systematic and strengthened way than we have been able to do in the past. We recently produced a short report with the Combat Poverty Agency highlighting what needs to be done and looking at the evidence across the island.
During the past ten years, we have led co-operation for public health on the island. We have built up a significant amount of expertise, skills and partners. Although the environment has changed considerably, and continues to do so, our aim will remain the same, namely, to promote co-operation and to use our resources to help to promote healthier people. Mr. Metcalfe and I will be happy to answer any questions.