Dáil Éireann Debate, Wednesday - 3 March 2004
153 Mr. Cuffe asked the Minister for Health and Children his views on recent studies from Britain which show a link between social class and ill health; if he will undertake a similar comprehensive study here; and if he will make a statement on the matter. [7084/04]
View answerI am aware of the reports to which the Deputy refers that show a link between social class and ill health. I understand the Deputy is referring to a number of studies but with particular reference to the Wanless report recently published. This report provides general policy on broad population health issues including health determinants, reducing health inequalities and on the public health delivery plans to underpin these.
The Deputy will be aware that both the national health strategy, Quality and Fairness: A Health System for You, and various reports of the chief medical officer, in particular the Annual Report of the Chief Medical Officer 1999 and Better Health For Everyone: A Population Health Approach for Ireland, the Annual Report of the Chief Medical Officer 2001, have pointed out the links between poverty and ill health in an Irish context.
On research studies, a number of initiatives have been undertaken already and others are currently under way on the issue of health status or mortality which disaggregate data by socio-economic group or occupational class.
In 2001, I launched Inequalities in Mortality 1989-1998: A Report on All-Ireland Mortality Data, jointly with my counterpart in Northern Ireland. This study was carried out by the Institute of Public Health in Ireland, which is an all-Ireland body. This report has shown that the all-cause mortality rate in the lowest occupational groups was 100 to 200% higher than the rate in the highest occupational group. These occupational class gradients in mortality were present for all major causes of mortality: cancers, circulatory diseases, respiratory diseases, injuries and poisonings.
The consultation process for the all-Ireland study on traveller health status and health needs has been concluded. An all-Ireland feedback event on this took place in December of last year. A proposal from the Institute of Public Health on the design, management and funding of the study is currently under consideration in my Department. A pilot study on the inclusion of an ethnic identifier in a number of data sources is also being supported.
Last year my Department commissioned the Institute of Public Health to progress work on data and monitoring requirements for the National anti-poverty strategy, NAPS, health targets. This work includes working with the Central Statistics Office to strengthen the quality of the reporting of socio-economic group information in mortality records, and specifying the data and analyses required to monitor progress towards the NAPS target on mortality from cardiovascular disease. Another relevant report is the Institute of Public Health North/South study on social capital which is due to be launched in spring of this year. To address a recognised shortage of representative health and lifestyle data available to health service planners the health promotion unit of my Department commissioned in 1998 the National health and lifestyle surveys to be carried out at four-yearly intervals. The first report was published in 1999 and the second on 16 April 2003. These surveys aim to produce reliable baseline data on key health related lifestyle behaviours including smoking, alcohol consumption and exercise for a representative cross-section of the Irish population.
I have no plans at present to undertake a study for Ireland similar to the Wanless report to which the Deputy refers for the reason that many of the issues and recommendations in Wanless have already been taken on board in recent strategies, in particular in the national health strategy, Quality and Fairness: A Health System for You. The four goals of the national health strategy are better health for everyone, fair access, responsive and appropriate care delivery and high performance. The four objectives of the first goal, better health for everyone, clearly address issues covered in Wanless. These four objectives are: the health of the population is at the centre of public policy; the promotion of health and well-being is intensified; health inequalities are reduced; specific quality of life issues are targeted.
The targets to reduce health inequalities set out in the Government's review of the NAPS, Building an Inclusive Society: Review of the National Anti-Poverty Strategy under the Programme for Prosperity and Fairness, have been integrated into the national health strategy. These targets were developed in the course of an extensive consultation process with poor and excluded groups. Key health targets are to reduce the gap in premature mortality and low birth weight between the highest and lowest socio-economic groups by 10% by 2007, and to reduce differences in life expectancy between Travellers and the rest of the population.
Many of the actions set out in the action plan accompanying the national health strategy are already under way. For example, the Department of Health and Children, in partnership with the Institute of Public Health, is developing a programme of health impact assessment, HIA. An introductory policy seminar for senior managers and the launch of HIA methodology guidelines and a screening tool for HIA took place in July 2003. Reforms currently under way acknowledge quality and fairness —with its targets —and will put in place structures to underpin this in the Department of Health and Children and the Health Service Executive. The Institute of Public Health has been commissioned to work with the Health Board Executive, the Office for Social Inclusion and the Combat Poverty Agency to support health boards in implementing actions to achieve NAPS targets.
The existing National Health Promotion Strategy 2000-2005 is also central to population health, as are the cardiovascular strategy, the new cancer strategy currently being developed and the mental health policy, which is also in development. My priority now is implementation of actions in the context of the above strategies and of the Government's health reform programme generally.
