International research has found that there are large differentials in mortality and morbidity between the higher and lower socio-economic groups and the conclusions from this research are that health inequalities are primarily a consequence of material differences in living standards.
The main principles underlying the 1994 Health Strategy are equity, quality of service and accountability. The strategy sets a framework for reorienting the health services to achieve health and social gain with a particular emphasis on improving the situation of people in the lower socio-economic groups. It states that the pursuit of equity must extend beyond the question of access to services and must also be concerned with variations in health status between groups.
In 1998, my Department commissioned the first nationally representative survey of lifestyle practices – the national health and lifestyle surveys – to provide baseline data to plan future interventions. This research reached similar conclusions as the health strategy. The data forms the basis of my Department's New Health Promotion Strategy for the years 2000 to 2005. This has specific strategic aims and objectives that will contribute to reducing health inequalities.
Many of the causal factors of health inequalities, such as poverty and unemployment, are outside the direct control of the health services. Inter-sectoral collaboration is required to tackle these problems. The Cabinet Committee on Social Inclusion and Drugs, chaired by the Taoiseach, includes Ministers from eight relevant Departments who meet regularly. Also, the NAPS inter-departmental group provides the principal strategic focus for the National Anti-Poverty Strategy. This strategy was published in 1997 and set out a programme to reduce poverty and social exclusion both in general and in a number of key policy areas. Substantial progress has been made in achieving the original targets. Although health or health targets were not included in the original NAPS targets, my Department has been involved in setting and reviewing annual work plans for NAPS. In addition, in the context of the new partnership agreement "Programme for Prosperity and Fairness", my Department will take part in a group to consider the setting of health targets to be included in the next phase of the National Anti-Poverty Strategy.