Mortality rates of poor twice that of rich

Mortality rates for almost all causes of death among the poorest people in Ireland are almost twice that of the richest, new …

Mortality rates for almost all causes of death among the poorest people in Ireland are almost twice that of the richest, new research carried out by the Institute for Public Health in Ireland (IPH) shows.

The evidence was found in relation to nearly all the main causes of death, including cancers, respiratory diseases and poisoning, a conference on equality has heard.

Dr Jane Wilde, the institute's director, said political leadership and policy coherence were essential in tackling the wide gap in health between rich and poor in Ireland.

On a wider level, mortality rates from chronic diseases, including heart disease and cancers, are higher in Ireland, both sides of the Border, than in most western European countries.

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"Between 1989-1998 breast, colorectal, lung, lymphoma and oesophageal cancer incidence and mortality rates for women in Ireland were significantly higher than rates for women in the EU.

"Among men in Ireland, colorectal, oesophageal and prostate cancer incidence and mortality rates were significantly higher than for men in the EU," she said.

"Estimates suggest that more than 300,000 children on the island are overweight or obese, with the annual number growing by 10,000.

"Lifestyle surveys show wide differences in levels of smoking, drug misuse, suicide and obesity between different socio-economic groups. No clear social class gradient is reported for alcohol use," Dr Wilde said.

Dr Wilde was speaking at an all-Ireland Action for Equity conference in Carlingford, Co Louth.

The conference was aimed at identifying the types of action and policies that could be effective in providing good health for all people.

The conference included speakers and delegates working in the areas of public health, human rights, equality and media.

Dr Wilde said that responding effectively to the wide and varied nature of public health challenges on the island raises critical issues, many of which feature internationally.

"In Ireland, the most important are political leadership and policy coherence; support for policy implementation including a widely shared agenda and sustainable public health system; and building knowledge.

"Government policy, South and North, espouses a strong vision for public health, highlighting the importance of broad determinants and joining up government policies," according to Dr Wilde.

However, she said policy coherence was often lacking with policy-makers in certain sectors failing to consider how their actions affect health.

"There is a constant preoccupation with economic success. Debates on health are dominated by waiting lists and when attention does turn to public health, it is often divisive, concentrating on arguments about individual and collective responsibility," she said.

Dr Wilde said encouraging and convincing politicians and opinion formers of the central idea of public health, the need for collective responsibility and action, was a major challenge facing society.

"The strongest policies will do little good if not implemented," she said.

"Examples from South and North illustrate the importance of understanding what is needed to put policy into practice, and providing realistic levels of support.

"The health strategy in the south was developed with a strong public health approach but the lack of an implementation plan and insufficient support has so far left many commitments unmet.

"And in the North, although there is wide support for the public health strategy, Investing for Health, implementation is hampered by the lack of a strong anti-poverty plan," Dr Wilde revealed.

Carl O'Brien

Carl O'Brien

Carl O'Brien is Education Editor of The Irish Times. He was previously chief reporter and social affairs correspondent