IPH gives evidence to NI Assembly Health Committee Inquiry into Obesity

IPH Chief Executive, Dr Jane Wilde gave evidence to the Northern Ireland Assembly Health Committee inquiry into obesity. Dr Wilde recommended the following: Supporting the Department of Health’s strategic approach based on an understanding of the nature and complexity of obesity. Urgent and short term action to coordinate current activities and ensure focus on the most vulnerable. Exploring new forms and incentives to promote cross departmental work. Setting intermediate outcomes and targets Building stronger links between research, policy and practice, for example asking the Health Committee to set up a round table of researchers and policy makers Working systematically and transparently to identify key areas for cooperation with UK, Ireland and Europe Drawing from IPH work and other research, Dr Wilde briefed the Health Committee on the extent and impact of obesity, reasons for rising levels of obesity and the need for a stronger strategic response. She highlighted the importance of cross government action, the responsibilities of those beyond the health sector and the need for stronger evidence-informed policy and practice.

Response to Northern Ireland Housing Executive Review of Housing and Health

The Institute of Public Health in Ireland welcomes the opportunity to comment on the Northern Ireland Housing Executive (NIHE), Review of Housing and Health – Towards a Shared Agenda policy.   The Institute aims to improve health in Ireland, North and South by working to combat health inequalities and influence public policies in favour of health. The Institute recognises the potential health impacts linked with housing and welcome the proactive approach NIHE is adopting. By identifying the wider determinants of health, the NIHE acknowledges that as a statutory organization they have a major role to play in contributing to improved health for Northern Ireland.   There are many causal pathways linking housing to health and due to the nature of social housing, a number of vulnerable groups, for example those on a low income or the Travelling Community are subject to NIHE policies.  Overall the policy outlines a number of key recommendations.  The Institute advise that the Implementation Plan which will incorporate the recommendations should outline targets which can be measurable, for example, under Objective 1 which identifies the reduction of fuel poverty.  We recommend that key targets are outlined to show what action the NIHE has set in accordance to measure a reduction in fuel poverty.

Institute Responds to DSD Consultation on Cathedral Quarter Masterplans

The Institute of Public Health welcomes the opportunity to respond to the following consultations on the regeneration of Belfast City Centre; A. Draft North East Quarter Masterplan Key Regeneration Principles and Concept Plan – February 2005B. Draft North West Quarter Masterplan Key Regeneration Principles and Concept Plan – February 2005 The Institute of Public Health is a cross border organisation funded by the Department of Health, Social Services and Public Safety in Northern Ireland and the Department of Health and Children in the Republic of Ireland (www.publichealth.ie). It aims to improve health and tackle inequalities in health across the island of Ireland. The Institute believes that one of the most effective ways of addressing inequalities in health across the island is to ensure that all Government Departments recognise the wider determinants which influence health and maximise opportunities within their policies to improve the health of the population.

Extra healthy years or just extra years? What can we know from the data we have on the island of Ireland?

As life expectancy continues to rise, the prevalence of chronic conditions is increasing in our society. However, we do not know if the extra years of life gained are being spent with disability and illness, or in good health. Furthermore, it is unclear if all groups in society experience their extra years of life in the same way. This report examines patterns of health expectancies across the island of Ireland, examining any North-South and socio-economic differences as well looking at differences in data sources. The older population (aged 65 or over) on the island of Ireland is growing and becoming a larger percentage of the total  population. Republic of Ireland Census 2011 revealed that 12% of the RoI population was aged 65 or over (CSO, 2012), and Northern Ireland Census 2011 revealed that 13% of the NI population was aged 65 or over (NISRA, 2012). By 2041 the population aged 65 or over is projected to reach 22% in RoI and 24% in NI (McGill, 2010). It is unclear, however, if this increasing longevity will be enjoyed equally by all strata of society.

IPH response to 'Towards a Childcare Strategy' (Northern Ireland)

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. Giving every child the best start in life is recognised by governments worldwide as the most effective way to improve life chances and health outcomes.  This is one of IPH’s key strategic action areas in our Business Plan and we endorse the need for early intervention, particularly in tackling health inequalities and improving the health and wellbeing of children in the most disadvantaged communities.  International evidence is increasingly pointing towards investment in the early years as a critical component of any sensible approach to improving population health and tackling health inequalities across the life course (WHO, 2008 and Marmot, 2010).  It is also apparent that Northern Ireland public policy is now reorienting towards achieving better and fairer outcomes in the early years, as demonstrated through the recent draft public health strategy (DHSSPS, 2012a) and the draft early years strategy (Department of Education, 2012).

IPH response to the HIQA consultation on the National Demographic Dataset and Guidance for use in health and social care settings in Ireland

The remit of the Institute of Public Health in Ireland (IPH) is to promote cooperation for public health between Northern Ireland and the Republic of Ireland in the areas of research and information, capacity building and policy advice. Our approach is to support Departments of Health and their agencies in both jurisdictions, and maximise the benefits of all-island cooperation to achieve practical benefits for people in Northern Ireland and the Republic of Ireland. IPH have previously responded to consultations to the Department of Health’s Discussion Paper on the Proposed Health Information Bill (June 2008), the Health Information and Quality Authority on their Corporate Plan (Oct 2007), and the Road Safety Authority of Ireland Road Safety Strategy (Jul 2012). IPH supports the development of a national standard demographic dataset for use within the health and social care services. Provided necessary safeguards are put in place (such as ethics and data protection) and the purpose of collecting the information is fully explained to subjects, mandatory provision of a minimum demographic dataset is usually the best way to achieve the necessary coverage and data quality. Demographic information is needed in several forms to support the public health function: Detailed aggregated information for comparison to population counts in order to assess equity of access to healthcare as well as examining population patterns and trends in morbidity and mortality Accurate demographic information for the surveillance of infectious disease outbreaks, monitoring vaccination programmes, setting priorities for public health interventions Linked to other data outside of health and social care such as population data, survey data, and longitudinal studies for research and analysis purposes.   Identify and address public health issues to tackle health inequalities, and to monitor the success of such efforts to tackle them.

Institute of Public Health in Ireland's (IPH) Open Access Statement

This document states the Institute of Public Health in Ireland’s (IPH) commitment to an Open Access policy and outlines how it implements that policy. "Open Access is the immediate, online, free availability of research outputs without restrictions on use commonly imposed by publisher copyright agreements. Open Access includes the outputs that scholars normally give away for free for publication; it includes peer-reviewed journal articles, conference papers and data of various kinds."1 The Open Access (OA) movement aims to: Provide access to scientific outputs in publications that are freely available Foster the adoption of open access publication models

Prevalence of chronic conditions – Hypertension

IPH has estimated and forecast clinical diagnosis rates of hypertension among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007. The data describe the number of people who report that they have experienced doctor-diagnosed hypertension in the previous 12 months (annual clinical diagnosis). Data are available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the Republic of Ireland. In Northern Ireland, the data is based on the Health and Social Wellbeing Survey 2005/06. The data describe the number of people who report that they have experienced doctor/nurse-diagnosed hypertension at any time in the past (lifetime clinical diagnosis). Data are available by age and sex for each Local Government District in Northern Ireland. Clinical diagnosis rates in the Republic of Ireland relate to the previous 12 months and are not directly comparable with clinical diagnosis rates in Northern Ireland which relate to anytime in the past.   The IPH estimated prevalence per cents may be marginally different to estimated prevalence per cents taken directly from the reference study. There are two reasons for this: 1) The IPH prevalence estimates relate to 2010 while the reference studies relate to earlier years (Northern Ireland Health and Social Wellbeing Survey 2005/06, Survey of Lifestyle, Attitudes and Nutrition 2007, Understanding Society 2009). Although we assume that the risk of the condition in the risk groups do not change over time, the distribution of the number of people in the risk groups in the population changes over time (eg the population ages).  This new distribution of the risk groups in the population means that the risk of the condition is weighted differently to the reference study and this results in a different overall prevalence estimate. 2) The IPH prevalence estimates are based on a statistical model of the reference study. The model includes a number of explanatory variables to predict the risk of the condition. Therefore the model does not include records from the reference study that are missing data on these explanatory variables. A prevalence estimate for a condition taken directly from the reference study would include these records.

Prevalence of chronic conditions – Coronary Heart Disease

IPH has estimated and forecast clinical diagnosis rates of CHD (heart attack and/or angina) among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007 . The data describe the number of people who report that they have experienced doctor-diagnosed heart attack and/or angina in the previous 12 months (annual clinical diagnosis). Data is available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the Republic of Ireland. In Northern Ireland, the data are based on the Health and Social Wellbeing Survey 2005/06 . The data describe the number of people who report that they have experienced doctor-diagnosed heart attack and/or angina at any time in the past (lifetime clinical diagnosis). Data are available by age and sex for each Local Government District in Northern Ireland. Clinical diagnosis rates in the Republic of Ireland relate to the previous 12 months and are not directly comparable with clinical diagnosis rates in Northern Ireland which relate to anytime in the past. The IPH estimated prevalence per cents may be marginally different to estimated prevalence per cents taken directly from the reference study. There are two reasons for this: 1) The IPH prevalence estimates relate to 2010 while the reference studies relate to earlier years (Northern Ireland Health and Social Wellbeing Survey 2005/06, Survey of Lifestyle, Attitudes and Nutrition 2007, Understanding Society 2009). Although we assume that the risk of the condition in the risk groups do not change over time, the distribution of the number of people in the risk groups in the population changes over time (eg the population ages).  This new distribution of the risk groups in the population means that the risk of the condition is weighted differently to the reference study and this results in a different overall prevalence estimate. 2) The IPH prevalence estimates are based on a statistical model of the reference study. The model includes a number of explanatory variables to predict the risk of the condition. Therefore the model does not include records from the reference study that are missing data on these explanatory variables. A prevalence estimate for a condition taken directly from the reference study would include these records.

Prevalence of chronic conditions – Chronic Airflow Obstruction

IPH has estimated and forecast clinical diagnosis rates of CAO among adults for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007. The data describe the number of people who report that they have experienced doctor-diagnosed chronic bronchitis, chronic obstructive lung (pulmonary) disease, or emphysema in the previous 12 months (annual clinical diagnosis). Data is available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the Republic of Ireland. In Northern Ireland, the data are based on the Health and Social Wellbeing Survey 2005/06. The data describe the number of people who report that they have experienced doctor-diagnosed COPD or chronic obstructive pulmonary disease eg chronic bronchitis / emphysema or both disorders at any time in the past (lifetime clinical diagnosis). Data are available by age and sex for each Local Government District in Northern Ireland. Clinical diagnosis rates in the Republic of Ireland relate to the previous 12 months and are not directly comparable with clinical diagnosis rates in Northern Ireland which relate to anytime in the past.   The IPH estimated prevalence per cents may be marginally different to estimated prevalence per cents taken directly from the reference study. There are two reasons for this: 1) The IPH prevalence estimates relate to 2010 while the reference studies relate to earlier years (Northern Ireland Health and Social Wellbeing Survey 2005/06, Survey of Lifestyle, Attitudes and Nutrition 2007, Understanding Society 2009). Although we assume that the risk of the condition in the risk groups do not change over time, the distribution of the number of people in the risk groups in the population changes over time (eg the population ages).  This new distribution of the risk groups in the population means that the risk of the condition is weighted differently to the reference study and this results in a different overall prevalence estimate. 2) The IPH prevalence estimates are based on a statistical model of the reference study. The model includes a number of explanatory variables to predict the risk of the condition. Therefore the model does not include records from the reference study that are missing data on these explanatory variables. A prevalence estimate for a condition taken directly from the reference study would include these records.

Prevalence of chronic conditions – Musculoskeletal Conditions

IPH has estimated and forecast the number of adults with MSCs for the years 2010, 2015 and 2020. In the Republic of Ireland, the data are based on the Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007 . The data describe the number of people who report that they have experienced doctor-diagnosed MSC in the previous 12 months:     Lower back pain or any other chronic back condition     Rheumatoid arthritis (inflammation of the joints)     Osteoarthritis (arthrosis, joint degradation) Data are  available by age and sex for each Local Health Office of the Health Service Executive (HSE) in the Republic of Ireland. In Northern Ireland, the data are based on the Health and Social Wellbeing Survey 2005/06 and Understanding Society 2009. The data describe the number of adults who:     Have ever consulted a doctor about back pain     Are currently receiving treatment for musculoskeletal problems (such as arthritis, rheumatism)     Have ever been told by a doctor or other health professional that they had have arthritis? Data are available by age and sex for each Local Government District in Northern Ireland. There are significant differences between the definitions used in RoI and NI and North-South comparisons are not valid. The RoI measures relate to specific MSCs in the previous 12 months that had been diagnosed by a doctor. The NI measures relate to doctor-consultations at any time in the past, doctor-diagnosis at any time in the past and current treatment. The IPH estimated prevalence per cents may be marginally different to estimated prevalence per cents taken directly from the reference study. There are two reasons for this: 1) The IPH prevalence estimates relate to 2010 while the reference studies relate to earlier years (Northern Ireland Health and Social Wellbeing Survey 2005/06, Survey of Lifestyle, Attitudes and Nutrition 2007, Understanding Society 2009). Although we assume that the risk of the condition in the risk groups do not change over time, the distribution of the number of people in the risk groups in the population changes over time (eg the population ages).  This new distribution of the risk groups in the population means that the risk of the condition is weighted differently to the reference study and this results in a different overall prevalence estimate. 2) The IPH prevalence estimates are based on a statistical model of the reference study. The model includes a number of explanatory variables to predict the risk of the condition. Therefore the model does not include records from the reference study that are missing data on these explanatory variables. A prevalence estimate for a condition taken directly from the reference study would include these records.

Mortality counts and rates for injuries in Republic of Ireland, Northern Ireland, England, Scotland and Wales

Number of deaths and age-standardised death rates by type of injury for the following regions and year of occurrence:Republic of Ireland 1982, 1983, 1995-2004Northern Ireland 1982, 1983, 1995-2002England 1996-2003Scotland 1982, 1983, 1995-2004Wales 1996-2003

Hospital admission counts and rates for injuries in Republic of Ireland, Northern Ireland, England, Scotland and Wales

Number of hospital discharges and age-standardised discharge rates for emergency hospital admissions for injury by sex and type of injury for the following regions and year:Republic of Ireland 2006Northern Ireland 2006England 2006/07Scotland 2006/07Wales 2006 Numbers and rates are based on official hospital statistics from each region. All regions use International Classification of Disease (ICD) version 10 for hospital discharges in these years. Only emergency inpatient hospital spells with an ICD 10 code in the range S000-T739, T750-T759, T780-T789 (in any diagnostic position) and an ICD10 external cause code in the range V01-Y36 (in any diagnostic position) were included. A hospital spell is an unbroken period of time that a person spends as an inpatient in a hospital. The person may change consultant and/or specialty during a spell but is counted only once. See http://www.injuryobservatory.net/analysis-of-inpatient-admissions-data-f... for more details.

Longstanding health conditions among three-year-old children in the Republic of Ireland in 2011

Access audio, video and slides from the launch of the report The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to longstanding health conditions among young children across the island of Ireland. This report, based on a systematic analysis of data from the Growing Up in Ireland National Longitudinal Study of Children in the Republic of Ireland, is the first comprehensive look at longstanding health conditions among young children in Ireland. Estimated prevalence (per cent and number of cases) of longstanding health conditions among three-year-olds in the Republic of Ireland in 2011 by administrative counties/cities. The conditions are carer-reported: - "Longstanding illness, condition or disability” (where longstanding was defined as “anything that has troubled him/her over a period of time or that is likely to affect him/her over a period of time”) - Diagnosed asthma or asthma symptoms - Diagnosed eczema/any kind of skin allergy - Sight problem that required correction - Hearing problem that required correction - The estimates are based on data from the Growing Up in Ireland National Longitudinal Study of Children (www.growingup.ie) and population data. See the Chronic Conditions Hub for more details.  

Longstanding health conditions among three-year-old children in the Republic of Ireland in 2011: Executive Summary

Access audio, video and slides from the launch of the report The Institute of Public health in Ireland (IPH) produces population prevalence estimates and forecasts for a number of chronic conditions among adults. IPH has now applied the methodology to longstanding health conditions among young children across the island of Ireland. This report, based on a systematic analysis of data from the Growing Up in Ireland National Longitudinal Study of Children in the Republic of Ireland, is the first comprehensive look at longstanding health conditions among young children in Ireland. Estimated prevalence (per cent and number of cases) of longstanding health conditions among three-year-olds in the Republic of Ireland in 2011 by administrative counties/cities. The conditions are carer-reported: - "Longstanding illness, condition or disability” (where longstanding was defined as “anything that has troubled him/her over a period of time or that is likely to affect him/her over a period of time”) - Diagnosed asthma or asthma symptoms - Diagnosed eczema/any kind of skin allergy - Sight problem that required correction - Hearing problem that required correction - The estimates are based on data from the Growing Up in Ireland National Longitudinal Study of Children (www.growingup.ie) and population data. See the Chronic Conditions Hub for more details.