IPH Response to draft Northern Ireland Programme for Government 2011-15

On 17 November 2011, the First Minister and deputy First Minister published the draft Programme for Government 2011-2015 for consultation. IPH recognise that health is influenced by a wide range of social determinants, including economic, biological, environmental and cultural factors such as housing, the environment, income, employment and access to education and health services . Improvements to health can be achieved through a well-designed PfG which addresses the economy, creates safer communities and delivers efficient public services.  IPH welcome this opportunity to submit our views to the Northern Ireland Executive on the Draft Programme for Government 2011-15. Key points from the IPH response include: • Northern Ireland has a poor population health status in key areas when compared to other regions in the United Kingdom and in the Republic of Ireland. IPH support and particularly welcome allocation of an increased proportion of the Northern Ireland budget to public health. • IPH endorses the perspective in the PfG that good population health makes a central contribution to economic and social development.   However we would welcome greater acknowledgement of the links between social deprivation and health outcomes.  • IPH welcomes the adoption of a social determinants of health approach to improving population health and tackling health inequalities which is in line with current health policy and recent policy developments across the United Kingdom and internationally (See report of the Commission on the Social Determinants of Health (CSDH))

IPH Response to OFMDFM Consultation ‘Everyone’s Involved’ - Sustainable Development Strategy Implementation Plan

The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  IPH promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. Its key focus is on efforts to improve health equity. The work of IPH (www.publichealth.ie) includes health impact assessment, building and sharing evidence for public health development, developing Ireland and Northern Ireland’s population health observatory (INISPHO www.inispho.org ), and providing public health policy advice in areas such as health inequalities, obesity, fuel poverty and food poverty.   Health is influenced by a wide range of social determinants, including economic, environmental, social and biological factors. IPH has a key interest and significant experience in raising awareness and developing work to influence these wider social and environmental determinants in ways which improve health. Sustainable development and public health are inextricably linked, in ways which are described in section 3.  Sustainable development is essentially at the heart of healthy communities and individuals as well as a healthy environment and sustainable economic development   - all factors at the heart of public health.

IPH response to draft Sustainable Development Strategy 'Everyone's Involved'

The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health.  IPH promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. Its key focus is on efforts to improve health equity. The work of IPH (www.publichealth.ie) includes health impact assessment, building and sharing evidence for public health development, developing Ireland and Northern Ireland’s population health observatory (INISPHO www.inispho.org ), and providing public health policy advice in areas such as health inequalities, obesity, fuel poverty and food poverty.   Health is influenced by a wide range of social determinants, including economic, environmental, social and biological factors. IPH has a key interest and significant experience in raising awareness and developing work to influence these wider social and environmental determinants in ways which improve health. Sustainable development and public health are inextricably linked, in ways which are described in section 3.  Sustainable development is essentially at the heart of healthy communities and individuals as well as a healthy environment and sustainable economic development   - all factors at the heart of public health.

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).

Annual Report of the Chief Medical Officer for the year 1999

The general purpose of the Report is: To make a contribution to the debate on issues relevant to the development of public health policy. To describe aspects of the health status of the Irish people by reference to certain indicators of mortality and lifestyle. To identify particular factors which are relevant to the major disease entities affecting the Irish population. To identify a specific theme of particular contemporary relevance to health in Ireland Download the Report here

Breastfeeding in Ireland. A five-year strategic action plan - National Committee on Breastfeeding 2005

The protection, promotion and support of breastfeeding has been identified in many national policy documents as a major public health issue. Breastfeeding offers mothers and babies significant health advantages both in the short term and throughout their lives.From a health policy point of view, it is generally agreed that the better health afforded by breastfeeding can result in major savings in the provision of health care. Studies have also shown that breastfeeding has a positive effect on the wider economy with fewer days being lost by employed parents of breastfed babies to illness. Although progress is being made in promoting and supporting this health enhancing, environmentally friendly and low-cost feeding option, breastfeeding rates in Ireland continue to be among the lowest in Europe. This Strategic Action Plan has been developed by a Ministerial appointed, multi-disciplinary National Committee on Breastfeeding, in consultation with relevant stakeholders, to further promote breastfeeding among all sectors of the population and particularly among those currently least likely to breastfeed. Its goal is the achievement of optimum health and well-being for children, their mothers, families and communities. Click here to download PDF

Reducing the Risk: A Strategic Approach - The Report of the Task Force on Sudden Cardiac Death

The Minister for Health and Children established the Task Force on Sudden Cardiac Death (SCD) in the Autumn of 2004, with the following terms of reference:1) Define SCD and describe its incidence and underlying causes in Ireland.2) Advise on the detection and assessment of those at high risk of SCD and their relatives.3) Advise on the systematic assessment of those engaged in sports and exercise for risk of SCD.4) Advise on maximizing access to basic life support (BLS) and automated external defibrillators (AEDs) and on:- appropriate levels of training in BLS and use of AEDs, and on the maintenance of that training- priority individuals and priority groups for such training- geographic areas and functional locations of greatest need- best practice models of first responder scheme and public access defibrillation, and- integration of such training services.5) Advise on the establishment and maintenance of surveillance systems, including a registry of SCD and information systems to monitor risk assessment, and training and equipment programmes.6) Advise and make recommendations on other priority issues relevant to SCD in Ireland.7) Outline a plan for implementation and advise on monitoring the implementation of recommendations made in the Task Force’s report. In undertaking its work the Task Force was mindful of national health policy, relevant national strategies and of the recently reformed structures for health service delivery in Ireland. Read the Report (PDF, 1.66mb)

Annual Report of the Elder Abuse National Implementation Group, 2006

Annual Report of the Elder Abuse National Implementation Group, 2006 The specific function of the Elder Abuse National Implementation Group (EANIG) is to overview the implementation of Protecting Our Future (Department of Health and Children, 2002) by various government agencies and other bodies. Protecting our Future became official health policy in November 2002. The group met on four occasions during 2006. I would like to thank the following members who retired from the Group for their hard work and contribution to the elder abuse programme: Ms Mary McDermott, Cllr Eibhlin Byrne, Mr Shay Costello, Ms Anne-Marie Ross and Mr Tom Leonard. A full list of current members is provided at Appendix A. Click here to download PDF 157kb

First Annual Report of the Independent Monitoring Group on "A Vision for Change"

First Annual Report of the Independent Monitoring Group on “A Vision for Change” In January 2006, the Government adopted the Report of the Expert Group on Mental Health Policy "A Vision for Change"Âù as the basis for the future development of mental health services. In March 2006, the Minister of State at the Department of Health and Children, Mr Tim Oâ?TMalley, T.D., with special responsibility for mental health services, established the independent Monitoring Group to monitor progress on the implementation of the report recommendations. Click here to download PDF 255kb

2nd Report of the Independent Monitoring Group on A Vision For Change

This is the Second Annual Report of the Independent Monitoring Group for A Vision for Change the Report of the Expert Group on Mental Health Policy. The Monitoring Group was established in March 2006 to monitor and assess progress on the implementation of A Vision for Change. In this Second Report, the Monitoring Group has found that by and large the recommendations in its first report were not addressed in 2007, although some have been prioritised for implementation in 2008. Download document here

Standard of Healthy Living on the Island of Ireland

Pre-requisites for health are equity, minimum income, nutrition, peace, water, sanitation, housing, education, work, political will and public support (WHO, 1986). It has long been known that social disadvantage harms health (Black, 1980, Ettner, 1996). Many researchers have documented that those in lower socio-economic groups are more at risk of developing major chronic diseases such as cardiovascular diseases (Beaglehole and Yach, 2003, WHO, 2003a), diabetes (Wilder et al., 2005), and some cancers (Brunner et al., 1993, Strong et al., 2005), and are at a higher risk of having multiple risk factors associated with these diseases (Lynch et al., 1997). The living standards that many people enjoy and the behavioural choices they make are heavily determined by their access to resources such as income, wealth, goods and services (O’Flynn and Murphy, 2001). The most prominent explanation between disadvantage and health is that lack of resources restricts access to the fundamental conditions of health such as adequate housing (Macintyre et al., 2003, Macintyre et al., 2005), good nutrition (Nelson et al., 2002) and opportunities to participate in society (McDonough et al., 2005). Each of these issues are very much influenced by material and structural factors inherent to and determined by fiscal, social and health policy (Graham and Kelly, 2004, Milio, 1986).

Self-harm, suicide and risk: helping people who self-harm. Final report of a working group.

The focus of this report is to enquire into and report on why people harm and kill themselves and to consider the role (including the limits of the role) that psychiatrists and other mental healthcare professionals play in their care and treatment. The experiences and views of people who harm themselves as well as those of their carers, health professionals and third-sector workers are central to this enquiry. As there is much policy and guidance on self-harm and suicide prevention, the report does not attempt to retrace this same ground but rather examines the evidence of practice on the ground, including the implementation of the National Institute for Health and Clinical Excellence (NICE) guidelines on self-harm (National Collaborating Centre for Mental Health, 2004). This report is the second in the Royal College of Psychiatristsââ,¬â"¢ programme of work on the broad issue of risk. The College report Rethinking Risk to Others was published in July 2008 (Royal College of Psychiatrists, 2008a) and a new Working Group was set up under the chairmanship of John, Lord Alderdice, to examine risk, self-harm and suicide. This clinical issue is an integral part of the role of the psychiatrist in ensuring the good care and treatment of patients. Our central theme is that the needs, care, well-being and individual human dilemma of the person who harms themselves should be at the heart of what we as clinicians do. Public health policy has a vital role to play and psychiatrists must be involved and not leave these crucial political and managerial decisions to those who are not professionally equipped to appreciate the complexities of self-harm and suicide. But we must never forget that we are not just dealing with social phenomena but with people who are often at, and beyond the limit of what they can emotionally endure. Their aggressive acts towards themselves can be difficult to understand and frustrating to address, but this is precisely why psychiatrists need to be involved to bring clarity to the differing causes for the self-destructive ways in which people act and to assist in managing the problems for the people concerned, including family, friends and professional carers, who sometimes find themselves at the end of their tether in the face of such puzzling and destructive behaviour.

Parental alcohol use and resilience in young people: A study of family, peer and school processes

Funded by HSC R&D Division, Public Health Agency Parental alcohol misuse or ‘hidden harm’ presents a very significant challenge to public health policy and practice in the UK and internationally. A parent’s alcohol problems can have a profound impact on their children. Children depend on their family to meet their physical, psychological and social needs, their economic security and well-being, all of which can be jeopardised by parents misusing substances (NACD, 2011). The prevalence of parental alcohol misuse is extremely difficult to estimate, due to the ‘hidden’ nature of the problem within the family unit. Approximately 40,000 children in Northern Ireland are estimated to live with parental alcohol misuse (DHSSPS, 2008). In the UK, 30% of children (3.3 to 3.5 million) under 16 years, live with at least one binge drinking parent and 22% of children (2.6. million) with a hazardous drinker (Manning et al., 2009).  

Assisted reproductive technology – IVF treatment in Ireland: A study of couples with successful outcomes

Human Fertility 17(3):165-9 This article describes the experiences of twelve Irish couples who had successful IVF treatment in Ireland. Irish Medical guidelines specify that IVF may only be used when no other treatment is likely to be effective. This article is based on data drawn from a longitudinal research study by Cotter (2009) which tells the stories of 34 couples who sought fertility treatment. Initially, the women assumed that they would become pregnant when they stopped using contraception. As a couple, it was the ‘right time’ for them to have a child - they were ready, socially and financially. For several months they were patient, hoping it would happen naturally. With envy and some despair they watched as their friends had babies. Infertility came as a shock to most of them. They were reluctant to talk about it to anyone, and over time their anxieties were accompanied by feelings of regret, stigma and social exclusion. They finally sought medical treatment. The latter involved a series of diagnostic treatments, which eventually culminated in IVF which offered them a final chance of having a ‘child of their own’. While IVF can be clinically assessed in terms of cycle success rates, their stories showed treatment as a series of discoveries, as an extensive range of diagnostic tests and procedures helped to reveal to them where their problems might lie. They described their treatments as a series of sequential ‘hurdles’ that they had to overcome, which further strengthened their resolve to try IVF. Much more knowledgeable at that stage, they embraced IVF as a final challenge with single minded dedication while drawing on all their psychological and biological resources to promote a successful outcome. Of the 34 couples who took part in the study, twelve got pregnant. Unfortunately, two children died shortly after birth but eighteen babies survived (see Table I). The findings suggest that health policy should raise awareness of infertility, and advise women to become aware of it just as in the past, when health policy addressed contraception. Increased public knowledge would reduce the stigma attached to the inability to have a baby. In the Irish case, infertility diagnosis should be reviewed with a view to giving eligible couples earlier access to IVF.  

Health Impact Assessment Policy analysis tool

The policy analysis tool provides a framework to review government and other relevant agency policy related to the proposal.