NI Draft Priorities and Budget Consultation 2006-2008 - Institute response

The Institute of Public Health in Ireland works to combat health inequalities and influence public policies in favour of health in Ireland, North and South. The Institute applies a holistic model of health which emphasises a wide range of determinants, including economic, educational, environmental, social and biological factors, as well as public services. The Institute’s work is based on the premise that improving health and reducing health inequalities in a sustainable way can only be achieved through addressing these broader determinants of health. We believe that the strategic direction of public spending in Northern Ireland has enormous potential to impact on people’s health, well being and prosperity.  We welcome the opportunity to comment on the draft priorities and the associated budget for 2006-2008 as set out in the consultation document.

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.

DHSSPS Consultation on smoking in enclosed public places and workplaces

The Institute of Public Health welcomes the current consultation on smoking in enclosed workplaces and public places. Having considered the three options given the Institute strongly supports option 5c – “a total ban on smoking in all enclosed workplaces and public places”. This clearly outlines that a total ban on smoking in all enclosed public places and workplaces is the only option which will adequately protect the health of all workers and contribute to reducing the prevalence of smoking in the population of Northern Ireland.As an organisation set up to promote North South co-operation we believe that a similar approach to smoking in public places and workplaces should be taken to that in the Republic of Ireland where there is clear evidence that such policies are practical, well supported and effective.

IPH Response to Consultation on a Draft Dtrategy for Children

The Institute of Public Health welcomes the Consultation on a Draft Strategy for Children and Yung People in Northern Ireland. We believe that in addition to the human rights to which we are all entitled, children and young people constitute, in many instances, a vulnerable group within society and therefore special effort is needed to ensure that they are able to maximise their potential and live healthy, fulfilling lives.  In our response to the Consultation Document we will focus on how inequality impacts on children’s lives and how, as a consequence ways in which to combat inequalities need to be at the heart of a strategy for children. We will also highlight the potential for strengthening the strategy by increased cooperation with similar initiatives in the Republic of Ireland.

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.

Stroke Briefing

The Chronic Conditions Hub is a website that brings together information on chronic health conditions. It allows you to easily access, manage and share relevant information resources. The Chronic Conditions Hub includes the Institute of Public Health in Ireland’s (IPH) estimates and forecasts of the number of people living with chronic conditions. On the Chronic Conditions Hub you will find: - A Briefing for each condition - Detailed technical documentation - Detailed national and sub-national data that can be downloaded or explored using online data tools - A prevalence tool that allows you to calculate prevalence figures for your population data A stroke happens when blood flow to a part of the brain is interrupted by a blocked or burst blood vessel. A lack of blood supply can damage brain cells and affect body functions. IPH has systematically estimated and forecast the prevalence of stroke on the island of Ireland.   Epidemiology Age, family history, diabetes, high blood pressure, high cholesterol, smoking, unhealthy diet, physical inactivity and alcohol are the main risk factors for stroke. The World Health Organization estimates that stroke and cerebrovascular disease is responsible for 10% of all world deaths and is the second most common cause of death worldwide. Cerebrovascular diseases (ICD 10 codes I60-I69) were responsible for 7.2% of all deaths in the Republic of Ireland in 2009 and for 8.6% of all deaths in Northern Ireland in 2010.

A Healthier Future: A Strategic Framework for Respiratory Conditions

In Northern Ireland in 2002-03, there were almost 30,000 admissions to hospital for respiratory conditions utilizing over 180,000 bed days and costing almost å£50m. Social security support for people with long term chest and breathing problems amounts to å£26m annually. This framework sets out how with better prevention and self management a reduction in ill health and a contribute to a reduction in avoidable deaths can be achieved. And with better co-ordinated and integrated services more consistent and effective care for those people unfortunate enough to suffer from serious disease can be provided. This in turn will enable services to better respond to the increasing needs of a more elderly population. The document contains a number of recommendations. These include significant service re-organisation and re-design so that the whole system – the primary, community and hospital sectors, provides for a more responsive and effective service to users and carers. This should result in much more of the overall caseload being proactively managed in community and primary care environments allowing scarce hospital capacity to be devoted to the most critical cases. This includes the development of new ways of caring for at risk patients, more effective rehabilitation in the community, improved education and training of professionals and better communication across the community and hospital sectors.

A Fitter Future for All: Consultation Document

The prevalence of people who are overweight and obese has been steadily rising in Northern Ireland, and in the western world, over the last few decades. It has been described as an “obesity time-bomb”, given the impact that obesity can have on physical and mental health and wellbeing.Evidence has shown that, while weight gain is the result of a relatively simple energy imbalance, the causes that underpin changes to energy intake and expenditure are very complex and cover issues such as social and individual psychology, physiology, food production and consumption, individual activity, and the built environment.This Framework aims to “empower the population of Northern Ireland to make healthy choices, and reduce the level of harm related to overweight and obesity, by creating an environment that supports and promotes a physically active lifestyle and a healthy diet”.In addition, the following overarching target has been set: to reduce the level of obesity in Northern Ireland to the 2005-06 level by 2021.

Professional Estates Letters (PELs)

Professional Estates Letters (PELs)

Patient Education/Self Management Programmes for People with Long Term Conditions

Regional Summary Report 2012/13

New Strategic Direction for Alcohol & Drugs Phase 2 Second Update Report (June 2014) (PDF 1MB)

This second annual report provides an update of progress against the outcomes and indicators set out in NSD Phase 2.