Response to the discussion paper on proposed Health Information Bill

The Institute of Public Health in Ireland is an all-island body which aims to improve health in Ireland by working to combat health inequalities and influence public policies in favour of health. The Institute promotes North-South co-operation in research, training, information and policy. The Institute commends the Department of Health and Children for producing the Discussion Paper on Proposed Health Information Bill (June 2008) and welcomes the opportunity to comment on it. The first objective of the Health Information: A National Strategy (2004) is to support the implementation of Quality and Fairness: A Health System for You (2001).The National Health Goals - such as ‘Better health for everyone’, ‘Fair access’ and ‘Responsive and appropriate care delivery’ - are expressed in terms of the health of the public as well as patients. The Discussion Paper focuses on personal information, and the data flows within the health system, that are needed to enhance medical care and maximise patient safety. The Institute believes that the Health Information Bill should also aim to more fully support the achievement of the National Health Goals and the public health function. This requires the development of more integrated information systems that link the healthcare sector and other sectors. Assessment of health services performance - in terms of the public’s health, health inequalities and achievement of the National Health Goals - require such information systems. They will enable the construction of public health key performance indicators for the healthcare services.

Public Health Function Review

Public Health Function Review

Obesity in an ageing society implications for health, physical function and health service utilisation.

Key Findings • Based on body mass index (BMI) measurements, 36% of Irish over 50s are obese and a further 43% are overweight. • Based on waist circumference measurements, 52% of Irish over 50s are ‘centrally obese’, i.e., with a ‘substantially increased’ waist circumference, while a further 25% have an ‘increased’ waist circumference. • Using BMI as an indicator of obesity, a higher proportion of men (38%) are obese than women (33%); however, using waist circumference as an indicator of obesity, a higher proportion of women (56%) have a ‘substantially increased’ waist circumference than men (48%). • The prevalence of obesity in Irish men over 50 is comparable with US men over 50 (while English rates are much lower).     .This resource was contributed by The National Documentation Centre on Drug Use.

Autonomic Function Is Impaired in Elderly Stroke Survivors

Impaired autonomic function is common in the acute poststroke phase but little is known about the longer term effects, particularly in older people. This study sought to determine if autonomic function is impaired after stroke recovery in older patients. This is a cross-sectional case-control study comparing autonomic function in 76 nondemented stroke patients with 70 community-living controls aged older than 75 years.

Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment

Physical activity is beneficial for healthy ageing. It may also help maintain good cognitive function in older age. Aerobic activity improves cardiovascular fitness, but it is not known whether this sort of fitness is necessary for improved cognitive function.��Eleven studies of aerobic physical activity programmes for healthy people over the age of 55 years have been included in this review. Eight of these 11 studies reported that aerobic exercise interventions resulted in increased fitness of the trained group and an improvement in at least one aspect of cognitive function. The largest effects were on cognitive speed, auditory and visual attention. However, the cognitive functions which improved were not the same in each study and the majority of comparisons yielded no significant results.��The data are insufficient to show that the improvements in cognitive function which can be attributed to physical exercise are due to improvements in cardiovascular fitness.

Making the Link Between Obesity and wellbeing

Making the links between Obesity & Well-being. A briefing paper developed for Care Services Improvement Partnership (CSIP) North West. The paper covers the epidemiology and evidence of links between health and obesity. Mental well-being is a key factor of obesity and weight management. Good mental health is a protective factor for good physical health and against physical illness and is essential for making healthy lifestyle choices and behaviour changes. Poor mental health can lead to unhealthy lifestyle choices and unhealthy weight management. Obesity and physical illness can also lead to poor mental health. People with mental health problems, especially severe, are also at increased risk of obesity and related poor health. In order to ensure that strategies and programmes effectively address the relevant mental well-being factors, a mental well-being impact assessment (MWIA) could be undertaken. This process is based on health impact assessment methodology and a set of evidence based mental well-being determinants and factors, grouped under the four themes of enhancing control, increasing resilience and community assets, facilitating participation and promoting inclusion. The process also involves identifying indicators to measure progress. Evaluation shows it is effective in engaging stakeholders in service development and evaluation and it increases understanding of mental well-being and its determinants.