DETERMINE Working Document #1 'Policies and actions addressing the social determinants of health inequalities: examples of activity at EU member state level in Europe'

The Institute of Public Health in Ireland (IPH) is a partner in the European project DETERMINE, building on its previous involvement in the Closing the Gap project in 2004-2006. In the first year of the project (2007-2008) 15 DETERMINE partners identified policies and actions that have taken place within countries, and at the EU level, to address Social Determinants of Health Inequalities. These policies and actions were identified via a questionnaire, which also identified structures and tools/mechanisms being used in the country to support a 'health in all policy' approach.

Strategic development review of health board food control laboratories

The Official Food Safety laboratories have a critical role in ensuring food safety and public health for the whole population of the Republic of Ireland. These public health laboratories are made up of 7 microbiological testing laboratories and 3 chemical or Public Analyst’s laboratories. The laboratories are regionally based and offer an accredited (INAB) service to 10 health boards thus spanning the country. The role of the laboratories is to test food for compliance with the relevant legislation and guidelines, identify food-borne hazards and disease outbreaks, provide essential risk assessment information for national and international needs, provide a food testing service for consumers and a water testing service on a national basis. They also participate in dedicated National and EU surveys under the auspices of the Food Safety Authority of Ireland (FSAI). There has been significant investment and development in food-related public health protection in Ireland in recent years. However, there are still a number of issues that have the potential to impact on these laboratories in delivering a fully effective public health service in a cost efficient manner. Building on what has been achieved to date, this strategic review identifies those issues to be addressed in order to ensure (1) a cost effective national co-ordinated food safety laboratory service, (2) that future laboratory service needs are accounted for in the delivery of their Public Health role, and (3) that this Service meets both national and international requirements and standards.

Framework for Corporate and Financial Governance for Regulatory Bodies under the aegis of the Department of Health and Children

The document should be read as supplementary to existing requirements as set out both in statute â?" particularly legislation specific to your organisation, the Health Acts 1947-2004, Ombudsman Act, 1980, Data Protection Acts 1988 & 2003, Freedom of Information Acts 1997-2003, Ethics in Public Office Acts 1995 & 2001, Ombudsman for Children Act, 2002 and the Comptroller and Auditor General (Amendment) Act, 1993 – and in Government approved guidelines, including the Code of Practice for the Governance of State Bodies (2001), Public Financial Procedures, The Role and Responsibilities of Accounting Officers (2003) and Risk Management Guidance for Government Departments and Offices (2004). Read the report (PDF, 1.4mb)  

Department of Health (RoI)

The role of the Department of Health is to provide strategic leadership for the health service and to ensure that Government policies are translated into actions and implemented effectively.  It supports the Minister and Ministers of State in their implementation of Government policy and in discharging their governmental, parliamentary and Departmental duties. This includes: advising on the strategic development of the health system including policy and legislation; evaluating the performance of the health and social services; and working with other sectors to enhance people’s health and well-being. The health service seeks to improve the health and wellbeing of people

A picture of health: A study of the health status and health promotion needs of homeless people in the west.

Homeless people have been identified as a group that experience inequality in health and a target group in relation to health promotion initiatives. In developing health promotion initiatives it is important to take account of the broader determinants of health and to address the physical, mental and social well-being of homeless people. The study aimed to identify the health status and health promotion needs of homeless people in the Western Health Board region.To gain an understanding of the health problems and health promotion needs of homeless people one to one interviews were carried out with homeless people and focus groups were carried out with service providers. Sixty five interviews were carried out with people currently accessing voluntary services in Galway and Mayo. Three focus groups were carried out with service providers from voluntary and statutory services.This resource was contributed by The National Documentation Centre on Drug Use.

Strategic review of health inequalities in England post 2010 (Marmot review consultation paper)

In November 2008, Professor Sir Michael Marmot was asked to advise the Secretary of State for Health on the future development of a health inequalities strategy in England post-2010. The consultation relates to the first phase of the review and is based on submissions from nine task groups, who considered the evidence base across the social determinants of health. This document discusses issues raised during this first phase of the review and identifies key questions for respondents. The consultation document is set out in the following sections: Section 1 The Review Consultation: Aims and consultation questions Section 2 The Strategic Review of Health inequalities: The Background to the Review, the remit, structure, context and the social determinants approach to health inequalities. Section 3 Key Strategic Themes: A summary of a thematic analysis of proposals made by the Review task groups. Each task group was asked to assess national and international evidence about interventions and policies from within their policy area, which would likely lead to reductions in health inequalities. Section 4 Cross-Cutting Challenges for the Review: A summary of challenges currently under consideration by the Review.

Review of Health Impact Assessment for the Institute of Public Health in Ireland

IPH commissioned a review of HIA work in 2009 to detail progress and achievements of HIA from 2001. This included an assessment of current levels of HIA awareness and activity and suggestions for the direction of future work.

Review of Health Impact Assessment

IPH commissioned a review of HIA work in 2009 to detail progress and achievements of HIA from 2001.  This included an assessment of current levels of HIA awareness and activity and suggestions for the direction of future work.

DETERMINE Working document #4 'Economic arguments for addressing social determinants of health inequalities'

The Institute of Public Health in Ireland (IPH) is a partner in the European project DETERMINE, building on its previous involvement in the Closing the Gap project in 2004-2006. In Year 2 the DETERMINE project  focused on identifying and exploring economic arguments to support action on social determinants of health inequalities.  Working document #4 'Economic arguments for addressing social determinants of health inequalities' presents the findings.

Partnerships: community involvement and perceptions of health inequalities

The Research and Development Office for Health and Personal Social Services in Northern Ireland funded the Institute of Public Health in Ireland (IPH) to undertake research into partnerships between 2003 and 2006, as part of their New Targeting Social Need programme.The aim of the research was to identify the impacts of multisectoral partnerships, how they can be measured, and what contribution they make to tackling inequalities in health. This document is one of a suite of three produced as a result of this work.

Consideration of health in Strategic Environment Assessment (SEA) on the island of Ireland

This IPH report explores the extent health was incorporated into SEA in a manner which would suggest a good understanding of the many social and economic factors which strongly influence health. The research identifies that a consideration of health is not routinely included in SEAs. There is a need to build capacity and change mindsets in how SEAs are undertaken to more completely factor in the health impacts.

IPH response to Department of Health (ROI) consultation on National Strategy on Dementia

The current prevalence of dementia and its associated economic and social burden presents a challenge for the configuration of dementia care services at present and it is clear that this challenge will become ever more urgent as a consequence of population ageing. IPH supports the development of a Dementia Strategy in Ireland that is comprehensive and holistic. We recommend that the strategy encompasses aspects of prevention as well as optimal management at all stages of the disease. IPH considers that a social determinants of health approach that focuses on the prevention of disease and disability could form an important strand of the strategy. Key points from IPH response IPH would emphasise the following key priorities for inclusion in the Dementia Strategy.   Adoption of a public health approach as set out by WHO (2011) and the development of an implementation plan and structures to support the Strategy A commitment to primary, secondary and tertiary prevention of dementia.  Resourcing of a programme of research to support primary, secondary and tertiary prevention of dementia to ensure a systematic approach to generate an evidence-base and disseminate pertinent findings in the Irish context. Emphasis should be placed on high quality research specifically to:enhance information systems on dementia at a national level A life course approach to tackle the social determinants of dementia and ill-health in later life. Supporting carers for people with dementia

IPH response to Department of Health (UK) Standardised Packaging of Tobacco Products

Enhanced tobacco control policies and programmes are an important component of any strategic approach to improving population health and tackling health inequalities. The consultation on standardised packaging of tobacco products in the UK is particularly timely in view of the recent publication of the Ten Year Tobacco Strategy for Northern Ireland (DHSSPS, 2012). In this strategy the Department expressed its support for the introduction of further measures to reduce the influence of tobacco advertising and promotion upon children e.g. the introduction of plain packaging for cigarettes and hand rolling tobacco.  IPH key points •    The extent of tobacco-related harm across the island of Ireland and across the UK is unacceptable. Increasingly comprehensive and effective tobacco-control interventions are required. •    IPH recommends the adoption of option 2: require standardised packaging of tobacco products. •    IPH acknowledges that as plain packaging has not yet been introduced in any country, it is not possible at this time to accurately forecast the extent and nature of this intervention on population level health outcomes in the UK context. •    The proposed approach appears comprehensive in addressing the direct and indirect ways in which elements of tobacco packaging can promote brand appeal and can portray impressions in respect of tobacco-related harm. Consideration should be given to include specific provisions relating to roll-your-own (RYO) tobacco packaging. Any approach needs to be regularly reviewed to take into account attempts to bypass restrictions and evaluate responses in respect of consumer choices. •    IPH considers that the introduction of plain packaging has the potential to support the achievement of the goals set out in the Ten Year Tobacco Control Strategy for Northern Ireland ( DHSSPS, 2012). •    Among children in Northern Ireland who reported trying their first cigarette, around one quarter were aged 11 or under and three quarters were 14 or under when they did so (DHSSPS, 2012).  The very young age of these children is concerning on many levels including their susceptibility to sophisticated branding and marketing techniques linked to tobacco packaging.

IPH response to Your Health is Your Wealth – Health and Wellbeing Framework 2012- 2020 (Department of Health)

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. The Department of Health is developing a Health and Wellbeing policy to improve the health of the population and reduce health inequalities by addressing causes of preventable illnesses. The Policy Framework is at an advanced stage with a number of background analytical documents prepared and published on the Department website to allow views to be incorporated into final drafts.  IPH responded to the consultation call in 2011 and we welcome the placement of these supporting documents on the Department website with the request for additional comments.

IPH response to European Review of the Social Determinants of Health and the Health Divide

IPH welcomes this European Review conducted by the Marmot Review Team which aims to inform action on social determinants of health and health equity within the forthcoming health policy for the European region, Health 2020. IPH calls for clear mandates supporting whole-of-government approaches to address social determinants and outlines some of the specific challenges and opportunities within the current Ireland and Northern Ireland policy landscape.