Food poverty in rural Northern Ireland

“Decent Food for All” (DFfA) was a three-year integrated, partnership-based programme committed to reducing food poverty and addressing inequalities in physical and financial access to safe healthy food in the Armagh and Dungannon area of Northern Ireland. DFfA is led by the Armagh and Dungannon Health Action Zone (ADHAZ) and involves the delivery of a range of programmes and workshops which provide practical community based focused help and advice on food issues and nutrition. A comprehensive research and evaluation programme entitled ‘All-island learning from the Decent Food for All programme’ runs throughout the lifetime of the programme, which ensures effective evaluation, and the sharing of best practices and experiences. The research and evaluation program is coordinated by the Institute of Public Health in Ireland (IPH) with cooperation from ADHAZ. Funding for the research is provided by the Food Safety Promotion Board. To take into account background changes not directly attributable to the DFfA Programme a matched comparison area was selected in the Newry/Mourne area of Co. Down. An accurate measure of the changes that have occurred over the period of the DFfA programme is required. Valid estimates of change are based on measures before and after the programme. Pre-test and post-test community surveys provide a wide range of measures. This fact-book highlights the findings from the pre-test community survey.The aims of the pre-test survey were to:- Provide pre-test measures of the Key Performance Indicators underpinning the Key Expected Outcomes of the DFfA programme;- Identify factors influencing these pre-test measures; and- Contribute to the development of the programmes in DFfA.

IPH response to Seanad Consultation Committee on 'Changes in lifestyle can prevent approximately one third of cancers. How does Government and Society respond to this challenge?'

IPH responded to the Seanad Consultation Committee on the consultation topic ‘Changes in lifestyle can prevent approximately one third of cancers.  How does Government and Society respond to this challenge?’. Between 2010 and 2020 the total number of cancers in Ireland is projected to increase by 40% for women and by just over 50% for men (National Cancer Registry).  A focus is needed on developing social, economical and built environments that support healthy choices. IPH presented recommendations based on the international evidence-base as well as national cancer data and research.

IPH response to DARD rural antipoverty framework

The Institute of Public Health in Ireland (IPH) 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 cooperation in research, training, information and policy in order to contribute to policies which tackle inequalities in health. IPH welcomes the opportunity to comment on the DARD Rural anti-poverty and social inclusion Framework.  IPH has conducted extensive work on poverty, equality and health across the island of Ireland.  We have also been specifically involved in other projects looking at the impact of rural areas and health, which may be found at www.publichealth.ie We would like to highlight the importance of considering the health needs of rural communities in policy such as the Rural Anti Poverty and Social Inclusion Framework. A wide variety of issues affect people’s health including employment, transport and access to services, for example the health and wellbeing of people in rural communities can be adversely affected by social isolation from a lack of public transport.

Towards a Society for All Ages: Conference Proceedings

The Conference provided the opportunity for delegates to explore issues relating to social inclusion of older Irish people, issues such as income, housing and health which have great impact on the quality of life of older people. It also afforded the opportunity to examine progress towards a society for all ages at the European level as well as in Ireland in relation to equality legislation, the National Anti-Poverty Strategy and pensions policy Download the Report here

Towards a tobacco free society : Report of the Tobacco Free policy Review Group

This report is the latest of four reports dealing with various aspects of smoking. There is some inevitable overlap in these reports and the actual recommendations may be somewhat different but there is a common objective of seeking the most effective measures possible to dramatically reduce the level of smoking in our society and above all to prevent our children from starting to smoke Download the Report here

Address by Michea¡l Martin to the Conference - Legislating for Tobacco Free Society

Thank you Chairman I would like to extend a warm welcome to our keynote speakers, David Byrne of the European Commission, Derek Yach from the World Health Organisation, and Paul Quinn representing Congressman Marty Meehan who sends his apologies. When we include the speakers who will address later sessions, this is, undoubtedly, one of the strongest teams that have been assembled on tobacco control in Europe. The very strength of the team underlines what I see as a shift – a very necessary shift – in the way we perceive the tobacco issue. For the last twenty years, we have lived out a paradox. It isn´t a social side issue. I make no apology for the bluntness of what I´m saying, and will come back, a little later, to the radicalism I believe we need to bring – nationally – to this issue. For starters, though, I want to lay it on the line that what we´re talking about is an epidemic as deadly as any suffered by human kind throughout the centuries. Slower than some of those epidemics in its lethal action, perhaps. But an epidemic, nonetheless. According to the World Health Organisation tobacco accounted for just over 3 million annual deaths in 1990, rising to 4.023 million annual deaths in 1998. The numbers of deaths due to tobacco will rise to 8.4 million in 2020 and reach roughly 10 million annually by 2030. This is quite simply ghastly. Tobacco kills. It kills in many different ways. It kills increasing numbers of women. It does its damage directly and indirectly. For children, much of the damage comes from smoking by adults where children live, study, play and work. The very least we should be able to offer every child is breathable air. Air that doesn´t do them damage. We´re now seeing a global public health response to the tobacco epidemic. The Tobacco Free Initiative launched by the World Health Organisation was matched by significant tobacco control initiatives throughout the world. During this conference we will hear about the experiences our speakers had in driving these initiatives. This Tobacco Free Initiative poses unique challenges to our legal frameworks at both national and international levels; in particular it raises challenges about the legal context in which tobacco products are traded and asks questions about the impact of commercial speech especially on children, and the extent of the limitations that should be imposed on it. Politicians, supported by economists and lawyers as well as the medical profession, must continue to explore and develop this context to find innovative ways to wrap public health considerations around the trade in tobacco products – very tightly. We also have the right to demand a totally new paradigm from the tobacco industry. Bluntly, the tobacco industry plays the PR game at its cynical worst. The industry sells its products without regard to the harm these products cause. At the same time, to gain social acceptance, it gives donations, endowments and patronage to high profile events and people. Not good enough. This model of behaviour is no longer acceptable in a modern society. We need one where the industry integrates social responsibility and accountability into its day-to-day activities. We have waited for this change in behaviour from the tobacco industry for many decades. Unfortunately the documents disclosed during litigation in the USA and from other sources make very depressing reading; it is clear from them that any trust society placed in the tobacco industry in the past to address the health problems associated with its products was misplaced. This industry appears to lack the necessary leadership to guide it towards just and responsible action. Instead, it chooses evasion, deception and at times illegal activity to protect its profits at any price and to avoid its responsibilities to society and its customers. It has engaged in elaborate ´spin´ to generate political tolerance, scientific uncertainty and public acceptance of its products. Legislators must act now. I see no reason why the global community should continue to wait. Effective legal controls must be laid on this errant industry. We should also keep these controls under review at regular intervals and if they are failing to achieve the desired outcomes we should be prepared to amend them. In Ireland, as Minister for Health and Children, I launched a comprehensive tobacco control policy entitled “Towards a Tobacco Free Society“. OTT?Excessive?Unrealistic? On the contrary – I believe it to be imperative and inevitable. I honestly hold that, given the range of fatal diseases caused by tobacco use we have little alternative but to pursue the clear objective of creating a tobacco free society. Aiming at a tobacco free society means ensuring public and political opinion are properly informed. It requires help to be given to smokers to break the addiction. It demands that people are protected against environmental tobacco smoke and children are protected from any inducement to experiment with this product. Over the past year we have implemented a number of measures which will support these objectives; we have established an independent Office of Tobacco Control, we have introduced free nicotine replacement therapy for low-income earners, we have extended our existing prohibitions on tobacco advertising to the print media with some minor derogations for international publications. We have raised the legal age at which a person can be sold tobacco products to eighteen years. We have invested substantially more funds in health promotion activities and we have mounted sustained information campaigns. We have engaged in sponsorship arrangements, which are new and innovative for public bodies. I have provided health boards with additional resources to let them mount a sustained inspection and enforcement service. Health boards will engage new Directors of Tobacco Control responsible for coordinating each health board´s response and for liasing with the Tobacco Control Agency I set up earlier this year. Most recently, I have published a comprehensive Bill – The Public Health (Tobacco) Bill, 2001. This Bill will, among other things, end all forms of product display and in-store advertising and will require all retailers to register with the new Tobacco Control Agency. Ten packs of cigarettes will be banned and transparent and independent testing procedures of tobacco products will be introduced. Enforcement officers will be given all the necessary powers to ensure there is full compliance with the law. On smoking in public places we will extend the existing areas covered and it is proposed that I, as Minister for Health and Children, will have the powers to introduce further prohibitions in public places such as pubs and the work place. I will also provide for the establishment of a Tobacco Free Council to advise and assist on an ongoing basis. I believe the measures already introduced and those additional ones proposed in the Bill have widespread community support. In fact, you´re going to hear a detailed presentation from the MRBI which will amply illustrate the extent of this support. The great thing is that the support comes from smokers and non-smokers alike. Bottom line, Ladies and Gentlemen, is that we are at a watershed. As a society (if you´ll allow me to play with a popular phrase) we´ve realised it´s time to ´wake up and smell the cigarettes.´ Smell them. See them for what they are. And get real about destroying their hold on our people. The MRBI survey makes it clear that the single strongest weapon we have when it comes to preventing the habit among young people is price. Simple as that. Price. Up to now, the fear of inflation has been a real impediment to increasing taxes on tobacco. It sounds a serious, logical argument. Until you take it out and look at it a little more closely. Weigh it, as it were, in two hands. I believe – and I believe this with a great passion – that we must take cigarettes out of the equation we use when awarding wage increases. I am calling on IBEC and ICTU, on employers and trade unions alike, to move away from any kind of tolerance of a trade that is killing our citizens. At one point in industrial history, cigarettes were a staple of the workingman´s life. So it was legitimate to include them in the ´basket´ of goods that goes to make up the Consumer Price Index. It isn´t legitimate to include them any more. Today, I´m saying that society collectively must take the step to remove cigarettes from the basket of normality, from the list of elements which constitute necessary consumer spending. I´m saying: “We can no longer delude ourselves. We must exclude cigarettes from the considerations we address in central wage bargaining. We must price cigarettes out of the reach of the children those cigarettes will kill.” Right now, in the monthly Central Statistics Office reports on consumer spending, the figures include cigarettes. But – right down at the bottom of the page – there´s another figure. Calculated without including cigarettes. I believe that if we continue to use the first figure as our constant measure, it will be an indictment of us as legislators, as advocates for working people, as public health professionals. If, on the other hand, we move to the use of the second figure, we will be sending out a message of startling clarity to the nation. We will be saying “We don´t count an addictive, killer drug as part of normal consumer spending.” Taking cigarettes out of the basket used to determine the Consumer Price Index will take away the inflation argument. It will not be easy, in its implications for the social partners. But it is morally inescapable. We must do it. Because it will help us stop the killer that is tobacco. If we can do it, we will give so much extra strength to health educators and the new Tobacco Control Association. This new organisation of young people who already have branches in over fifteen counties, is represented here today. The young adults who make up its membership are well placed to advise children of the dangers of tobacco addiction in a way that older generations cannot. It would strengthen their hand if cigarettes move – in price terms – out of the easy reach of our children Finally, I would like to commend so many public health advocates who have shown professional and indeed personal courage in their commitment to this critical public health issue down through the years. We need you to continue to challenge and confront this grave public health problem and to repudiate the questionable science of the tobacco industry. The Research Institute for a Tobacco Free Society represents a new and dynamic form of partnership between government and civil society. It will provide an effective platform to engage and mobilise the many different professional and academic skills necessary to guide and challenge us. I wish the conference every success.

An Age Friendly Society: A Position Statement

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Minority Report by Mature Enjoyment of Alcohol in Society Limited

MEAS (Mature Enjoyment of Alcohol in Society Limited) is an alcohol social responsibility organisation committed to tackling the problems of alcohol abuse and misuse. A registered charity, MEAS works in partnership with Government, with other appropriate bodies, including An Garda Siochana, the Road Safety Authority and local authorities and with the alcohol industry to promote the responsible marketing, retailing and use of alcohol in Irish society. Click here to download PDF 176kb

Towards an Age Friendly Society in Ireland: Conference Proceedings

9.2.2006 This is a publication of The National Council on Ageing and Older People On 17 May 2005, the National Council on Ageing and Older People (NCAOP) held a national conference in Tullamore, Co. Offaly, on the theme, Towards an Age Friendly Society in Ireland.The conference aimed to focus discussion on the kind of society we want to achieve for older people in Ireland. This report chronicles the proceedings of that conference. Read the report (PDF, 675kb)  

Rural larne health programme

This has been one of the first opportunities to get health on the agenda in the rural area of Larne. This builds on the work and experience of a previously funded BCPP project in Larne town. This project will carry out information sessions in order to; facilitate discussion, disseminate information and identify relevant health issues. The project will mainly target women in the rural areas of the Larne Borough. Other aims of the project include; supporting local women to share health message to the wider community. This project will mainly be based in the pharmacy, with the pharmacist working with the women to identify how the can develop additional rooms in the pharmacy to meet local community health needs

Rural Health Partnership

This is their 3rd BCPP project and this is a Level 3 project. Rural Health Partnership is a community based initiative which assists people to recover from a mental illness. Previous BCPP projects focussed on supporting the needs of women in relation to mental health and more specifically, those experiencing post natal depression through the 2nd BCPP project using a lay health approach. This project seeks to build on this previous work. A very good working relationship has developed between the pharmacist and RHP. A programme of activities that can enhance the skills and knowledge base of the participants will be developed and so will relationships with other services eg GPs, primary care team etc. The project aims to educate the community at large on the issues faced by vulnerable women, with particular emphasis on symptoms of postnatal depression and anxiety.

Differentiated normalization and drug transitions among rural youth in Ireland.

Prevalence surveys in Ireland indicate an increased trend of youth drug use with rural areas reporting comparable drug availability and prevalence of use in urban settings (Currie, C., Nic Gabhainn, S., Godeau, E., Roberts, C., Smith, R., & Currie, D. (Eds.). (2008). Inequalities in young people's health: HBSC international report from the 2005/2006 survey. Copenhagen: WHO Regional Office for Europe). Few studies have explored the contexts and meaning of drug use on rural youth transitions in terms of increased drug prevalence, recent influx of rural drug activity, normative tolerance of recreational drug consumption and fragmentation of traditional rural communities. Qualitative interviews were conducted with 220 young people (15–17 years), and 78 service providers in a rural area of Ireland, in order to yield contextualized narratives of their experiences of drug use and achieve a wider exploration of processes, drug transitions and realities of rural youth. The thematic analysis of the research described varied pathways, attitudes and typologies of rural youth drug use, ranging from abstinent, recreational and moderated to maturing out. The research suggests support for a ‘differentiated’ normalization theory (Shildrick, T. (2002). Young people, illicit drug use and the question of normalisation theory. Journal of Youth Studies, 5, 35–48) in terms of consumerist and normative rural youth drug use transitions in their negotiation of risk within integrating rural and urban dichotomies. In conclusion, it is recommended that drug education programmes need to situate localized rural drug taking behaviours within a wider understanding of rural community life.This resource was contributed by The National Documentation Centre on Drug Use.

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.

In-depth assessment delivers the verdict on the Government�۪s promise of a more equal society

An independent and detailed expert analysis of a decade of reforms (published 25 February) takes up the challenge made by Peter Mandelson in 1997 to “judge us after ten years of success in office. For one of the fruits of that success will be that Britain has become a more equal society.����”Commissioned by the Joseph Rowntree Foundation, the study, by a team led by LSE’s Centre for Analysis of Social Exclusion, shows sharp contrasts between different policy areas. Notable success stories include reductions in child and pensioner poverty, improved education outcomes for the poorest children and schools, and narrowing economic and other divides between deprived and other areas.But health inequalities continued to widen, gaps in incomes between the very top and very bottom grew, and poverty increased for working-age people without children.����In several policy areas there was a marked contrast between the first half of the New Labour period and the second half, when progress has slowed or even stalled.John Hills, one of the leaders of study, said, “Whether Britain has moved towards becoming a ‘more equal society’ depends on what you look at, and when. Where clear initiatives were taken, results followed. But as the growth of living standards slowed, even well before the recession, and public finances tightened, momentum seems to have been lost in several key areas.”Kitty Stewart added, “The government can take heart from achievements such as the reduction in child poverty up to 2004.����Recent data show that by then, child well-being in the UK had begun to move up the European league table from its dismal showing at the start of the decade that formed the basis of UNICEF’s damning 2007 report. But even with improved figures, Britain was still left with one of the highest rates of child poverty out of the 15 original EU members, and the latest figures show it had increased again by 2006/7.”����The study concludes that the decade from 1997 was favourable to an egalitarian agenda in several ways: the economy grew continuously; the government had large majorities and aspired to create more equality; and public attitudes surveys suggested pent-up demand for more public expenditure. But that environment now looks very uncertain, not just in the near future, but also in the longer term.����Fiscal pressures from an ageing society could further constrain resources available for redistribution, and public attitudes towards the benefit system have hardened while support for redistribution has declined.Hills added, “The 1980s and 1990s showed that hoping that rapid growth in living standards at the top would ‘trickle down’ to those at the bottom did not work.����The period since 1997 has shown that gains are possible through determined interventions, but they require intensive and continuous effort to be sustained.”JRF Chief Executive Julia Unwin added, “We know the potential impact the deepening recession will have on those already living in poverty. This book provides an important, timely and comprehensive assessment of where we are and what remains to be done.”

Fair Society, Healthy Lives (The Marmot Review)

Inequalities are a matter of life and death, of health and sickness, of well-being and misery. The fact that in England today people in different social circumstances experience avoidable differences in health, well-being and length of life is, quite simply, unfair. Creating a fairer society is fundamental to improving the health of the whole population and ensuring a fairer distribution of good health.