Inequalities in Health in an Aging Population: Patterns, Causes and Consequences

The increase in life expectancy that we continue to observe raises a complex set of challenges for policy. Among these challenges is the need to respond to the heterogeneity that remains in life expectancy within the older population. Most important is that life expectancy, even at older ages, differs markedly by socioeconomic position. In addition, despite increases in longevitymany individuals now effectively retire before state pension age and a large proportion of these are dependent on benefit income. In contrast, the contribution by older people to informal careprovision and other services has the potential to provide an important input into society, the economy and their own well-being. A crucial question, therefore, is which sections of the older population will live healthy active lives and which will be dependent on formal and informal sources of support. To answer this, we need to understand how inequalities in health are distributed in the older population and what the underlying causal processes are.

Mapping health inequalities across London

Analysis of infant mortality and life expectancy across London by various dimensions of inequality- socioeconomic; gender; geographical, and trends

Inequalities in Perceived Health

A report on the All-Ireland Social Capital and Health Survey. This is the first report in Ireland, North or South, which measures and identifies systematically the connections between perceived health and an extensive range of demographic and socio-economic characteristics and lifestyle behaviours. The concept of social capital and the ways in which social capital may be an important determinant of health is receiving increased attention from policy-makers. The Institute of Public Health in Ireland produced a report in 2004 based on its All Ireland Social Capital and Health Survey. The report explores how people feel about their health and highlights how this is linked with perceptions of the local social environment as well as to demographic and socio-economic circumstances and lifestyle behaviours.

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.

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.

Briefing Paper on Health Inequalities for Elected Members of Local Government (ROI)

The social and economic circumstances in which people live strongly influence their chances to be healthy.  Factors such as housing, transport, environment, education and employment are just some of the functions of local government that influence health. IPH, in partnership with CAN and Nexus developed a briefing paper to support elected members of local government to ensure that the decision in which they are involved have a positive impact on health, especially the health of vulnerable groups.  It provides councillors with information to assist in contributing to a better quality of life for constituents with healthier decision making in areas such as safer environments, increased education opportunities, better housing stock and improved public transport availability.

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 the Strategic Review of Health Inequalities in England post 2010

IPH contributed to the Strategic Review of Health Inequalities in England being carried out by Professor Sir Michael Marmot, Chair of the Commission on the Social Determinants of Health.  IPH acknowledges the immense work done by the Review team and welcomes the opportunity to inform its work. We see the review as a vital opportunity to provide a “catalyst for concerted action” not only in England but in its near neighbours in Northern Ireland and Ireland. Health inequalities are rife across the UK and Ireland despite a range of developments in policy and practice designed to create more equal opportunities for health. We commend the approach taken in the Review, which applies scientific rigour and the combined expertise of a number of defined task groups to seek solutions to the vexing challenge of health inequality.

IPH responds to EC Director-General for Health and Consumer Affairs consultation on EU action to reduce health inequalities

The aim of the consultation was to collect views on how the European Union can contribute to reducing health inequalities both within and between member states. 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 co-operation between Northern Ireland and the Republic of Ireland in research, training, information and policy to contribute to policies which tackle inequalities in health. IPH acknowledges and appreciates the benefits of information sharing and joint action in relation to policy and practice between European countries and we are proud to have been the Irish/Northern Irish partner in several projects, most recently as Work Package Leader for DETERMINE, coordinated by EuroHealthNet and as collaborating partner for I2SARE, coordinated by Federation National des Observatories de Sante (FNORS).  Both projects are funded by the European Commission.

A Tobacco-Free Future - An all-island report on tobacco, inequalities and childhood 2013

A Tobacco-Free Future - An all-island report on tobacco, inequalities and childhood 2013 reveals declines in smoking rates among both children and pregnant women over the past decade, both North and South of the border. This report published by the Institute of Public Health in Ireland (IPH) and the TobaccoFree Research Institute Ireland (TFRI), shows that while tobacco control measures are being successful, disadvantaged children are at particular risk of tobacco-related harms.

Inequalities Monitoring Update Second Bulletin 2007 (PDF 1952 KB)

Despite some relative improvements, there is a continuing health gap between the most deprived areas and NI overall. This is most evident in the potential years of life lost, infant mortality rates, teenage births, standardised admission rates to hospitals and cancer incidence rates indicators. The suicide rate within deprived areas, although still considerably higher (almost 50% higher), is now closer to the overall NI rate. Despite the reduction in the inequality gap, there was a recent increase in the number of deaths attributed to suicide across all areas. The extent to which this increase in suicides actually indicates an increase in the problem or it is due to recording/reporting practices changing over time has not been established. Life expectancy has been increasing in recent years for both males and females in both deprived areas and NI overall and there is no evidence of a narrowing of the inequality gap. The gap between deprived areas and Northern Ireland was maintained for circulatory and respiratory standardised death rates. The gap between the proportion of the deprived population suffering from a mood or anxiety disorder and that in NI overall has also remained fairly steady. Deprived areas actually fared better than NI generally for relative hospital waiting times and ambulance response times (although this may be an urban issue). åÊ

Health And Social Care Inequalities Monitoring System: First Update Bulletin 2004 (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the first annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years åÊ

Health and Social Care Inequalities Monitoring System (PDF 273 KB)

The Inequalities Monitoring System comprises a basket of indicators which are monitored over time to assess area differences in morbidity, utilisation of and access to health and social care services in Northern Ireland. Inequalities between the 20% most deprived electoral wards and Northern Ireland as a whole are measured with deprived areas identified from an update of the Noble Income domain for current ward boundaries. Results for 20% most rural areas were also compared against Northern Ireland overall using population density from the 2001 Census of Population as a measure of rurality. This report is the firståÊ annual update of the baseline results presented in Chapter 8 of Equality and Inequalities in Health and Social care in Northern Ireland – A Statistical Overview (DHSSPS 2004) which focused on 2001/2002. The morbidity and utilisation data in this report are the latest available while the locations of services for the accessibility analysis will be updated in subsequent years. åÊ åÊ

Equality and Inequalities in Health and Social Care in Northern Ireland

A Statistical Overview: 2002 Following some scene setting, the report draws together wide ranging information to document inequalities in health and social care in Northern Ireland that are relevant to the New Targeting Social Need (New TSN) policy, including the base report of the ‘Inequalities Monitoring System’. The overview also documents comparisons between people living in rural and non-rural areas, and between the statutory equality categories of Section 75 of the Northern Ireland Act. While some of the information has been previously published most of the results are new, and the majority of the new analyses has been undertaken by IAD. åÊ