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 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.

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.

IPH Submission: Belfast City Centre Northside Urban Village Regeneration Framework - June 2008

IPH welcome the opportunity to comment on the Department for Social Development, Draft Regeneration Framework for the North West Quarter Part 2 area of Belfast City Centre, the ‘Northside Urban Village’. The Framework outlines the vision for the redevelopment of an inner city area of Belfast.    It is recognized that a number of social, economic and environmental factors influence health. Urban regeneration has major implications for health as it includes not only physical redevelopment but also issues such as education, employment, environmental conditions, housing, welfare and healthcare.   Urban regeneration can also help to address health inequalities at a local level, as the areas where regeneration is undertaken are usually marked by poor economic and social conditions. The North West Quarter Part 2 area of Belfast is a historic part of the city. The identified area is one of the most socio-economically deprived areas of not only Belfast but Northern Ireland. The area is characterised by the large number of people who receive income and housing benefits, have low levels of educational qualifications, high rates of long-term illnesses and it is also an area of high long-term unemployment.

IPH response to the HIQA consultation on the National Demographic Dataset and Guidance for use in health and social care settings in Ireland

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. IPH have previously responded to consultations to the Department of Health’s Discussion Paper on the Proposed Health Information Bill (June 2008), the Health Information and Quality Authority on their Corporate Plan (Oct 2007), and the Road Safety Authority of Ireland Road Safety Strategy (Jul 2012). IPH supports the development of a national standard demographic dataset for use within the health and social care services. Provided necessary safeguards are put in place (such as ethics and data protection) and the purpose of collecting the information is fully explained to subjects, mandatory provision of a minimum demographic dataset is usually the best way to achieve the necessary coverage and data quality. Demographic information is needed in several forms to support the public health function: Detailed aggregated information for comparison to population counts in order to assess equity of access to healthcare as well as examining population patterns and trends in morbidity and mortality Accurate demographic information for the surveillance of infectious disease outbreaks, monitoring vaccination programmes, setting priorities for public health interventions Linked to other data outside of health and social care such as population data, survey data, and longitudinal studies for research and analysis purposes.   Identify and address public health issues to tackle health inequalities, and to monitor the success of such efforts to tackle them.

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.

A Health Economics Model. The cost benefits of the Physical Activity Strategy for Northern Ireland - a summary of key findings

This summary report follows on from the publication of the Northern Ireland physical activity strategy in 1996 and the subsequent publication of the strategy action plan in 1998. Within this strategy action plan a recommendation was made for the health sector, that research should be carried out to evaluate and compare the cost of investing in physical activity programmes against the cost of treating preventable illness. To help in the development of this key area, the Department of Health, Social Services and Public Safety's Economics Branch agreed to develop a model that would seek to establish the extent of avoidable deaths from physical inactivity and, as a consequence, the avoidable economic and healthcare costs for Northern Ireland.

Ambulatory healthcare information system: a conceptual framework

Despite the tremendous amount of data collected in the field of ambulatory care, political authorities still lack synthetic indicators to provide them with a global view of health services utilization and costs related to various types of diseases. Moreover, public health indicators fail to provide useful information for physicians' accountability purposes. The approach is based on the Swiss context, which is characterized by the greatest frequency of medical visits in Europe, the highest rate of growth for care expenditure, poor public information but a lot of structured data (new fee system introduced in 2004). The proposed conceptual framework is universal and based on descriptors of six entities: general population, people with poor health, patients, services, resources and effects. We show that most conceptual shortcomings can be overcome and that the proposed indicators can be achieved without threatening privacy protection, using modern cryptographic techniques. Twelve indicators are suggested for the surveillance of the ambulatory care system, almost all based on routinely available data: morbidity, accessibility, relevancy, adequacy, productivity, efficacy (from the points of view of the population, people with poor health, and patients), effectiveness, efficiency, health services coverage and financing. The additional costs of this surveillance system should not exceed Euro 2 million per year (Euro 0.3 per capita).

Delivering Healthcare to the Armed Forces (PDF 88 KB)

A Protocol for Ensuring Equitable Access to Health and Social Care Services