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.

A review of the health effects of stimulant drinks

The Food Safety Promotion Board, following a request from the Minister of State at the Department of Health and Children, Dr. Tom Moffatt T.D., established the Stimulant Drinks Committee (consisting of external experts) to carry out research into the health effects of stimulant drinks. The task and terms of reference for the group were: • to review the potential health effects on the population of Ireland from the consumption of stimulant drinks • to assess the knowledge gaps • to consider the need for any action to protect public health.

All Together Active (A2A)

All Together Active (A2A) is an innovative 12 month programme specifically developed to concentrate on overweight and obese young people (5 13 years) with opportunity to continue with physical activity after graduating from the programme. It is a structured targeted intervention for overweight children and their families, with concentrated focus on behaviour modification, healthy eating and physical activity to coincide with Change For Life and their initiatives. It offers an opportunity for families to be supported and motivated to lead a healthier lifestyle through a series of group activity and nutrition sessions that are designed to be progressive and empowering, thus giving families the knowledge and tools to sustain healthy behaviour modifications in the long term. This is all done in a fun and encouraging way designed for the child to achieve their healthy goals.

Fuel Poverty and Cold Home-related Health Problems

Evidence Review 7 - Tackling fuel poverty and cold home-related health problems Briefing 7 - Fuel poverty and cold home-related health problems This pair of documents, commissioned by Public Health England, and written by the UCL Institute of Health Equity, address the health impacts of fuel poverty and cold homes. These documents provide an overview of fuel poverty, describing the evidence linking fuel poverty, cold homes, and poor health outcomes. They examine the scale of the problem across England and trends over time. Evidence shows that living in cold homes is associated with poor health outcomes and an increased risk of morbidity and mortality for all age groups. The documents also provide a brief overview of national policy and sets out the role of local authorities and potential interventions at local level. Fuel poverty is not just about poverty, but also about the quality of England’s housing stock and energy efficiency. The review discusses some of the interventions that have been implemented at the local level to help people on low incomes during cold weather and to address cold home-related health problems. The full evidence review and a shorter summary briefing are available to download above. This document is part of a series. An overview document which provides an introduction to this and other documents in the series, and links to the other topic areas, is available on the ‘Local Action on health inequalities’ project page. A video of Michael Marmot introducing the work is also available on our videos page.

A Study of a Staff Alcohol Policy in a Large Public Health Organisation, Looking at the Policy Content, the Policy Development and the Implementation Process, and the Policy Impact

There are different approaches to dealing with alcohol related problems in the workplace. A literature review indicates that two of the models that underpin programmes to deal with alcohol related problems in the workplace are the disease model and the health promotion model. The disease model considers alcoholism as an illness and uses curative techniques to restore the individual to sobriety. The health promotion model looks at the determinants of health and promotes changes in the environment and structures, which would support healthy behaviour in relation to alcohol. Employee Assistance Programmes (EAPs) may have elements of both theses models. Dealing with alcohol problems at work involves a captive audience and the workplace as a setting can be used to influence healthier lifestyles. A workplace alcohol policy is a mechanism through which alcohol related issues might be dealt with, and the necessary resources and commitment of managers and staff channelled to this end. The policy aims should be clear and unambiguous, and specific plans put in place for implementing all aspects of the policy. In the case of the alcohol policy in the organisation under study, the policy was underpinned by a health promotion ethos and the policy document reflects broad aims and objectives to support this. The steering group that oversaw the development of the policy had particular needs of their own which they brought to the development process. The common theme in their needs was how to identify and support employees with alcohol related problems within an equitable staff welfare system. The role of the supervisor was recognised as crucial and training was provided to introduce the skills needed for an early intervention and constructive confrontation with employees who had alcohol related problems. Opportunities provided by this policy initiative to deal with broader issues around alcohol and to consider the determinants of health in relation to alcohol were not fully utilised. The policy formalised the procedures for dealing with people who have alcohol related problems in an equitable and supportive manner. The wider aspect of the health promotion approach does not appear to have been a priority in the development and implementation of the policy.This resource was contributed by The National Documentation Centre on Drug Use.

A vision for change: Report of the Expert Group on Mental Health Policy (2006)

This report, the first comprehensive review of mental health policy since 'Planning for the Future' was published in 1984, makes a series of recommendations for the mental health services, including the closure of all psychiatric hospitals and re-investment of the resources into a community-based mental health service.This resource was contributed by The National Documentation Centre on Drug Use.

A Study on Health Behaviours and Young People

Numerous reports have documented the health status of young people, concluding that the main threats to their health are predominantly the health risk behaviours and choices they make. Focussing on four of these, alcohol consumption, tobacco smoking, illicit drug use and sexual activity, this study seeks to assess their levels among a group of young people in Galway City with the aim of helping with the development of Health Education in these areas. In order to develop appropriate interventions, it is first of all necessary that accurate information on the extent of the problem, if any, be available. In 1989, studies on risk taking were carried out in the Muirhouse and Easterhouse areas of Glasgow and Edinburgh in Scotland. These areas were seen as underprivileged and had high and low rates of HIV infection respectively. In 1993, a similar study was carried out in the Westside area of Galway, an area which is also seen as under-privileged with high rates of unemployment. In 1996, a follow-up to the 1993 survey was carried out. This study also attempted to determine if there was a relationship between the behaviours reported and socio-economic class. This study is a follow-up to the previous two, with the addition that it attempts to investigate whether any relationship exists between the provision of health education in schools and subsequent health behaviour patternsThis resource was contributed by The National Documentation Centre on Drug Use.

Implementing A vision for change: moving towards a modern, quality and responsive mental health service. Carlow / Kilkenny / South Tipperary.

The key element of the HSE South’s Programme is to enhance and develop community mental health services in Carlow, Kilkenny and South Tipperary, to enable the service user to remain in the community to the greatest extent possible. HSE South has prioritised the implementation of the change programme and has allocated more than €20m capital funding and over €1.75m revenue funding to support this comprehensive development programme. Speaking at the briefings Mr. Pat Healy, Regional Director of Operations, HSE South said, “When this plan is delivered, clients will have access to the highest standards of services in all three counties, which should significantly improve these clients’ treatment programmes and quality of life. The National Service Users Executive are supporting the change programme, which is of immense importance to HSE South. The programme heralds the enhancement and development of community mental health services, the closure of old long stay institutions, the separation of North and South Tipperary acute inpatient mental health services and development of appropriate acute inpatient services, for the extended catchment area, in line with the national strategy for mental health “A Vision for Change”. The programme also acts on recommendations of the Mental Health Commission.”This resource was contributed by The National Documentation Centre on Drug Use.

Does income inequality cause health and social problems?

Key points• The literature shows general agreement about a correlation between income inequality and health/social problems. • There is less agreement about whether income inequality causes health and social problems independently of other factors, but some rigorous studies have found evidence of this. • The independent effect of income inequality on health/social problems shown in some studies looks small in statistical terms. But these studies cover whole populations, and hence a significant number of lives. • Some research suggests that inequality is particularly harmful beyond a certain threshold. Britain was below this threshold in the 1960s, 1970s and early 1980s, but rose past it in 1986–7 and has settled well above it since 1998–9. If the threshold is significant it could provide a target for policy. • Anxiety about status might explain income inequality’s effect on health and social problems. If so, inequality is harmful because it places people in a hierarchy which increases competition for status, causing stress and leading to poor health and other negative outcomes. • Not all research shows an independent effect of income inequality on health/social problems. Some highlights the role of individual income (poverty/material circumstances), culture/history, ethnicity and welfare state institutions/social policies. • The author concludes that there is a strong case for further research on income inequality and discussion of the policy implications.This resource was contributed by The National Documentation Centre on Drug Use.

Behaviour change at population, community and individual levels: NICE Public Health Guidance 6

This guidance is aimed at those responsible for helping people to change their behaviour to improve their health. This includes policy makers and those working in local authorities and the community and voluntary sectors. It gives advice on how to plan and run relevant initiatives. The recommendations include the following advice: base interventions on a proper assessment of the target group, where they are located and the behaviour which is to be changed: careful planning is the cornerstone of success  work with other organisations and the community itself to decide on and develop initiatives build on the skills and knowledge that already exists in the community, for example, by encouraging networks of people who can support each other take account of and resolve problems that prevent people changing their behaviour (for example, the costs involved in taking part in exercise programmes or buying fresh fruit and vegetables, or lack of knowledge about how to make changes) base all interventions on evidence of what works train staff to help people change their behaviour evaluate all interventions.This resource was contributed by The National Documentation Centre on Drug Use.

Health at a glance: Europe 2012.

This second edition of Health at a Glance: Europe presents a set of key indicators of health and health systems in 35 European countries, including the 27 European Union member states, 5 candidate countries and 3 EFTA countries. The selection of indicators is based largely on the European Community Health Indicators (ECHI) shortlist, a list of indicators that has been developed by the European Commission to guide the development and reporting of health statistics. It is complemented by additional indicators on health expenditure and quality of care, building on the OECD expertise in these areas. Contents: Introduction 12 Chapter 1. Health status 15 1.1. Life expectancy and healthy life expectancy at birth 1.2. Life expectancy and healthy life expectancy at age 65 1.3. Mortality from all causes 1.4. Mortality from heart disease and stroke 1.5. Mortality from cancer 1.6. Mortality from transport accidents 1.7. Suicide 1.8. Infant mortality 1.9. Infant health: Low birth weight 1.10. Self-reported health and disability 1.11. Incidence of selected communicable diseases 1.12. HIV/AIDS 1.13. Cancer incidence 1.14. Diabetes prevalence and incidence 1.15. Dementia prevalence 1.16. Asthma and COPD prevalence Chapter 2. Determinants of health 49 2.1. Smoking and alcohol consumption among children 2.2. Overweight and obesity among children 2.3. Fruit and vegetable consumption among children 2.4. Physical activity among children 2.5. Smoking among adults 2.6. Alcohol consumption among adults 2.7. Overweight and obesity among adults 2.8. Fruit and vegetable consumption among adults Chapter 3. Health care resources and activities 67 3.1. Medical doctors 3.2. Consultations with doctors 3.3. Nurses 3.4. Medical technologies: CT scanners and MRI units 3.5. Hospital beds 3.6. Hospital discharges 3.7. Average length of stay in hospitals 3.8. Cardiac procedures (coronary angioplasty) 3.9. Cataract surgeries 3.10. Hip and knee replacement 3.11. Pharmaceutical consumption 3.12. Unmet health care needs Chapter 4. Quality of care 93 Care for chronic conditions 4.1. Avoidable admissions: Respiratory diseases 4.2. Avoidable admissions: Uncontrolled diabetes Acute care 4.3. In-hospital mortality following acute myocardial infarction 4.4. In-hospital mortality following stroke Patient safety 4.5. Procedural or postoperative complications 4.6. Obstetric trauma Cancer care 4.7. Screening, survival and mortality for cervical cancer 4.8. Screening, survival and mortality for breast cancer 4.9. Screening, survival and mortality for colorectal cancer Care for communicable diseases 4.10. Childhood vaccination programmes 4.11. Influenza vaccination for older people Chapter 5. Health expenditure and financing 117 5.1. Coverage for health care 5.2. Health expenditure per capita 5.3. Health expenditure in relation to GDP 5.4. Health expenditure by function. 5.5. Pharmaceutical expenditure 5.6. Financing of health care 5.7. Trade in health services Bibliography 133 Annex A. Additional information on demographic and economic context 143 Most European countries have reduced tobacco consumption via public awareness campaigns, advertising bans and increased taxation. The percentage of adults who smoke daily is below 15% in Sweden and Iceland, from over 30% in 1980. At the other end of the scale, over 30% of adults in Greece smoke daily. Smoking rates continue to be high in Bulgaria, Ireland and Latvia (Figure 2.5.1). Alcohol consumption has also fallen in many European countries. Curbs on advertising, sales restrictions and taxation have all proven to be effective measures. Traditional wine-producing countries, such as France, Italy and Spain, have seen consumption per capita fall substantially since 1980. Alcohol consumption per adult rose significantly in a number of countries, including Cyprus, Finland and Ireland (Figure 2.6.1).This resource was contributed by The National Documentation Centre on Drug Use.

Food and Health Project Longford/Westmeath

The Food and Health Project offers practical healthy eating and lifestyle courses to groups cooking on a lower income. Courses offered include: C/O Athlone Community Taskforce Ball Alley Lane Athlone Westmeath HSE and community group Initiative Type Nutrition Education and Training Programmes Location Longford Westmeath Funding HSE and community group Partner Agencies HSE

Food and Health Project

Provision of community based Healthy Food Made Easy, Cool Dude and related courses. Based at Birchgrove Community Centre, Birchgrove, Portlaoise. HSE Initiative Type Nutrition Education and Training Programmes Location Laois Offaly Funding HSE Partner Agencies HSE Health Promotion

Survey of Lifestyle, Attitudes and Nutrition in Ireland. Mental Health and Social Well-being Report

SĹN 2007: Older People, Loneliness and Social Support to Mental HealthSĹN, the national Survey of Lifestyle, Attitudes and Nutrition, shows that most Irish adults have a reasonably high level of positive mental health. It is the largest national survey on positive and negative mental health and social well-being in the Irish adult population.��One finding highlights the significance of loneliness and social support to mental health. Finding reveal that 14% of respondents reported being often lonely in the last four weeks, with women, older people and respondents in lower social class groups reporting high levels of loneliness. The SĹN report indicates that being widowed and not being in paid employment are the strongest overall predictors of loneliness. Respondents who are widowed are about five times more likely to feel lonely than those who are married or cohabiting, while 17% of respondents aged 65 and over report being often lonely.��SLAN 2007 highlights the significance of loneliness and social support to mental health. It proposes community-based interventions, including community development approaches and strategies to promote community involvement as a way to tackle such social and health inequities at local level. The report also highlights the importance of implementing the recommendations of the policy document A Vision for Change. It says that protection and promotion of the future health and well-being of the Irish population requires the implementation of effective cross-sectoral policies that will help create and maintain a mentally healthy society, with consequent health, economic and social benefits for all.����SLAN is commissioned by the Department of Health and Children and involved face-to-face interviews with 10,364 respondents aged 18 years and over.��

National Audit of the Organisation of Services for Falls and Bone Health of Older People

This report presents the results of the second national audit which examines the organisation of services provided to older people for falls prevention and bone health. Falls and fractures are a common and serious problem affecting older people, with high levels of personal and financial cost. National guidelines, supported by the research evidence, require the provision of integrated services for falls and fracture prevention and treatment. Effective commissioning is needed to produce such high quality services.��This audit was commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the second cycle of audits on services for the prevention of falls and fractures in older people. It follows the first organisational audit, performed in 2005, and the clinical audit of 2007. All were audited against specific standards from the National Service Framework for Older People (NSF) and guidance from the National Institute for Health and Clinical Excellence (NICE). Since the first audit, indicators have been added or updated in line with new guidance including that on falls prevention of inpatients following the National Patient Safety Agency (NPSA) report on slips, trips and falls in hospital (2007). For the first time, the audit also looks specifically at falls and fracture prevention in mental healthcare and a sample of care homes.