Health inequalities set to worsen

There are already significant health inequalities in Ireland and the current cost of living crisis will only exacerbate this, a workshop has heard.

The workshop, which was organised by academics from RCSI University of Medicine and Health Sciences, Trinity College Dublin (TCD) and Queen’s University Belfast, aimed to strengthen the evidence base for reducing health inequalities and identify possible interventions.

Attendees included policy makers, public health experts and health promotion experts and they were told that while heath inequalities are a persistent cause of concern, this issue has become even more urgent since the advent of the Covid-19 pandemic and the recent rise in the cost of living.

According to figures from the Central Statistics Office, before the pandemic (2019), there were marked inequalities in the health of the most advantaged compared to the most disadvantaged people and communities.  On average, people living in the least deprived areas of Ireland were living five years longer and enjoying significantly better health than those in more deprived areas.

This situation is unfair and avoidable, the workshop organisers noted.

Prof Debbi Stanistreet of RCSI University of Medicine and Health Sciences pointed out that the link between poverty and ill health “is very well established”.

“The most significant factors affecting health are the conditions in which people are born, grow, live, work and age. These conditions are known as the social determinants of health. Academics and policymakers need to redouble their efforts to understand and address the pathways through which these social determinants impact on the most vulnerable in our society,” Prof Stanistreet insisted.

She said that this is even more urgent given both the climate emergency and the cost of living crisis, “which we know will disproportionately affect the most vulnerable and further exacerbate existing health inequalities”.

The workshop was also told that the impact of inequalities on children has implications for later life. In Ireland in 2019, almost 200,000 children were living in poverty and in the nine months between July 2021 and April 2022, the number of homeless children increased by 38%.

This should be cause for concern given the impact on the individual child and the potential for long-term adverse health effects, leading to costs for both the individual and also the social and healthcare sector, attendees were told.

According to Prof Diarmuid O’Donovan of Queen’s University Belfast, there is a large body of evidence which demonstrates that early life disadvantage can influence a person’s health trajectory later in life.

“Prenatal and early life to age five offer a critical period which shapes later health risks. This is partly because, for some bodily systems, effects of inequalities can persist, particularly for metabolic, endocrine and cognitive systems, but also because early life opportunities shape educational and occupational outcomes.

“Investment in early years education and support is central to addressing both health inequalities and equality of opportunity in Ireland and needs to be a cornerstone of national policy,” Prof O’Donovan said.

He emphasised that health inequalities need to be addressed across all government sectors, rather than being considered the sole responsibility of the health sector.

“All health and social policies should be considered in light of the impact they will have on inequality. We need to consider ‘what impact will this have on the most disadvantaged in the population and will it reduce health inequalities locally?’ This approach demonstrates the importance of the public health function working closely with local government, along with the voluntary and private sector, to reduce health inequalities and promote good health and longer life for all Irish society,” he added.

The workshop, which was held in Dublin, was informed by the work of Teenpath, a research collaboration between RCSI and TCD, funded by the Health Research Board, which has been examining socio-economic inequalities in the health of young people in Ireland.