Irish Health Survey 2019

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The Irish Health Survey is based on self-reported data from persons aged 15 years and over, and outlines their view of their health status – from how well they are feeling, to their engagement with the Irish health system, to the personal choices made around important health determinants like smoking, alcohol consumption and exercise.

Some key findings include:

• Affluent people are more likely to feel their health status is Very good or good than people who are disadvantaged - 92% of Very affluent persons compared to 78% of persons who are Very disadvantaged.
• Over a quarter of persons aged 15 years and over report having a long lasting condition, with older persons reporting higher levels.
• Majority of persons (82%) report no limitations in everyday activities due to a health problem.
• Over a fifth (21%) of Unemployed persons report some form of mental ill-health compared to 9% of those In employment.
• Prevalence of hospital in-patient admissions rises with age and disadvantage level.
• In general, females and older people more likely to use a preventive health service.
• Physical activity declines with age and relative disadvantage level.
• Younger persons more likely to drink 6 or more units of alcohol in one sitting.
• Over half of persons aged 15 years and over in the State are overweight or obese.

Health status

The publication analyses the data by relative affluence, and it can be seen that the more disadvantaged a person is, the poorer their self-reported health status and the more they engage with the Irish health system. The survey also highlights the poorer health status of the unemployed compared to those in employment, as reported by people themselves. In particular, unemployed persons report higher levels of mental ill-health compared to those in employment– more than a fifth of unemployed persons report some form of depression compared to less than a tenth of those in employment.

Those in employment report higher positive levels of health than those who are unemployed, 93% of those in employment report their health as being Very good or good compared to 82% of those who are unemployed. Almost a fifth (19%) of Unemployed persons report having unmet health care needs in the 12 months prior to survey due to waiting lists, compared to 12% of persons In employment. At State level, 14% of persons aged 15 years and over report unmet health care needs due to waiting lists, with females (16%) experiencing this more than men (11%). Unmet health care needs due to waiting lists generally rises with level of disadvantage, with 18% of Very disadvantaged persons reporting this compared to 10% of Very affluent persons.

One of the most obvious concerns about the Irish Healthcare system is to do with access. Ireland’s health system ranked 22nd out of 35 countries in 2018[1], but on the issue of accessibility, Ireland ranked worst. That report notes that even if a waiting-list target of 18 months were reached, it would still be the worst waiting time situation in Europe – and this is without the impact of Covid-19 which has exacerbated Ireland’s waiting list times.  Ireland’s complex two-tier system for access to public hospital care means that private patients have speedier access to both diagnostics and treatment, while those in the public system can spend lengthy periods waiting for a first appointment with a specialist and for treatment.

Just over a quarter (26%) of persons aged 15 years and over report having a long lasting condition which requires supervision, observation or care. The prevalence of having such a long lasting condition increases as people get older, with twice as many persons aged 75 years and over (49%) reporting having a long lasting condition, compared to those aged 45-54 years (24% of this age cohort). Disadvantaged persons report higher levels of having a long lasting condition - 29% of Very disadvantaged persons compared to 22% of Very affluent people. Unemployed persons report higher levels of having a long lasting condition than those In employment at levels of 27% and 17% respectively.

Disadvantaged persons aged 15 years and over report suffering more from high blood pressure than more affluent persons, with 14% of Very disadvantaged persons aged 15 years and over reporting having high blood pressure compared to 9% of Very affluent persons.

In 2019, 27% of Very affluent persons reported being absent from work due to a health related problem in the 12 months prior to survey. However, the rates of absence for Very disadvantaged persons were about half of the Very affluent absence levels, 14% of Very disadvantaged persons compared to 27% of Very affluent persons.

In order to address the issues and challenges identified in the Irish Health Survey and the different reported health statues and outcomes for different socio-economic cohorts Social Justice Ireland has identified a number of policy recommendations.  Access to healthcare based on need, not income, should remain an important aim for Ireland’s healthcare system. Furthermore, investment in a reconfigured model of healthcare is overdue, one that emphasises primary and social care.

The following is a summary of key policy priorities and actions that Social Justice Ireland recommends:

• Ensure that announced budgetary allocations are valid, realistic and transparent and that they take existing commitments into account.
• Increase the availability and quality of Primary Care and Social Care services.
• Ensure medical card-coverage for all people who are vulnerable.
• Act effectively to end the current hospital waiting list crisis.
• Create a statutory entitlement to Home Care Services. This will require increased funding, but may save the State money long-term, as home support allows people to remain living in their own homes, rather than entering residential nursing care.
• Create additional respite care and long-stay care facilities for older people and people with disabilities and provide capital investment to build additional community nursing facilities. Implement all aspects of the dementia strategy.
• Increase educational campaigns promoting health, targeting particularly people who are economically disadvantaged, acknowledging that a preventative approach saves money in the long-run.
• Properly resource and develop mental health services, and facilitate campaigns giving greater attention to the issue of suicide.
• Adopt a target to reduce the body mass index (BMI) of the population by 5 per cent by 2021.
• Work towards full universal healthcare for all. Ensure new system structures are fit for purpose and publish detailed evidence of how new decisions taken will meet healthcare goals.
• Enhance the process of planning and investment so that the healthcare system can cope with the increase and diversity in population and the ageing of the population projected for the next few decades.
• Ensure that structural and systematic reform of the health system reflects key principles aimed at achieving high performance, person-centred quality of care and value for money in the health service.

[1] https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf