Celtic Tiger. Yeah, right, whatever.

Coyler · May 24, 2006

Below excerpt is from an article in to-day's Irish Times (apologies for the length of it but the site requires registration). Ignore the digs at personalities and the local politics and have a look at the indented section in bold, figures from an ignored Public Health report on mortality rates in Ireland and the inequal way in which the Grim Reaper, no longer the great leveller of old, seems to be conducting his or her business not only under the grey skies of the Celtic Fatcat's jurisdiction but that of the Fatdad as well...

I am aware that certain demographic trends are to be expected in the occurrence of particular conditions, but can any of the posters with experience of health services elsewhere tell me if this is not a shocking and abnormal level of inequality in the different success rates these afflictions have in different socio-economic groups?

Labour not serious on inequality

In a response to my column of last week*, Liz McManus complained I had not been listening to her in a debate at UCC earlier this month, when she spoke about the very issues I accused the Labour Party of ignoring, writes Vincent Browne.

I am surprised Liz should so accuse me, for she knows I have hung on her every word for decades, but in that same letter to the editor she avoided my point: that the Labour Party, along with every other party, has failed to address the huge issues of inequality that arise from the report, Inequalities in Mortality, published in 2001 by the Institute of Public Health in Ireland.

Although I took notes of her contribution, I have no recollection of her making any mention of the report. There is a reference to the report in the policy document on health she released recently, Healthcare, A New Direction, and she has often drawn attention to inequalities in the healthcare system. But that was not the point I was making.

The report shows that in both jurisdictions in Ireland "the 'all causes' mortality rate in the lowest occupational class was 100 per cent to 200 per cent higher than in the highest occupational class".

This was evident for nearly all the main causes of death. For circulatory diseases it was over 120 per cent higher.

For cancer it was over 100 per cent higher. For respiratory diseases it was over 200 per cent higher (ie, three times higher). For injuries and poisonings it was 150 per cent higher.

More specifically, for infectious and parasitic diseases in the Republic the mortality rate was 370 per cent higher than the rate in the highest occupational class.

For tuberculosis in both jurisdictions it was over 300 per cent higher. For cancers of the oesophagus it was over 230 per cent higher.

For colon cancer 50 per cent higher. For lung and bronchial cancers it was 280 per cent higher. Mortality rates arising from diabetes mellitus were 230 per cent higher.

For mental and behavioural disorders, 360 per cent higher. Alcohol abuse, 280 per cent higher. Drug dependence, 590 per cent higher.

These inequalities in mortalities arise not just from inequalities in healthcare but from a broader base of inequality in society, in housing, education, income, wealth, power influence and environmental inequalities.And the point I was and am making is that the scale of such inequalities is not addressed by the major parties, including the Labour Party.

Were it so, for instance, Pat Rabbitte would not be stating his policy priorities as "first" no increase in taxation and everything else secondary. Surely, "first" should be dealing with the appalling incidence of inequality as represented by inequalities in mortality.

My point was to urge that the scale of inequality become a central issue in the election campaign, and the media have a role in making it so.

...

*Relevant excerpt from the earlier article:

A report was published five years ago now, Inequalities and Mortalities, by the Institute of Public Health which has got no political attention at all and almost no media attention - there was a segment of a Prime Time programme on it a few years ago but no follow-through there or elsewhere.

The report gave a shocking insight into the scale of inequalities in Irish society. I suspect that if the people on the "doorsteps" had an appreciation of what the report revealed, the issues raised in the report would be red-hot issues on the "doorsteps".

The report showed that for all the major fatal diseases, the incidence of premature death among the lower socio-economic groups was far higher than in the case of the higher socio-economic groups in both jurisdictions in Ireland.

One would have thought that the incidence of heart disease causing premature death would have been fairly uniform across the social spectrum. But in both jurisdictions, the mortality rate for the lowest occupational class for all heart diseases was 120 per cent higher than in the highest occupational class.

The premature mortality rate for strokes was 2½ times higher (150 per cent) for the lowest occupational class, compared with the highest occupational class. For cancer of the oesophagus, the premature mortality rate for the lowest occupational group was nearly 3½ times (250 per cent) that of the highest occupational group; for stomach cancers it was over twice (110 per cent); for pancreatic cancer, 60 per cent more.

Mortality rates for infectious and parasitic diseases for the lowest occupational class are nearly five times those of the highest occupational class. The mortality rate for mental and behavioural disorders was more than 4½ times; for alcohol abuse nearly four times; for drug abuse almost seven times; for pneumonia it was more than three times higher; for chronic lower respiratory disease it was nearly 4½ times; for diseases of the digestive system nearly three times; and for the genito-urinary system, nearly five times higher. The mortality rate for congenital malformations and chromosomal abnormalities for the lowest occupational group was nearly 10 times higher (930 per cent) than for the highest class.

The A&E crisis is not the most important issue in health, it is the massive disparities in mortality rates between those in the lower occupational classes as compared with those in the top occupational classes.

Of course, the causes for these huge disparities lie outside the healthcare system as well as within it. But isn't there something weird that such huge disparities in health welfare never get mentioned in debates over health? You would expect the Labour Party, for instance, to highlight this extraordinary evidence of inequality, but as far as I can see, it is entirely silent on it.

Ostrich Man · May 24, 2006

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