Geographical Locations - Ireland

• (Statistical) Number of Inhabitants per Doctor: 681
• CIA World Factbook : Ireland

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Ireland
  - WHO - Tobacco control: Country Profile: Ireland
  - WHO - Environmental Burden of Disease: Country Profile – Ireland
  - WHO – Progress in the prevention of injuries in the WHO European Region: Ireland
• Regional Office for Europe (EURO) in Copenhagen (Denmark)

Government

• Combat Poverty Agency - a state agency working for the prevention and decrease of poverty and social exclusion and the reduction of inequality in Ireland
• Department of Agriculture, Food and Rural Development
• Department of Education and Science
• Department of the Environment, Heritage and Local Government
• Department of Health and Children
  - Health Promotion Unit
• Department of Social, Community and Family Affairs
• Health and Safety at Work (Ireland)
• National Safety Council - "established in December 1987 to promote Road Safety, Water Safety and Fire Safety through education, training programmes and publicity campaigns"
• Public Health Department, North Western Health Board

Non-Government

• Irish Heart Foundation
• National Youth Council of Ireland - "the co-ordinating body for voluntary youth organisations and services in Ireland representing over half a million young people"

Academic Institutions

• European Institute of Women's Health
• Irish Clearing House on Health Outcomes - "to enable those engaged in evaluating the impact of their practice and those who have an interest in the effect of current practice on the health status of the Irish population, to have access to a range of information and advice. Hopefully, this database, in association with the 'Quality Initiatives' database which is currently being developed by the Irish Society for Quality in Healthcare will facilitate a high level of exchange of ideas and practice"
• Irish Nutrition and Dietetic Institute (INDI) - "the professional organisation for Clinical Nutritionists/Dietitians in Ireland. Founded in 1968, the Institute has grown steadily, and represents Clinical Nutritionists/ Dietitians throughout Ireland as well as having members worldwide"
• National University of Ireland (Galway), Department of Health Promotion
• Trinity College Dublin, Faculty of Health Sciences, Department of Public Health & Primary Care
• University College Dublin, Faculty of Medicine, Department of Public Health Medicine & Epidemiology

National Policy and Related Documents

• The National Guidelines on Physical Activity for Ireland

Reports, Guidelines, and Projects

• Asylum in Ireland: a public health perspective
  "The focus of this report… is on the range of public health consequences surrounding the prolonged asylum determination process and especially the prohibition of work and other rights for those seeking refugee status [in Ireland]. We examine some of the obstacles to integration from the perspective of the lived experience of asylum seekers and explore the relationship between current social, legal and healthcare service delivery (what is supplied) and the felt but unmet needs (what is required) of the asylum seeking population." [Department of Public Health Medicine and Epidemiology, University College Dublin, 1999]
• Hiding the evidence: the State and spatial inequalities in health in Ireland
  The Irish State has consistently reduced its production of publicly accessible disease / mortality maps over the last fifty years. State health statistics, and the small number of disease / mortality maps that have been produced in official publications, show a declining level of detail and are routinely out of date. Following a review of the production of disease / mortality maps in Ireland by the State and allied health agencies, two reasons are suggested for this decline. The first explanation relates to spatial inequalities in healthcare provision and to the absence of a health funding formulae in Ireland. The second explanation focuses on the potential politicisation of spatial inequalities in health status. Researchers in these fields are urged to disseminate information widely on spatial inequalities in healthcare provision, healthcare access and health status, both within and outside of the academic literature. Researchers in these fields are also urged to adopt an advocacy role on these issues, or to develop strategic alliances with such advocates. [author abstract] [Irish Geography, Volume 38(1), 2005, 96-106]
• Ireland: health system review
  The Irish health system can be characterized as having been in a process of constant review and implementation of staged initiatives since the late 1990s. This process has culminated in major structural changes, made possible due to the economic growth that Ireland has enjoyed recently. The changes affect both the organization and orientation of the health care system. The reforms have revolved around the abolition of the former Health Boards and the creation of a single national body, the Health Service Executive (HSE). The aim is to make the system more primary and community care driven, backed up by improved access to specialist, acute and long-stay services. Implementing such major change is challenging and it is too early to reach any definitive judgement on the success of these reforms, particularly as the pace of reform has varied across different sectors of the health system. Promoting equity within the health system is likely to remain a critical concern. Access to the primary care system tends to be pro-poor, in that services are free for this group, while the remaining 70% of the population who do not qualify for free primary care must pay the substantial cost of general practitioner (GP) fees out of pocket. In contrast, in the secondary care sector, those who can afford private health insurance can avoid waiting for treatment. While much has been done to change the Irish health care system for the better since the late 1990s, major challenges remain, and none more so than primary care reform. The implementation of promised reforms is the key challenge, particularly now that the country, like most of the developed world, is likely to experience an economic downturn which will give the Government less room for manoeuvre in the near future. [excerpt from publication abstract] [Health Systems in Transition, Vol. 11 No. 4 2009]
• Health inequalities on the island of Ireland: the facts, the causes, the remedies
  "People who are poor and those who are socially excluded are more likely to die at a younger age and experience a higher rate of ill health. The risk of poor health increases for those furthest down the socio-economic scale. On the island of Ireland health inequalities can be shown to exist through comparison with international ratings, contrasts between health data from Northern Ireland (NI) and the Republic of Ireland (ROI) and in relation to a range of factors including socio-economic status, age, gender and geographic location. This report presents a sample of the current data on the inequalities in health experienced on the island of Ireland, together with a brief discussion on the causes of, and remedies for, such inequalities. It is hoped that the report will prompt further discussion, debate and action to equitably address the root causes of ill health and inequality." [Public Health Alliance for the Island of Ireland, 2007]
• Making Chronic Conditions Count: Hypertension, Stroke, Coronary Heart Disease, Diabetes – A systematic approach to estimating and forecasting population prevalence on the island of Ireland
  "Chronic diseases cause significant morbidity and mortality, and result in poorer quality of life for many people in the Republic of Ireland and Northern Ireland. In both jurisdictions there are also considerable financial costs to health and social care, and to the economy. Accurate estimates and forecasts of the population prevalence of chronic diseases help us identify need, plan and develop disease prevention and management programmes, and monitor performance. This important study shows that we can expect a substantial rise in the number of people living with a chronic disease. This is because our population is growing, ageing and lifestyle risk factors such as obesity are becoming more common. The study’s importance is all the greater as most chronic diseases and their complications are preventable. Previously the Institute of Public Health in Ireland systematically developed estimates and forecasts for diabetes at national and local levels. Those figures have been widely used and made a significant contribution to policy, service planning and public health practice. This new study extends that systematic approach to hypertension, coronary heart disease (angina and heart attack) and stroke as well as updating earlier diabetes figures. It documents the chronic disease epidemic we are facing over the next 15 years and the challenges posed to our population, our health and social care systems, and our economies. It describes the unequal way in which the burden of chronic disease is distributed in Northern Ireland and the Republic of Ireland and highlights the pressing need for a greater emphasis on prevention, tackling health inequalities and addressing the social determinants of health. This requires action across government and by many sectors. Considerably greater benefits can be achieved by influencing policies of the non health sector than by health policies alone." [The Institute of Public Health in Ireland, February 2010]
• Private health insurance in Ireland: a case study
  "This paper analyses the Irish private health insurance (PHI) market. It describes how PHI interacts with the public system, and assesses its contribution to equity, efficiency and responsiveness of the health system. The analysis identifies some of the factors affecting insurance market performance and its impact on the health system, including market characteristics, the regulatory and fiscal environment, health system organisation, and any actors’ incentives and behaviours.” [OECD Health Working Papers: DELSA/ELSA/WD/HEA(2004)1]
• Public health nurses' perception of clinical leadership in Ireland: narrative descriptions
  Aim: The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery. Background: Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles. Method: Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery. Results: Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective. Conclusions: Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor. [author abstract] [Journal of Nursing Management, 2009, 17, 435–445]
• Symposium on ‘Influence of social and cultural variations on diet’: effect of social variation on the Irish diet
  Both jurisdictions of Ireland have high rates of chronic degenerative diseases, particularly of the cardiovascular system, and Irish migrants have worse health profiles, often lasting at least two generations. The influence of socio-demographic variation over the life course, and what role diet plays, has not been well researched in epidemiological terms. There is a long history of an unusual Irish diet. Estimated dietary fat intake (% total energy intake) in 1863 was only 9, but had reached 30 in 1948 and 34 in 1999. Conversely, carbohydrate intake has fallen steadily over 150 years. From 1948 onwards household budget survey data illustrate patterns of increasing urbanisation and socio-economic gradients in food availability. The National Survey of Lifestyles, Attitudes and Nutrition, (n 6539, 62·2 % response rate) provides clear evidence of inverse social-class gradients in intake of fruit and vegetables and dairy products and in reported patterns of healthy eating. Median carbohydrate and vitamin C levels are higher among social classes 1–2 and mean saturated fat intake is lower. International comparisons indicate a continuing, if narrowing, north–south gradient across Europe. Data from the Boston-Ireland study suggest a crossover in both dietary intake patterns and risk of heart disease in Ireland and the USA in the 1970s. Contemporary comparative data of middle-aged Irish and American women demonstrate patterns of diet intake and inactivity consistent with the modern epidemic of obesity and non-insulin-dependent diabetes. Thus, dietary variations within and between countries and over time are consistent with chronic disease patterns in contemporary Ireland. [author abstract] [Proceedings of the Nutrition Society (2002), 61, 527–536]
• Tackling Health Inequalities An All-Ireland Approach to Social Determinants
  Looks at: Concepts, Definitions and Theories; Health Inequalities in Ireland and Northern Ireland; and Key Social Determinants of Health: Poverty and Inequality; Social Exclusion and Discrimination (Gender; Ethnicity; Travellers; Asylum Seekers, refugees and low income migrant workers; Homelessness; Disability; Mental Health; Sexual Orientation); A Life Course Perspective (Pregnancy; Childhood; and Older Age); Public Policies and Services (Health services; Education; Housing and accommodation; Transport; The Built Environment (Work and Employment; and Community and Social Participation); Health Behaviours (Alcohol; Food; and Smoking); and Stress.
• The interaction of public and private health insurance: Ireland as a case study
  In Ireland, the public health system has a symbiotic relationship with private health insurance not seen in other European countries. Everyone has entitlement to public hospital care from the state, but half the population now pay for private health insurance. The insured avail of ‘private’ health care, much of it delivered in public hospitals, and the resulting two-tier system is problematic from both an efficiency and an equity perspective. This paper uses the Irish case to explore the dynamics of the interaction between public and private health care and their impact on the demand for health insurance and on equity. It brings out how a structure designed to take advantage of possible benefits for the public system of close interaction with private care can be both destabilizing for the public system and inequitable in terms of access and utilization. [author abstract] [The Geneva Papers, 31, 633–649, 2006]
• The role of the public health nurse in a changing society
  Aim: This study is a report of a study to clarify the role of the public health nurse in one Irish community care area in the light of acknowledged problems in defining boundaries of the role. Background: Demographic developments and planned reorientation towards primary care of the health service in Ireland have changed the workload of public health nurses, which is unique compared with other countries. However, there is a lack of clarity and consequent problems in defining the role of the Irish public health nurse. Method: A descriptive qualitative study was conducted with 25 representatives of community nursing from one county in Ireland with a population of 209,077 and a complement of 65 full-time equivalent public health nurses. Purposive sampling was used and 21 public health nurses, two registered general nurses, one assistant director and one school nurse participated. Tape-recorded, individual semi-structured interviews were conducted over a 15-month period from 2002 to 2004. The constant comparative method was used for analysis. Findings: Four themes emerged: ‘Jack of all trades: the role of the public health nurse defined and described’, ‘the essence of the role’, ‘challenges to the role of the public health nurse’ and ‘communication’. The first theme is discussed in this paper. Conclusion: Public health nurses need to define and redesign their role so that they no longer think that they are the catch-all service in the community. This will enable them to deal with the rapid demographic, sociological and cultural changes in the population, a change that has international resonance. [author abstract] [Journal of Advanced Nursing 66(4), 743–752 (2010)]

Educational Resources

• CDC - Travel Information : Western Europe
• Health Impact Assessment Guidance - Developed by the Institute of Public Health in Ireland on behalf of the Ministerial Group on Public Health, this document describes Health Impact Assessment (HIA) and the steps involved in HIA. It gives advice based on the experience of HIA practitioners and provides tools to help carry out these steps and adapt HIA to local circumstances.
• Population Health Intelligence System (Online) - The ‘Population Health Intelligence System (PHIS (Online))’ website is designed to be a ‘first port of call’ for intelligence about health, the factors that affect it and the interventions that improve it in Ireland and Northern Ireland. The main components of the PHIS (Online) website are: A population Health Knowledge Resource Catalogue – searchable catalogue of knowledge resources together with standard details (‘metadata’) about each: A Reports System – searchable collection of key policies, strategies and programme documents as well as evaluation reports.
  An Indicators System – searchable collection of pre-calculated indicator sets together with online presentation tools and A Data System – searchable collection of aggregated data sets together with online data aggregation, indicator calculation and presentation tools.