7.1 General context
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Health in Ireland: Key trends
The Department of Health publishes an annual report ‘Health in Ireland: Key Trends’. It covers several areas, including demographics, population health, hospital and primary care, employment and expenditure and highlights Ireland’s significant achievements in key health outcomes in the past decade. Health in Ireland: Key Trends 2019 was the twelfth such report. While most of the report is about the whole population and/or older populations, it also provides some figures specifically related to youths.
The report found that while the overall number of people with a medical card (discussed in the introduction to Chapter 7) has decreased, the number of 12- to 24-year-olds with a medical card has increased, from 2009 to 2019.
Health in Ireland cites World Health Organization’s data on Health Behavior in School-aged Children, demonstrating a downward trend from 2010 to 2018 in the levels of risky health behavior among 11- to 17-year-olds. These trends relate to the numbers who:
- smoke monthly or more frequently
- have ever used alcohol
- have used cannabis in the last year.
Health in Ireland also showed a slight downward trend in the number of children waiting 6 months or more for elective procedures. In November 2019, there were 1,785. The number of people waiting 52 weeks or longer for an outpatient appointment and the total number of people on outpatient waiting list increased from 2018 to 2019, although the figures for youths are not available.
Healthy Ireland Survey
The Healthy Ireland Survey is an annual face-to-face survey, commissioned by the Department of Health. Interviews are conducted with a representative sample of the population aged 15 and older living in Ireland. The sample size is typically in the region of over 7500 people. This programme was launched in 2013 and provided a cross-government focus to deliver the vision for a Healthy Ireland. The Healthy Ireland public engagement and communications campaigns highlighted where people can find trusted information to start their journey to better health. So far there has been over €30 million invested in projects from 2017 until 2020.
The new Healthy Ireland Strategic Action Plan 2021-2025 gives the government a clear roadmap of how society can address the impacts of the Covid-19 pandemic. This action plan will build on the work and progress made to date and focus on the remaining years of the Healthy Ireland Framework from 2021-2025. This plans vision is:
A Healthy Ireland, where everyone can enjoy physical and mental health and wellbeing to their full potential, where wellbeing is valued and supported at every level of society and is everyone’s responsibility
This Framework aims to:
- bring a concerted focus on life-long wellbeing, prevention of illness
- seeks to reduce health inequalities
- address the settings in which health and wellbeing is impacted, and
- emphasise the need to empower people and communities to better look after their own health and wellbeing.
The Healthy Ireland Outcomes Framework was established in 2018 to monitor the targets of Healthy Ireland. This framework sets out four high level outcomes:
- Responsibility is shared in addressing the social determinants of health and wellbeing.
- People of all ages and abilities participate in education, work, and leisure activities to their full potential.
- Children are active and healthy, with positive physical and mental wellbeing.
- We live longer healthier lives in safe, healthy environments in resilient communities.
My World Surveys
The My World Survey is a survey about the mental health of 12- to 19-year-olds in Ireland. It aims to understand what can lead to an increased change of mental health difficulties among youths, and what can help to support a young person’s mental health and wellbeing. The original My World Survey took place in 2012. Its sequel, My World Survey 2, was carried out in 2019 with more than 19,000 12- to 25-year-olds across Ireland. The surveys were a collaboration between Jigsaw (The National Centre for Youth Mental Health) and University College Dublin.
Comparisons of the My World Surveys 1 and 2 indicate that there has been a notable increase in anxiety, depression, and body esteem among young people, particularly amongst females. My World Survey 2 found that
- 40% of adolescents reported experiencing levels of depression outside the normal range
- 49% reported levels of anxiety outside the normal range
- 6% of adolescents reported they had made a suicide attempt.
Comparing the studies also shows a decrease in protective mental health factors – such as self-esteem, optimism, and resilience - and an increase in anger. There was a decrease in the numbers reporting drinking, but adolescence in My World Survey 2 who reported more drinking engaged in more problematic drinking than adolescence in My World Survey 1.
National Self-Harm Registry Ireland
The National Self-Harm Registry Ireland is a national system of population monitoring for the occurrence of hospital-treated self-harm. It was established, at the request of the Department of Health, by the National Suicide Research Foundation. It is funded by the Health Service Executive’s National Office for Suicide Prevention.
According to Interim Report January to June 2019 (National Self-Harm Registry Ireland, 2019), in the first six months of 2019, there were 6,252 presentations to hospital as a result of self-harm. This is 2% higher than the number recorded for the same period of 2018. 51% of presentations were by persons under 30 years of age. The highest rates of self-harm for both males and females were among adolescents and young adults. In many age groups, there was little difference in incidence rates by sex. An exception was among 10- to 14-year-olds where hospital presenting self-harm was more than three times more common among girls compared to boys. Presentations by adolescents aged 15-19 years were almost twice as common among girls as boys. This has been a consistent pattern in recent years.
The National Youth Health Programme Statement of Strategy 2018-2022 defines health as
'everyone achieving their potential to enjoy complete physical, mental and social wellbeing. Healthy people contribute to the health and quality of the society in which they live, learn and grow up. Health is much more than an absence of disease or disability, and individual health, and that of the country, affects the quality of everyone’s lived experience'.
The Statement of Strategy defines wellbeing as
‘an integral part of this definition of health. It reflects the quality of life and the various factors which can influence it over the course of a person’s life. Wellbeing also reflects the concept of positive mental health, in which a person can realise their own abilities, cope with the normal stresses of life, grow up productively and fruitfully, and be able to make a contribution to their community'.
Ireland’s healthcare system aims to provide integrate care. In the Sláintecare Implementation Strategy the Committee defines Integrated Care as
Healthcare delivered at the lowest appropriate level of complexity through a health service that is well organised and managed to enable comprehensive care pathways that patients can easily access and service providers can easily deliver. This is a service in which communication and information support positive decision-making, governance and accountability; where patients’ needs come first in driving safety, quality and the coordination of care.