Events

IPH marks 25 years of shaping public health policy

maresa.fagan@publichealth.ie — Thu, 05 Oct 2023 10:17:39 +0000

IPH marks 25 years of shaping public health policy maresa.fagan@p… Thu, 05/10/2023 - 11:17

IPH marks 25 years of shaping public health policy

19 Dec, 2023

2023 marked a significant milestone for the Institute of Public Health (IPH), which hosted a special event in October to mark it's 25th anniversary. Set up prior to the signing of the Good Friday / Belfast Agreement in 1998, IPH has been shaping public health policy across the island of Ireland for 25 years.

To mark the occasion, IPH invited Professor of European Public Health at the London School of Hygiene and Tropical Medicine Martin McKee to give a keynote address: ‘Should governments make us healthier? Shifting the focus of public policy’.

Watch summary video

In his address, Professor McKee argued that governments will only achieve the best possible outcomes for their people if they invest in their health. Healthier populations are more resilient to threats, get better results from education, contribute to greater economic growth, and create more cohesive societies. And all of these, in turn, contribute to better health, creating a virtuous cycle.

Professor McKee made the case for a Health For All Policies approach - ensuring that every government department looks at all its policies through a health lens and commits to investing in healthier and more resilient communities.

An investment in health, he argued, can achieve other policy goals, pointing to evidence on increased labour force productivity, a more secure labour market, and better education outcomes as examples of potential social and economic benefits.

Watch full recording of 25th anniversary event here

_{Professor Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine}

Professor McKee said all government departments have a role to play in health:

“We’ve long known that policies in other sectors - housing, transport, education and so on - can safeguard and improve population health. But we now recognise how better health is essential if we are to achieve success in other sectors. Healthier people stay longer in the workforce and are more productive. Healthier children get better educational outcomes. Healthier families invest more in small and medium enterprises.”

Governments, Professor McKee added, have no alternative but to reorient their investments in health with a broader cross-sectoral approach:

“Everything affects health, but not everybody thinks health is their problem. Economic growth, security, social cohesion or wellbeing… whatever the goal, governments won’t achieve it if they fail to invest in health”.

“The pandemic has surely taught us that we fail to invest in the health of our people at our peril. We really have no alternative if we want Ireland and Northern Ireland to be strong, secure, cohesive and fit for an ever more uncertain future.”

IPH Chief Executive Suzanne Costello said a policy shift could include greater emphasis on health improvement and illness prevention:

“Healthcare services are of critical importance but so too is investing in health improvement, illness prevention, and finding solutions to the wider social and economic factors that influence health. Shifting the policy focus has the potential to secure a healthier economy, healthier communities, and a healthier future for all.”

A panel of invited guests responded to Professor McKee’s address and discussed the potential to reframe health policy and investment.

Watch full recording of 25th anniversary event here

The panel included ESRI health economist Dr Anne Nolan; SDLP MLA and Health and Wellbeing Spokesperson Colin McGrath; CEO of Empower Adeline O’Brien; Sinn Fein TD and Health Spokesperson David Cullinane; and Director of the Community Development and Health Network Joanne Vance.

The special gathering also heard contributions from the Chief Medical Officers for Northern Ireland and Ireland, Professor Sir Michael McBride and Professor Breda Smyth.

Wednesday’s event marked the 25th anniversary of IPH. It's establishment as a North / South agency in 1998 recognised that a geographical border offered no protection against disease or ill-health.

The Institute undertakes research, provides evidence and analysis for public health policy development, and works with a variety of stakeholders at local and national level.

IPH Chief Executive Suzanne Costello said that while significant progress was made in key public health policy areas, such as tobacco control, since 1998, both jurisdictions continue to face shared public health challenges that could benefit from enhanced North-South cooperation.

Ms Costello said:

“Faced with mounting challenges that affect our health – widening health inequalities, a cost of living crisis, the global climate crisis, and a rise in non-communicable diseases - there is a prime opportunity to reframe our approach to health on the island of Ireland and to harness enhanced cross border cooperation on shared public health challenges.”

“There is potential for both jurisdictions to mutually benefit through enhanced cooperation, knowledge exchange, and information-sharing, in particular to address population level health issues, such as alcohol harm, tobacco control, overweight and obesity, and the needs of an ageing population”.

Watch full recording of 25th anniversary event here

Click here to view a gallery of images from the day

Recent public health milestones

Smoking Ban - Ireland became the first country in the world to ban smoking in public places under the 2004 Public Health Act; Northern Ireland followed suit in 2007. Smoking rates have fallen since the ban – from around 1 in 4 adults in Ireland in 2002 to less than 1 in 5 adults in 2022. In Northern Ireland, around 114,000 homes moved from permitting smoking to being smoke-free between 2012 and 2019, with 6 out of every 7 homes considered smoke-free by 2019. A ban on smoking in cars with children was subsequently introduced in Ireland in 2014 and in NI in 2022. Smoking remains the leading cause of preventable deaths and preventable cancers across the island of Ireland, contributing to around 5,000 deaths in Ireland and 2,300 deaths in Northern Ireland every year.

Sugar Tax: Taxes on sugar-sweetened / soft drinks were introduced in Ireland and the UK in 2018. IPH conducted a Health Impact Assessment on the proposed Sugar Sweetened Drinks Tax in Ireland before it came into effect on water and juice-based drinks in May 2018. In 2022, the Irish sugar tax generated €31.4m in revenue. Since a similar sugar levy was applied to soft drinks in the UK, it is associated with an 8% reduction in obesity levels in 10-11 year old girls in England alone. Further research has found that the UK levy led to the reformulation of soft drinks and consequently a 10% reduction in sugar consumption per household per week.

Public Health (Alcohol) Act: Ireland’s Public Health (Alcohol) Act represents one of the most comprehensive pieces of public health legislation tackling alcohol harm enacted anywhere in the world. Signed into law in October 2018, it includes provisions for minimum unit pricing (MUP), structural separation, health labelling on products that contain alcohol, restrictions on the advertising and marketing of alcohol, the regulation of sports sponsorship and restrictions on certain promotional activities. MUP was introduced in Ireland in January 2022 as a targeted measure to reduce consumption among heavier drinkers where most of the direct harms occur. While it is too early to measure the impact of MUP on alcohol in Ireland, it is projected to reduce alcohol-attributable deaths by around 46 per year after 20 years. In Scotland, where MUP on alcohol was introduced in 2018, it has been shown to reduce health harms from alcohol use, in particular reducing hospital admissions.

Joint North South Public Health Conference: Call for abstracts now open

maresa.fagan@publichealth.ie — Thu, 20 Jul 2023 11:31:16 +0000

Joint North South Public Health Conference: Call for abstracts now open maresa.fagan@p… Thu, 20/07/2023 - 12:31

Joint North South Public Health Conference: Call for abstracts now open

Health Inequalities

Public Health

20 Jul, 2023

Register for the conference here.

The call for abstracts for the Joint North South Public Health Conference this November has now opened.

The all-island conference takes place online on 29 November and will focus on addressing health inequalities on the island of Ireland, under the theme of 'The Health-Wealth Divide: Leaving No One Behind'.

Health inequalities are pervasive in every country across the world and the island of Ireland is no exception. The wider social, economic, and environmental determinants of health can be drivers of health inequalities, with other crises, such as the cost-of-living crisis, widening and intensifying the health gap.

Working towards the Sustainable Development Goals and reducing health inequalities are strategic priorities in Northern Ireland and Ireland. This conference aims to provide an opportunity for knowledge exchange on what works, what doesn’t work, and what could work better when it comes to addressing health inequalities at a local and national level.

In addition to keynote plenary sessions, delegates will have the opportunity to attend parallel sessions. These sessions will explore examples of work aimed at addressing health inequalities, within the broad remit of socioeconomic disparities and the ‘health-wealth divide’.

Abstract submissions from those working to improve the health of people living in areas of social and economic disadvantage or working directly with underprivileged or marginalised communities are particularly welcome. The conference is open to abstract submissions from within and outside the island of Ireland.

Examples of work may include, but are not limited to, academic research, community-based projects / practice, health service programmes, participatory health research, public patient involvement (PPI), policy analysis or review, and public health interventions or evaluations.

Abstract submissions will be considered for 10-minute oral presentations or 3-minute oral presentations.

The closing date for submissions is Friday, 8 September at 5pm.

Please direct any queries in relation to the online submission form to r.corr@qub.ac.uk.

Submit Abstract Here

PROGRAMME ANNOUNCED: Joint North South Public Health Conference: Registration is Open

maresa.fagan@publichealth.ie — Fri, 07 Jul 2023 08:32:35 +0000

PROGRAMME ANNOUNCED: Joint North South Public Health Conference: Registration is Open maresa.fagan@p… Fri, 07/07/2023 - 09:32

PROGRAMME ANNOUNCED: Joint North South Public Health Conference: Registration is Open

Health Inequalities

Public Health

15 Nov, 2023

Downloads

Conference Programme

Registration is now open for the Joint North South Public Health Conference, which will take place online on Wednesday, 29 November from 10am-4pm.  

This year’s all-island conference is entitled ‘The Health-Wealth Divide - Leaving No One Behind’ and will focus on addressing health inequalities on the island of Ireland.  

This virtual event will bring together international and local experts to discuss the drivers of health inequalities in the context of the cost-of-living crisis and wider determinants of health.

It will also provide an opportunity for knowledge exchange on what works, what doesn’t work, and what could work better when it comes to addressing health inequalities at a local and national level.

A ‘Call for Abstracts’ will open soon and submissions from all professionals working to address health inequalities at a community, academic, health system, or strategic/policy level are encouraged. Further details to be announced shortly.   

Register Now

For updates on this public health conference subscribe here .

Please direct any queries about the 2023 Joint North South Public Health Conference to communications@publichealth.ie.

Toolkit and free online learning courses on evaluating arts and creativity programmes for older adults

maresa.fagan@publichealth.ie — Mon, 22 Apr 2024 10:58:34 +0000

Toolkit and free online learning courses on evaluating arts and creativity programmes for older adults maresa.fagan@p… Mon, 22/04/2024 - 11:58

Toolkit and free online learning courses on evaluating arts and creativity programmes for older adults

Ageing

Arts and Creativity

25 Apr, 2024

Downloads

Public Health Evaluation Toolkit: Assessing the Impact of Arts and Creativity Interventions for Older People

Summary of Public Health Evaluation Toolkit: Assessing the Impact of Arts and Creativity Interventions for Older People

Link

Access the free online learning courses

The Institute of Public Health (IPH) has launched an evaluation toolkit and two new online learning courses on how to use evidence to show the benefits of Arts and Creativity in later life.

IPH launched the new resources at a Healthier Ageing through Arts and Creativity webinar today, 25 April, where details of a new evaluation toolkit and online learning pathways were presented by Toby Finch, a member of the ageing team at IPH.

The toolkit - Assessing the Impact of Arts and Creativity Interventions for Older People: A Public Health Evaluation Toolkit – provides a ‘how to’ guide for assessing the impact of arts and creativity interventions for older adults.

The digital learning pathways - Arts and Creativity: Lessons for Active Ageing and A How to Guide – Evaluation Methods for Arts and Creativity Programmes – were developed by IPH for its Public Health Matters online learning platform.

The new online courses provide evidence on the benefits of arts and creativity in later life and a step-by-step practical guide, for those designing or delivering programmes, on how to use evaluation methods to show the benefits for older adults.

The new resources were developed on foot of an evidence review conducted by IPH, which highlighted the need for an evaluation toolkit for the arts and creativity sector to be able to better measure, record and assess the impact of their programmes.

The 2021 report, ‘Arts and Creativity in Later Life: Implications for Public Health and Older People’, reviewed more than 70 international studies investigating the potential health and wellbeing benefits of dancing, music and singing, visual and creative arts, and drama and theatre and found that arts and creativity can help improve physical, psychological, and social health and wellbeing in older adults.

The webinar also featured a panel discussion with input from Stephanie McKervill from Arts Care NI; Dominic Campbell from Creative Aging International; and Dr Tara Byrne from Age and Opportunity.

IPH Director of Ageing Research & Development Professor Roger O’Sullivan, who led the development of the new resources said: “These new resources build on our previous work highlighting the benefits of engaging in group-based arts and creativity in later life, which were shown to improve the physical, psychological, and social health and wellbeing of older adults. This work also identified the need to develop ways of evaluating arts and creativity interventions for older adults and today we are delighted to launch an evaluation toolkit and learning pathways that will provide practical guidance on assessing the value, benefits, and impact of such programmes.

“These new resources are available, free of charge, on our Public Health Matters platform and will support organisations working with older adults at a community, local, or national level on how to evaluate and measure the impact of their arts and creativity programmes and interventions,” Professor O’Sullivan added.

Evaluation Toolkit

Assessing the Impact of Arts and Creativity Interventions for Older People: A Public Health Evaluation Toolkit
A summary of the evaluation toolkit is also available here.

Online learning courses

The following new learning pathways are available on IPH's Public Health Matters online learning platform:

Arts and Creativity: Lessons for Active Ageing
A How to Guide: Evaluation Methods for Arts and Creativity Programmes.

Webinar on Healthier Ageing through Arts and Creativity to launch new resources

maresa.fagan@publichealth.ie — Wed, 27 Mar 2024 09:23:51 +0000

Webinar on Healthier Ageing through Arts and Creativity to launch new resources maresa.fagan@p… Wed, 27/03/2024 - 09:23

Webinar on Healthier Ageing through Arts and Creativity to launch new resources

Arts and Creativity

27 Mar, 2024

The Institute of Public Health (IPH) is hosting a Healthier Ageing through Arts and Creativity webinar to launch a number of new resources on using evidence to show the benefits of Arts and Creativity in later life.

IPH is launching an evaluation toolkit and two new online learning pathways that will provide practical guidance on how to assess the impact of arts and creativity interventions in later life.

These new resources follow the publication in 2021 of an evidence review on how arts and creativity can have positive outcomes for older people’s health and wellbeing.

Toby Finch from IPH's ageing team will present details of the Toolkit for Assessing the Impact of Arts and Creativity Interventions for Older People and the following online learning pathways :

Arts and Creativity: Lessons for Active Ageing
How to Guide for Evaluation Methods for Arts and Creativity Programmes.

The learning pathways were developed by IPH for its Public Health Matters platform.

As part of the webinar, IPH Director of Ageing Research and Development, Professor Roger O'Sullivan, will chair a panel discussion with input from Stephanie McKervill from ArtsCare; Dominic Campbell from Creative Aging International; and Tara Byrne from Age and Opportunity.

Register Here

Webinar to launch ‘Mellow Village: A Health Impact Assessment Case Study’

maresa.fagan@publichealth.ie — Wed, 27 Mar 2024 09:05:24 +0000

Webinar to launch ‘Mellow Village: A Health Impact Assessment Case Study’ maresa.fagan@p… Wed, 27/03/2024 - 09:05

Webinar to launch ‘Mellow Village: A Health Impact Assessment Case Study’

Health Impact Assessment

27 Mar, 2024

The Institute of Public Health (IPH) is hosting a webinar at 11am on Tuesday 9th April 2024 to launch ‘Mellow Village: A Health Impact Assessment Case Study’.

The case study provides a practical example of how to undertake a Health Impact Assessment (HIA) and sets out in detail the process and steps required to apply HIA to Mellow Village, a hypothetical mixed-use urban neighbourhood development.

This HIA case study was developed as a support tool for using HIA Guidance that was developed and updated by IPH in 2021.

It also complements the digital learning module, ‘Introduction to HIA’, which is available free of charge on IPH's Public Health Matters platform.

The webinar will hear from IPH Public Health Development Officer Dr Joanna Purdy, who will present the findings from a recent survey on the support and training needs of the HIA community, and Mr Ben Cave from BCA Insight, who will give an overview of the Mellow Village HIA Case Study.

There will also be an opportunity for questions.

Register Here

Blog: Alcohol-related liver disease on the island of Ireland – conversations on a silent epidemic

maresa.fagan@publichealth.ie — Wed, 21 Feb 2024 11:03:03 +0000

Blog: Alcohol-related liver disease on the island of Ireland – conversations on a silent epidemic maresa.fagan@p… Wed, 21/02/2024 - 11:03

Blog: Alcohol-related liver disease on the island of Ireland – conversations on a silent epidemic

Alcohol

21 Feb, 2024

In this blog, IPH Public Health Development Officer, Dr Joanna Purdy, shares insights from a recent seminar on alcohol-related liver disease (ARLD) on the island of Ireland.

In late 2023, the Institute hosted a seminar on alcohol-related liver disease (ARLD) on the island of Ireland on behalf of the North South Alcohol Policy Advisory Group (NSAPAG). The event captured perspectives from public health professionals, clinicians, researchers, advocacy and community sector representatives.

_{^{IPH Director of Policy Dr Helen McAvoy chatting with Prof John Ryan and Dr Roger McCorry who took part in the Alcohol-Related Liver Disease seminar.}}

This blog highlights some of the issues raised during the event, with a focus on the scope for prevention and the health service response.

ARLD in Ireland and Northern Ireland – a snapshot of the data

There can be no doubt that alcohol consumption on the island currently, and over the past 20 to 30 years, is contributing to an increasing burden of alcohol-related liver disease.

Northern Ireland

In Northern Ireland, the number of alcohol-specific deaths[1] have been steadily increasing year on year.

Here are some key statistics and facts to consider:

1 in 50 deaths in Northern Ireland are considered directly attributable to alcohol and it is now evident that alcohol-related liver disease is the main driver of the rising trend of alcohol-specific deaths.
2020 saw the highest ever number of deaths from alcohol-related liver disease and alcohol-specific deaths ever recorded in Northern Ireland.
Alcohol-related liver disease is now the second highest contributor to years of working life lost in Northern Ireland. In other words, this disease kills many people, and does so, at a young age.
The mean age of death from alcohol-related liver disease is just 57 years.
People living in deprived areas are five times more likely to die from this disease than those in non-deprived areas.

_{Source: Bill Stewart and Caolan Laverty, Information Analysis Directorate, Department of Health}

The NSAPAG seminar heard that the contribution of alcohol-related liver disease to poor population health in the region was under-recognised. Contributors also challenged why the disease receives a fraction of the attention at policy level, and in the media, compared to the other major contributors to early death, like cancer and heart disease.

Ireland

In Ireland the profile of alcohol-related liver disease epidemiology is incomplete due to ongoing deficiencies in health information infrastructure and data collection. The latest available data was presented by Anne Doyle from the Health Research Board.

Here are some statistics and facts to consider:

3,610 hospital discharges were recorded in 2022 with a diagnosis of alcohol-related liver disease.
Across all ages, alcohol-related liver disease discharges increased by 42% between 2001 and 2022, with the highest ever rate reported in 2021.
The data suggests that this form of alcohol-related harm is increasing among both the young and old, with implications for how we perceive risk at community level and within the health service.

_{Source: Anne Doyle, Health Research Board}

Approaching a policy problem

IPH Director of Policy Dr Helen McAvoy acknowledged the importance of addressing upstream policy on alcohol to ‘turn off the tap’ on the high-risk alcohol use profile of the population. She welcomed the recent establishment of the Irish Liver Foundation and the comprehensive analyses on alcohol-related liver disease presented by the Department of Health in Northern Ireland. While welcoming the Public Health (Alcohol) Act in Ireland she cautioned that a shift in alcohol use at population level will take decades.

In the meantime, there is a rising problem of alcohol-related liver disease, and without a formal response on prevention, early detection, service investment and development and clinical audit, the situation is likely to worsen.

Dr McAvoy further observed that strategies relating to drugs and alcohol in Ireland and Northern Ireland acknowledge the wide range of alcohol-related harms but tend not to specify actions in relation to alcohol-related liver disease. She challenged the audience to consider how we might reframe the response by considering alcohol-related liver disease firstly as a policy failure rather than some sort of ‘failure’ of the individual.

Perspectives from the clinical frontline

Prof John Ryan, a Consultant Hepatologist at Beaumont Hospital, Dublin, and Dr Roger McCorry, a Consultant Hepatologist at the Royal Victoria Hospital, Belfast, shared their experiences of diagnosing and caring for patients with alcohol-related liver disease.

Prof Ryan described admissions to Beaumont Hospital in the previous month noting that 87% of admissions with severe liver disease were alcohol-related. Patients were aged 30-68 years; seven had to undergo emergency procedures; four patients commenced palliative care; and two patients died (aged 41 and 62 years).

Reflecting on his experience, Dr McCorry noted that there is some fatalism, even cynicism, adopted in the response to patients and alcohol-related liver disease is highly stigmatised.

Despite these pre-existing views, the National Confidential Enquiry into Patient Outcome and Death[2] concluded:

not enough was done about the patient’s harmful drinking at the time
there was a failure to screen adequately for harmful use of alcohol
those identified as having alcohol misuse disorders were not referred for support.

So, what can be done to reduce ARLD incidence?

Contributors were supportive of fully implementing all provisions within the Public Health (Alcohol) Act in Ireland and introducing Minimum Unit Pricing (MUP) for alcohol in Northern Ireland as upstream actions to address alcohol-related liver disease.

Early detection and intervention were discussed and both Prof Ryan and Dr McCorry emphasised the importance of a strategic approach to screening for alcohol problems within primary care, the provision of FibroScan technology and appointment of alcohol liaison nurses within appropriately resourced multidisciplinary team. Collectively, these measures can help detect alcohol problems early, allowing for appropriate support and intervention before alcohol misuse leads to alcohol-related liver disease.

Prof Ryan emphasised the return on investment from appointing hospital-based Alcohol Care Teams and multidisciplinary teams.

Dr McCorry noted that modelling studies[3] suggest Alcohol Care Teams in non-specialist acute hospitals will:

save 254,000 bed days annually*
save 78,000 admissions annually*[4]
create a cost saving by the first year of £3.85 for each £1.00 invested.

Prof Ryan further recommended additional recruitment and development of hepatology expertise as this can reduce hospital mortality and readmissions. At present only one in three patients admitted to hospital with alcohol-related liver disease in Ireland were under the care of a liver specialist and this was a contributor to poor outcomes for those patients.

Influencing policy for change

Dr Sheila Gilheany, Chief Executive of Alcohol Action Ireland, called for acceleration on implementation of all provisions within the Public Health Alcohol Act. She proposed a whole of government approach to tackle alcohol-related harm through the establishment of an ‘Office for Alcohol Harm Reduction’ to drive progressive alcohol policy development, coordinate alcohol policy issues across government, commission research to inform policy and set targets for alcohol harm reduction.

Alex Bunting, who is Group Director of Care & Support at Inspire, a mental health and addiction services in Northern Ireland,shared some of the challenges in relation to commissioning and service planning. He proposed that alcohol-related harm should be addressed in the context of poverty and as a priority within approaches to address health inequalities. Mirroring the views of Alcohol Action Ireland, he highlighted the need for policy reform to take on the extent of the problem through a cohesive prevention strategy with cross-departmental alignment. He also referred to the importance of investment in mental health and addiction services coupled with an anti-poverty strategy to target those most in need and most at risk.

Further Information and Resources

If you, or someone you know, is affected by alcohol, the following supports and services are available:

Ireland: Health Service Executive Alcohol Services and Drug and Alcohol Information Support
Northern Ireland: Drugs and Alcohol NI

For more information about Alcohol-Related Liver Disease see:

You can read more about IPH work on alcohol policy here.

References

[1] Prior to 2017 ‘Alcohol Related Deaths’ was used in Northern Ireland and defined as “when the underlying (i.e. primary) cause of death recorded on the death certificate is most directly due to alcohol consumption”. Since 2017, the new definition, ‘Alcohol-Specific Deaths’, includes conditions known to be exclusively caused by alcohol (that is, wholly attributable causes) and excludes conditions where only a proportion of the deaths are caused by alcohol (that is, partially attributable causes). Source: Alcohol-Specific Deaths Northern Ireland Information Paper (NISRA, 2019)

[2] National Confidential Enquiry into Patient Outcome and Death – Alcohol Related Liver Disease: Measuring the Units Report (2013)

[3] Optimal Alcohol Care Teams (ACTs) as part of an effective alcohol treatment system

[4] *by the 3rd year of full optimisation.

Taking Stock: Past achievements and future challenges in public health

maresa.fagan@publichealth.ie — Thu, 08 Feb 2024 11:11:50 +0000

Taking Stock: Past achievements and future challenges in public health maresa.fagan@p… Thu, 08/02/2024 - 11:11

Taking Stock: Past achievements and future challenges in public health

Commercial Determinants of Health

Public Health

Social Determinants of Health

8 Feb, 2024

There have been many significant achievements in public health over the past 25 years, but considerable challenges lie ahead, in particular the impact of climate change on our health and on the health of the planet.

As part of the Institute of Public Health’s special anniversary event in October last year, we spoke to prominent voices in public health to take stock of past achievements and future challenges.

Set up prior to the signing of the Good Friday / Belfast Agreement in 1998, the Institute has been shaping public health policy across the island of Ireland for 25 years.

In this series of short videos, Martin McKee, Róisín Shortall, Des Cox, Anne Nolan, Norah Campbell, and Liz Mitchell give their personal perspectives on what progress has been made in public health while also casting an eye on challenges, old and new.

Watch: Professor of European Public Health, Martin McKee, shares

his thoughts on public health achievements and future priorities

Transcript: Martin McKee, Professor of European Public Health

I am Martin McKee and I'm Professor of European Public Health at the London School of Hygiene and Tropical Medicine.

What are your thoughts on future public health priorities?

I have a lot of thoughts on future public health priorities. I was a member of a pan-European Commission looking at health and sustainable development reporting to the World Health Organization and we set out a framework for thinking about these threats. Many of them related to the interaction between humans, animals, the natural environment, antimicrobial resistance and so on, and others related to the health of our planet. The things that we can't plan for, like, earthquakes, natural disasters, but also the things where we have a role to play, like global warming.

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

Ireland was the first country to introduce a ban on smoking in public places. Tobacco smoking has been one of the biggest immediate threats to public health throughout the 20th century and the rest of the world has looked at Ireland as being in the vanguard of this struggle.

Watch: Róisín Shortall, Social Democrats TD and Health Spokesperson shares

her thoughts on public health achievements and future priorities

Transcript: Róisín Shortall, Social Democrats TD and Health Spokesperson

My name is Róisín Shortall. I'm a TD for the Social Democrats and I'm the spokesperson on health.

What are your thoughts on future public health priorities?

I think there's enormous potential. We've been talking for years about the need to expand the capacity of public health, to put more emphasis on health promotion and early intervention and yet we haven't been doing that in practice. It is front and centre in relation to the Sláintecare programme but there are enablers that need to be put in place in order that public health can play its full part. Those enablers, I think, are first of all, better data systems and there are big problems there. I think the other thing is in relation to identifying the social determinants of health and tackling the growing problem of child poverty.

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

I think you'd have to say there are two things, you know, I think that come to my mind. The vaccination programmes, you know, operators throughout the schools, in particular child vaccinations and others, and they have been very successful and there's been very positive public acceptance of those. And, you know, we have avoided huge levels of illness as a result of that. I think the other role that public health has played, particularly in recent years, is highlighting the social determinants of health and also I think the commercial determinants of health. I think increasingly we're coming to understand those better.

What do you see as the greatest public health challenge that we face into the future?

I think it would have to be viruses, unknown viruses, and certainly after the experience of Covid, I think that is an enormous challenge. There are also challenges in terms of funding public health properly and recognising the importance of that and indeed funding anti-poverty measures. So, you know, is government serious about this or not? And that's the question, it's an open question and it is yet to be answered. You know, there's a lot of lip service being paid to the need to tackle these issues and yet, you know, time and time again, over recent years, the same issues are coming up. So why are we not doing this? Why are we not, why do we not have an objective resource allocation model, so that, you know, we can target those areas of greatest need and tackle the fact that we have, you know, the inverse care law. But also then I think to be much more strategic and targeted about health promotion messages because clearly they're not being heard by a lot of people. There are reasons for that and it's generally to do with poverty.

Watch: Anne Nolan from the Economic and Social Research Institute

shares her thoughts on public health achievements and future priorities

Transcript: Anne Nolan, Economic and Social Research Institute

I am Anne Nolan. I work at the Economic and Social Research Institute in Dublin.

What are your thoughts on future public health priorities?

I was really enthused by the discussion today. I think there was a lot of discussion, obviously about the sort of major risk factors that we think about in terms of public health, like things like smoking. But I think what really brought home to me in terms of the discussion was the sort of the broader determinants. So things like, you know, our housing conditions, poverty, inequality, wealth, education. So it's those sort of wider policies that are just as important in terms of public health, as the sort of action on the risk factors.

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

So the achievement I'm going to focus on, is in terms of our improvement in mortality. So, often we don't think enough about mortality. It's a sort of a really good indicator of social progress. It's something that we use to compare outcomes across countries and Ireland has achieved really impressive reductions in mortality, both in old age and you know, also in younger ages. If you look at infant mortality, for example, 25 years ago in 1998, we had a rate of infant mortality, that was slightly higher than the EU average. We're now a good bit below the EU average, it's continuing to fall and we have a rate that's a lot lower than our nearest neighbour in the UK and much lower than in the US. And I think this is something to be really celebrated. It means that there are now more children that are living, to contribute to society, and are there for their families. And I suppose that's due to achievements, not only in terms of core public health measures, but also those wider policies that I was talking about. So, things like better housing conditions, better environmental conditions, income supports, reductions in poverty.

What do you see as the greatest public health challenge that we face into the future?

I think one of the biggest challenges we face is still one of our most enduring challenges, which is inequalities in health outcomes across different population groups. So again, if I use that example of mortality, if you look at mortality very early in life, so even within the first week of life, you see real differences across population groups. So, for example, children that are born to mothers in lower socioeconomic positions have much higher mortality rates than children that are born to working better off mothers. And that's really striking and that's really something that we should be intervening on.

Watch: Professor Des Cox, Paediatric Respiratory Consultant, shares

his thoughts on achievements and future priorities in public health

Transcript: Des Cox, Paediatric Respiratory Consultant

My name is Professor Des Cox. I'm a consultant in paediatric respiratory medicine at CHI (Children’s Hospital Ireland) Crumlin and I was previously the chair of the policy group on tobacco for the RCPI (Royal College of Physicians of Ireland).

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

Well, there's been lots of different successes internationally and nationally and I suppose I'll pick one example from each. I think internationally, the response to Covid and the vaccine rollout was probably the biggest achievement in public health that we've seen. To get the vaccine rates that they did, not only in Ireland, but in many countries across the world, was a massive achievement. And I think what the previous speakers at the conference today were saying is that, you know, Covid has taught us a lot. And we should learn from it and how countries were able to mount a public health response to a public health emergency was extremely impressive to see. So, I think that was, for me, the greatest achievement of the last 25 years and demonstrated that we can unify and respond to, you know, a common problem from a public health standpoint. Nationally, I would’ve said, you know, as a tobacco control advocate, I'd have to be biased and say the smoking ban for workplaces that came in in 2002, certainly that's had the most dramatic impact on passive smoking. It's also de-normalised smoking as a behaviour in this country. And so, from that perspective, that's been a massive achievement. And of course, Ireland being a leader in that, I would like to have seen more legislative measures like that over the last 25 years, you know, more follow on, improving anti-tobacco legislation in Ireland. I felt that we maybe haven't done enough on that, but as a success, you know, I think we can look on that as one of the greater successes that we've had here in Ireland.

What do you see as the greatest public health challenge that we face into the future?

When I was thinking about this, the first thing that came to mind was climate change. And it's not only that climate change is going to affect all of us in different ways, but it's going to have a massive impact on public health. So, as global warming continues, we're going to see more and more natural disasters, we’re going to see more and more extreme weather conditions and that's going to move people from different continents on around, and it's going to cause greater refugee crises than we've never seen before. Also, you know, the changes in the climate, even on a national level in Ireland, what's going to happen? It's going to be wetter and warmer here and what's that going to change? That's going to have a massive impact on the health of our citizens. And I think we need to plan ahead for that. And, you know, experts in the area, we need to take into account what climate change will, how that will impact our health system, and how are we going to manage that. I think that's probably the greatest challenge that we're going to face. Obviously, again, as a tobacco control advocate, we would like to see more done towards introducing tobacco measures but certainly that's something that we should be working towards in the future in tobacco control and we need to be more proactive about that.

Watch: Norah Campbell from Trinity College Dublin, shares

her thoughts on public health achievements and future priorities

Transcript: Norah Campbell, Trinity College Dublin

My name is Norah Campbell. I'm an Associate Professor of Marketing in Trinity Business School at Trinity College, Dublin.

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

So I think one of the most recent and probably one of the most impactful public health achievements has been Ireland's public health alcohol bill. And the reason why is because it coalesced lots of public health actors from academia and from practice who came together and really worked to look at the reasons why alcohol was so available, so cheap, and so convenient for the entire population rather than focusing on individual acute level stresses caused by alcohol. And it's a model of the types of achievement and cultural shifts and paradigm shifts that can occur when we take a truly public health lens and work together to look at population level health rather than acute individual level health.

What do you see as the greatest public health challenge that we face into the future?

In the next 25 years, we are going to be living in an era of multiple cascading crises, probably the biggest one being the threat of climate change. And it is not an exaggeration to say that it will change our public health irrevocably, it will create what will be a paradigm shift in health, like a Copernican revolution, a Darwinian revolution in health. And in 25 years’ time, we will understand that the focus on health has to be at upstream prevention rather than in downstream cures. For too long, we have had four major industries that have contributed to population level ill health and inequities - alcohol, tobacco, ultra processed foods, and fossil fuel. They have created very high levels of concentrated wealth among very few members of the population and they've managed to externalise the costs of their unhealthy commodities on the rest of the population. We will necessarily see a change in that, where governments, because of the public health advocacy that is going on, will focus on degrowing these majorly difficult and deleterious industries. And when they do, they will create what the anthropologist Jason Hickel calls an almost miraculous convenience. Because what we do know now is that in degrowing industries like that, it actually contributes to population level wealth and health. And that is the shift that public health has already made. And it's all of our education systems, our governments, institutions, and indeed our medical institutions that are lagging behind what public health already knows.

Watch: Liz Mitchell, former IPH Chief Executive, shares her

thoughts on public health achievements and future priorities

Transcript: Liz Mitchell, Former Chief Executive at IPH

I am Liz Mitchell. I was a Deputy CMO (Chief Medical Officer) in the Department of Health in the North and I worked in the Institute of Public Health and ended up for a short time as the CEO.

What is the greatest public health achievement of the past 25 years? Are there any particular successes that stand out in Ireland or Northern Ireland?

Well, I think, it's always hard to pick one thing, but I really think in this case, it's no contest because I think tobacco control in both, here in the South and also in the North, have really been outstanding. I think Ireland led the way in terms of tobacco control and the ban of smoking in public places. And, I think in both jurisdictions, tobacco control has continued to be a strong feature of public health action. And I think the successes have shown, and indeed the Institute has recently helped with the review of the tobacco strategy in the North, which shows what progress has been made. Still challenges remain, of course, particularly in terms of health inequalities, in terms of tobacco control, and also in terms of how to deal with the new presence of vaping and e-cigarettes. So, we can't rest on our laurels yet. We have to keep on working.

What do you see as the greatest public health challenge that we face into the future?

Again, there are many possibilities for this in terms of what the greatest public health challenges for the future, but for me it has to be providing sustainable healthy food for the planet. And I think that applies across, in terms of the whole climate change agenda, in terms of what we're doing, in terms of pollution and all the other impacts that humanity is having on our environment. And then the challenges that we're getting so many highly processed foods, which are in their own way quite addictive and make us, you know, crave more. And yet, it's encouraging people to take a more healthy approach to their diet and to work with them on that so that we can all have adequate access to affordable food.

IPH hosts special event to mark its 25th anniversary

maresa.fagan@publichealth.ie — Fri, 12 Jan 2024 16:22:31 +0000

IPH hosts special event to mark its 25th anniversary maresa.fagan@p… Fri, 12/01/2024 - 16:22

IPH hosts special event to mark its 25th anniversary

Public Health

5 Oct, 2023

The Institute of Public Health (IPH) hosted a special event on Wednesday, 4th October to mark it's 25th anniversary.

Set up prior to the signing of the Good Friday / Belfast Agreement in 1998, IPH has been shaping public health policy across the island of Ireland for 25 years.

Professor Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine

Professor McKee said all government departments have a role to play in health:

Governments, Professor McKee added, have no alternative but to reorient their investments in health with a broader cross-sectoral approach:

IPH Chief Executive Suzanne Costello said a policy shift could include greater emphasis on health improvement and illness prevention:

A panel of invited guests responded to Professor McKee’s address and discussed the potential to reframe health policy and investment.

The special gathering also heard contributions from the Chief Medical Officers for Northern Ireland and Ireland, Professor Sir Michael McBride and Professor Breda Smyth.

Wednesday’s event marked the 25th anniversary of IPH. It's establishment as a North / South agency in 1998 recognised that a geographical border offered no protection against disease or ill-health.

The Institute undertakes research, provides evidence and analysis for public health policy development, and works with a variety of stakeholders at local and national level.

Ms Costello said:

Recent public health milestones

Over 1,000 delegates to consider health inequalities at all-island public health conference

maresa.fagan@publichealth.ie — Tue, 28 Nov 2023 09:09:24 +0000

Over 1,000 delegates to consider health inequalities at all-island public health conference maresa.fagan@p… Tue, 28/11/2023 - 09:09

Over 1,000 delegates to consider health inequalities at all-island public health conference

Health Inequalities

28 Nov, 2023

More than 1,000 health professionals, researchers and policymakers, from across Ireland and Northern Ireland and beyond, will gather this week for an all-island public health conference on health inequalities.

The 2023 Joint North South Public Health Conference on Wednesday 29 November will focus on addressing health inequalities on the island of Ireland, under the theme of 'The Health-Wealth Divide: Leaving No One Behind'.

The annual conference takes place online and is organised by the Institute of Public Health, Public Health Agency, Department of Health in Northern Ireland and Ireland, Queen’s University Belfast, Ulster University, University College Cork, Trinity College Dublin, University College Dublin, University of Galway, University of Limerick, the Royal College of Surgeons in Ireland, and HSE Strategy & Research.

The event will hear from international and local experts about the drivers of health inequalities and the wider social, economic, and environmental determinants of health, while also considering how best to promote health and deliver services to those most in need.

Keynote speakers include Professor of Health Equity at the Stretton Institute in Australia, Professor Fran Baum, who will give a presentation on ‘Tackling Health Inequities in an Era of Poly-crises’ and Director of Health Inequalities at NHS England, Professor Bola Owolabi, who will give a keynote on ‘The Business Case for Tackling Health Inequalities’.

The conference will also hear from those working at the coalface of homelessness in Dublin, with opening remarks from Alice Leahy of the Alice Leahy Trust, which provides social and health services to people who are homeless, and a keynote talk on ‘Making Sense of Street Chaos’ from Dr Austin O’Carroll, a Dublin-based GP working with marginalised and homeless communities in the inner city.

It will feature 18 lightning talks and abstract presentations on a wide range of issues, from addressing health inequalities to homelessness services, trauma-informed interventions, and reaching marginalised groups.

Health inequalities are differences in health between different groups of people. They can be caused by social, economic and environmental factors and arise in a variety of ways, such as differences in life expectancy or the prevalence of chronic diseases.

Director of Policy at the Institute of Public Health, Dr Helen McAvoy, who will chair the conference said: “This year’s Joint North South Public Health Conference provides a prime opportunity to consider how we can address health inequalities on the island of Ireland, to assess what is working well, and to consider how we can narrow the health gap.”

For more information about this conference visit https://jointpublichealthconference.org/

Register here