Irish people are not making the lifestyle changes needed to promote and improve their health. Despite repeated information campaigns on quitting smoking, drinking less alcohol, eating healthily, and being more active, no one appears to be listening to, or acting on, the advice from health experts.
The recently published Healthy Ireland Survey 2016 shows that population health behaviours are virtually identical to those found a year ago. Smoking rates are the same at 23 per cent. Slightly fewer people are consuming sugar-sweetened drinks and bingeing on alcohol but the differences in rates are not statistically significant. As was found in 2015, those who are unemployed and/or living in deprived areas are more likely to engage in unhealthy behaviours.
The survey, involving face-to-face interviews with 7,498 individuals aged 15 and over, provides information for the Department of Health and the Health Service Executive (HSE) which can inform the development of new policies and services needed to promote the health of the population.
The 2016 survey provides new data on the numbers of people who indulge in more than one of four unhealthy behaviours: smoking, binge drinking, consuming less than five portions of fruit and vegetables daily, or spending eight or more hours a day sitting down.
The vast majority (86 per cent) of the population have at least one unhealthy habit and almost half engage in two or more unhealthy behaviours. Men are much more likely to have multiple unhealthy behaviours than women.
Only 13 per cent of respondents reported positive mental health meaning they “felt full of life”, “calm and peaceful,” “had lots of energy” and “been a happy person” in the four weeks before the survey took place.
One in 10 had negative mental health meaning they “were a very nervous person”, felt “downhearted and blue”, “worn out”, “tired” and “so down in the dumps that nothing could cheer them up”.
Mental health operates on a continuum from flourishing to languishing. A majority of respondents (77 per cent) scored somewhere in the middle of this continuum.
Not flourishing
People who are average or not flourishing have more health problems than those who have a mental health condition. For example, they are about seven times more likely to take sick leave and four times more likely to visit a doctor for a mental or physical health problem than those languishing. Mental health service providers need to find out why so few people have positive mental health. Are most of us living lives of quiet desperation?
The most interesting finding was that so few people changed their health behaviour since the 2015 survey. Almost half of smokers would like to stop and 40 per cent of respondents would like to be more physically active. Many would like to lose weight and eat healthily but cannot afford it.
Health campaigns organised by the HSE and others are not working. RTÉ is now recruiting "leaders" for the 10th series of Operation Transformation, which will be aired in early 2017. The "flagship" health and fitness programme is not changing lifestyles either. In January this year Operation Transformation launched "The Million Pound Challenge" which aimed to encourage the whole population to lose a million pounds in weight by the end of the year.
At the time of writing there were 885,201lbs to go so the challenge is obviously not succeeding. And how many people have put weight on since the beginning of the year? Do these extra pounds cancel out those lost so far?
Unfortunately, information campaigns and television programmes have little influence on health behaviour. Campaigns can increase knowledge but actions rarely follow. Health information relayed by experts competes against a barrage of “real life” experiences that promote a different message. Scare tactics do not work either.
Telling people they will develop chronic diseases at some point in the future if they do not stop smoking, binge drinking or whatever, is largely unsuccessful.
Legislation and fiscal policies have the greatest effect on health behaviour. Smoking rates have halved in the past 20 years because of smoking laws. Ireland's shops and restaurants sell the cleanest food in Europe because of legislation enforced by the Food Safety Authority of Ireland.
The Government must do more to ensure that the overall environment makes healthy choices easier for everyone, not just those living in better off areas. Like it or not more legislation is needed. We must be forced to change if we are not prepared to do so voluntarily.
Jacky Jones is a former Health Service Executive regional manager of health promotion and is a member of the Healthy Ireland Council.
drjackyjones@gmail.com