Data shows health is a class issue, writes Dr Muiris Houston, Medical Correspondent.
The research published yesterday by the Health Research Board (HRB) Unit for Health Status and Health Gain represents a massive undertaking by a broad range of health researchers.
Involving almost 40,000 people over seven years, it helps plug a major gap in our knowledge about the social determinants of health status in the State.
When the project started in 2000, there was no means of directly tracking mortality and morbidity patterns here, even though we had high rates of heart disease and cancer compared with other European countries.
A key element in the Health Gain Unit's work was the establishment of a three-generation family study called the Lifeway study. Some 1,082 mothers were recruited during early pregnancy and the 1,094 babies born to these women were also included in the study group. This enabled investigators to look at several areas of mother and child health over a five-year period.
Researchers made a significant breakthrough when they looked at the diets of women during pregnancy and the subsequent risk of asthma in their children.
The results show clearly that the three-year-old children of mothers with a relatively high fruit and vegetable intake and who had a higher consumption of oily fish when pregnant were less likely to develop childhood asthma. The findings suggest that antioxidants found in fruit and vegetables and eaten by the mother in pregnancy may have a protective effect on the respiratory systems of developing children.
But the asthma paper carries another significant message for health service planners: mothers who consumed a small quantity of fruit and vegetables were more likely to belong to lower socio-economic groups. These mothers were more likely to be single, have a low income and to be eligible for a medical card.
Another major objective of the Lifeway study was to examine how socio-economic differences affect the use of health services by pre-school children. After a three-year follow-up of over 1,000 children, a clear relationship emerged: the lower the social class, the higher the childhood consultation rate in general practice. This inverse relationship between consultation rates in children and social class is likely to be the result of greater morbidity in the children of the less well-off.
But the overall consultation rate for all children, at 5.5 GP visits per child per year, is relatively high and suggests that all pre-school children in the Republic, regardless of income level, should receive free primary care.
An analysis of data from the 2002 Irish Health Behaviour of School Going Children study (HBSC) found a link between positive health in 10- to 18-year-olds and the number of supportive interpersonal relationships they had. Again, there is a policy message for Government, namely that there are health gains to be made from helping children maintain and build interpersonal relationships.
A significant theme running through the research is that health status is influenced by our social position. Education, where we live and income are major determinants of who develops certain diseases and which of us has ready access to facilities that help prevent ill-health.
The research unveiled yesterday must now be used by Government to formulate strategy on health needs and to monitor changes in the health status of Irish people in the years ahead.