Improvements in some lifestyle risk factors

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Improvements have been noted in terms of some lifestyle risk factors, in the first Healthy Ireland Outcomes Framework Report. 

Smoking rates have seen positive change since 2015 (23% of people smoked in 2015 vs 17% in 2019 and 18% in 2021). Levels of overweight and obesity have shown declines (39% in 2017 to 37% in 2019), while the use of cannabis (the most prevalent illegal drug in Ireland) has also shown a decrease. The percentage of adults meeting the National Physical Activity Guidelines in adults has risen from 44% in 2015 to 46% in 2019.  

The Report’s findings also highlighted rising life expectancy (now 84.7 years in women and 80.8 years in men), an increase of almost three years in healthy life years, declining trends in incidence and mortality rates for many cancers and high levels of participation in screening and immunisation (although slight declines in participation were noted from baselines).

However, the Report also highlighted some issues of concern, notably the socio-economic and health impacts of COVID-19, the impacts of high housing costs, pollution and climate change, and the need for continued vigilance in terms of reducing lifestyle related risks to public health in the context of an ageing population.

Preventative Measures

  • Rates of screening and immunization, though high, have been declining.
  • Static or declining trends in both incidence and mortality rates for most cancers have been observed; however, the incidence of breast cancer in females has been rising significantly since 2014.  

Mortality and Morbidity

  • Life expectancy in Ireland is increasing (84.7 years for women and 80.5 years for men), as are healthy life years (70.5 years for women and 68.6 years for men). However, the effects of Covid-19 reflect international trends of falling life expectancy in 2020-2021 as a result of the pandemic.
  • Mortality from road traffic accidents involving collisions between vehicles and cyclists and pedestrians decreased between 2018 and 2021 (41 -20 fatalities; pedestrians, 9-7 fatalities, cyclists).
  • The unconditional probability of dying between ages 30 and 70 (all causes) and separately, from the 4 major classes of non-communicable disease has decreased. 

Lifestyle and Behaviour Risks

  • Improvements have been noted in terms of some lifestyle risk factors. Indicators such as smoking rates and levels of overweight and obesity, while remaining issues of concern, have shown declines or are broadly stable.  However, the increase of overweight and obesity in women is of concern.
  • The number of adults meeting the national physical activity guidelines has risen from 44% – 46% (a 4.5% rise), between 2015 and 2019. 
  • Breastfeeding rates have shown a slight increase, reaching almost 58% in 2019.
  • The number of adolescents ever having sex between the ages of 15-17 has fallen. Condom use in this age group, amongst those who are sexually active, has also fallen, but the data may not fully reflect increased uptake of newer forms of contraception.  
  • The proportion of people self-reporting heavy episodic drinking (binge drinking) showed a large decline between 2018 and 2021, from 37% to 22%. However, these results should be interpreted with caution as data collection coincided with a period of high Covid-19 restrictions. 

Wellbeing Factors

  • In terms of health and social connectedness, 81% of Healthy Ireland Survey (2021) respondents reported lower levels of social connectedness and 30% reported worsening mental health since the start of the pandemic. However, this survey took place during a period of high Covid-19 restrictions. These figures may be subject to improvement as people are now free to interact more.  
  • Figures for overall self-rated health show that in 2016, 87.0% of the population felt they had good or very good health, down slightly from 2011 when it was 88.3%. Data from the 2022 National Census 2022 will provide a comprehensive update.
  • The percentage of young people who report always feeling safe in the area where they live decreased by 4.4% between 2002 and 2018. However, a similar metric regarding people over 50 feeling safe outside after dark was broadly stable. 
  • A high percentage of the urban population (94.5%) has access to recreational green space within 10 minutes’ walking distance, but improved data coverage may be needed.

Socio-Economic and Environmental Factors

  • The pandemic significantly impacted employment; some after-effects continue, although Ireland is currently at full employment. The number of people living in jobless households has decreased from 9.5% to 7.2% in 2021.
  • Homelessness decreased during the pandemic due to unprecedented government intervention (e.g. an introduction of a ban on eviction of tenants, a rent freeze and increased bed capacity). However, following the lifting of such preventive measures, homeless numbers have been rising. 
  • The percentage population with Leaving Cert or above increased between 2018 and 2021 (from 78% in 2018 to 82% in 2021). Educational retention rates are high and stable, with 91.2% completing the Leaving Certificate in 2018 -19.
  • Energy efficiency ratings of homes are improving, with a significant increase (54.5%) in the total number of A or B ratings between 2018 and 2021.
  • Drinking water quality showed slight increases, however, the EPA air quality index decreased from 34-29 between 2018 and 2021.
  • The percentage of people unable to keep their home adequately warm decreased from 4.4% to 3.2% from 2018-2021. However, these results do not take into account recent rises in the cost of energy in 2022.

Websites:

The original Healthy Ireland Outcomes framework, and the Report,are available here: https://www.gov.ie/en/publication/030396-healthy-ireland-outcomes-framework/

The Government Wellbeing Framework is available here: https://www.gov.ie/en/campaigns/1fb9b-a-well-being-framework-for-ireland-join-the-conversation/?referrer=http://www.gov.ie/wellbeing-framework/