| How can the NHS better help the Irish?
 The
Irish are the only ethnic minority group in Britain whose health is worse
than if they had stayed at home. Niamh Hennessy and Cornelia Lucey look
at the possible reasons why and ask how the problem should be tackled.
Heart disease kills more Irish people than any other ethnic group in
Britain. That the Irish die young is evidently a fact causing an urgent
need for effective and focused action by health and social care providers.
We spoke to people close to the problem and this is what ANT HANLON had
to say.
We’ve learnt a lot from The Irish Die Young conference on heart
disease. We all came back from it, sat down and had a thought about how
we can really tackle this problem.
We have a lot of smaller groups and opportunities for people to lead healthier,
more active lifestyles. We try to offer opportunities for people to have
a break from the kind of socialising that involves alcohol.
We have now decided to offer more regular events where life-skills are
taught particularly among the older male generation. We are planning more
ways to encourage people to cook for themselves using less salt and partake
in routine exercise that we will organise.
We had a monthly rambling group but because of recent funding we can start
to make rambling trips more often.
As a result of a focus on the problems of heart disease we have introduced
two new coffee mornings in Beeston and Hyde Park, Leeds where people can
come for a chat and guidance on how to lead a better lifestyle.
We now realise that it is increasingly important to target women too,
who are not always the stronger part of Irish societies. We are contacting
other societies where we hope to find women who need our help and are
promoting the skills services we can offer them.
Our community developer Eddie Mulligan noticed even more so at the conference
that heart disease is an issue that also needs to be tackled on a higher
level.
His post is funded by the Primary Care Trust (PCT) which shows that
they recognise the Irish as an important part of the community. But in
six recent NHS studies on mental health, older people, alcohol, healthy
eating, coronary heart disease and tobacco only the tobacco programme
looked at the Irish community.
Eddie will be responding to why we were left out and hoping to introduce
the Irish into the NHS future agenda. The NHS must ensure the health issues
of the Irish are consciously addressed.
In the sense of things changing progress is very slow. At least the conference
shows PCTs are now having to recognise the Irish community. But it’s
up to us to ensure that we stay in people’s minds.
One of the new ways we think we can respond is by setting up voluntary
home-care services for the elderly Irish in Leeds offering help with services
which local social services can no longer fund or manage.
We are now calling on our local community to support non-profit social
enterprises in the coming months and asking if anyone has suggestions
on how we can improve our services to please come forward.
One of our workers started a knitting group this year and it has been
a great success. LIHH also run a health stall in Leeds market every month
providing information on healthy eating.
n For more information on the work of Leeds Irish Health and Homes, or
to find out how you can help them please contact 0113 262 5614.
Why is there a worry?
THE Irish community in Britain is the only ethnic minority group whose
health is worse here than if they had stayed where they were.
Worried? It seems that you should be.
It will come as no surprise to most Irish people in Britain that there
is a major crisis in the health service.
Recently top officials in the NHS, the British Department of Health and
the British Heart Foundation admitted they were largely unaware of the
health needs of the Irish community in Britain.
They also spoke about how they need to raise awareness of the needs of
the Irish community in Britain, how the NHS has the capacity to look after
the Irish but never had the focus and most worrying of all they admitted
that there are voices that need to be listened to and have not yet been
heard.
These voices are from the thousands of people who moved from Ireland many
years ago and made Britain their home.
The people who need to listen are those who can help find a solution to
the problem.
So why is there a problem in the first place? Why do Irish people living
in Britain need to be listened to?
Firstly we need to look at the people in question.
In the last Census around 691,000 people in Britain identified themselves
with the White Irish category thus comprising 1 per cent of the population.
According to the Federation of Irish Societies (FIS) despite the size
and vulnerability of the Irish as a minority ethnic population in Britain,
the Black and Minority Ethnic agenda persistently neglects the health
needs of the Irish.
The percentage of Irish people aged 50 and over (51.5 per cent) exceeds
the White British population (35.2 per cent) in Britain.
This marks a very large number of elderly Irish people who will need care
and assistance as they progress further into old age.
What are the main problems?
According to research there is a tendency among Irish people to assume
stoicism and put their faith in the Almighty which contributes to a reluctance
to seek help.
Also physical work engaged in by men and some women leads them to dismiss
chest pain as muscular in origin.
The problems facing the Irish community in Britain are broad-ranging.
The Standard Mortality Rates (SMR) for cancer are significantly increased
for Irish people at all ages, with the SMR for lung cancers higher for
men than women. Also the SMR for heart disease is elevated for Irish people.
Add this to the high suicide rates among the Irish in Britain, the high
mental health rates and addiction problems and the high rates of permanent
sickness and disabilities and there you have a problem.
Not only do people born in Ireland die much younger than other people
in England, those born in England to Irish-born parents and grandparents
die earlier too.
Lifestyle choices also come into play here. Smoking rates are high in
the Irish community, as are drinking rates.
Irish men (34 per cent) drink more than 21 units per week compared with
30 per cent of all men. Also Irish women drink 5 per cent more than all
women.Dr Mike Knapton, Director of Care and Prevention at the British
Heart Foundation (BHF) said that the Irish in Britain have the highest
prevalence of cardiovascular disease (CVD) in men and women of all ethnic
groups.
Although he found that prevalence rates of heart disease among the Irish
was not as high as among the Indian and Pakistani populations, the Irish
compensated for this by having an excess prevalence of stroke —
and unexpectedly this was even higher than the well-known prevalence found
among Black Caribbeans.
“CVD is a disease of deprivation and we at the BHF are committed
to tackling the inequalities in CVD — therefore the Irish issue
is an issue for us,” he said.
One of the major problems is a reluctance to seek help.
There is a great fear around heart disease and cancer and many Irish
people in Britain do not know or understand the advances that have been
made and theoptions that are currently available.
What people had to say
“FIS will continue to work with the health agencies and to lobby
British Government to ensure that the statutory authorities are taking
Irish health issues seriously.”
Mary Tilki, chair of the Federation of Irish Societies.
“It has now been recognised that the Irish community
suffers significantly poorer health than normal and that these unique
health needs are not being addressed. The challenge for the future is
for the authorities to act. We need to see practical, Irish-specific initiatives
at local level and quickly.”
Peter Hammond, director of the London Irish Centre.
“A bigger step needs to be made in reaching people who are too
proud to seek help, particularly the older age bracket of Irish men. The
health and living conditions among many of the elderly Irish is unacceptable.”
Rita O’Connor, Sister and a volunteer at a London homeless shelter.
“The Irish stand-out as having the highest all-cause mortality
rates of all the minorities in Britain. We need to be more pro-active
in tackling the Irish as a group. There is a need for a National Strategy
in which the Irish must be included.”
Prof. Roger Boyle, National Director for Heart Disease.
“I would encourage all Irish community organisations and indeed
the entire Irish community to continue to raise awareness of key health
issues and ensure that they get access to the health provision available.”
Conor McGinn, FIS Health Development Officer.
What are the solutions?
THE NHS and the Department of Health admit there is a problem that needs
to be addressed but how and when will this happen?
To begin with the FIS say there should be an Irish category in all data
collection.
Also needed are more health promotion campaigns through Irish community
organisations such as quiting smoking groups and healthy eating clubs.
“We need to raise awareness amongst the professional community to
address this,” according to Averil Dongworth, chief executive of
Barnet and Chase Farm Hospitals NHS Trust, who agreed this was vital,
especially on Irish health issues.
The Department of Health also needs to be more proactive in terms of identifying
groups in our society where special attention needs to be placed —
and clearly Irish people living in this country are one such group.
This was the general feeling at The Irish Die Young conference, organised
by the FIS and held in London recently.
There was a widespread acknowledgement by speakers from the Department
of Health and Trusts that a lot of service planners and providers —
including themselves — had been largely unaware of the health needs
of the Irish or the extent of their health disadvantage.
Adding to this lack of awareness was the admission that the health service
was not addressing Irish needs in service planning.
However many speakers felt that dealing with the Irish community was necessary
given their impoverished health profile.
One professor suggested health professionals need to find a way of factoring
in Irishness as a risk factor, as has been done for South Asian people
and for Afro-Caribbeans.
Speakers drew parallels with other ethnic minority communities’
experiences of gaining recognition at health service level as a model
for how the Irish community might move forward to work in partnership
with a range of organisations to raise awareness, access treatment and
prevent further community ill-health.
Mina Bhavsar, Head of Service Improvement, Leicester City PCT, talked
about the lessons the Irish might learn through the success of Project
Dil. This reduced CVD risk within the South Asian community and was developed
as a model for other interventions.
She stressed the importance of focusing on the similarities in terms of
the challenges and the solutions between the South Asian and Irish communities,
rather than on differences.
Ms Bhavsar argued that change would only come when Irish ill-health was
acknowledged nationally.
Bridget Riches, director, National Programme Delivery (Health Improvement
Directorate) said she would raise Irish health with her Programme Leads
in the Department of Health and would inform them that: “There are
voices out therethat need to be listened to, just as strong for the Irish
population as there are for other minority groups.”
Speakers said communities themselves can be part of the solution rather
than being seen as just the problem.
Ms Riches stressed the importance of addressing the needs of local populations
through targeting in partnership, using the mechanism of Local Area Agreements.
She said local communities need to tailor national strategies for use
at local level.
The Irish in Britain need to make sure their voice is heard they pay
taxes in Britain and have a right to good health and health care.
It is up to each and every person to ensure that they stand up and be
counted.
Current research Can you help?
A FRENCH post-graduate student has recently launched a research project
about the health of the first and second-generation Irish living in Coventry
in an aim to understand why the Irish have a poorer health profile.
Despite a great response from the Coventry public, she still needs second-generation
Irish men who would be willing to be interviewed at the Coventry Irish
Society.
The volunteers need to be born in Coventry, to have at least one Irish
parent who migrated to Britain in the 1950s, ’60s or early ’70s
AND to have lived in Coventry for a long time.
Few second-generation Irish men have come forward so far and the research
cannot be completed without them.
Please contact Marie Clucas on 07917 137810.
There are voices out there that need to be listened to, just as strong
for the Irish population as there are for other minority groups.
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