Population up by 40% since 1966 in Eastern Health Board region

Main findings of the Eastern Health Board's department of public health report, Public Health in the Eastern Health Board Region:

The population of the region has increased by 40.6 per cent since 1966 - compared to 25.7 per cent nationally - and now stands at 1,295,938. The increase is particularly marked in the older age groups, with 84,386 people aged over 70. The greatest population increases have occurred in the southern and western suburbs of Dublin and near the main towns in counties Kildare and Wicklow. There has been a substantial population decline in some inner-city Dublin areas and in Ballymun, Finglas, Raheny and Crumlin.

Live births in the region fell by almost 30 per cent - 26,202 to 18,879 - between 1980 and 1996. The average age for mothers giving birth rose from 28 to 29 years. Births to mothers over 35 rose from 14 per cent to 17 per cent.

Births to teenage mothers fell from 1,401 to 1,052 over the same period although there was a slight increase in such births as a proportion of total births. Non-marital births rose from 1,956 (7 per cent of total births) to 5,394 (29 per cent) in the 16 years to 1996.

Distribution of the population by social class varies markedly. EHB community care area (CCA) one - the Dun Laoghaire area - has the highest proportion of people in social class one, while the CCA areas four, five and six - the Dublin south-west, west and north-west areas - have the lowest. These areas also have the highest rate of male unemployment. High levels of deprivation occur mainly in the Dublin inner city area and in Blanchardstown, Finglas, Ballymun, Priorswood, Cherry Orchard, Clondalkin and Tallaght.

Cancer accounts for about 2,484 deaths - one in four - in the region each year. Some 776 (31 per cent) occur under the age of 65 years. The average numbers of deaths from all cancers are 2,103 in Co Dublin (656 under 65), 193 in Co Kildare (63 under 65) and 189 in Co Wicklow (56 under 65). The mean national figure for all cancer deaths is 7,431 (2,126 under 65).

Mortality from lung cancer is considerably higher in Co Dublin - (513 deaths, including 145 under 65) than the national average of 1,543 deaths, including 404 under 65. The lung cancer rate is above average for all males in counties Wicklow and Kildare.

Overall mortality rates from lung cancer are falling in men but there is no corresponding fall among women. About 90 per cent of lung cancer and 35 per cent of all cancers are attributable to smoking, and smoking prevention is the key to tackling the problem. Cigarette smoking has fallen by 15 per cent in men and 8 per cent in women since the early 1970s. One in five second-level pupils is smoking on a daily basis.

There are an average of 234 deaths from breast cancer in the EHB region every year, including 107 under 65 years. There are 1,543 deaths nationally, including 404 under 65.

Some 2,182 people die from coronary heart disease (CHD) in the EHB region each year of whom 56 per cent are men and 44 per cent are women. In Dublin, Kildare and Wicklow, there are about 1,793, 203 and 186 deaths respectively from CHD each year. The mortality rate from CHD is lower in Co Dublin than the national average but higher in Kildare for both men and women.

Some 380 deaths occur following accidental injury in the EHB region each year (310, 40 and 30 for Dublin, Kildare and Wicklow respectively).

Each year some 200 children under five in the region are admitted to hospital following poisoning with three times as many children treated for poisoning in A & E departments. Some 70 per cent of poisonings result from medicines - mainly tranquilisers, anti-depressants and paracetamol - while petroleum products, pesticides and caustic acids/alkalis are the most common non-medication causes of poisoning.

Road traffic accidents (RTAs) account for about 100 deaths and almost 5,000 non-fatal injuries in the EHB region each year. Mortality rates from RTAs are lower in Dublin and Wicklow than the national average but higher in Kildare.

A study of Dublin's homeless population found 80 per cent were smokers and 30 per cent drank alcohol beyond recommended limits. Almost half perceived themselves to be in poor health. Development of a fixed-term strategy for health services for the homeless is recommended.

Initiatives to improve traveller health are recommended. Travellers have excess mortality particularly from accidents, infant and perinatal deaths. A project is being piloted to identify traveller babies at birth.

Evaluation of health services produced recommendations for GPs to address an underlying level of dissatisfaction with some of their services, an advertising campaign to persuade people to attend their GP before going to A E departments, better use of acute hospital beds and improved community care.

The report notes a 1996 survey found a high rate of illicit drug use in second level schools in the EHB region.

Meningococcal disease continues at a high level in the EHB region while E.coli 0157 is an emerging cause of food-borne illness. One child died from the complications of E.coli 0157 in January 1997. Two large outbreaks of salmonella food poisoning occurred in August 1996 in the Dublin area. One case was linked to turkeys and the other to the use of unpasteurised eggs in a cake. There were no deaths but 11 people required hospitalisation.

Vaccination coverage is less than 70 per cent in the region while target coverage is 95 per cent.

The Republic had the 10th-highest incidence of AIDS among the 15 EU countries in 1996. Up to March 1998, 615 AIDS cases had been reported in the national surveillance system. The report recommends public health control strategies should reflect that much of the disease is drug-related.