Children living in the most disadvantaged areas are more than four times more likely to develop severe mental health challenges than those from wealthier communities, a professor in general practice has said.
Prof Susan Smith, a GP in Inchicore in Dublin who teaches general practice at Trinity College Dublin, said there is “overwhelming evidence” living in the most disadvantaged areas can lead to poorer health outcomes.
“These children have a higher prevalence of chronic disease. That would be the likes of heart disease, diabetes, mental health difficulties,” she said.
“In adulthood, these children who have grown up in poverty die three to four years earlier than those from the most affluent areas. There is a 4.5 times higher likelihood of developing severe mental health difficulties among those from disadvantaged backgrounds compared to those from the most affluent. And it is likely represented across mild and moderate mental illness too.”
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Evidence also shows there is an 18- to 19-year difference in years lived in good health between those from poorer communities and those from the most affluent ones, she added.
Speaking in advance of her appearance at the Royal College of Physicians of Ireland Faculty of Paediatrics autumn conference, Prof Smith said the stress of living in poverty is almost certainly among the reasons for this.
“The day-to-day living is just much more difficult. They don’t have the same head space for preventive measures, like remembering to book in for appointments,” she said.
“Then there is the intergenerational effect, and family structures. That’s not to say everybody who experienced this will have these effects, but it is much more likely.”
Furthermore, getting help is often most difficult for these individuals, as those with more disposable income are able to pay privately for mental health services, for example, when waiting lists are longer.
“So waiting lists are longer where need is greater,” she said.
Prof Smith cited research from the Economic and Social Research Institute, which found up to a quarter of a million people in families that include a child under five are living below the poverty line when housing costs are taken into account.
According to Prof Smith, this highlights a need for a national health inequity strategy.
“There are a number of policy solutions, such as allocating resources based on needs. Currently, we have an allocation system based on population, and we don’t take deprivation at all into account,” she said.
“When really, very disadvantaged areas should have probably double the number of Camhs [Child and Adolescent Mental Health Services] than the more affluent areas.”
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