Health inequality is the difference in the prevalence of health problems between individuals of higher and lower socio-economic status. Health inequality results where avoidable inequalities, which are both unnecessary and unfair, persist. Dr Muiris Houston reports.
A recently published report from the Public Health Alliance of Ireland (PHAI), Health in Ireland - An Unequal State, found that death rates for all cancers are more than three times greater in the lowest occupational class compared with the highest.
Death from lung cancer is four times greater for people in the lowest occupational class, while death from stroke is three times greater.
The report noted: "In no other area is the impact of inequality on society as devastating as it is on our health."
Sara Burke, one of the report's authors, says: "Some 4,500 fewer people would die on the island of Ireland if our death rates decreased to match those of Europe."
Forty per cent of people identified financial problems as the greatest single factor preventing them from improving their health.
For those without a medical card, the report highlighted the impact of one episode of illness. For a single person living alone who earns just above the €135 ceiling for a medical card, the combined cost of a visit to the GP and the cost of a prescription can consume 43 per cent of that person's weekly income. So, in spite of the massive growth in our economy, it appears from the PHAI report that the poor and those on the margins of society have been left behind.
It has been documented elsewhere that the wider the gap between socio-economic groups in terms of health indices, the poorer the health of that nation as a whole.
For doctors working in Ballymun Health Centre and other areas of urban deprivation, the effects of inequality are seen on a daily basis. People with asthma are having to do without more expensive "preventer" inhalers while overusing cheaper "reliever" ones.
How can poorer people change from a high-fat, high-salt diet to more expensive meals made from healthier alternatives following a doctor's advice? Unable to implement preventive medicine, it is no wonder the death statistics for so many diseases are weighted against the less well-off.