Sir, - A recent ESRI survey highlights inequities in the Irish health care system and the overwhelming public support for reduced hospital waiting lists (The Irish Times, August 24th).
At this stage in the country's development, while giving due cognisance to health care, we must also focus on how health is created, and how illness and disability arise. Dr Muiris Houston (August 25th) contributes to the debate by noting that one of the most striking changes to have occurred on the island this century has been the reduction in deaths from tuberculosis. He attributes this improvement to "the introduction of effective antibiotic treatment and the huge improvement in living conditions and sanitation". This is just one example of the way the circumstances in which we live, work and play have had a major impact on health.
For good health we clearly need an equitable, effective and efficient health care system. However, improved public health and reduced inequalities in health also require that we tackle underlying causes of illness and disability. Such an endeavour will involve not just the health care system.
Social, economic and environmental policies and initiatives all have a vital part to play in creating this healthier future. - Yours, etc.,
Kevin P. Balanda, Owen Metcalfe, Institute of Public Health in Ireland, Royal College of Physicians, Kildare Street, Dublin 2.