Poverty the real killer in Ireland

Maybe 20 people will have died of cocaine abuse here this year at most

Maybe 20 people will have died of cocaine abuse here this year at most. For the families and close friends of most of these people, this is a cause of terrible distress and, for the people whose lives are cut short, a tragedy. However, what is astonishing is that this is a cause of a moral panic, supposedly reflective of the "new" hedonistic, indulgent Ireland, writes Vincent Browne

Astonishing because thousands of people die prematurely every year for different reasons and nobody bothers referring to this at all. It doesn't even enter the realm of political debate.

No Prime Time specials (although to be fair, they did do an hour special on the issue several years ago). No banging on and on by Morning Ireland. No scream features in the Sunday Independent, no tabloid hysteria. No "mumsy" finger-wagging by Mary McAleese, no Minister for Justice warnings of the wider social responsibility for these deaths.

Ruth Barrington, head of the Health Research Bureau (hardly a source of reckless hype), has said that 5,400 people die here every year because of deprivation. She writes in a Combat Poverty publication, Poverty is Bad for your Health: "It has been estimated that 5,400 fewer people would die prematurely each year if death rates were reduced to match those in Europe by tackling social deprivation and inequalities". She based this calculation on the report by the Institute of Public Health, Inequalities in Mortality, which, as far as the political class, and most of the media, are concerned, is almost a classified secret document, never to be mentioned in public.

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The report simply confirms the findings of research internationally, that deep inequalities and relative deprivation result in huge inequalities in the death rates for most diseases.

There was a lecture at the Economic and Social Research Institute in Dublin a few weeks ago by Prof Sir Michael Marmot, director of the International Centre for Health and Society, University College London, on Health in an Unequal World: A Matter of Social Justice, which emphasised the worldwide phenomenon that inequalities in society generally cause huge incidence of premature deaths among poor people. Nobody in politics bothered to turn up for the event, no breathless reporting from the ESRI by RTÉ correspondents, no scare headlines in any of the newspapers.

Similarly, that report on Inequalities in Mortality revealed: death rates from all causes were twice to three times higher in the lowest occupational class than the rate in the highest occupational class; for circulatory diseases, death rates were over 120 per cent higher; for cancers, death rates were 100 per cent higher; for respiratory diseases, death rates were over 200 per cent higher.

The report showed: "As well as the huge gap in mortality between the poorest and the richest, for many diseases there was a steep gradient running across all social groups".

It stated: For all infectious and parasitic diseases in the Republic death rates were over 370 per cent more (that is nearly five times more) among the lowest occupational class as compared with the highest, and the death rate increased as one goes down the social gradient. For tuberculosis, death rates were over 300 per cent more for poor people as compared with the richest, that is four times more. For all neoplasms (cancers), death rates were over 110 per cent more for poor people."

And on and on for all the major diseases and, by the way, for mental and behavioural disorders, death rates were 360 per cent higher; for alcohol abuse, death rates were 280 per cent more; for drug dependence, toxic mania, death rates were 590 per cent more. Similar results were revealed in a report from the Institute of Public Health, Unequal at Birth last year.

Maev Ann Wren, who has written authoritatively on health, has stated: "Irish people die younger because they tolerate an inequality between them that breeds ill-health, and they accept a healthcare system and a view of healthcare which implicitly places lesser value on the lives of those with lesser means."

The only possible explanation for the hysteria over a relatively insignificant phenomenon - the recent premature deaths of young people from cocaine abuse (and I do not dismiss the distress of the families and friends concerned, or the tragedy for the young dead people) - and the wilful indifference to the phenomenon of over 5,000 premature deaths because of deprivation is denial.

Society, or rather the power centres of society (in politics, business and the media) simply cannot confront the consequences of the inequitable system of which the powerful are the beneficiaries.

But wouldn't you think that occasionally, a few mavericks would break ranks in the Dáil and demand that the real killer in Irish society be confronted?

And as I write (just after 8.30am yesterday) there is a news item on Morning Ireland reporting that five homeless people died last year and their average age was 42. This item was just reported on a programme that since 7.00am has been dominated by around the same number of cocaine abuse deaths.