The Institute of Public Health (IPH) hosted a special event on Wednesday, 4th October to mark it's 25th anniversary.
Set up prior to the signing of the Good Friday / Belfast Agreement in 1998, IPH has been shaping public health policy across the island of Ireland for 25 years.
To mark the occasion, IPH invited Professor of European Public Health at the London School of Hygiene and Tropical Medicine Martin McKee to give a keynote address: ‘Should governments make us healthier? Shifting the focus of public policy’.
In his address, Professor McKee argued that governments will only achieve the best possible outcomes for their people if they invest in their health. Healthier populations are more resilient to threats, get better results from education, contribute to greater economic growth, and create more cohesive societies. And all of these, in turn, contribute to better health, creating a virtuous cycle.
Professor McKee made the case for a Health For All Policies approach - ensuring that every government department looks at all its policies through a health lens and commits to investing in healthier and more resilient communities.
An investment in health, he argued, can achieve other policy goals, pointing to evidence on increased labour force productivity, a more secure labour market, and better education outcomes as examples of potential social and economic benefits.
Professor Martin McKee, Professor of European Public Health at the London School of Hygiene and Tropical Medicine
Professor McKee said all government departments have a role to play in health:
“We’ve long known that policies in other sectors - housing, transport, education and so on - can safeguard and improve population health. But we now recognise how better health is essential if we are to achieve success in other sectors. Healthier people stay longer in the workforce and are more productive. Healthier children get better educational outcomes. Healthier families invest more in small and medium enterprises.”
Governments, Professor McKee added, have no alternative but to reorient their investments in health with a broader cross-sectoral approach:
“Everything affects health, but not everybody thinks health is their problem. Economic growth, security, social cohesion or wellbeing… whatever the goal, governments won’t achieve it if they fail to invest in health”.
“The pandemic has surely taught us that we fail to invest in the health of our people at our peril. We really have no alternative if we want Ireland and Northern Ireland to be strong, secure, cohesive and fit for an ever more uncertain future.”
IPH Chief Executive Suzanne Costello said a policy shift could include greater emphasis on health improvement and illness prevention:
“Healthcare services are of critical importance but so too is investing in health improvement, illness prevention, and finding solutions to the wider social and economic factors that influence health. Shifting the policy focus has the potential to secure a healthier economy, healthier communities, and a healthier future for all.”
A panel of invited guests responded to Professor McKee’s address and discussed the potential to reframe health policy and investment.
The panel included ESRI health economist Dr Anne Nolan; SDLP MLA and Health and Wellbeing Spokesperson Colin McGrath; CEO of Empower Adeline O’Brien; Sinn Fein TD and Health Spokesperson David Cullinane; and Director of the Community Development and Health Network Joanne Vance.
The special gathering also heard contributions from the Chief Medical Officers for Northern Ireland and Ireland, Professor Sir Michael McBride and Professor Breda Smyth.
Wednesday’s event marked the 25th anniversary of IPH. It's establishment as a North / South agency in 1998 recognised that a geographical border offered no protection against disease or ill-health.
The Institute undertakes research, provides evidence and analysis for public health policy development, and works with a variety of stakeholders at local and national level.
IPH Chief Executive Suzanne Costello said that while significant progress was made in key public health policy areas, such as tobacco control, since 1998, both jurisdictions continue to face shared public health challenges that could benefit from enhanced North-South cooperation.
Ms Costello said:
“Faced with mounting challenges that affect our health – widening health inequalities, a cost of living crisis, the global climate crisis, and a rise in non-communicable diseases - there is a prime opportunity to reframe our approach to health on the island of Ireland and to harness enhanced cross border cooperation on shared public health challenges.”
“There is potential for both jurisdictions to mutually benefit through enhanced cooperation, knowledge exchange, and information-sharing, in particular to address population level health issues, such as alcohol harm, tobacco control, overweight and obesity, and the needs of an ageing population”.
Recent public health milestones
Smoking Ban - Ireland became the first country in the world to ban smoking in public places under the 2004 Public Health Act; Northern Ireland followed suit in 2007. Smoking rates have fallen since the ban – from around 1 in 4 adults in Ireland in 2002 to less than 1 in 5 adults in 2022. In Northern Ireland, around 114,000 homes moved from permitting smoking to being smoke-free between 2012 and 2019, with 6 out of every 7 homes considered smoke-free by 2019. A ban on smoking in cars with children was subsequently introduced in Ireland in 2014 and in NI in 2022. Smoking remains the leading cause of preventable deaths and preventable cancers across the island of Ireland, contributing to around 5,000 deaths in Ireland and 2,300 deaths in Northern Ireland every year.
Sugar Tax: Taxes on sugar-sweetened / soft drinks were introduced in Ireland and the UK in 2018. IPH conducted a Health Impact Assessment on the proposed Sugar Sweetened Drinks Tax in Ireland before it came into effect on water and juice-based drinks in May 2018. In 2022, the Irish sugar tax generated €31.4m in revenue. Since a similar sugar levy was applied to soft drinks in the UK, it is associated with an 8% reduction in obesity levels in 10-11 year old girls in England alone. Further research has found that the UK levy led to the reformulation of soft drinks and consequently a 10% reduction in sugar consumption per household per week.
Public Health (Alcohol) Act: Ireland’s Public Health (Alcohol) Act represents one of the most comprehensive pieces of public health legislation tackling alcohol harm enacted anywhere in the world. Signed into law in October 2018, it includes provisions for minimum unit pricing (MUP), structural separation, health labelling on products that contain alcohol, restrictions on the advertising and marketing of alcohol, the regulation of sports sponsorship and restrictions on certain promotional activities. MUP was introduced in Ireland in January 2022 as a targeted measure to reduce consumption among heavier drinkers where most of the direct harms occur. While it is too early to measure the impact of MUP on alcohol in Ireland, it is projected to reduce alcohol-attributable deaths by around 46 per year after 20 years. In Scotland, where MUP on alcohol was introduced in 2018, it has been shown to reduce health harms from alcohol use, in particular reducing hospital admissions.