All-Island Census Atlas - Health

All-Island Atlas

Workshop 3

Health

Justin Gleeson

North-South Ministerial Council, Armagh, 30/09/14

What is the All-Island Research Observatory (AIRO)

• AIRO is a spatial data portal and consultancy service focused on improving evidence informed planning in Ireland – Collects, analyses and provides evidence and

tools to support better planning and decision making

• Maps, data, policy advice, research and training

– Maximise the usage and benefit of publically funded and readily available datasets

– Highlight the benefit of proper collection, management and dissemination of datasets

• Who do we work with? – Government Departments – Semi-State bodies – Regional Authorities, Local Authorities, Local

Partnerships, Charities etc – Academics, Researchers, Public, Private sector – Funding Bodies (ESPON, SEUPB,INTERREG)

Mapping Resources: Census Toolkits

Mapping Resources: National Census Toolkits

Mapping Resources: National Census Toolkits

• SEUPB / INTERREG: Evidence Based Planning • Develop an All-Island on-line Digital Atlas Tool

– All-Island – Cross Border specific – Local Authority/Local Government District

• Census Seminars (preliminary analysis and mapping) – Demography, Economy, Housing, Transport, Health, Deprivation

• All-Island 2011 Deprivation Index & All-Island Travel to Work mapping • Data for Decisions QGIS workshops: workshops on using data to support evidence informed

planning, funding applications etc • Digital Atlas Hard Publication

– Sectoral analysis (population, education, transport, health, housing, environment etc) – Expert commentary from NI and RoI academic/policy community – Cross Border case-studies

All-Island Spatial Mapping Toolkits – Census 2011

All-Island Health Census Data

• General Health (AI)

• Unpaid Carers (AI)

• Disability (RoI and NI)

• On-line All-Island Atlas

• Data Days and AIRO Data Store

General Health • A question on general health was introduced for the first time in Census

2011 in both RoI and NI – First Health question on RoI Census, history of health recording in NI/UK

• General health rather than present state of health – Self-perceived health (SPH) provides a well validated and widely used

measure of actual health, despite its subjective nature. – Rate their general health in one of five categories

• Very Good, Good, Fair, Bad, Very Bad

General Health • High proportion in both jurisdictions considered their health to be Very

Good or Good (90.3% in RoI v 79.5% in NI) – Very Good was considerably higher in RoI (61.7%) – Compared to 47.7% in NI

• Bad or Very Bad health was much higher in NI at 5.6% (102,100) – Much lower in RoI at 1.6% (69,700)

47.7

31.8

14.9

4.4 1.2

61.7

28.6

8.2

1.3 0.3 0

10

20

30

40

50

60

70

Very Good Good Fair Bad Very bad

NI RoI

General Health - International

• Major difference between Health scores in RoI and UK – Northern Ireland is similar to the rest of UK – More in line with Wales – Industrial past? Scotland

• What are the reasons for this? – RoI more optimistic than others – ‘We’re grand’ – Possible higher link between self perceived health and Benefits claim in UK – Age factor? Median age in RoI 34, NI was 37, EU average 41 – More developed gathering of health data in UK than RoI (it’s a new question)

90.3

79.5 81.4 77.8

82.2

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

RoI NI England Wales Scotland

Very Good & Good

General Health - International

General Health - International

• Major difference between Health scores in RoI and UK – Northern Ireland is similar to the rest of UK – More in line with Wales – Industrial past? Scotland

• What are the reasons for this? – RoI more optimistic than others – ‘We’re grand’ – Possible higher link between self perceived health and Benefits claim in UK – Age factor? Median age in RoI 34, NI was 37, EU average 41 – More developed gathering of health data in UK than RoI (it’s a new question)

• EU SILK General Health 18-64: Very Good & Good (18-64)

86.6 81.9

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

General Health • Difference between the perceived score by Gender

– In both jurisdictions • Males were more likely than females to perceive their health as Very

Good • Males were less likely to perceive their health as Bad or Very Bad

General Health • Perceived General health deteriorates

with Age – NI has higher rates in all age

groupings – The gap widens from Age 30

onwards • From 35-55 the rate in NI is 4

times higher than RoI – At Age 80, over 16% of the

population have Bad or Very Bad Health in NI

0.00 5.00 10.00 15.00 20.00

0 to 4

5 to 9

10 to 14

15 to 19

20 to 24

25 to 29

30 to 34

35 to 39

40 to 44

45 to 49

50 to 54

55 to 59

60 to 64

65 to 69

70 to 74

75 to 79

80 to 84

85 plus

RoI

NI

% with Bad or Bad Health

General Health • Perceived General health and Social Class

– Not comparable on an all-island scale – In general, people in higher social classes enjoyed better health – In RoI 95% of people in Social Class 1 (Professional workers) enjoyed Good or

Very Good Health – This dropped to 83% for Social Class 6 (Unskilled)

0

10

20

30

40

50

60

70

80

90

100

SC 1 SC 2 SC 3 SC 4 SC 5 SC 6 SC 7

Very Bad

Bad

Fair

Good

Very good

General Health • Perceived General health by Location

– In general, people in the cities of Ireland had the highest level of perceived Bad or Very Bad health

– Highest levels in NI are in Belfast (8.2%), Strabane (7.2%) and Derry City (6.9%)

– Lowest levels are in North Down (4.2%) and Ballymena (4.2%)

0 2 4 6 8 10

Belfast Strabane

Derry Craigavon

Cookstown Omagh

Limavady Carrickfergus

Ards Newry and Mourne

Newtownabbey Ballymoney Castlereagh

Lisburn Moyle

Banbridge Down

Dungannon Larne

Armagh Coleraine

Magherafelt Antrim

Fermanagh Ballymena

North Down

% Bad or Very Bad Health

General Health • Perceived General health by Location

– In general, people in the cities of Ireland had the lowest level of perceived Bad or Very Bad health

– Although rates are lower in RoI the highest rates of Bad health are still in cities

– Highest levels in RoI are in Limerick City (2.7%), Cork City (2.2%) and Dublin City (2.1%)

– Lowest levels are in Cork County(1.1%), Fingal (1.1%), Meath (1.1%) and DLR (1.2%)

• Demographics and social class

– Suburbs of main cities in RoI had the best overall health with 92% having Good or Very Good health

– Rural areas in RoI were the next healthiest with 90% of population with Good or Very Good health

General Health – Very Good

General Health – Good

General Health – Fair

General Health – Bad

General Health – Very Bad

Kavanagh-Foley Index of Well-Being (KFIW)

• Kavanagh-Foley Index of Wellbeing (KFIW) • Simple Calculation from Census 2011 • =(% VGH*1)+(%GH*2)+(%FH*3)+(%BH*4)+(%VBH*5) • Operational across scales

– County, Health Area, ED, SA • Requires further age-standardisation • Provides a useful ‘average’ measure of well-being/health

Kavanagh-Foley Index of Wellbeing (KFIW)

Unpaid Carers • Comparable census question in 2011

– Some slight differences on census form definition • 401,092 people provided unpaid care across the island. This equates to

6.8% of total population • Major difference between NI and RoI

– NI (11.8%) provides three times the proportion found in RoI (4.2%) – Reasons for this? 1. Older age profile in NI 2. Higher prevalence of self

perceived bad health and 3. Difference in question on census form

Unpaid Carers - Increasing level of Caring • Change in unpaid carers between 2001-2011

– Much higher rate of increase in RoI (23%) compared with NI (16%) – The highest growth rates were in the 65+ age group

• The total population in this age group increased by 21% since 2001 • Increase in unpaid care increased by approximately 50%

Unpaid Carers - Increasing level of Caring • Change in unpaid carers between 2001-2011

– Much higher rate of increase in RoI (23%) compared with NI (16%) – The highest growth rates were in the 65+ age group

• The total population in this age group increased by 21% since 2001 • Increase in unpaid care increased by approximately 50% • Major demographic changes coming down the road.....

Unpaid Carers – Age of Carers • Levels of unpaid carer increased with

age in both jurisdictions – Highest rates were in the 50-54 Age

category – 23% of population were undertaking

Unpaid Care in NI, less than 10% in RoI

• Also very clear gender in-balance with females far more likely to provide unpaid care in both jurisdictions

• Approximately half of carers in both NI and RoI were aged 40-59

– 52% in RoI – 47% in NI

Unpaid Carers – Hours of Caring • Hours of Unpaid Care

– 327 million hours of unpaid care in RoI in 2011

– €?

• Low level: 0-19 hours – 57% of carers in NI – 54% of carers in RoI

• Substantial: 20-49 hours – 17% of carers in NI – 23% of carers in RoI

• High intensity: 50+ hours – 26% of carers in NI – 23% of carers in RoI

Unpaid Carers – Geographical Spread • Proportionally, much more carers in rural

areas • Highest percentage of carers are in NI

– 6 Districts with >12.5% of population providing unpaid care

• Ards (13.6), Castereagh (13.5), North Down (13.1), Carrickfergus (12.7), Newtownabbey (12.6) and Larne (12.5)

• Belfast (12.1) and Derry (11.3) with lower rates

• In RoI rates are much lower – Much higher in rural areas

• Mayo (5.1), Sligo (5), Kerry (4.9), Roscommon (4.8) and Limerick City (4.8)

– Per-urban/Urban areas with much lower rates

• Kildare and Fingal ( 3.4), Meath (3.5), South Dublin (3.7)

• Dublin City (4)

Provision of Unpaid Care: 0-19

Provision of Unpaid Care: 20-49

Provision of Unpaid Care: 50+

Disability • Not possible to compare Disability on an All-Island basis

– Different questions and different listing of disability types – Statistics team at CSO not comfortable with merging data on All-Island basis

• Total disabilities in RoI = 595,335 or 13% of the population • Total disabilities in NI = 374,646 or 21% of the population

Disability • Highest disability rates were in all urban cities

– Limerick City was highest (18%) – Cork, Waterford and Dublin City all with rates >

15% – Only Galway City was well below national average

at 11.9% • Very much an age link to high disability rates

– Fingal , Meath and Kildare all have the lowest rates – Low rates for those in 20’s – high increase from this

point – Interesting trend in young male disability –

considerably higher than female

Disability by Type

• Total of 595,335 people (13% of population) with one or more disability – This accounted for a total of 1.6 million disabilities or difficulties – Most common disabilities were ‘Other disability including chronic illness’ and

‘Limits one or more basic physical activity’

3.1

5.6

14.9

3.5

8.3

5.8

16.7

7.6

10.1

11.8 12.6

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

Blindness or a serious vision impairment

Deafness or a serious hearing

impairment

Limits one or more basic

physical activities

An intellectual disability

Difficulty in learning,

remembering or

concentrating

Psychological or emotional

condition

Other disability, including

chronic illness

Difficulty in dressing, bathing or

getting around inside the

home

Difficulty in going outside home alone

Difficulty in working or attending

school/college

Difficulty in participating

in other activities

Disability by Type

• Total of 595,335 people (13% of population) with one or more disability – This accounted for a total of 1.6 million disabilities or difficulties – Most common disabilities were ‘Other disability including chronic illness’ and

‘Limits one or more basic physical activity’ – Mixed level of disability types in all LAs but no major trends

Disability (RoI) – Total

Disability by Age - 0 to 14 (RoI)

Disability by Age - 15 to 24 (RoI)

Disability by Age - 25 to 44 (RoI)

Disability by Age - 45 to 64 (RoI)

Disability by Age - 65 and Over (RoI)

On-Line Mapping Toolkit

• New All-Island Atlas now on-line and integrated in AIRO website

• AIRO Data Store

On-Line Mapping Tool

• All mapping layers now available for analysis on on-line toolkit

• Raw numbers, percentages

• Data available at Small Area (SA) on an all-island basis

Hard back Atlas • Demography (Prof Jim Walsh) • Religion (Dr Andrew McClelland & Justin

Gleeson) • Ethnicity and Place of Birth • Economy • Industry • Occupation • Health (Dr Ronan Foley, NUIM) • All-Island Deprivation • Transport

Data Days - QGIS

Thanks

Questions?

w: www.airo.ie e: justin.gleeson@nuim.ie

twitter: airo_nuim