Death rates higher among poor

Death rates are more than three times higher among the lowest occupational class compared to the highest income earners, research…

Death rates are more than three times higher among the lowest occupational class compared to the highest income earners, research shows.

Research on health inequalities in Ireland by the Irish College of General Practitioners shows a stark contrast between the health of people at the top and bottom of the socio-economic ladder.

Other figures show that perinatal mortality rates are three times higher for skilled manual families compared to higher professionals.

Chronic illness is also much higher among unskilled or manual workers (25 per cent) compared to higher professionals (10 per cent).

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Speaking at a seminar organised by the Combat Poverty Agency, the report's author, Dr Philip Crowley, said that despite high rates of demand for GP services in deprived areas, there were substantially more GPs in wealthier areas.

Poorer areas were also associated with greater numbers of home visits, higher demand for out-of-hours services and more use of accident and emergency facilities.

Dr Crowley, who is now deputy chief medical officer at the Department of Health, said the development of general practice could play a crucial role in tacking health inequalities.

Research has found that investment in primary care can improve the health of the population and that deprivation-weighted payments could enhance services.

Addressing the health needs of people who fall just outside the income limit for medical card was also a major issue.

A survey of GPs as part of Dr Crowley's research suggested there were serious difficulties in providing quality care in deprived areas.

Lack of access to hospital and community services for patients was an issue among 59 per cent of GPs in deprived areas, along with lack of time to deliver care (44 per cent) and social or psychological problems among patients (54 per cent).

However, he said the positive aspects of working in poorer communities that had been reported by GPs deserved to be highlighted. They included having a good relationship with patients (84 per cent), a real need for the service (82 per cent) and the potential for having a greater impact (64 per cent).

Priorities for action among GPs were the provision of an additional deprivation payment, an increase in the medical card income threshold and multi-disciplinary teams.

Carl O'Brien

Carl O'Brien

Carl O'Brien is Education Editor of The Irish Times. He was previously chief reporter and social affairs correspondent