Second Opinion: Emigration is a major public health issue

Nearly 250,000 healthy citizens have left since 2008, but no one seems to care

The goodbyes are over. Emigrants came home for the holidays and went back to wherever in the world they now live and work. RTÉ did the usual airport welcomes and farewells and the topic of emigration is closed for another year. Although nearly a quarter of a million healthy, hardworking citizens have emigrated from Ireland since 2008, no one seems to care too much or feels angry enough to organise political action. Water charges (a necessary expense) brought demonstrators to the streets in large numbers but not emigration (an important public health issue).

A recent report from the Irish Longitudinal Study on Ageing (Tilda) concluded “there are public health implications from the large-scale exodus from Ireland in recent years.”

Other European countries that have been badly affected by the current recession and austerity measures, such as Greece and Portugal, have tiny rates of emigration compared to Ireland. There has been no enquiry into why Irish people continue to emigrate in large numbers.

The prevailing attitude is that emigration is part of our culture. No Government minister has responsibility for emigration. The appointment of a Minister of State for the Diaspora means the Government has accepted emigration as the default position of the jobless Irish, even a good thing and a lifestyle choice. The word ‘diaspora’ softens the awful reality and ignores the considerable health consequences.

Health is determined by educational attainment levels; social connectedness; equal and fair societies; and the physical and cultural environment. Emigration can cause both physical and mental health problems. Although emigrants are, on average, very healthy, the stress of moving to another country for a long period, maybe forever, can gradually erode any health advantage.

This is true for all nationalities as shown by recent studies of Albanian emigrants and Asian/Pacific Islanders. Older Irish people living in England have among the highest levels of long-term illness and self-reported poor health, including cancer, depression, anxiety and harmful drinking. More money never makes up for the loneliness and homesickness that can be experienced by emigrants.

Those left behind

Emigration can also affect the health of families and friends left behind. The Tilda study found that the mental health of mothers suffered as a consequence of the emigration of one or more of their children during this recession. Mothers experienced more depression and loneliness, than mothers whose children did not emigrate. Emigration of their children had a greater impact on the health of mothers than other life events such as retirement, the onset of cardiovascular disease, and loss of close relatives or friends (although not spouses). Apart from men over 65, the Tilda study found that fathers did not suffer an equivalent decline in mental health following the emigration of their children.

One possible explanation for this could be that the males involved in this study were born before the late 1950s and would have been the main, if not the only, family breadwinners.

As such, they might see a job and being “a good provider” as more important than social connectedness. By the time fathers reach retirement age they may realise that family relationships are as important as having a job.

The vast majority of women involved in the Tilda study would have been homemakers and more dependent on having their children around to give them a purpose in life. Jobs and social supports are equally important and having to sacrifice one for the other is unfair and bad for health.

Large-scale emigration has been a feature of Irish life for centuries. In 1841, Ireland, with 8.2 million people, was one of the most densely populated countries in Europe. By 1911, the population had shrunk to 3.1 million. A British government report of 1836, noted that “the Irish poor were perceived as being of a different and degenerate race”. With these official attitudes it is no wonder so many emigrated in the 19th and early 20th centuries.

Unfortunately, the new Republic did not view emigration as its most serious social problem. By 1961, the population was only 2.8 million. Roscommon had more than a quarter of a million inhabitants in 1841 and the 2011 census shows the county population is now only 65,896.

All governments since the foundation of the state have shown little or no interest in creating a society where resources are shared equally and everyone can live and work in the country of their birth if they so choose. What a waste.

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