Last week's publication of the findings by Dr Cecily Kelleher and her colleagues in the Centre for Health Promotion Studies at the National University of Ireland in Galway was significant insofar as it established a new benchmark evaluation of the state of health of people in this State. Figures were set down for 1998 which can be compared with similarly assembled figures in future years to assess whether various health-promotion strategies are working or failing. Some of the data were reasonably reassuring and a few were relatively alarming. Most will be of value in setting and targeting new health-promotion strategies for the future.
The figures were drawn from two large and representative surveys of the population: the Survey of Lifestyle, Attitudes and Nutrition (SLAN) which dealt with adult behaviours and attitudes, and the survey of Irish Health Behaviour in School-aged Children (HBSC). The surveys were designed to elucidate what might be happening under the main headings set out in the Health Promotion Strategies published in 1994 and 1995. These were concerned with smoking, alcohol consumption, nutrition and diet, exercise, blood pressure and cholesterol, and accidents. The surveys, therefore, while representative, are not comprehensive.
Perhaps the most alarming revelation relates to smoking among children. Half of the children surveyed have smoked at least one cigarette and 33 percent of 15 to 17 year-olds are regular smokers. Given that nicotine is highly addictive, this does not presage well for the future unless much more focused and effective means are found to discourage young people from taking that fateful first cigarette. Professor Kelleher's suggestion is surely worthy of urgent consideration: remove tobacco products from the Consumer Price Index and raise the cost to levels that will be financially punitive.
On food and nutrition, the situation seems to be a bit better than it used to be insofar as almost two thirds of those surveyed report taking the recommended quantities of fruit and vegetables per day. But 32 per cent of respondents were deemed to be overweight, while 23 per cent of children said that they needed to lose weight and eight per cent reported being on a weight-reducing diet. From the figures on alcohol consumption it would appear that Irish drinking habits are changing: most adults now take alcohol and while most stay safely within the weekly recommended limits, 27 per cent of males and 21 per cent of females consume more than the recommended limit. Alarmingly, nearly one quarter of adults admit to driving after consuming two or more alcoholic drinks.
In surveys of this size (a total of 6,500 adults and 8,500 children) data are necessarily presented in broad brush-strokes, so that more refined mechanisms are required to identify the kind of detail that will ensure a greater success for national intervention strategies. It is always evident, for instance, in surveys like these, that those in the lower socio-economic groups have greater health risks and poorer health status than those in the higher groups. Obviously, such considerations as these will have implications for targeting educational and other activities.
What is now required, using the data from the surveys, is further research into how the targeting of those most at risk can be most effectively achieved and appropriate health education most effectively delivered.