Oireachtas presentation 11/12/2014
Dr. Mary Tilki, Chair, Irish in Britain
Despite many Irish people being successful and leading fulfilling lives in Britain, there are still many
concerns about the poor health of the Irish community. Although there are problems with statistics
because of the way in which data about the Irish are aggregated into the overall White ethnicity
category, our recent analyses of the 2011 census shows is continuing evidence of very poor health
among Irish people in Britain. Irish people in England have among the highest levels of Limiting Long
Term Illness (LLTI) and self- reported poor health. Irish Travellers have the highest self-reported
poor/health and are second highest in relation to LLTI
The Irish have an older age profile than the general population with a median age of 53 compared to 42
for White British population and 32 for Asian and 40 for the Caribbean – the next oldest minority groups.
However age does not explain all the ill- health and premature mortality.
There is excess and sometimes increasing, mortality among Irish men and women from coronary heart
disease, hypertension and stroke (Harding et al 2008). The Irish have the highest mortality rates from
cancer in the population. Patterns of ill-health improve across generations but are still evident in the third
generation. This differs from other migrant groups who revert to the patterns of the host community
within a generation.
There is evidence that material hardship, occupation, lifestyle and age all play a part but they do not
explain the full picture. Because of the failure to collect or analyse data about the Irish there is limited
knowledge about uptake of screening, access to GPs, hospital services and treatment outcomes.
Irish people have highest mortality rates from most cancers and unlike patterns observed in wider
society, they are declining more slowly, staying the same and in some cases rising. There is evidence
that even where the incidence is similar or marginally elevated, death rates are still higher than in the
general population. Recent figures from the London Health Observatory show high admission rates for
most cancers than would be expected from the size of the population
Smoking rates are declining slowly in the Irish community and there are issues around obesity, poor
nutrition and alcohol which mainstream health programmes are not addressing. Research and our work
with clients demonstrates that fear and beliefs about cancer, delay people from accessing the screening
that is on offer, seeking early diagnosis and benefitting from early treatment. We are working with
community organisations to raise awareness of cancer, get people using the term Cancer, promoting
screening and early diagnosis as well as support groups for people affected by cancer.
However, we strongly suspect that because many Irish live in areas of multiple deprivation, they are not
getting the timely or effective treatment they deserve. We hear repeatedly of people fobbed off by
doctors, misdiagnosed and who don’t have the confidence or support to assert their concerns. We are
currently lobbying the NHS Clinical Commissioning Board, Public Health England and various cancer
charities to gather and more importantly analyse data on the Irish.
There is evidence of long term illness relating to depression and anxiety.. Second generation Irish who
grew up in material hardship and parental psychological distress show greater psychological problems
than children of non-Irish parents. Alcohol is a sensitive issue in the community with both high rates of
abstinence and dangerous patterns of consumption. Harmful alcohol use in early adulthood is a problem
for second generation Irish men and women. Although it reduces in their 40s,patterns of binge drinking
and smoking can be transmitted across generation.
1
The Count Me in Census from 2005 -2010 repeatedly demonstrated excessive admissions to mental
health establishments of Irish people over fifty. Many of these also had physical ill-health. There is also
evidence of considerable chronic ill-health among men from about 50 onwards, leading to early exit
from employment pushing them into a vicious cycle of isolation, depression and alcohol misuse for
some.
Suicide levels in have remained consistently high for Irish people for over three decades and have not
shown the decline seen in other populations. Our research with new migrants and statistics from
helplines like Console demonstrate considerable isolation and distress among new Irish migrants.
Mental ill-health and suicide are particular issues for Irish Travellers.
The 2011 census shows the Irish to have a very the old age profile and this predisposes them to
dementia. Irish organisations increasingly deal with people with memory loss, most of which is
undiagnosed or untreated. Alzheimer’s Society estimates suggest that there may be around 10,000
Irish people with dementia but that ignores the enhanced cardio-vascular risk. Social isolation related to
poverty and living in areas of multiple deprivation is a key issue for Irish people and it confounds their
ability to access health and social care in an equitable or timely manner. Travellers who have a short life
span anyway are significantly more likely to develop young age dementia.
Because Irish people are white and speak English, their need for culturally sensitive care is not widely
recognized. Although older people have spent decades in England, “the troubles” and discrimination led
many to remain insular in closed communities. There is increasing recognition that people from the
Caribbean, India and Pakistan have cultural needs but the Irish tend to be forgotten. This can make for a
very lonely and frightening experience in hospital, a care home or in end of life care.
Staff can’t or don’t bother to understand their accents, pronounce Irish names, have little knowledge of
their culture and often make stereotypical assumptions about them. Family carers who might request an
Irish careworker in their own home can be deemed racist.. Dementia is a frightening and isolating
experience for people and we know that when people cant speak their emotions become more
important. It is particularly important that people with memory problems are in as familiar environment as
possible and that activities like reminiscence or cognitive stimulation takes account of their culture.
We have seen peoples’ eyes light up when they hear an Irish accent or some Irish music. I have seen
the joy when a group of people can collectively recite Anois Teacht an Earraigh or sing Skibareen! We
also know that although family members take on the caring role willingly, they have very little support or
respite. An afternoon with other carers and some activities at a memory café for the relative with
dementia can be a life saver.
It is for this reason we embarked on the Cuimhne Irish Memory Loss Campaign. To date we have
trained around 100 volunteers in different parts of England in dementia awareness, how to communicate
confidently with Irish people especially. We are working with several community organisations to help
them become more dementia friendly and develop services for Irish people. We have recently been
granted 3 year funding to recruit a volunteer coordinator to recruit and train Cuimhne Champions- older
volunteers who will work with organisations to make them more dementia aware and provide culturally
sensitive services for Irish people. We are leading and advising Brent Local Authority towards being a
dementia friendly borough, working with three Irish organisations, other minority ethnic communities,
Alzheimer’s Society, AgeUK, an interfaith group and obviously with people who have dementia and their
carers. There is a lot more I could say but time precludes this but watch our website!.
A major part of the role of Irish in Britain is representing the needs of our community, challenging
exclusion and working with statutory bodies and major charities to address their needs. We have made
progress in many areas but recessions, reforms and reorganisations make it much harder. We are very
grateful for the Emigrant Support Programme.
2