Health and Spatial JusticepR. Foley & A. Kavanagh (Geography, NUI Maynooth)Royal Irish Academy: Spatial Justice, Housing a...
Layouty1 M i H l h & W llb i1. Measuring Health & Wellbeing2. Spatial Data & Justice in Ireland3. Composition or Context4 ...
1 Measuring Health & Wellbeing1. Measuring Health & Wellbeing• Quantitative Approaches• Qualitative Approaches• Definition...
2 Spatial Data & Justice in Ireland2. Spatial Data & Justice in Ireland• Critical Aspects of Data Gaps and Absences• Limit...
Questions on Census Form.Q
3 Composition or Context3. Composition or Context• Debates within Medical/Health Geography• Explaining health injustices• ...
4 Health and Justice at National Scale4. Health and Justice at National Scale
National General Health DataGeneral Health  2001/2 2011% %Rep. of Ireland*Rep. of IrelandGood/Very Good No question 88.3Fa...
National Health/Age BreakdownNational Health/Age BreakdownSource: CSO
Health and Social Class80 00%Source: CSO60.00%70.00%80.00%1 Professional2 M i l30.00%40.00%50.00%2 Managerial3 Non-manual4...
5 Developing the KFIW5. Developing the KFIW• Kavanagh‐Foley Index of Wellbeing (KFIW) • Simple Calculation from Census 201...
6. Results at Variable Spatial Scales6. Results at Variable Spatial ScalesNational/RegionalNational/RegionalCounty/Local A...
KFIW Scores: Local Authority ScaleKFIW Scores: Local Authority ScaleLA Scale VG G F B VB KFIW Score LA Scale VG G F B VB K...
ED LevelED Level
SA Level
7 Validation and Comparisons7. Validation and Comparisons• Spatial Justice Geographies• Established relationships between ...
KFIW and Deprivation (ED)KFIW and Deprivation (ED)KFIW v HPI Scores186184182180178176174172170168166164162160158156KFIW201...
KFIW and Unemployment (ED)KFIW and Unemployment (ED)
KFIW and Social ClassKFIW and Social ClassKavanagh-Foley Index of Wellbeing171.19165.83180.00146.86127.41134.23141.69150.9...
KFIW and DisabilityKFIW and DisabilityTotal persons 146.86An intellectual disability 229.58Difficulty in learning, remembe...
KFIW and Informal CareKFIW and Informal CareCarer (HPW) PVG PG PF PB PVB KFIWUp to 14 54.00% 34.86% 9.28% 1.05% 0.18% 156....
8 Potential Uses for Spatial Justice8. Potential Uses for Spatial Justice• Potential Use for modelling changes• Build loca...
SummarySummary• Valuable new data set that can inform studies of spatial justice• Operates at meaningful geographical scal...
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Spatial Justice and the Irish Crisis: Health - Ronan Foley and Adrian Kavanagh

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Royal Irish Academy Conference: Spatial Justice and the Irish Crisis
23 April, 2013, Academy House

The on-going crisis and associated responses to it (political, governance, popular etc.) provides an entry point for a wide-ranging exploration of spatial justice as a theoretical construct and a departure point for empirical analysis. Discourses of justice, equality and fairness remain central to a range of interconnected debates as Ireland seeks to recover from the interrelated collapses of the banking system and property markets and the knock on effects through the rest of society and the economy. Scale is an important dimension in framing and constructing popular discourses concerning issues of justice, e.g. the role of EU institutions in shaping Ireland’s treatment of banking debt or the impact of national budgetary measures on particular places. The focus of this conference is on understanding these spatially connected processes, how they are functioning at different scales, their impact on particular or specific places and spaces, as they give rise to new or evolving social and economic geographies.

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Spatial Justice and the Irish Crisis: Health - Ronan Foley and Adrian Kavanagh

  1. 1. Health and Spatial JusticepR. Foley & A. Kavanagh (Geography, NUI Maynooth)Royal Irish Academy: Spatial Justice, Housing and the Financial CrisisTuesday 23rd April 2013Tuesday, 23 April 2013
  2. 2. Layouty1 M i H l h & W llb i1. Measuring Health & Wellbeing2. Spatial Data & Justice in Ireland3. Composition or Context4 Health and Justice at National Scale4. Health and Justice at National Scale5. Developing the KFIW Index6 R l V i bl S i l S l6. Results at Variable Spatial Scales7. Validation and Comparisons8. Potential Uses for Spatial Justice
  3. 3. 1 Measuring Health & Wellbeing1. Measuring Health & Wellbeing• Quantitative Approaches• Qualitative Approaches• Definitional Issues• Spatial Scales of Analysis• Spatial Scales of Analysis• Census Questions on Limiting Long‐Term Illness (LLTI) and General Health Stat s (GHS)and General Health Status (GHS)• Additional questions around disability
  4. 4. 2 Spatial Data & Justice in Ireland2. Spatial Data & Justice in Ireland• Critical Aspects of Data Gaps and Absences• Limited detailed geographyLimited detailed geography• Census data on measure of spatial injustice and deprivationdeprivation• Additional routinely collected admin data• New Question on General Health in 2011
  5. 5. Questions on Census Form.Q
  6. 6. 3 Composition or Context3. Composition or Context• Debates within Medical/Health Geography• Explaining health injustices• Individual v Aggregate forms• Administrative v Operational Units• Administrative v Operational Units• New SA geographies• Functional and Statistical Value
  7. 7. 4 Health and Justice at National Scale4. Health and Justice at National Scale
  8. 8. National General Health DataGeneral Health  2001/2 2011% %Rep. of Ireland*Rep. of IrelandGood/Very Good No question 88.3Fair No question 8.0Bad/Very Bad No question 1.5N th I l dNorthern IrelandGood/Very Good 70 79.5Fair 19.3 14.9Bad/Very Bad 10.7 5.6ScotlandGood 67.9 n/aFair 21.9 n/aNot Good 10 2 n/aNot Good 10.2 n/aEngland & WalesGood/Very Good 68.6 81.2Fair 22.2 13.1/Bad/Very Bad 9.2 5.6UK 3 point scale (Good‐Fair‐Not  5 point scale (VG‐Good) G‐F‐B‐VB)
  9. 9. National Health/Age BreakdownNational Health/Age BreakdownSource: CSO
  10. 10. Health and Social Class80 00%Source: CSO60.00%70.00%80.00%1 Professional2 M i l30.00%40.00%50.00%2 Managerial3 Non-manual4 Skilled manual5 Semi-skilled6 Unskilled0 00%10.00%20.00%6 Unskilled7 Other-unknown0.00%VG G F B VB NS
  11. 11. 5 Developing the KFIW5. Developing the KFIW• Kavanagh‐Foley Index of Wellbeing (KFIW) • Simple Calculation from Census 2011Simple Calculation from Census 2011• =(% VGH*1)+(%GH*2)+(%FH*3)+(%BH*4)+(%VBH*5)• Operational across scales• Means and RangesMeans and Ranges• Age‐Standardisation
  12. 12. 6. Results at Variable Spatial Scales6. Results at Variable Spatial ScalesNational/RegionalNational/RegionalCounty/Local AuthoritiesLEA – Local Electoral Areal l i i iED – Electoral DivisionsSA – Small AreasSA  Small AreasSettlementsFunctional Areas, e.g. Local Health Offices (LHO)
  13. 13. KFIW Scores: Local Authority ScaleKFIW Scores: Local Authority ScaleLA Scale VG G F B VB KFIW Score LA Scale VG G F B VB KFIW ScoreDún Laoghaire-Rathdown 66.71 25.50 6.53 1.02 0.23 142.55 Clare 60.05 30.14 8.28 1.25 0.26 151.53Fingal 65.63 27.21 6.01 0.95 0.20 142.89 Westmeath 60.46 29.42 8.47 1.34 0.32 151.63Meath 65.09 27.23 6.54 0.94 0.21 143.93 Kerry 59.48 30.28 8.79 1.17 0.27 152.46yCork County 64.97 27.01 6.88 0.93 0.20 144.38 North Tipperary 59.88 29.46 9.07 1.34 0.25 152.63Kildare 64.91 27.09 6.67 1.10 0.22 144.62 Offaly 59.86 29.63 8.82 1.38 0.31 152.66Wicklow 64.16 27.07 7.46 1.09 0.22 146.16 Carlow 59.63 29.73 9.01 1.38 0.25 152.88South Dublin 63.30 27.94 7.29 1.20 0.27 147.20 Sligo 58.99 29.71 9.59 1.44 0.26 154.28Waterford County 63.08 27.80 7.86 1.06 0.20 147.51 Leitrim 58.34 30.42 9.80 1.20 0.24 154.59Kilkenny 62.88 27.81 7.90 1.15 0.26 148.09 South Tipperary 58.65 30.11 9.46 1.49 0.31 154.70Cavan 62.85 27.43 8.40 1.11 0.20 148.39 Dublin City 59.11 29.51 9.26 1.71 0.40 154.77Limerick County 61.97 28.89 7.81 1.10 0.22 148.72 Waterford City 58.52 30.32 9.17 1.66 0.33 154.97Laois 61.58 28.82 8.07 1.21 0.32 149.86 Donegal 58.76 29.40 10.05 1.48 0.30 155.15State 61.66 28.58 8.20 1.28 0.28 149.92 Roscommon 58.52 29.66 10.01 1.48 0.33 155.44Galway City 60.64 30.12 7.72 1.25 0.27 150.38 Longford 57.95 30.28 9.96 1.46 0.34 155.95Galway County 61.05 29.00 8.46 1.22 0.26 150.66 Mayo 56.59 31.24 10.29 1.52 0.36 157.82Wexford 61.21 28.54 8.59 1.37 0.28 150.98 Cork City 56.71 30.45 10.61 1.84 0.39 158.73Monaghan 61.02 28.47 9.17 1.11 0.22 151.04 Limerick City 53.36 32.40 11.57 2.20 0.48 164.03Louth 61.23 28.32 8.74 1.41 0.30 151.23
  14. 14. ED LevelED Level
  15. 15. SA Level
  16. 16. 7 Validation and Comparisons7. Validation and Comparisons• Spatial Justice Geographies• Established relationships between health andEstablished relationships between health and a range of social indicatorsA f f i l j i i• A form of spatial justice mapping• Tested at a number of scales
  17. 17. KFIW and Deprivation (ED)KFIW and Deprivation (ED)KFIW v HPI Scores186184182180178176174172170168166164162160158156KFIW2011156154152150148146144142140138136134132130128126124122HPI 20111817161514131211109876543210-1-2-3-4-5-6-7-8-9-10-11-12-13-14-15-16-17-18-19-20-21-22-23-24-25-26-27-28-29-30-31-32-33-34-35120118116114112110
  18. 18. KFIW and Unemployment (ED)KFIW and Unemployment (ED)
  19. 19. KFIW and Social ClassKFIW and Social ClassKavanagh-Foley Index of Wellbeing171.19165.83180.00146.86127.41134.23141.69150.93155.03165.83120.00140.00160.00All social classesSC160 0080.00100.00KFIScoreSC2SC3SC4SC520.0040.0060.00 SC6SC70.00Social Class
  20. 20. KFIW and DisabilityKFIW and DisabilityTotal persons 146.86An intellectual disability 229.58Difficulty in learning, remembering or concentrating 236.35Deafness or a serious hearing impairment 236.94Total persons with a disability 241.75Blindness or a serious vision impairment 251.88pPsychological or emotional condition 255.37Total disabilities 272.10Diffi lt i ki tt di h l/ ll 276 34Difficulty in working or attending school/college 276.34Other disability, including chronic illness 276.84Difficulty in participating in other activities 281.60A condition that substantially limits one or more basic physical activities 286.98Difficulty in going outside home alone 287.68Difficulty in dressing, bathing or getting around inside the home 295.22
  21. 21. KFIW and Informal CareKFIW and Informal CareCarer (HPW) PVG PG PF PB PVB KFIWUp to 14 54.00% 34.86% 9.28% 1.05% 0.18% 156.66Up to 14 54.00% 34.86% 9.28% 1.05% 0.18% 156.6615 to 28 46.55% 38.26% 12.49% 1.62% 0.35% 168.7629 to 42 45.87% 38.67% 12.72% 1.68% 0.32% 169.6943 to 84 41.14% 40.51% 15.40% 1.91% 0.35% 177.7584‐167 41.55% 40.42% 15.04% 2.08% 0.31% 177.42168 36.03% 41.36% 18.42% 2.76% 0.65% 188.30NS 42.99% 36.11% 15.61% 3.05% 0.75% 178.01TOTAL 47.73% 37.10% 12.35% 1.69% 0.78% 169.65TOTAL 47.73% 37.10% 12.35% 1.69% 0.78% 169.65
  22. 22. 8 Potential Uses for Spatial Justice8. Potential Uses for Spatial Justice• Potential Use for modelling changes• Build local/community geographiesBuild local/community geographies• Secondary Care Utilisation Patterns (HIPE)• Primary Care Utilisation (GMS)• Comparisons with Mortality data as itComparisons with Mortality data as it emerges.• Potential for other forms of spatial analysis: MLM, Microsimulation
  23. 23. SummarySummary• Valuable new data set that can inform studies of spatial justice• Operates at meaningful geographical scales• Potential explanatory relationships identified withPotential explanatory relationships identified with range of indicators• Potential to inform health and social care planning• Potential to inform health and social care planning• Link to improved administrative data capacity and wider statistical analysiswider statistical analysis• Important to ground truth v qualitative work too.

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