Gretta Mohan

Gambling is increasingly recognised as a public health issue with several developed governments and supranational bodies such as the EU developing legislat

Nitrogen dioxide (NO2), a significant air pollutant from transport-related fossil fuel combustion, presents a critical environmental health challenge. This study analyses NO2 trends in Ireland from 2010 to 2020, leveraging the country’s low-pollution baseline as a unique case study to analyse inequalities in NO2 concentrations across the country. Data at a small area level from Census 2022 were integrated with measurements of NO2 concentrations to assess environmental inequalities across novel indicators such as housing tenancy and self-rated health alongside conventional socioeconomic measures. The research uncovers clear evidence of environmental inequalities in NO2 concentrations, with higher levels found in neighbourhoods with larger proportions of non-white populations and non-owner-occupied housing. A stratified urban-rural analysis shows these disparities were most pronounced in urban areas. A U-shaped relationship between NO2 levels and deprivation, educational attainment, and skills, suggests that while the most and least deprived may experience similar NO2 concentrations, the health burden on disadvantaged groups may be amplified by co-occurring vulnerabilities. These findings underscore an urgent need for targeted interventions to mitigate the disproportionate burden of NO2 air pollution on vulnerable communities in Ireland.

Background: In 2018, Scotland pioneered national legislation which set a Minimum Unit Price (MUP) of 50 pence (∼US$0.64, €0.59) per unit of UK alcohol sold (8 g/10 ml). To inform policy development, we examine the policy effect using the Alcohol Use Disorders Identification Test (AUDIT-C), employing longitudinal data for over 17 200 individuals. Methods: The effect of MUP on AUDIT-C scores is inferred by employing difference-in-difference regression. Pre- and post-intervention alcohol behaviours of individuals from Scotland are compared to a matched ‘control’ from England. Drinking at hazardous and harmful levels could be identified, as well as the frequency of alcohol consumption, number of drinks and heavy episodic drinking. Estimates adjust for demographic, socioeconomic and health characteristics. Potential inequalities by gender, age and household income are examined. Results: MUP led to an estimated 5.3% reduction in the number of drinks consumed on drinking occasions, though a statistically significant effect on overall reported AUDIT-C scores or drinking at hazardous levels was not detected, with few differential effects for subgroups. Conclusions: Differences in the findings of this research compared to other studies may be explained by differences in population coverage collected in the survey data, compared to more comprehensive, population-wide administrative data, as well as sample attrition.

The link between exposure to air pollution and adverse effects on human health is well documented. Yet, in a European context, research on the spatial distribution of air pollution and the characteristics of areas is relatively scarce, and there is a need for research using different spatial scales, a wider variety of socioeconomic indicators (such as ethnicity) and new methodologies to assess these relationships. This study uses comprehensive data on a wide range of demographic and socioeconomic indicators, matched to data on PM_2.5 concentrations for small areas in Ireland, to assess the relationship between social vulnerability and PM_2.5 air pollution. Examining a wide range of socioeconomic indicators revealed some differentials in PM_2.5 concentration levels by measure and by rural and urban classification. However, statistical modelling using concentration curves and concentration indices did not present substantial evidence of inequalities in PM_2.5 concentrations across small areas. In common with other western European countries, an overall decline in the levels of PM_2.5 between 2011 and 2016 was observed in Ireland, though the data indicates that almost all small areas in Ireland were found to have exceeded the World Health Organization (WHO)’s PM_2.5 annual guideline (of 5 µg/m³), calling for greater policy efforts to reduce air pollution in Ireland. The recent Clean Air Strategy contains a commitment to achieve the WHO guideline limits for PM_2.5 by 2040, with interim targets at various points over the next two decades. Achieving these targets will require policy measures to decarbonise home heating, promote active travel and the transition to electric vehicles, and further regulations on burning fossil fuels and enforcing environmental regulations more tightly. From a research and information-gathering perspective, installing more monitoring stations at key points could improve the quality and spatial dimension of the data collected and facilitate the assessment of the implementation of the measures in the Clean Air Strategy.

Objectives: To investigate how information communication technology (ICT) factors relate to the use of telemedicine by older people in Ireland during the pandemic in 2020. Furthermore, the paper tested whether the supply of primary care, measured by General Practitioner’s (GP) accessibility, influenced people’s telemedicine options. Method: Based on 2 waves from The Irish Longitudinal Study on Ageing, a nationally representative sample, multivariate logistic models were applied to examine the association between pre-pandemic use of ICTs and telemedicine usage (GP, pharmacist, hospital doctor), controlling for a series of demographic, health, and socioeconomic characteristics. Results: Previously reported having Internet access was a statistically positive predictor for telemedicine usage. The availability of high-speed broadband Internet did not exhibit a statistical association. The association was more prominent among those under 70 years old and non-Dublin urban areas. People with more chronic conditions, poorer mental health, and private health insurance had higher odds of using telemedicine during the period of study. No clear pattern between telemedicine use and differential geographic access to GP was found. Discussion: The important role of ICT access and frequent engagement with the Internet in encouraging telemedicine usage among older adults was evidenced. Conclusion: Internet access was a strong predictor for telemedicine usage. We found no evidence of a substitution or complementary relationship between telemedicine and in-person primary care access.