Widening Health Inequalities in the Republic of Ireland during ' Celtic Tiger' economic success 2000-2006

Aim: To investigate inequalities in mortality in the population of the Republic of Ireland, for the period 2000-2006 at national and local authority area levels, in order to improve the understanding of socio-economic inequalities in mortality, inform national and local authority policy, and facilitate informed change in health inequalities in Ireland. Methods: Population data was obtained from the Central Statistics Office (CSO), for the census years 2002 and 2006. Population mortality data was obtained for the period 2000-2006. This was subcategorized by county, socio-economic group, and by age for those 15-64 years and 65 years and over. Social Determinants of Health were examined. Mortality differentials were examined using age-standardised mortality ratios. Bayesian analysis was carried out on spatially distributed data. Multivariate analysis was carried out to investigate effects of social determinants of health. Results: Socio-economic inequalities in mortality in Ireland have increased substantially in the period 2000-2006. Persons in the lower social class are over four times more likely to die prematurely of all cause mortality, five times more likely to die prematurely of cardiovascular disease. For the first time in health inequality research in Ireland, Farmers are classified as lower social class. Poverty and small farm size had a strong independent effect on mortality among Farmers (R2 = 0.56). Spatial analysis confirms the co-existence of poverty and increased mortality. In addition, significant mortality inequalities among the elderly have been identified. Despite economic prosperity during the period 2000-2006, socio-economic inequalities in mortality have significantly increased in Ireland.