Speeches

Minister Frances Fitzgerald Public Health Conference – 13 June 2011

Good Morning and welcome to this Public Health Policy Framework Consultation Day.

I am delighted to be here today in my capacity as Minister for Children and Youth Affairs, a newly-created Government Department and, a position to which I was very honoured to be appointed by an Taoiseach.

As Minister for Children and Youth Affairs I hope to represent the interests of children, young people and families at the Cabinet table. There are over 1.1 million children aged under-18 living in Ireland which account for one-quarter of the total population.

These younger generations are our future so ensuring their good health is in our vital national interest. But unfortunately too much recent research on children’s public health point to an appalling vista.

Put simply, if we allow current trends relating to preventable public health risks to continue, then we are condemning our future generations to a future of ill health

We’ve heard warnings of the costs of our national debt on future generations and we’ve heard talk of a looming pension crisis. But I really don’t think we have yet faced-up to the health time-bomb, which if left unchecked, will be coming down the tracks very fast.

While it is impossible to put a monetary value on one’s health, it is very easy to put a cost on ill-health. As a state we simply cannot afford the future costs of healthcare that will flow if we do not seek to address the challenges posed by childhood obesity, alcohol, and tobacco given the predicted disease burden associated with these preventable public health risks.

For these reasons the new Public Health Policy Framework being initiated here today is so important. We are being presented with an opportunity we cannot let slip.

As Minister for Children and Youth Affairs I want to be a Champion for Children’s Health. One of the reasons we now have a dedicated senior ministry for children and young people is to provide leadership and coordination across government departments to improve the well-being of children. With this is mind I will be mandating my department to engage with the new framework to seek to map out robust strategies and a concerted programme of firm actions to arrest the rise of preventable public health risks and to improve the public health outcomes of our nation’s children.

Today I want to touch on some of these public health risks:

Alcohol.

As Minister for Children and Youth Affairs I am gravely concerned with the consumption of alcohol by Irish children. It is evident that Irish children are drinking from a younger age and drinking more than ever before with over half of Irish 16 year olds having been drunk at some point; and one in five is a weekly drinker.

The age at which Irish children start drinking is also falling. An analysis of recent National Drug Prevalence Survey data indicates that the mean age of first alcohol use among Irish drinkers had declined from 16 for children born in the 80’s to 14 for those born in the 90’s. Remember most children born in the 90’s are still aged under-18.

Alcohol is a contributory factor in half of all suicides in Ireland and is a factor in deliberate self harm. Sadly alcohol misuse increases the risk of children requiring special care. It was identified as a risk factor in three-quarters of Irish teenagers for whom social workers applied for admission to special care.

Heavy drinking in adolescence is related to problem alcohol use in adulthood. People who begin drinking before the age of 15 are four times more likely to develop alcohol dependence at some time in their lives than those who have their first drink at age 20 or older

Furthermore alcohol is increasingly being recognised as the ‘gateway’ drug, particularly in cultures where it is typically consumed in a binge type pattern by both adults and adolescents, such as Ireland

I really wonder are we doing enough, even half enough, to meet the challenges posed by children’s alcohol consumption?

Fetal Alcohol Syndrome.

For some years now in Ireland, there has been recognition of the seriousness of the issue of Fetal Alcohol Syndrome. This syndrome can and does have a devastating effect on the lives of children born to mothers who drink heavily during pregnancy. The less severe cases often present with behaviour or emotional disorders, mental health problems, school drop-out, substance abuse and so forth.

Smoking.

On another risk: the most recent State of the Nation’s Children Report prepared by my department contained the research finding that 8.5% of children aged 9-17 reported smoking cigarettes every day.

It should be of grave concern to us all here today that recent evidence points to the unsettling fact that smoking prevalence declined up to 2005 but has remained static ever since. There has been a sharp increase in smoking prevalence in children between the ages of 15-18 since 2006. Recent EU data shows that Ireland is one of the few countries in the EU with a rising prevalence of smoking

These are issues which require nothing less than the most serious response from government. The public health policy framework provides a fresh opportunity to review where we are; and where we are going.

Childhood Obesity.

However the greatest public health threat may well be posed by childhood obesity.

Obesity is a complex condition. Overweight and obesity contribute to a number of illnesses, including hypertension, type 2 diabetes, excess cholesterol, and of course cardiovascular disease, including stroke. Health problems relating to obesity substantially add to health service costs in the longer term, with current costs estimated at €4billion per year.

Most worrying of all is the fact that childhood obesity has reached epidemic proportions in Europe. Obesity in children is of major concern in that it causes a wide range of serious health and social consequences and may impact on mental health. Moreover, childhood obesity is linked to underachievement in school and to lower self-esteem. Over 60% of children who are overweight before puberty will be overweight in early adulthood.

Over recent years numerous studies in Ireland have measured body weight in primary school children. The most recent results come from the WHO European Childhood Obesity Surveillance Initiative which Ireland participated in and which found that of 13% of 7 year old boys were overweight with a further 5% obese while 19% of girls were overweight with a further 7% obese.

In summary almost one-quarter of 7 year old children are either overweight or obese.

If that was not enough cause for concern, I understand that preliminary raw data from the fieldwork being conducted by the ESRI for the 3 year wave of the ‘Growing Up in Ireland Study’, which is funded by my Department, suggests an even more worrying trend with a much higher percentage of children being overweight or obese at age 3 years.

Energy Imbalance

Often, I think, one of the simplest ways of considering the problem of obesity is in terms of the balance of ‘energy-in’ (in the form of food intake) versus ‘energy out’ (in the form of exercise and physical activity).

The world we live continue is ever –changing yet recent decades have seen the emergence of a sedentary existence with increasing urbanisation, television, computers, DVDs and use of cars combined with increasing use of convenience or processed calorie-dense foods. This has a very serious negative impact on our energy-balance.

Research by the Irish Universities Nutrition Alliance has illustrated the energy imbalance among Irish children aged 5-12. On one side of the scale we see a high intake of fat and sugar and a low intake of vitamins and minerals; while on the other side of the scale we see low levels of physical activity with 7-10 year olds spending 3 hours in front of a TV and/or a computer screen every night. In energy balance terms, ‘energy-in’ is far outweighing ‘energy-out’.

This research found that unfortunately a large percentage of Irish children are consuming far too many foods and drinks from the Top Shelf of the Food Pyramid.

In relation to physical activity, the research highlights important age and gender differences with girls being less physically active than boys; and activity in both boys and girls decreasing with age. The decrease in girls is particularly noticeable, dropping from 58% in 10 to 11 year olds to 28% when they reach 15 to 17 years.

Addressing the problem

I am determined that the new public health policy framework must give much a higher priority than ever existed before to addressing the problems of childhood obesity through seeking to reduce the consumption of foods high in fat, sugar and salt; and to increase physical activity and regular exercise by children.

I am delighted that my colleague Minister Reilly has begun prioritising action on Obesity and to this end has established a Special Action Group on Obesity. My Department will be actively participating in this group. The Special Action Group will be prioritising certain actions in the immediate future which I welcome.

The Department of Health has been working and liaising with the Broadcasting Authority of Ireland with a view to restricting marketing of high fat, high salt and high sugar foods and drinks to children;

The food Pyramid and Healthy Eating Guidelines are to be revised; and;

The feasibility of calorie posting on fast food outlet menus, as introduced in the US, is be explored here.

These are most welcome initiatives, but I think we will still need to go further. For the same reason that we would like to restrict advertising I believe we will also need to look at regulating the proliferation of fast-food outlets As a result of new policy provisions introduced by the UK Government, local authorities there have begun banning new takeaways from opening within 400m of any school, youth club or park. This is the type of firm action I would like to see replicated in this jurisdiction.

I believe we also need to look seriously at how we plan and provide for healthy and active communities. We should never underestimate the massive impact of providing something as simple as a signalised crossing on a busy road close to a school or sports club or other community facility. Where safe routes exist, parents can have the confidence to allow their children to walk or cycle more regularly. The government has already shown it’s commitment to ongoing efforts in this area with the announcement in the recent Jobs Initiative that an additional €15m is being allocated to smarter travel projects including pedestrian crossings, footpaths and cycle paths.

I also see a need to further work with both national sporting organisation and local sports clubs and recreational programmes on the objective of increasing participation of young females in sports and exercise.

I look forward to addressing these matters through the work of my department, in discussions with my fellow Ministers and through the new public health policy framework being initiated here today.

Conclusion.

The public health challenges facing our population are serious but with an appropriate and determined cross-societal response they can be addressed.

Today we start responding. I wish you all the very best in your discussion today and your work going forward.