Health inequalities: The #CancerGap
Cancer affects all parts of Irish society, but some people are more at risk than others. The Irish Cancer Society is aware that your risk of getting cancer and surviving it can depend on where you live, if you work, how much you earn and whether you’re male or female.
Inequality in society is the gap that opens up between the well off and the less well off in a society. The bigger the gap, the greater the inequality. A lot of evidence has been published which shows that the more unequal a society is, the more unhealthy it is. In Ireland, a person’s chances of getting cancer and dying from cancer are twice as high if he or she comes from and lives in a disadvantaged community.
An Irish person’s chance of surviving cancer depends on where they live, what they earn and whether they are male or female. We don’t think this is acceptable or fair. That’s why we are tackling health inequalities.
Did you know?
The gap between the richest and poorest in Ireland is above the EU average and statistics show that the gap is getting wider.
Report: Access to Diagnostics Used to Detect Cancer
An in-depth survey of GPs called “Access to Diagnostics Used to Detect Cancer”, commissioned by the Irish Cancer Society, carried out by the Irish College of General Practitioners (ICGP) shows a striking difference in access to tests for cancer between the public system and the private system.
Inequalities in every aspect of health
The number of women visiting their doctor in the first 15 weeks of pregnancy are lowest among the lower socio-economic groups.
In 2005, the highest percentage of low birthweight babies were born to mothers in the ‘unemployed’ socio-economic group. Low birthweight babies are at greater risk of death, illness, disability and poor academic development.
The prevalence of stroke, angina and heart attack in an area increase as the local neighbourhood circumstances worsen.
The mortality rate in the lowest occupational class is significantly higher than the rate in the highest occupational class – over 130%.
Inequalities in cancer incidence
Lung, stomach, mouth, head and neck and cervical cancers are all more common in areas of higher unemployment and lower levels of education.
- Lung cancer and head & neck cancer incidence is 1.7 times higher among the most deprived group in society compared to the least deprived.
- Cervical cancer incidence is 1.9 times higher among the most deprived compared to the least deprived.
- Men in areas with the poorest education levels have a 32 per cent greater risk of lung cancer than men living in areas with the highest level, while women have a 23 per cent greater risk.
- Men in the most densely populated areas had a 53 per cent greater risk of developing head and neck cancer than men in less densely populated areas.
- Men resident in the most densely populated areas had a 36% greater risk of stomach cancer than those resident in the least densely populated areas.
Inequalities in cancer survival
International research shows that higher relative risks of death are often found in deprived groups. Frequently, the most deprived group has a death excess of 30-50% compared to that of the most affluent one. In most studies the survival for all combined cancers was found always to be poorer for deprived groups.
The Irish data available on survival rates based on level of deprivation is limited; however, we do know that:
- From 2004‐2008 in women under 70 years, five-year survival from breast cancer was notably lower (80%) in the most deprived quintile compared to least deprived quintile (86%)
- From 2004-2007, one-year survival from lung cancer in the most deprived quintile (29%) was significantly lower than that of the least deprived quintile (31%).
- Similarly, five-year survival in the most deprived quintile (9%) was significantly lower than that of the least deprived quintile (11%)
The Irish Cancer Society is determined to work closely with these communities to turn this situation around. This will mean developing different and more focused ways of working with and communicating new messages and innovative services. It will also mean ensuring that the issue of health inequalities and cancer is addressed by Government and state agencies, as the urgent public health issue which it is.
Case study: The risk of developing lung cancer
Lung cancer is the third most common cancer in Ireland. The average number of new lung cancer cases diagnosed each year was 1,000 in women and 1,602 in men.
During 1995-2007, the number of new cases diagnosed increased by approximately 3% per annum for women and 1% for men. 90% of lung cancer cases are caused by smoking. Your risk of developing lung cancer, and surviving it, can also be looked at through the lens of ‘health inequalities’.
Where I live?
The risk of lung cancer is greater in certain areas of Ireland. The map above has been produced by the NCRI who collect data in relation to cancer cases, and what it shows is that there is a greater risk in getting lung cancer in areas such as north-inner city Dublin and west Dublin as well as certain area of Donegal, Louth, Longford, Carlow, Galway, Limerick and Cork.
If I work?
Areas around Ireland which have a high unemployment rate have a greater risk of lung cancer. In some cases, high unemployment areas have a 40% greater risk than an area where unemployment is low.
What my education is?
A strong association has also been found between when you finished your education and lung cancer. Men in areas with the poorest education levels had a 32% greater risk of lung cancer than men living in the areas with the highest level of educational attainment.
What gender I am?
You have a greater risk of developing lung cancer if you are male. The risk of developing lung cancer up to the age of 74 was 1 in 37 for women and 1 in 20 for men.
What is the Irish Cancer Society doing about health inequalities?
The Irish Cancer Society has recognised health inequalities in relation to cancer as a key objective in our strategy for 2013-2017, "Towards a Future without Cancer".
The We Can Quit project is a community based smoking cessation service to support women in disadvantaged communities to quit smoking. The Irish Cancer Society has been campaigning on the issue of women and smoking for a number of years. In 2012, we hosted a conference on the issue in association with the NWCI. One of the main findings of the conference was that women in disadvantaged communities have the same motivation to quit as their more affluent peers but have much lower successful quit rates.
The Society will also be carrying out a major research project on health inequalities and cancer in 2014. There is a wealth of international research on the topic but very little Irish research. This research will address what needs to be done to reduce these inequalities.
Note: Links to external websites are included below. The Irish Cancer Society is not responsible for the contents of external websites.
- "Tackling Health Inequalities", Combat Poverty Agency (2008)
- "Fair Society, Health Lives", Prof Sir Michael Marmot (2010)
- "Health in an unequal world", Prof Sir Michael Marmot (2006)
- "A Tobacco Free Future: An all-island report on tobacco, inequalities and childhood", Institute of Public Health in Ireland (2013)
To find out how you can get involved in the campaign to reduce health inequalities in Ireland, contact the Irish Cancer Society's Advocacy team on (01) 2310 500 or email firstname.lastname@example.org.