_Hlk4600755
to conception, during pregnancy and in the
which was published in 1989. The 2010 policy
352 Queensland Government (2016). Queensland Women’s Strategy 2016-21. Retrieved from:https://www.csyw.qld.gov.au/resources/ campaign/womens-strategy/queensland-womens-strategy.pdf
353 Government of Western Australia. (2013). Western Australia’s women’s health strategy. Retrieved from: https://www.fwhc.org.au/ wp-content/uploads/2017/12/wa-womens-health-strategy-2013-17.pdf
354 New South Wales Government. (2013). New South Wales Framework for Women’s Health 2013. Retrieved from: https://www.health. nsw.gov.au/women/Publications/womens-health-framework-2013.pdf
355 Victorian Women’s Health Sevices. (2015). Priorities for Victorian women’s health 2015–2019. Retrieved from: https:// womenshealthvic.com.au/resources/WHV_Publications/Position-Paper_2015.03.12_Priorities-for-Victorian-womenshealth-2015-2019_(Fulltext-PDF).pdf
356 Steel, A., Frawley, J., Dobson, A., Jackson, C., Lucke, J., Tooth, L., Brown, W., Byle, J., Mishra, G. (2013) Women’s health in NSW – a life course approach: a rapid review. University of Queensland, Centre of Research Excellence in Women’s Mental Health in the 21st Century. Retrieved from: https://www.saxinstitute.org.au/wp-content/uploads/Womens-health-in-NSW2.pdf
357 University of Newcastle and The University of Queensland. (1996). Australian Longitudinal Study on Women’s Health. Retrieved from: https://www.alswh.org.au
358 Government of Australia. (2010). National Women’s Health Policy. Retrieved from: http://www.health.gov.au/internet/main/ publishing.nsf/Content/3BC776B3C331D5EECA257BF0001A8D46/$File/NWHP.pdf
post-natal period can have a profound and
the national strategy. In Victoria, the 2015 Priorities
long-term effect on their own health and that
for Victorian Women’s’ Health (developed by a
of their children.
coalition of Victorian Women’s health services)
makes very limited reference to national policies.
- Healthy ageing; targeting musculo-skeletal
The Women’s Health in NSW report is a review of
conditions, disability and dementia. The policy
the issues.
highlights that the social, economic and
environmental conditions under which women
live and age can affect their experience of old
age.
The policy also identifies five policy goals. These
Figure from page 83
goals are intended to highlight ways that gender
inequality and health inequities (between women
and men, and between differing groups of women)
can be addressed. The policy goals are to:
- Highlight the significance of gender as a key
determinant of women’s health and wellbeing;
- Acknowledge that women’s health needs differ
according to their life stage;
- Prioritise the needs of women with the highest
risk of poor health;
- Ensure the health system is responsive to
all women, with a clear focus on illness
prevention and health promotion; and
- Support effective and collaborative research,
data collection, monitoring, evaluation and
knowledge transfer to advance the evidence
base on women’s health.
The policy recognises that there is an opportunity
to ensure that these goals are reflected in the
health reform process, to develop a health system
that is more responsive to the needs of Australian
women. The policy is not underpinned by a social
determinants framework359 but some of the more
recently produced state level strategies are.
Of the state level documents just the Western
Australian Women’s Health Strategy (2013-2017) is
aligned to and builds on the national strategy
while focusing specially on the needs of women
and what women are experiencing in Western
Australia. The NWS Health Framework for Women’s
Health 2013360 (developed by the New South Wales
Ministry of Health) in contrast does not reference
359 Australian Women’s Health Network. (2016). The Australian Women’s Health Charter. Retrieved from: http://awhn.org.au/wpcontent/uploads/2016/05/AWHN-Australian-Womens-Health-Charter.pdf
360 New South Wales Government. (2013). New South Wales Framework for Women’s Health 2013. Retrieved from: https://www.health. nsw.gov.au/women/Publications/womens-health-framework-2013.pdf
Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan
Figure from page 84
Section 5 — Section 5 — Conclusions Conclusions
The key conclusions arising from this evidence review are as follows:
5.1 Women in Ireland
never married children (of any age) suggesting
that a significant proportion of women continue
Women (aged 18 and over) make up over 38% of
to have an important role to play particularly in
the total Irish population. Although still relatively
relation to the health of children and in many
young by EU standards, the proportion of people
cases their partners. Women also make up three
aged 65 and over (female and male) in Ireland is
fifths of carers nationally.
growing rapidly, with many people now living
In 2019, over 15% of the population come from
longer and healthier lives. Women are living
other ethnic backgrounds, the largest minority
longer with more healthy life years that ever
group are other white backgrounds. Female Irish
before. These improvements are largely due to
Travellers make up 0.7% of the female population.
lower mortality rates and better survival from
Minority ethnic groups are however not spread
conditions such as heart disease and cancer
evenly across the country, with the Dublin region
affecting older age groups. With the proportion
the most ethnically diverse region and the Border
of women in older age groups increasing, the
region the least diverse. In contrast the region
number of women in child bearing age groups
with the highest percentage of female Travellers
has declined. The likely result of which is a steady
is the Midlands.
reduction in the number of births, even if Ireland
continues to experience fertility rates that are
Over the period 1991-2016 there has been a
higher that most EU countries. This demographic
significant change in the economic status of
transformation provides both opportunities and
women linked to the fact that Irish women are
challenges for women, for their health and for
better educated than ever before. More recently
health care providers.
the employment rate for women in Ireland has
risen from 59.1% in 2006 to 61.4% in 2016361.
The notion of what is family in Ireland has changed radically since the 1980’s. Now just over two fifths of Irish women are married (with or without children), while one third are single women, one in ten women are the head of a one parent households, while just less than one in ten women are part of cohabiting couples.
5.2 Women’s Health in Ireland
The understanding that women’s health is
affected by a wide range of factors, including:
the conditions in which women are born, grow,
live, work and age; whether or not a woman has
sufficient income, adequate housing, and social
or community bonds and support; as well as a
woman’s individual behaviour, diet and lifestyle,
is critical to ensuring that health services can
meet the changing needs of the diversity of
Significantly, about 45% women (820,251
women across the life stages.
individuals) live with one or more usually resident
361 CSO. (2016). Women and Men in Ireland 2016.
Statistically women in Ireland have a higher
Among the most common cancers represented
life expectancy than men, and rate their health
among the surviving (prevalent) cancer patient
as better than men, notwithstanding women
population are: breast cancer (23% of all cancer
often report more illness and distress. A distinct
survivors), colorectal cancer (12%) and skin
health gradient exists between women from
melanoma (7%). National cancer screening
disadvantaged/poorer backgrounds and women
programmes of specific relevance to women
from more affluent backgrounds with health
are BreastCheck and CervicalCheck. The Scally
generally improving with income. Particular
Report has identified a number of failings in
social groups (defined by ethnicity, gender
relation to the operation of CervicalCheck and
or geography for example) tend to be more
implementation of these recommendations
affected by these inequalities than other groups,
is being progressed, with an implementation
suggesting that measures will need to be
plan published by the Department of Health in
targeted at these groups in order to address these
December 2018362. A review of this implementation
inequalities. Significantly, women tend to be more
plan by Dr Gabriel Scally in March 2019 found that
pro-active about their health, suggesting that
this plan ‘is a comprehensive response to the original
health promotion campaigns targeted at women
report, and that it represents a very substantial body
can be effective.
of work for the Department of Health, the HSE and
the National Cancer Registry’.363 The development
of the WHAP is explicitly referenced in the
5.3 Women’s Health Concerns and Needs
implementation report.
Women’s mental health: Because women have
It is important to recognise that women’s health
different life experiences and socio-economic
needs and risks vary depending on their life stage,
realities to men, the mental health symptoms
that health services need to seek to meet women’s
they present with, are also often different, as are
needs at these different stages.
their pathways into services, and their treatment
needs. Statistically more women than men report
Women’s chronic disease: Key causes of mortality
mental health problems, linked to this more
for Irish women relate to respiratory issues. There
women than men engage in self-harm. Women
is also a high incidence of both allergic respiratory
are also more likely to attempt suicide (with men
disorders (rhinitis, asthma) and of genetic
more likely to die by suicide). Hospitalisation rates
respiratory disease in Ireland. Lung cancer is the
are somewhat lower for women than men for a
leading cause of cancer deaths for women, while
variety of diagnoses. Marginalised women are
cancers of the uterus and ovary are also common
disproportionately impacted by poor mental health.
cancers in women.
Many women’s preferred interventions are talking
therapies/counselling, while women report that
Again health gradients exist in relation to the risk of cancer, with women in areas with the lowest education levels at significantly higher risk of cervical cancer than those in areas with higher educational attainment.
mental health services generally tend to rely more
on medication.
Issues also exist in relation to perinatal mental
health with a perinatal mental health service
clinical pathway needing to continue to be rolled
out and resourced across maternity hospitals
nationwide.
362 Department of Health, Health Service Executive. (2018). Implementation Plan for the Scoping Inquiry into CervicalCheck Issues. Retrieved from:https://health.gov.ie/wp-content/uploads/2018/12/Implementation-Plan-for-Recommendations-of-the- Scoping-Inquiry.pdf
363 MerrionStreet.ie (2019, 22 March). Minister for Health Publishes Review of Implementation Plan by Dr. Gabriel Scally. [Press Release]. Retrieved from: https://merrionstreet.ie/en/NewsRoom/Releases/Minister_for_Health_Publishes_Review_of_ Implementation_Plan_by_Dr_Gabriel_Scally.html
Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan
Women’s sexual health: This review has found
compared with men. Older women (>75 years)
that younger women are more likely to use
are the group most likely to consume unhealthy
contraception and have more sexual partners
food, while women living in disadvantaged areas
than older women. Notwithstanding, older women
are more likely to consume unhealthy food than
remain sexually active into their 60s and 70s,
women in affluent areas. Women are also at risk
with or without a partner.
of developing gestational diabetes in pregnancy
and developing Type 2 diabetes in the following
This indicates that women need to be able to easily access sexual health related services throughout the life course.
5-10 years. Clearly, work needs to continue to help
and support women in relation to tackling obesity.
Work also needs to continue in relation to raising
the activity levels of women, as the health impacts
of their inactivity could be significant if inactivity
Women’s’ reproductive health: Key elements of
persists as women age. In this context walking is
reproductive health for women include access to
the most popular and accessible form of physical
affordable and accessible contraception, access
exercise for women from all backgrounds and
to abortion services, maternity entitlements,
work needs to be done to encourage women and
the ongoing development of women-centred
younger women in particular to participate in
maternity care, family formation (including
more physical activities.
the regulation and public provision of assisted
Women and gender-based violence: Statistically
human reproduction), treatment of health
women are very significantly more likely and more
issues following pregnancy and the prevention
vulnerable to experiencing gender-based violence
of infertility. Reproductive wellbeing for non-
throughout their life time. This includes domestic
pregnant woman is also important with more
violence and abuse, it also includes rape and sexual
attention needing to be given to meeting these
abuse, crimes against women based on notions
needs (e.g. the provision of menstrual health and
of ‘honour’, forced marriage, forced prostitution
menopause services).
and trafficking, female genital mutilation and
Given that Ireland has the highest rate of babies
sexual harassment. A whole series of health
born with spina bifida in the EU, work also needs
problems can be linked to violence against women
to continue to encourage women to take a folic
including depression, emotional distress and
acid supplement.
suicidality as well as injuries, pain and long-term
health conditions, sexually transmitted infections
Women’s lifestyle behaviours: The positive news
or diseases, miscarriage and neonatal death.
is that smoking rates are dropping, although a
Mental health impacts of rape include suicidality,
lot of work still needs to be done particularly
flashbacks, anxiety, depression and panic attacks.
with younger women and with women living
Estimating the exact scale of this violence against
in disadvantaged areas. Concerns also continue
women is however difficult due to definitional
to exist for women in relation to alcohol
and underreporting issues. The recent ratification
consumption, linked to alcohol as a risk factor
of the Istanbul Convention364 and the proposal to
for breast cancer for women; the risk of Foetal
undertake a new SAVI II report365 are both very
Alcohol Syndrome and recommendations in
welcome in this context. Key also is putting in
relation to alcohol free pregnancy. Illicit drug use
place the necessary acute and long-term health
is most common among younger women, with
and others supports for women who have/who are
cannabis the most commonly used drug followed
experiencing violence, based on the recognition
by MDMA/ecstasy and cocaine. Women make up
that different responses are needed for individuals
a growing number of clients of specialised drug
at immediate risk/in the immediate aftermath and
treatment centres. Women have a significantly
for individuals who experienced abuse as a child
higher risk of premature death due to obesity
364 Department of Justice and Equality. (2019, 8 March). Minister Flanagan announces ratification of the Istanbul Convention by Ireland on International Women’s Day. [Press Release]. Retrieved from: http://www.justice.ie/en/JELR/Pages/PR19000066
365 Department of Justice and Equality. (2019, 10 January). Department of Justice and Equality and the Central Statistics Office sign Memorandum of Understanding on the Undertaking of a National Sexual Violence Prevalence Study. [Press Release]. Retrieved from: http://www.justice.ie/en/JELR/Pages/PR19000007
or adult. The separation of the issue of violence
5.4 Women’s engagement with the Health Services
against older women and inclusion under the
category of elder abuse is also something that needs
to be re-examined.
Internationally, the Sustainable Development
Goals are being used to advance women’s
Women, health and disadvantage: The general
health globally, while at European level both
structural inequalities which women face which
Health 2020 and the 2016 Strategy on women’s
have the potential to negatively impact on their
health and well-being in the WHO European
health include the facts that women are more likely
Region acknowledge gender as a determinant of
to: Be poor (have a medical card); Parent alone;
health, and identify gender mainstreaming as
Be the main provider of unpaid care work; Be in
a mechanism to achieve gender equity. Possible
precarious or part time employment earning low/
areas of focus for the new Women’s Health Action
lower wages and be at risk of gender-based violence.
Plan arising from these perspectives include:
Women from disadvantaged and minority backgrounds face even more inequalities that in turn can negatively affect these women’s health to varying
—The need to provide equal access to health —
services for all women (recognising that gender
inequalities in employment, education, quality
of work, etc. have a negative influence on
health).
degrees.
—The need to address the various health —
conditions that arise at the different life stages
At its simplest this is because women with access
of women.
to larger incomes can pay to rapidly access
—Recognition that gender stereotypes have —
health services as well as other societal resources
consequences for women’s health in terms of
including education, food, housing, recreational
self-confidence and well-being, with concerns
activities etc. The variation among individuals and
about physical appearance having the
groups due to income is often referred to as the
potential to cause young women in particular
‘social gradient’, while the relationship between
to develop eating disorders and other mental
poverty, social inclusion and health inequalities is
illnesses, such as depression and anxiety.
now incontrovertible.
—Violence against women persists across all —
Groups of women who experience multiple
population groups.
disadvantage within the health service and who
—Women’s increasing exposure to risk factors —
need particular targeted interventions to overcome
(including substance misuse, obesity, lack
this level of multiple disadvantage include: Women
of physical exercise) increases the risk of
from disadvantaged areas; Traveller and Roma
developing diseases and disabilities earlier in
women; Women who are homeless; Migrant
life.
women; Women with disabilities; Women who
are carers; LBTQI+ women; Women who offend;
—Major depressive disorders are the main cause —
Women involved in prostitution; and Women who
of disease among women and dementia and
are trafficked. Each of these groups has particular
Alzheimer’s disease are main causes of ill
health needs and some of the common barriers
health among older women in western Europe
that face these groups and that need to be tackled
—The impact of socioeconomic inequalities has —
include: Lack of easy access to affordable health
a huge influence on women’s mental health
services; Inability to access female doctors as well
both as patients and informal providers of
as discrimination and prejudice including racism
care.
and homophobia. A key element in the provision
—In areas where domestic heating needs are —
of health services to these disadvantaged groups
met by burning solid fuels (e.g. wood) on open
include the training of health staff to understand
fires women who spend a significant amount
the diversity of needs and challenges faced by these
of time indoors at home are disproportionally
different groups.
Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan
exposed to high levels of household air
5.5 Health policies and services relevant to women’s health
pollution, which includes a range of health-
damaging pollutants.
Internationally and at EU level, the key policies
—Women are overrepresented as care providers —
the WHAP needs to connect with and be informed
in the formal and informal sectors.
by are the UN’s Global Strategy For Women’s,
—Women are also overrepresented as care —
Children’s And Adolescents’ Health 2016-2030 and
recipients among those aged 65 and over in
the WHO Strategy on women’s health and well-being
institutions and at home.
in the WHO European Region. The WHO strategy
—Gender specific barriers that need to be —
has four key areas for action: 1) Strengthening
addressed in order to support to women access
governance for women’s health and well-being,
health services include: poverty; unequal
with women at the centre; 2) Eliminating
power relationships between men and women;
discriminatory values, norms and practices that
an exclusive focus on women’s reproductive
affect the health and well-being of girls and
roles; as well as potential or actual experience
women; 3) Tackling the impact of gender and
of physical, sexual and emotional violence.
social, economic, cultural and environmental
determinants on women’s health and well-being;
Nationally, there are a number of issues in relation to women’s engagement with
and 4) Improving health system responses to
women’s health and well-being. These four action
areas could usefully be applied in the Irish WHAP.
health services. The first is the nature and extent of health care services available, the second is women’s ability to access and uptake these services and the third concern, the characteristics and health needs of individual/groups of women. All three of these issues need to be explored and addressed within the WHAP.
Nationally, Ireland has three women specific
health policies (and one dedicated Dublin based
women health project focusing on the needs of
women involved in prostitution). It is striking
that the three policies focus on the reproductive
role of women, rather than the general health of
women. There a much larger number of health
policies (at least nine) that while they do not have
a specific gender focus are relevant to meeting the
health needs of women and connections will need
to be made to these in the WHAP, most of these
Challenges that will need to be addressed in
strategies have been prepared using a population
this context include the existence of the number
or life-cycle approach. This review also identifies
of significant data gaps linked to a lack of sex
a number of other key policies and strategies that
disaggregated data and gender analysis of
have an impact on women’s health and well-
service users. For example, the largest national,
being that it will be important for the WHAP to
continuous data source on utilisation of health
reference and make connections with.
services the Hospital In-Patient Enquiry (HIPE)
has not been examined from the point of view of
gender differentials in utilisation patterns.
Figure from page 88
GP’s provide the key gateway to access health
services for women and women are more likely
to visit their GP than men, suggesting that the
GP has a critical role in relation to identifying
the gender specific needs of women and of
signposting women to the services they need.
5.6 Models of practice in relation to Women’s Health Policy
5.7 In conclusion
The evidence provided in this review confirms the
need for a national women’s health action plan
The review found that the WHO has a dedicated
which will facilitate and provide an enhanced
strategy on Women’s Health and Well-being in
response to the health inequalities experienced
the European Region. The Strategy has six guiding
by women. The review has documented the
principles all of which are relevant for the Irish
significant health needs of women spanning all
WHAP as follows;
categories of health from healthy lifestyles to
- The application of human rights approach
chronic disease to mental health. In addition, the
which means that women’s rights and the
review identified how particular groups of women,
right to health are integral to all priorities and
including women with disabilities and LGBTQI+
actions.
women, are experiencing particular health
inequalities and barriers to care.
- The Strategy is equity driven, recognising that
women are not a homogenous group.
The evidence presented identifies key areas for
- The gender-responsive focus of the Strategy
consideration as part of the WHAP development
reflects the need to adopt whole-of-
process, including through consultation with
government approach to promoting gender
women:
equality.
—Changing health needs of women throughout —
- The application of life-course approach to
the life cycle;
women’s health.
—Women’s health behaviours and lifestyles, —
- Making intersectoral action central to the
within the context of women’s lives and
Strategy.
responsibilities;
- Making the participation of women central to
—Specific mental health needs and —
all stages of the strategy from development to
presentations of women;
implementation.
—Reproductive and sexual healthcare needs of —
Australia in contrast has both afederal women’s
women at all stages of life;
health policy and a series of state level women’s
—Health supports needed for women who have/ —
health strategies. It also benefits from data
are experiencing violence;
generated by a national Longitudinal Study on
—Services for diseases predominantly affecting —
Women’s Health. Both of these models of practice
women;
can provide useful learning for the WHAP both
in terms of how the plans were developed and in
—Barriers to healthcare and poor health —
terms of how women were invited to participate in
outcomes experienced by women who are
the plan development and implementation.
socially or economically disadvantaged; and
—The application and use of gender —
mainstreaming approaches with health
services.
Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan
Figure from page 90
Appendix 1 – Women in Ireland
| Table A.1 Number of females by age band (1991 - 2016) | ||||||
|---|---|---|---|---|---|---|
| Ages | 1991 | 1996 | 2002 | 2006 | 2011 | 2016 |
| 0 - 4 | 133,179 | 121,654 | 135,590 | 147,696 | 174,253 | 161,784 |
| 5 - 9 | 155,157 | 137,608 | 128,200 | 140,341 | 156,733 | 174,091 |
| 10 - 14 | 169,400 | 158,710 | 139,594 | 133,368 | 147,415 | 156,098 |
| 15 - 19 | 163,618 | 165,586 | 152,775 | 142,016 | 138,757 | 147,908 |
| 20 - 24 | 130,093 | 144,211 | 163,042 | 169,709 | 150,595 | 136,052 |
| 25 - 64 | 791,679 | 861,456 | 1,004,992 | 1,124,716 | 1,255,721 | 1,290,774 |
| 65+ | 229,175 | 236,630 | 246,846 | 260,831 | 292,079 | 340,730 |
| All ages | 1,772,301 | 1,825,855 | 1,971,039 | 2,118,677 | 2,315,553 | 2,407,437 |
Source: CSO Census 2016
| Table A.2 Proportion of females by age band, 1991 – 2016 | ||||||
|---|---|---|---|---|---|---|
| Age band | 1991 | 1996 | 2002 | 2006 | 2011 | 2016 |
| 0 - 4 | 7.5% | 6.7% | 6.9% | 7.0% | 7.5% | 6.7% |
| 5 - 9 | 8.8% | 7.5% | 6.5% | 6.6% | 6.8% | 7.2% |
| 10 - 14 | 9.6% | 8.7% | 7.1% | 6.3% | 6.4% | 6.5% |
| 15 - 19 | 9.2% | 9.1% | 7.8% | 6.7% | 6.0% | 6.1% |
| 20 - 24 | 7.3% | 7.9% | 8.3% | 8.0% | 6.5% | 5.7% |
| 25 - 64 | 44.7% | 47.2% | 51.0% | 53.1% | 54.2% | 53.6% |
| 65+ | 12.9% | 13.0% | 12.5% | 12.3% | 12.6% | 14.2% |
Source: CSO Census 2016
| Table A.3 Change in proportion of females by age band, 1991 – 2016 | |
|---|---|
| Age band | 1991 - 2016 |
| 0 - 4 | -0.8% |
| 5 - 9 | -1.5% |
| 10 - 14 | -3.1% |
| 15 - 19 | -3.1% |
| 20 - 24 | -1.7% |
| 25 - 64 | +8.9% |
| 65+ | +1.2% |
Source: CSO Census 2016
| Table A.4 Distribution of females by region and age, 2016 | |||||||
|---|---|---|---|---|---|---|---|
| Census Region | Total female population | Females under 18 years | % of under 18 years | Females between 18- 64 years | % aged 18-64 | Females over 65 years | % over 65 years |
| ROI | 2,407,437 | 581,717 | 24.2% | 1,484,990 | 61.7% | 340,730 | 14.2% |
| Dublin | 688,988 | 149,099 | 21.6% | 447,972 | 65.0% | 91,917 | 13.3% |
| South-West | 348,845 | 82,546 | 23.7% | 213,460 | 61.2% | 52,839 | 15.1% |
| Mid-East | 347,746 | 94,321 | 27.1% | 212,535 | 61.1% | 40,890 | 11.8% |
| Mid-West | 237,476 | 58,058 | 24.4% | 142,611 | 60.1% | 36,807 | 15.5% |
| West | 228,022 | 54,788 | 24.0% | 137,463 | 60.3% | 35,771 | 15.7% |
| South-East | 212,691 | 53,214 | 25.0% | 127,549 | 60.0% | 31,928 | 15.0% |
| Border | 197,686 | 50,480 | 25.5% | 116,145 | 58.8% | 31,061 | 15.7% |
| Midlands | 145,983 | 39,211 | 26.9% | 87,255 | 59.8% | 19,517 | 13.4% |
Source: CSO Census 2016
| Table A.5 Number and percentage of females by county and age (Census, 2016) | |||||||
|---|---|---|---|---|---|---|---|
| Census County | Total female population | Females under 18 years | % under 18 years | Females between 18-64 years | % 18-64 years | Females over 65 years | % over 65 years |
| Dublin City | 282,284 | 48,262 | 17.1 | 192,946 | 68.4 | 41,076 | 14.6 |
| Cork County | 210,258 | 54,945 | 26.1 | 126,664 | 60.2 | 28,649 | 13.6 |
| Fingal | 150,780 | 40,844 | 27.1 | 95,405 | 63.3 | 14,531 | 9.6 |
| South Dublin | 142,490 | 36,616 | 25.7 | 89,245 | 62.6 | 16,629 | 11.7 |
| Dún Laoghaire-Rathdown | 113,434 | 23,377 | 20.6 | 70,376 | 62.0 | 19,681 | 17.4 |
| Kildare | 111,958 | 30,449 | 27.2 | 69,962 | 62.5 | 11,547 | 10.3 |
| Meath | 98,268 | 27,959 | 28.5 | 59,426 | 60.5 | 10,883 | 11.1 |
| Limerick City and County | 97,559 | 22,984 | 23.6 | 59,890 | 61.4 | 14,685 | 15.1 |
| Galway County | 89,527 | 23,408 | 26.1 | 52,734 | 58.9 | 13,385 | 15.0 |
| Donegal | 80,170 | 20,412 | 25.5 | 46,858 | 58.4 | 12,900 | 16.1 |
| Tipperary | 79,885 | 19,895 | 24.9 | 47,104 | 59.0 | 12,886 | 16.1 |
| Wexford | 76,000 | 19,060 | 25.1 | 45,383 | 59.7 | 11,557 | 15.2 |
| Kerry | 74,652 | 17,021 | 22.8 | 44,515 | 59.6 | 13,116 | 17.6 |
| Wicklow | 72,269 | 18,656 | 25.8 | 43,862 | 60.7 | 9,751 | 13.5 |
| Mayo | 65,460 | 15,683 | 24.0 | 37,979 | 58.0 | 11,798 | 18.0 |
| Louth | 65,251 | 17,257 | 26.4 | 39,285 | 60.2 | 8,709 | 13.3 |
| Cork City | 63,935 | 10,580 | 16.5 | 42,281 | 66.1 | 11,074 | 17.3 |
| Clare | 60,032 | 15,179 | 25.3 | 35,617 | 59.3 | 9,236 | 15.4 |
| Waterford City and County | 58,525 | 14,349 | 24.5 | 34,995 | 59.8 | 9,181 | 15.7 |
| Kilkenny | 49,699 | 12,523 | 25.2 | 29,852 | 60.1 | 7,324 | 14.7 |
| Westmeath | 44,688 | 11,660 | 26.1 | 27,011 | 60.4 | 6,017 | 13.5 |
| Laois | 41,886 | 11,862 | 28.3 | 25,148 | 60.0 | 4,876 | 11.6 |
| Galway City | 40,868 | 7,689 | 18.8 | 28,175 | 68.9 | 5,004 | 12.2 |
| Offaly | 39,123 | 10,262 | 26.2 | 23,258 | 59.4 | 5,603 | 14.3 |
| Cavan | 37,846 | 10,349 | 27.3 | 22,190 | 58.6 | 5,307 | 14.0 |
| Sligo | 33,170 | 7,694 | 23.2 | 19,907 | 60.0 | 5,569 | 16.8 |
| Roscommon | 32,167 | 8,008 | 24.9 | 18,575 | 57.7 | 5,584 | 17.4 |
| Monaghan | 30,520 | 8,015 | 26.3 | 17,989 | 58.9 | 4,516 | 14.8 |
| Carlow | 28,467 | 7,282 | 25.6 | 17,319 | 60.8 | 3,866 | 13.6 |
| Longford | 20,286 | 5,427 | 26.8 | 11,838 | 58.4 | 3,021 | 14.9 |
| Leitrim | 15,980 | 4,010 | 25.1 | 9,201 | 57.6 | 2,769 | 17.3 |
Source: CSO Census 2016
Women’s Health in Ireland — Appendices
| Table A.6 Females over 18 years by marital status | |||||
|---|---|---|---|---|---|
| Single | Married (incl. same sex civil partnership) | Separated | Divorced | Widowed | |
| Number | 654,917 | 895,037 | 66,563 | 60,586 | 148,617 |
| Proportion | 35.9% | 49.0% | 3.6% | 3.3% | 8.1% |
Source: CSO Census 2016
| Table A.7 Persons over 65 living alone in a private household, 2016 | ||
|---|---|---|
| Persons living alone in private households | Percentage of persons living alone in private households | |
| Both sexes | 156,799 | 26.7% |
| Female | 97,636 | 31.5% |
| Male | 59,163 | 21.3% |
Source: CSO Census 2016
| Table A.8 Ethnic background of female population usually resident in the state, 2016 | ||
|---|---|---|
| Ethnic group | Number | Proportion |
| All ethnic or cultural backgrounds | 2,369,461 | 100.0% |
| White Irish | 1,951,406 | 82.4% |
| White Irish Traveller | 15,610 | 0.7% |
| Any other White background | 226,200 | 9.5% |
| Black or Black Irish - African | 29,600 | 1.2% |
| Black or Black Irish - any other Black background | 3,315 | 0.1% |
| Asian or Asian Irish - Chinese | 10,427 | 0.4% |
| Asian or Asian Irish - any other Asian background | 38,660 | 1.6% |
| Other including mixed background | 35,181 | 1.5% |
| Not stated | 59,062 | 2.5% |
Source: CSO Census 2016
| Table A.9 Ethnic background of female population usually resident in the state by region, 2016 | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Region | State | Border | Dublin | Mid-East | Midlands | Mid-West | South-East | South- West | West |
| White Irish | 82.4% | 86.7% | 76.1% | 84.2% | 83.7% | 85.9% | 86.4% | 84.1% | 83.7% |
| White Irish Traveller | 0.7% | 0.5% | 0.4% | 0.5% | 1.3% | 0.8% | 0.8% | 0.5% | 1.4% |
| Any other White background | 9.5% | 8.0% | 11.5% | 8.9% | 8.8% | 7.9% | 8.1% | 9.6% | 9.4% |
| Black | 1.4% | 0.6% | 2.2% | 1.6% | 1.5% | 0.7% | 0.7% | 1.0% | 1.0% |
| Asian | 2.1% | 1.1% | 3.8% | 1.7% | 1.4% | 1.5% | 1.1% | 1.5% | 1.3% |
| Other including mixed background | 1.5% | 0.9% | 2.2% | 1.3% | 1.2% | 1.1% | 1.0% | 1.3% | 1.3% |
| Not stated | 2.5% | 2.1% | 3.8% | 1.8% | 2.1% | 2.1% | 1.8% | 2.1% | 1.9% |
Source: CSO Census 2016
| Table A.10 The 10 counties with the highest proportion of population made up of Irish Travellers | ||
|---|---|---|
| County | All ethnic or cultural backgrounds | White Irish Traveller |
| Longford | 20253 | 2.5% |
| Galway City | 37901 | 2.1% |
| Galway County | 88387 | 1.5% |
| Offaly | 39090 | 1.2% |
| Westmeath | 44290 | 1.1% |
| Wexford | 75257 | 1.1% |
| Mayo | 64165 | 1.0% |
| Limerick City and County | 96222 | 0.9% |
| Laois | 41832 | 0.9% |
| Carlow | 28323 | 0.9% |
Source: CSO Census 2016
| Table A.11 Irish Traveller population by broad age bands, 2016 | |||
|---|---|---|---|
| State | Irish Travellers | General population | |
| 0 - 24 years | 8,816 | 56.5% | 24.2% |
| 25 - 64 years | 6,313 | 40.4% | 61.7% |
| 65 years and over | 481 | 3.1% | 14.2% |
Source: CSO Census 2016
| Table A.12 Females usually resident and present in the state by nationality | ||
|---|---|---|
| Nationality | Number | Proportion |
| Irish | 2,066,874 | 87.2% |
| Polish | 60,655 | 2.6% |
| UK | 50,389 | 2.1% |
| Other EU28 | 24,833 | 1.0% |
| Lithuanian | 19,633 | 0.8% |
| Other Asian | 19,094 | 0.8% |
| Romanian | 14,096 | 0.6% |
| Latvian | 11,345 | 0.5% |
| African | 10,630 | 0.4% |
| Brazilian | 7,267 | 0.3% |
| Spanish | 7,235 | 0.3% |
| German | 6,539 | 0.3% |
| American (US) | 6,109 | 0.3% |
| French | 5,795 | 0.2% |
| Other nationalities | 5,713 | 0.2% |
| Other European | 5,538 | 0.2% |
| Italian | 5,297 | 0.2% |
| Indian | 4,229 | 0.2% |
| Not stated, including no nationality | 34,200 | 1.4% |
Source: CSO Census 2016
Women’s Health in Ireland — Appendices
| Table A.13 Females aged 15 and over by highest education completed | |||||
|---|---|---|---|---|---|
| No formal/ Primary | Secondary | Third level non degree | Degree or higher | Other (including not stated) | |
| State | 9.5% | 26.7% | 15.6% | 25.7% | 22.5% |
| Dublin | 8.9% | 23.4% | 12.9% | 29.8% | 25.0% |
| South-West | 8.7% | 27.4% | 16.4% | 25.5% | 22.0% |
| Mid-East | 8.8% | 27.5% | 17.1% | 25.1% | 21.5% |
| Mid-West | 9.5% | 29.6% | 16.4% | 22.6% | 22.0% |
| West | 9.5% | 26.6% | 15.6% | 26.5% | 21.7% |
| South-East | 10.6% | 30.0% | 17.5% | 21.9% | 20.0% |
| Border | 12.7% | 27.0% | 17.1% | 22.1% | 21.1% |
| Midlands | 10.5% | 29.5% | 16.9% | 21.0% | 22.0% |
Source: CSO Census 2016
Figure from page 94
Source: CSO Census 2016
| Table A.15 Females ages 15-64 by education level and employment rate (Q2 2009 – Q2 2017) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| 2009 Q2 | 2010 Q2 | 2011 Q2 | 2012 Q2 | 2013 Q2 | 2014 Q2 | 2015 Q2 | 2016 Q2 | 2017 Q2 | |
| Primary | 30 | 27 | 26 | 26 | 24 | 24 | 24 | 26 | 25 |
| Upper secondary | 62 | 60 | 58 | 58 | 57 | 59 | 58 | 60 | 60 |
| Third level | 78 | 78 | 77 | 77 | 77 | 78 | 79 | 79 | 81 |
Source: CSO Census 2016
| Table A.16 Unemployed females aged 15 and over by ethnic group, 2016 | ||
|---|---|---|
| All persons aged 15 years and over | Unemployed - Looking or recently having lost or given up previous job | |
| White Irish Traveller | 9653 | 37.0% |
| Black or Black Irish-African | 18226 | 20.5% |
| Black or Black Irish – any other Black background | 2223 | 13.4% |
| Other including mixed background | 24305 | 13.1% |
| Asian or Asian Irish – any other Asian background | 27542 | 11.1% |
| Any other White background | 188753 | 10.6% |
| Asian or Asian Irish - Chinese | 8220 | 8.4% |
| All ethnic or cultural backgrounds | 1879591 | 6.6% |
| Not stated | 46537 | 6.5% |
| White Irish | 1554132 | 5.6% |
Source: CSO Census 2016
Figure from page 95
Source: CSO Census 2016
| Table A.18 Female population by type of disability | |
|---|---|
| % of total female population | |
| Total persons with a disability | 13.8% |
| Other disability, including chronic illness | 6.8% |
| A condition that substantially limits one or more basic physical activities | 6.2% |
| Difcfi ulty in participating in other activities | 5.3% |
| Difcfi ulty in working or attending school/college | 4.5% |
| Difcfi ulty in going outside home alone | 4.5% |
| Difcfi ulty in dressing, bathing or getting around inside the home | 3.3% |
| Difcfi ulty in learning, remembering or concentrating | 3.0% |
| Psychological or emotional condition | 2.7% |
| Deafness or a serious hearing impairment | 2.0% |
| Blindness or a serious vision impairment | 1.2% |
| An intellectual disability | 1.1% |
Source: CSO Census 2016
Women’s Health in Ireland — Appendices
| Table A.19 Percentage of the female population with a disability by region, 2016 | |
|---|---|
| State | 13.8% |
| Border | 13.8% |
| Midland | 14.0% |
| West | 13.4% |
| Dublin | 13.7% |
| Mid-East | 12.8% |
| Mid-West | 14.6% |
| South-East | 14.4% |
| South-West | 14.1% |
Source: CSO Census 2016
| Table A.20 Female carers by age | ||
|---|---|---|
| Age band | Number | Proportion |
| 0-24 years | 6,945 | 5.9% |
| 25-64 years | 94,483 | 80.0% |
| 65+years | 16,723 | 14.2% |
| Total | 118,151 |
Source: CSO Census 2016
| Table A.21 Hours of unpaid care provided by female carers (aged 15 and over)366 | ||
|---|---|---|
| Hours unpaid care | Number of carers | Proportion by hours |
| 1-14 hours unpaid help per week | 47,838 | 41.2% |
| 15-28 hours unpaid help per week | 19,223 | 16.5% |
| 29-42 hours unpaid help per week | 8,897 | 7.7% |
| 43-84 hours unpaid help per week | 9,317 | 8.0% |
| 85-167 hours unpaid help per week | 5,838 | 5.0% |
| 168 hours unpaid help per week | 11,889 | 10.2% |
| Not stated - hours unpaid help per week | 13,224 | 11.4% |
Source: CSO Census 2016
Figure from page 96
Source: Various CSO Vital Statistics Releases
366 This excludes the 1,925 female carers under the age of 15 years of age. These females account for 1.63% of total female carers.
| Table A.23 Life expectancy by aged and gender (1996, 2006 and 2016) | |||||
|---|---|---|---|---|---|
| Life expectancy at age | 1996 | 2006 | 2016 | % Change 1996-2016 | |
| Female | 0 | 78.7 | 81.7 | 83.6 | 6.2 |
| 1 | 78.2 | 80.9 | 82.8 | 5.9 | |
| 40 | 39.9 | 42.6 | 44.3 | 11.0 | |
| 65 | 17.4 | 19.9 | 21.1 | 21.3 | |
| 75 | 10.3 | 12.0 | 13.1 | 27.2 | |
| Male | 0 | 73.1 | 76.9 | 79.9 | 9.3 |
| 1 | 72.6 | 76.2 | 79.2 | 9.1 | |
| 40 | 35.2 | 38.5 | 41.0 | 16.5 | |
| 65 | 13.9 | 16.6 | 18.6 | 33.8 | |
| 75 | 8.1 | 9.7 | 11.2 | 38.3 |
Source: Department of Health. (2018). Health in Ireland Key Trends 2018. Retrieved from: https://health.gov.ie/wp-content/uploads/2018/12/ Key-Health-Trends-2018.pdf
| Table A.24 Female Population by urban and rural area (Census, 2016) | |||||
|---|---|---|---|---|---|
| State | Aggregate Town Area | Aggregate Rural Area | % Aggregate Town Area | % Aggregate Rural Area | |
| 2016 | 2,407,437 | 1,527,054 | 880,383 | 63.4% | 36.6% |
| 2011 | 2,315,553 | 1,457,722 | 857,831 | 63.0% | 37.0% |
Source: Department of Health, 2019
Women’s Health in Ireland — Appendices
Figure from page 98
Appendix 2 – Summary of Wider Determinants of Women’s Health
Source: Department of Health, 2019
than childless men, while working mothers
typically suffer a 15% pay penalty373.
Socio-Economic Factors
—Some of the difference may be accounted —
for by fathers working longer hours and
—The gender pay gap was 14% in Ireland in 2017 —
mothers cutting time at work to attend
(this gap is relatively low by international
to caring responsibilities associated with
standards, but has risen by 2% since 2012)367.
parenthood,374,375,376.
—The pay gap between men and childless —
—American data suggests that the motherhood —
women is lower; American data suggests that
penalty has been reducing for high earning
never-married women earn 96% of what men
women, but that the fatherhood premium is
earn368.
showing steady increases377.
—Women who do reach positions of seniority —
—To further exacerbate inequality, the —
have proportionately less children, or other
motherhood penalty is at its worst for low
dependents369,370,371.
earning women, while the fatherhood premium
—It has been found that the average earnings of —
is largest for the highest earning men378.
men increase with fatherhood (the so-called
—In Ireland, the employment rate for men is —
fatherhood premium), while the wages of
approximately 10% higher for men than for
mothers decrease (the motherhood penalty)372.
women. Moreover, only 47.8% of lone parents
—A British study has found that men with —
work, as opposed to 70.2% of adults in two
children can earn as much as 21% more
367 Gartland, F. (2017, 19 October). Gender pay gap is widening in Ireland, CSO figures show. The Irish Times. Retrieved from: https:// www.irishtimes.com/news/social-affairs/gender-pay-gap-is-widening-in-ireland-cso-figures-show-1.3260896
368 WGN. (2016, 27 April). TUC study finds significant wage gap between working fathers and childless men. Retrieved from: https://www. wgn.co.uk/news/tuc-study-finds-significant-wage-gap-working-fathers-childless-men/
369 Cain Miller, C. (2016, 6 September). The Motherhood Penalty vs. the Fatherhood Bonus. The New York Times. Retrieved from: https://www.nytimes.com/2014/09/07/upshot/a-child-helps-your-career-if-youre-a-man.html; Budig, J. (2014). The Fatherhood Bonus and The Motherhood Penalty: Parenthood and the Gender Gap in Pay. Third Way. Retrieved from: https://www.thirdway.org/ report/the-fatherhood-bonus-and-the-motherhood-penalty-parenthood-and-the-gender-gap-in-pay
370 CSO. (2017, 27 July). Census 2016 Results: Profile 4 Households and Families - Number of families increases to 1,218,370. [Press Release]. Retrieved from: https://www.cso.ie/en/csolatestnews/pressreleases/2017pressreleases/pressstatementcensus2016resultsprofile4- householdsandfamilies/
371 CSO. (2016). Employment. Retrieved from: https://www.cso.ie/en/releasesandpublications/ep/p-wamii/ womenandmeninireland2016/employment/
372 WGN. (2016, 27 April). TUC study finds significant wage gap between working fathers and childless men. Retrieved from: https://www. wgn.co.uk/news/tuc-study-finds-significant-wage-gap-working-fathers-childless-men/
373 Ibid.
374 Budig, M. J., & Hodges, M. J. (2010). ‘Differences in Disadvantage: Variation in the Motherhood Penalty across White Women’s Earnings Distribution’. American Sociological Review, 75(5), 705–728. Retrieved from: https://doi.org/10.1177/0003122410381593
375 The Economist. (2017). ‘The Gender Pay Gap.’ The Economist. Retrieved from: https://www.economist.com/ international/2017/10/07/the-gender-pay-gap
376 Weeden, K.A., Cha, Y., Bucca, M. (2016). Long Work Hours, Part-Time Work, and Trends in the Gender Gap in Pay, the Motherhood Wage Penalty, and the Fatherhood Wage Premium. The Russell Sage Foundation Journal of the Social Sciences. 2(4):71-102. Retrieved from: https://www.rsfjournal.org/content/2/4/71
377 Budig, M. J., & Hodges, M. J. (2010). ‘Differences in Disadvantage: Variation in the Motherhood Penalty across White Women’s Earnings Distribution’.
378 Ibid.
parent families, and 86% of lone parents are
earning power more than men’s. In such
female379.
circumstances, long waiting lists are likely to
impact more on women than on men, and more
—Meanwhile, 76.6% of those in receipt of the —
so on those who cannot afford access to private
means tested Carer’s Allowance, which limits
care.
engagement in employment, training or
education to a maximum of 15 hours per week,
—Interestingly, although women may be —
are women380.
disproportionately impacted as parents or
next-of-kin of the patient, and not as the
—It is clear, therefore, that the burden of caring —
patient themselves, this is not captured in
for dependents, whether they be children,
health outcome statistics or in lifetime health
people living with disabilities, or frail older
outcomes such as women’s own NCD risk
adults, rests disproportionately with women,
factors or life expectancy data.
who as a consequence, have lower rates of
engagement with the labour market and
—Additionally, the burden that caring —
therefore lower incomes.
responsibilities and consequent loss of
economic power places on women is,
—This is relevant to women’s experience of the —
however, not without health consequences
health services as the burden of engaging
for disadvantaged women. For example, the
with health services on behalf of others
2018 Healthy Ireland Survey identified the
disproportionately falls on women, in addition
population most likely to smoke as single
to their personal engagement with health
people engaged in home duties aged 35-54,
services to meet their own needs.
who left home without a Leaving Certificate.
—Women also have higher rates of part time —
73% of this cohort smoked, in comparison to
work and are proportionately less well
the national average of 20% (and the female
represented in senior positions that are better
average of 17%)383.
remunerated and are more likely to have
security of tenure381.
Maternal Health Factors
—Women with caring responsibilities and —
female parents in particular, therefore operate
—81% of women in Ireland have a child or —
at a significant economic disadvantage, with
children by the ages of 40-44384.
the greatest inequalities experienced by those
—This life event can have short, medium and —
least able to bear them.
long-term health impacts.
—Socio-economically disadvantaged cohorts —
—“Normal” pregnancies can include all sorts of —
also have a higher burden of ill-health and
adverse and discomfort-inducing side effects
disability382.
such as “morning” sickness that occurs in
—Many women have reduced access to resources —
75% of all pregnancies and can often last well
that in the current two-tier system may
beyond the morning and also, well beyond the
deepen this inequality.
first trimester385.
—Moreover, sudden sickness or accidents —
—Other adverse, but unfortunately common —
affecting family members are likely to
outcomes of pregnancy can include loosening
adversely affect women’s employment and
379 CSO. (2017, 27 July). ‘Census 2016 Results: Profile 4 Households and Families - Number of families increases to 1,218,370’.
380 Ibid.
381 Weeden, K.A., Cha, Y., Bucca, M. (2016). Long Work Hours, Part-Time Work, and Trends in the Gender Gap in Pay, the Motherhood Wage Penalty, and the Fatherhood Wage Premium.
382 Government of Ireland. (2013). Healthy Ireland – a framework for improved health and wellbeing.
383 Ipsos MRBI and Department of Health. (2018). Healthy Ireland Survey 2018 Summary of Findings.
384 OECD Family Database, OECD Social Policy Division: Directorate of Employment, Labour and Social Affairs. (2018). Childlessness. Retrieved from: http://www.oecd.org/els/family/SF_2-5-Childlessness.pdf
385 Pregnancy Statistics.org (2011). Morning Sickness Statistics. Retrieved from: http://www.pregnancystatistics.org/content/morningsickness-statistics.html
Women’s Health in Ireland — Appendices
of ligaments causing sciatica and symphysis
post-partum392 while the figure for urinary
pubis, chronic reflux and indigestion and
incontinence at 6 weeks post-partum is 11.4%393.
a variety of other digestive and urinary
—Post-partum/post-natal depression is difficult —
outcomes that occur within expected
to quantify unless severe, but may be common
parameters and are not considered unhealthy
in a significant minority of women (estimated
in that they don’t impact adversely on the
at about 10-20%)394.
outcomes of the pregnancy.
—Breastfeeding is rightly recommended for a —
—“Morning” sickness is in fact significantly —
wide variety of very significant health benefits
linked to fewer miscarriages and better
to the baby, as well as a reduction in breast
pregnancy outcomes in terms of fewer low
cancer risk for younger mothers. However,
weight babies386.
if practiced exclusively as recommended, it
—More abnormal (but unfortunately, common —
places the burden of sleepless nights firmly on
enough) outcomes include hyperemesis
post-partum women; sleep deprivation may
gravidarum (up to 2% of pregnancies)387, pre-
increase risk of postnatal depression395.
eclampsia (3% of pregnancies)388, miscarriage
—In summary, even normal reproductive —
(more than 1/5 of pregnancies, usually first
processes can result in significant feelings
trimester)389, placenta praevia (0.15% of
of being unwell in a majority of women at
pregnancies)390 and many others that can have
various points in the life-cycle. Given that
long term adverse health consequences for
many of these symptoms occur within the
both mother and baby.
so-called “normal” range, it is possible that
—This is without listing the possible adverse —
these issues are, on occasion, not treated with
outcomes of the birth process itself.
sufficient compassion by some elements of the
health service. Moreover, these can result in
—Caesarian sections are performed in 19- —
significant absences from work in addition to
38% of births (rates vary by hospital)391, and
maternity leave, thereby impacting on lifetime
necessitate longer post-partum recovery
earnings, pensions and career progression
times.
and reinforcing socio-economic factors
—Vaginal births can result in significant —
summarised above.
tearing, the necessity for episiotomies and a
resulting degree of post-delivery incontinence
in a significant minority of women; faecal
incontinence peaks at 6.4% of women 6 weeks
386 Weigel, R.M., Weigel, M.M. (1989). Nausea and vomiting of early pregnancy and pregnancy outcome. A meta-analytical review. Br J Obstet Gynaecol. 96(11):1312-8. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/2611170
387 Philip, B. (2003). Hyperemesis gravidarum: literature review. WMJ. 102(3):46-51. Retrieved from: https://www.ncbi.nlm.nih.gov/ pubmed/12822290
388 Hutcheon, J.A., Lisonkova, S., Joseph, K.S. (2011). ‘Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy’. Best Practice & Research Clinical Obstetrics & Gynaecology. 25(4): 391-403. Retrieved from: https://www.ncbi.nlm.nih.gov/ pubmed/21333604
389 The Miscarriage Association of Ireland. (2009) About Miscarriage. Retrieved from: http://www.miscarriage.ie/aboutmiscarriage. html
390 Kollmann, M.,& Gaulhofer, J., Lang, U., Klaritsch, P. (2013). Placenta previa: Incidence, risk factors and outcome. Ultraschall in der Medizin - European Journal of Ultrasound. 34. 10.1055/s-0033-1354833.
391 AIMS Ireland. (2014). Detailed Statistics on Ireland’s 19 Public Maternity Units Published for the First Time. Retrieved from:http:// aimsireland.ie/detailed-statistics-on-irelands-19-public-maternity-units-published-for-the-first-time/
392 Brincat, C., Lewicky-Gaupp, C., Patel, D. Sampselle, C., Miller, J., Delancey, JO., Fenner, DE. (2009). Fecal incontinence in pregnancy and post partum. Int J Gynaecol Obstet. 106(3):236–238. Retrieved from: https://www.ncbi.nlm.nih.gov/ pubmed/19481750
393 Burgio, KL., Zyczynski, H., Locher, JL., Richter, HE., Redden, DT., Wright, KC. (2003). ‘Urinary incontinence in the 12-month postpartum period.’ Obstet Gynecol. 102(6):1291-8. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/14662217
394 Postpartum Depression. (2019). Statistics on PostPartum Depression. Retrieved from: https://www.postpartumdepression.org/ resources/statistics/
395 Dennis, C., Ross, L. (2005). Relationships Among Infant Sleep Patterns, Maternal Fatigue, and Development of Depressive Symptomatology. Birth, 32: 187-193. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/16128972
—61% of girls have missed school because of —
Sexual Health and Reproductive Factors
their period (often related to pain)398.
—Moreover, nearly 60% of young women —
—Even normal reproductive processes in —
and girls said school does not inform them
women who choose not to have children can
adequately about periods, with six out of ten
impact on quality of life in a way that is not
young women reporting feeling shame and
experienced by men and may not receive
embarrassment about their period and more
sufficient attention from health services.
than 80% not feeling comfortable talking
about their periods with their father or a
—Women require medical supervision when —
teacher28.
using hormonal contraception on a long-
term basis. This may actually lead to better
—Periods adversely impact the ability to —
health outcomes as other health issues may be
participate in sport; notably, the participation
picked up earlier with more frequent visits to
rates for Irish teenage girls are significantly
the doctor. However, hormonal contraception
worse than those for teenage boys399.
currently comes at a significant financial
—Endometriosis affects an estimated 10% of —
cost for those not covered by medical or GP
women during their reproductive years and
visit cards. A Departmental committee on
can cause significant pain and disability on a
contraception is currently seeking to explore
monthly basis. Moreover, if sufficiently severe,
avenues to reducing or eliminating these cost
scars and adhesions can result in enduring
barriers.
symptoms post-menopausally400.
—A recent Oireachtas motion on period poverty —
—Menopause, while a “normal” part of the —
(passed by both Houses) seeks to address the
lifecycle, similarly results in significant
annual cost of periods for those with limited
feelings of being unwell (e.g. hot flushes,
means. The cost has been estimated at over
dizziness, forgetfulness, fatigue), and is
€132-208 per woman per annum, with period
linked to chronic pain and the emergence of
poverty impacting significantly on teenage
a number of chronic conditions, including
girls in particular396.
fibromyalgia401.
—A recent survey of 1,100 Irish girls aged 12- —
19 years undertaken by Plan International,
Domestic, sexual and gender-based violence
an NGO that advances children’s rights and
equality for girls, found that nearly half (50%)
of girls aged 12-19 years have experienced
—COSC estimates suggest that 15% cent of —
issues around affordability of sanitary
women and 6% of men have experienced
products, and approximately 10% of the
severe levels of abuse from a partner402.
young women who participated in the survey
said they were forced to use a “less suitable
—The burden of domestic, sexual and gender- —
sanitary product” because of the high monthly
based violence (DSGBV) is therefore borne
cost involved397.
disproportionately (but not exclusively) by
women.
396 Martin, C. (2019, 13 March). Dail Eireann Debate: Period Poverty Motion. Retrieved from: https://www.oireachtas.ie/en/debates/ debate/dail/2019-03-13/30/
397 Plan International. (2018). We Need to Talk. Period: Listing the Barriers to Girls’ Education.
398 Nauert, R. (2019). Menopause Symptoms Linked to Chronic Pain. Retrieved from: https://psychcentral.com/news/2019/04/05/ menopause-symptoms-linked-to-chronic-pain/143500.html
399 Woods, C.B., Tannehill D., Quinlan, A., Moyna, N. and Walsh, J. (2010). The Children’s Sport Participation and Physical Activity Study (CSPPA). Research Report No 1. School of Health and Human Performance, Dublin City University and The Irish Sports Council, Dublin, Ireland. Retrieved from: https://www.ucd.ie/t4cms/CCLSP_Study_Report1.pdf
400 Endometriosis-uk.org. (2011). Endometriosis Facts and Figures. Retrieved from: https://www.endometriosis-uk.org/endometriosisfacts-and-figures
401 Nauert, R. (2019). Menopause Symptoms Linked to Chronic Pain.
402 COSC The National Office for the Prevention of Domestic, Sexual and Gender-based Violence. (2003). National Study of Domestic Abuse. Retrieved from: http://www.cosc.ie/en/COSC/Pages/WP08000146
Women’s Health in Ireland — Appendices
—Violence is a matter for the criminal justice —
increased at a greater rate (9%) compared with
system, the Department of Justice and An
men (3%).
Garda Siochána, however, treatment of victims
—Among the 50+ age group falls causing injury —
is carried out by the health services.
are more common for women (13%) compared
—As the recent SATU Policy Review evidence —
to men (7%) and the prevalence of falls has
collection highlighted these services have
been found to increase from the age of 40 for
been under-invested and under-managed
women403.
systemically for a long time.
—For the 75+ age group a significantly higher —
proportion of women report low levels of
physical activity: 31% of women report
Health and wellbeing of women aged 50 and older
walking the recommended 150 minutes per
week compared to 45% of men.
Several chronic conditions are particularly
Data is from the Irish Longitudinal Study on Ageing
prevalent for women aged 50 and older:
(TILDA) Wave 4, 2017404.
osteoporosis (29%); arthritis (46%); cataracts
(17%); and pain (41%).
—The burden of osteoporosis and arthritis is —
greater for women aged 75 and older: 38%
have osteoporosis and 61% have arthritis, and
this increases the risk of disability and low
physical activity levels.
—The prevalence of cataracts for women aged —
50+ is 17 % and the prevalence of cataracts
among women aged 50-64 years old has
increased from 4% in 2009 to 6% in 2017.
—Rates of disability, frailty, falls and recurrent —
falls and low physical activity are also higher
for women aged 50 and older.
—20% of women aged 75+ living at home in the —
community have limitations with activities
of daily living (ADL): dressing, bathing, or
getting around inside the home.
—Frailty is a risk factor for single and recurrent —
falls, fear of falling and disability, and frailty
negatively impacts on mental health and
cognition. Frailty is not inevitable and can be
avoided, delayed and reversed with timely and
appropriate interventions.
—Frailty disproportionately affects women (25% —
for women and 13% for men).
—Between 2009 and 2017 for the over 50s age —
group the prevalence of frailty among women
403 Peeters , G., van Schoor, N.M., Cooper, R., Tooth, L., Kenny, R.A. (2018). ‘Should prevention of falls start earlier? Co-ordinated analyses of harmonised data on falls in middle-aged adults across four population-based cohort studies’. PLOS One. Retrieved from: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201989
404 TILDA (2017), The Irish Longitudinal Study on Ageing:Wellbeing and Health in Ireland’s over 50s 2009-2016. Retrieved from: https:// tilda.tcd.ie/publications/reports/pdf/w4-key-findings-report/TILDA-Wave4-Key-Findings-report.pdf
Figure from page 103
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Women’s Health in Ireland — Appendices
Women’s Health in Ireland — Appendices
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