_Hlk8908892

6 Piang L.K., Khattar, P. & Nandan, D. (2010). ‘Mainstreaming gender perspectives in the national health programmes: the challenges ahead’. Health and Population: Perspectives and Issues. 33 (1): 34-41.

7 Health Service Executive, National Women’s Council of Ireland. (2012). Equal but Different: A Framework for integrating gender equality in Health Service Executive Policy, Planning and Service Delivery. Retrieved from: https://www.nwci.ie/download/pdf/equal_ but_different_final_report.pdf

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

age as well as whether or not a woman has

Women have been found to be more pro-active

sufficient income, adequate housing, and social

about their health (for example women are more

or community bonds and support, in addition

likely to visit a dentist than men, while women

to behaviour, diet and lifestyle. For example,

also visit their GP more regularly).10 However,

women can experience particular inequalities

many women report difficulties in accessing

in accessing healthcare, because the average

health services, linked to discriminatory or

income of a woman is less than that of a man.

stereotypical views held by doctors and health

This in turn means that women are more

care practitioners and poor diagnosis and

reliant on public health services which often

treatment for the causes of mental ill health or

have long waits. Women generally provide most

heart disease.11

family carein Ireland, looking after children

There are also large health inequities between

and older family members. The impact of these

women from different backgrounds. It is, for

caring responsibilities can be detrimental to

example, women from lower socio-economic

women’s participation in paid employment, with

groups who experience the greatest disadvantage

consequences in older age of risk of poverty,

in health, are at a greater risk of poor health,

poorer access to health and social care services

experience a higher burden of ill-health and

and poor health.9

live shorter lives than women from other

Women also have specific health concerns –

groups. Women living in poverty and isolation,

such as maternal health – which men do not.

particularly lone parents and older women

Women are more likely to experience gender-

and women from marginalised social groups,

based violence, eating disorders and depression,

including Traveller women, homeless women

affecting women’s wellbeing. Women generally

and women living in direct provision, regularly

live longer, but this also means that women tend

highlight the impact of low income on their

to have more years of ill-health with chronic

health.12

disease such as heart disease, cancer and COPD.

Figure from page 11

9 Temmerman, M. et al. (2015). ‘Women’s health priorities and interventions’.

10 Department of Health. (2018). Health in Ireland Key Trends 2018.

Health Service Executive, National Women’s Council of Ireland. (2012). Equal but Different: A Framework for integrating gender equality in Health Service Executive Policy, Planning and Service Delivery.

12 Ibid.

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

Women’s health – European policy context

Prioritising women’s health in Ireland – the Women’s Health Action Plan

Internationally, women’s health is also receiving

increased consideration. In Europe, the WHO has

Ireland’s first and only specific women’s health

developed a comprehensive framework to address

policy (to-date) was the Plan for Women’s Health

women’s health via the Strategy on women’s health

1997-1999. This had four objectives:

and wellbeing in the WHO European Region 13. At

1. Maximise the health and social gain of Irish

its core, the WHO strategy recognises gender

women

inequalities and inequalities linked to social and

economic determinants of health as at the core of

2. Create a woman-friendly health service

health inequities for girls and women. The four

3. Increase consultation and representation of

WHO priorities provide a coherent guide for the

women in the health services

development of Ireland’s WHAP:

4. Enhance the contribution of the health

5. Strengthening governance for women’s health

services to promoting women’s health in the

and well-being, with women at the centre

developing world

2. Eliminating discriminatory values, norms and

As a part of the plan, a statutory Women’s Health

practices that affect the health and well-being

Council was established in 1997 to advise the

of girls and women

Minister for Health and Children on all aspects

of women’s health. The Council was dissolved

3. Tackling the impact of gender and social,

in 2009.

economic, cultural and environmental

determinants on women’s health and well-

Current government action to address gender

being

inequality across all sectors, including health,

4. Improving health system responses to

centres on the National Strategy for Women and

women’s health and well-being

Girls 2017-2020. This cross-government strategy

aims to create ‘an Ireland where all women enjoy

The strategy further promotes a life-course

equality with men and can achieve their full

approach to women’s health, acknowledging

potential, while enjoying a safe and fulfilling life’

that sex and gender, combined with social and

(p.7). To drive this goal across the health sector

environmental determinants of health, influence

the Strategy contains a formal commitment to

how health risks and benefits accumulate through

the development of a Women’s Health Action Plan

life. The Strategy recognises women as powerful

(WHAP):

actors for change and supports their leadership of,

and participation in, decision-making, including

Objective Two: Advance the Physical and Mental

women who are socially disadvantaged or

Health and Wellbeing of Women and Girls

excluded, or belong to minority groups.

Action 2.1: Strengthen the partnership work

with the National Women’s Council of Ireland

in identifying and implementing key actions

to address the particular physical and mental

health needs of women and girls in order to

advance the integration of their needs into

existing and emerging health strategies,

policies and programmes through an action

plan for women’s health.

13 World Health Organisation Europe. (2016). Strategy on women’s health and well-being in the WHO European Region. P. 2

Other health actions within the national Strategy

making’ (p.1) which can ensure women’s

aim for improvements for women and girls: as

health issues are prioritised within the health

carers and cared-for women; increased physical

system.

activity level; improved health for women over

—The passing of the 2018 referendum on the 8th —

65; intercultural health support for women and

amendment and subsequent development of

girls; improved and standardised maternity

HSE abortion services.

care; improved sexual health and wellbeing;

—The #MeToo movement, through which —

and wellbeing and inclusion of LGBTI+ young

women have highlighted women’s experience

people. These national commitments to women’s

of sexual harassment and violence, creating

health and engagement with different groups of

a national and international dialogue about

women are echoed across the service delivery

the need to prevent sexual violence, to hold

commitments of the HSE in their Service Plan 2019,

perpetrators accountable and strategies

together with a strong focus on increasing patient

needed to secure long-term change in

and service user engagement, and actions in areas

response to survivors, including in the health

directly related to women’s health, including

system.

developments in the National Screening Service,

the HPV vaccination, maternity care, abortion care,

Traveller and migrant health, actions to address

Female Genital Mutilation (FGM), perinatal mental

Figure from page 13

health, dementia care and youth mental health.

The commitment to develop a specific WHAP is

part of arenewed focus on women’s health in

Ireland. This renewed focus can in turn be linked

to a number of wider developments including:

—The sharing of women’s experiences as —

part of the CervicalCheck controversy

and linked to this the work and findings

of the Scally Inquiry14 into the cervical

screening service which placed the voices

and experiences of women at its centre and

made recommendations that the Irish health

system would better prioritise women’s

health. Recommendation 2 in particular called

for ‘consideration to how women’s health

issues can be given more consistent, expert

and committed attention within the health

system and the Department of Health’ (p.22).

In response to the Scally recommendations,

the Department of Health and HSE

Implementation Plan15 identified 126 actions,

including prioritisation of the development of

the WHAP, alongside actions to ‘identify high-

potential solutions and necessary changes to

policy analysis, processes and decision-

14 Scally, G. (2018). Scoping Inquiry into the CervicalCheck Screening Programme. Retrieved from: http://scallyreview.ie/wp-content/ uploads/2018/09/Scoping-Inquiry-into-CervicalCheck-Final-Report.pdf

15 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

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

Figure from page 14

Section 1 – Women in Ireland

This section, based primarily on data from Census 2016, provides an overview of women in Ireland, including demographic, social and economic and health-related statistics.

1.1 Total population

female population demonstrating the increased

ageing of the Irish population.

According to Census 2016 the total Irish

The population aged 65 and over has increased by 35% since 2009, which is considerably higher than the EU average of 16%.

population was 4,761,865, of which females

accounted for 2,407,437 or 50.56%. There are

1,825,720 females aged 18 and over. The population

in 2018 had grown by an estimated 2% since the

2016 Census. The total population is projected

to reach 5.64 million with more than one in five

people are expected to be aged 65 years or older

Collectively, these changes will clearly have

by 203816.

a significant impact on the nature and extent

of demand for health care services in Ireland.

For details, see Appendix 1 Table A.1 Number

1.2 Demographics

of females by age band (1991-2016); Table A.2

Proportion of females by age band, 1991–2016; and

1.2.1 Age

Table A.3 Change in proportion of females by age

Census data shows that the population of

band, 1991–2016.

Ireland – female and male – has been getting

Nationally, approximately 24.2% (581,717

steadily older since the 1980’s. The proportion

individuals) of the female population are under

of the female population aged 25 to 64 years has

18 years old, 61.7% (1,484,990 individuals) are

increased by 8.9% over the period 1992-2016 (from

aged between 18 and 64 years, and 14.2% (340,730

44.7% in 1992 to 53.6% in 2016). The proportion

individuals) are 65 years or over. The largest

of the female population aged over 65 years

proportion of under 18-year-old females (27.1%)

increased by 1.2% from 1991 to 2016. A total of

is in the Mid-East region of Ireland, with the

14.2% of the population are 65 years and over

largest proportion of adult women aged 18 to 64

with 340,730 women in this age group. Between

years found in the Dublin region. The Border and

2011 and 2016 the number of females aged over 65

West regions share the highest proportion of over

increased by 16.7%. The number of people over the

65 females at 15.7%. See Appendix 1 Table A.4

age of 65 is currently increasing by over 20,000

Distribution of females by region and age, 2016.

a year with the number of people over the age

of 85 projected to increase to over 2.5 times the

At a county level Leitrim and Roscommon have

current figure by 2038.17 All younger age bands

the smallest proportion of adult women aged 18

have decreased in their relative proportion of the

to 64 at 57.6% and 57.5%, respectively. Counties

16 Department of Health. (2018). Health in Ireland Key Trends 2018. Retrievedfrom:https://health.gov.ie/wp-content/uploads/2018/12/ Key-Health-Trends-2018.pdf

17 Ibid.

with the highest over 65 female population are

Children in families of cohabiting couples had a

Mayo (18%) and Kerry (17.6%). See Appendix 1

younger profile with 76.6% of this family type

Table A.5 Number and percentage of females by

having only children under the age of 15. This

county and age.

compares with just 47% of married couples having

only children under the age of 15. Children in

1.2.2 Household composition and marital status

one parent families were likely to have an older

age profile. Census 2016 shows 35.9% of females

(654,917) over 18 years are single; 49% (895,037)

At the time of the last census (2016) there were

are married (including same sex civil partnership);

1,218,370 families nationally (for CSO Census

3.3% are divorced; and 8.1% are widowed. See

purposes, a family is defined as a couple with or

Appendix 1Table A.6 for details of the marital

without children, or a one parent family with one

status of females in the state. Of women aged

or more children). 862,721 of these were families

over 65 years, 31.5% are living alone in a private

with children, an increase of 28,455 since 2011.

household which is notably higher than for males

The number of married couples with children

(21.3%). This may be linked to women’s longer life

increased by 1.7% to 568,317, while the number

expectancy, and to the fact that older women are

of cohabiting couples with children increased by

more likely to be widowed (and not remarried)

25.4% to 75,587. One parent families headed by a

than older men.18. See Appendix 1Table A.7 for

female with children increased by 1.5%. Table 1.1

details.

provides a breakdown of families which involved

females as head/or shared heads of household.

Table 1.1 Families which involve females (as part of a couple/or as head of a one parent family)
Family type		Sub-total	Total	Proportion
Married couple	Female is part of a married couple with one or more usually resident never-married children (of any age);	559,006	832,504	71%
	Female is part of a married couple without children	273,498
One parent household with children	One parent household headed by a female with one or more usually resident never-married children (of any age);	186,391	186,391	16%
Cohabiting couple	Female is part of a cohabiting couple together with one or more usually resident never- married children (of any age)	74,854	148,749	13%
	Female is part of a cohabiting couple without children	73,895
Total			1,167,644
Source: CSO. (2017). Census 2016 Results: Profile 4 Households and Families

18 Stepler, R. (2016). Gender gap in share of older adults living alone narrows. Pew Research Center. Retrieved from: http://www. pewsocialtrends.org/2016/02/18/1-gender-gap-in-share-of-older-adults-living-alone-narrows/

Women’s Health in Ireland — Evidence Base for the development of the Women’s Health Action Plan

Nationality

1.2.3 Ethnicity and nationality

12.8% (302,587 individuals) of the female

Of the female population usually resident in

population are not Irish nationals.

Ireland, 82.4% are White Irish. The largest

Proportionately, the Polish population represents

minority group are those of any other white

2.6% of the female population, while UK nationals

background (9.5%), Asian 2.1% and Other

make up 2.1% females nationally. See Appendix

(including mixed backgrounds) 1.5%. See Appendix

1Table A.12 for breakdown of the total female

1 Table A.8 for ethnic background of female

population by nationality.

population usually resident in the state.

The Dublin region has the lowest proportion

1.3 A socio-economic profile

of White Irish at 76.1%, followed by West and

Midlands regions with 83.7%. The largest

1.3.1 Education

proportion of female Irish Travellers exists in the

Midlands region where they account for 1.3% of

Nationally, 25.7% of females aged 15 and over,

the female population. All other minority groups

achieved education at degree level or higher. 15.6%

exist in their largest relative proportions in the

achieved a third level education (non-degree),

Dublin region. See Appendix 1 Table A.9 Ethnic

26.7% have a secondary education while 9.5% have

background of female population usually resident

either no formal education or primary education,

in the state by region, 2016.

with a further 22.5% of females in the category

of other (which includes not stated). The Dublin

Traveller women

region has the highest proportion of females with

a degree level education or higher at 29.8%. The

The 2016 census recorded 15,610 Irish Travellers