MOST OECD COUNTRIES conduct regular health surveys that ask respondents how, in general, they would rate their health. We know from many studies published in the medical literature that this in an important question to ask. The reason is that self-rated health is a reliable measure of actual health.
A question on self-rated health was introduced for the first time in the Irish Census questionnaire in 2011. The question was as follows: “How is your health in general?”. Respondents could answer by selecting one of the following five options: “very good”, “good”, “fair”, “bad” and “very bad”.
The exact same question was asked again in the 2016 Census and in the 2022 Census. Therefore, one can compare responses over time and see if people living in Ireland in 2022 are rating their health better or worse compared to people who were their age in 2011 and 2016.
The key finding, if one compares responses in 2011, 2016 and 2022, is that there has been a shift from good to less good health.
In 2011, 88% of the population rated their health as very good or good. The corresponding figure was similar in 2016 (87%). In 2022, it dropped to 83%.
A decrease of 4 to 5 percentage points in the proportion of people rating their health as very good or good is not negligible. However, not all age groups have experienced a decline in self-rated health. There are encouraging findings for some age groups, and less encouraging findings for other age groups. Let us have a closer look at the findings.
The encouraging findings come from the older population. Among those aged 75 and above, there has actually been a small increase in the proportion reporting good or very good health.
In 2011, 54.7% of people aged 75 and above reported to be in good or very good health. This increased to 57.5% in 2016 and to 58.4% in 2022.
As health tends to deteriorate with age, we can welcome – with some cautious optimism – the finding that older people in our society are rating their health, if anything, a bit better than a decade ago.
All the other age groups have experienced a shift from good to less good health. One group that seems to be particularly affected is the 30 to 39 age group. In 2011, 93% of those aged 30 to 39 reported being in good or very good health.
In 2016, the corresponding figure was 91%. In 2022, it dropped to 86%. More detailed data provided by the Central Statistics Office also shows that both males and females in this age group reported a decline in self-rated health. A noticeable drop is also observed in the younger age groups.
The percentage among those aged 15 to 24 rating their health as good or very good was 95% in 2011, 94% in 2016 and 90% in 2022. Once again, the shift from good to less good health applies to both males and females.
The 2016 Census was carried during what was a relatively good year for Ireland, and before the onset of the Covid-19 pandemic. The 2022 Census was carried out after the pandemic had hit us. One cannot say with certainty that the Covid-19 pandemic is driving these results.
There might be other factors at play. However, it is likely that the pandemic explains, at least to some extent, why most age groups have experienced a shift from good to less good health.
The pandemic has brought many changes to people’s lives. Many studies document that most of these changes have been detrimental to health. Examples of such changes are a more sedentary lifestyle, less frequent use of health services, less in-person interactions with family, friends and colleagues, more caring responsibilities, more stress and anxiety and economic uncertainty.
Also, the vast majority of the population contracted Covid-19 at some stage between 2020 and 2022. To date, the confirmed cases of Covid-19 in Ireland amount to 1,712,6542. A policy paper by the WHO European Observatory on Health Systems and Policies report that one in 10 people contracting Covid-19 are still unwell after 12 weeks3.
There are at least three questions that in my view deserve some more thoughts and further investigation. The first question is: why are the older age groups different, in the sense that they did not experience a shift to less good health? The second question is: for all the other age groups, is the 2022 Census data capturing a shift to worse physical health, a shift to worse mental health or both?
The third question is: if this decline is indeed explained by the pandemic and all the negative changes that have come with it, will we see the trend reverse in the next Census, with people being again more satisfied with their level of health? Personally, I really hope so. I am sure I am not the only one.
Dr Irene Mosca is an assistant professor of economics at Maynooth University.
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