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The 2024 iteration of the Irish Health Survey (IHS) took place in November and December 2024 primarily via an online questionnaire with a very small number of telephone-based interviews. The IHS was previously undertaken in 2015 and 2019. In 2015, paper based self-completion questionnaires were provided to respondents and took place between Quarter 3 (July, August, September) 2015 and Quarter 2 (April, May, June) 2016. In 2019, face-to-face interviews with interviewers took place with respondents and took place between Quarter 2 2019 and Quarter 1 (January, February, March) 2020.
The data collection was conducted in November and December 2024 via an online questionnaire. This differs to previous iterations which were undertaken by interviewers or by using self-completed paper forms. Previous iterations were collected at a different time of year. Any direct comparison between the results in 2024 and the 2015 & 2019 results needs to consider these differences.
The Irish Health Survey is a voluntary survey which is conducted annually. In Irish law, it is carried out under Section 24 of the Statistics Act, 1993, which allows this Office to invite people to provide information on a voluntary basis. In 2025 and 2031, it will be conducted under the provisions of European Union regulations 2019/1700, 2023/2529, and 2024/297.
The survey fulfils the need for public health policies to obtain reliable data on health status, access to health care, and health determinants. It allows for health comparisons to be made across Europe in the relevant regulation years.
The Central Statistics Office wishes to thank the participating persons for their co-operation in agreeing to take part in the survey, and for facilitating the collection of the relevant data.
The Irish Health Survey was designed in line with the fourth wave of the European Health Interview Survey (EHIS). The collection of the data under the aforementioned European Regulation implies that harmonised data can be obtained across the European continent in the relevant regulation years. The Irish Health Survey can be divided into three fundamental components. These are:
The module on health status is a central element of the survey. It allows measurement of the health status of the population in general, and not only in relation to specific health problems. It covers different aspects and dimensions of health: physical and mental health, chronic and temporary problems and specific conditions and neurodiversity. It covers the general impact on the functional status and the limitations in activities of daily living of the respondents. The first three general questions on self-perceived health, long standing illnesses or health problems, and activity limitations constitute the Minimum European Health Module (MEHM) and the CSO Data Standard for General Health.
The module on health care collects data on the use of health care services and the unmet needs for health care. Information on health care consumption is an essential part of the health information system in order to assign necessary resources to the population. This allows analysis of the relationships between health consumption and several determinants such as health status, lifestyles or socio-demographic characteristics as well as the relationships between different types of health care use.
The general focus of the health determinants module is to measure aspects in lifestyles or health-related behaviours. These may have a positive or negative impact on an individual’s health status. Questions are included on body mass index (BMI), physical activity, nutritional habits, social media use, alcohol consumption, smoking and cannabis use, social support and the provision of informal care or assistance.
The complete list of sub-modules are as follows:
The survey responses were linked to Census 2022 data in order to source relevant demographic data, including deprivation index and HSE Health Region.
A copy of the Irish Health Survey 2024 questionnaire (PDF 225KB) is available on the CSO website.
A simple random sampling (SRS) method without stratification was used to select approximately 24,000 persons aged 18 years and over from the Census 2022 frame. With an SRS approach, every individual within the target population, who were aged 18 years and over, had an equal chance of selection regardless of demographics characteristics such as sex, age or self-perceived general health status.
A letter was sent to approximately 24,000 individuals in the sample asking them to complete the survey. The letter contained a QR code and a request to complete the IHS via online questionnaire by typing in the survey link. After two weeks, a reminder letter was sent to those who were yet to complete the survey. Proxy responses were allowed in cases where a person would have difficulty completing the questionnaire themselves. In a small number of cases, when an individual was unable to complete the survey online and did not have a proxy available to respond for them, a telephone-based interview took place. The reference period for the survey is 2024. Data collection occurred in November and December 2024. There were 5,101 completed responses to the survey, which resulted in a response rate of 21%.
The Irish Health Survey weighting procedure had two steps: non-response adjustment and calibration. Design weights were calculated for all people in the initial sample. The design weights are computed as the inverse of the selection probability of the unit and were the same for all sampled due to the simple random sampling approach. The purpose of design weights is to eliminate the bias induced by unequal selection probabilities.
The non-response adjustment used a propensity score adjustments method to assess non-response. Propensity score adjustment uses a logistic regression approach, utilising variables from the Census 2022 frame to estimate the probability of non-response for cohorts with specific characteristics related to non-response and the variables of relevance to the survey. Several iterations of the propensity score adjustment took place, optimising the model and including the following Census 2022 variables in the non-response calculation; deprivation index grouping, relationship status, principle economic status, internet at home, citizenship, number of carers in the household, sex, age, self-perceived general health, age, marital status, disabled to some extent, employment status, ethnicity, and level of education. Each group is then given a weight based on the estimated probability of responding. This eliminated the bias introduced by discrepancies caused by non-response, particularly critical when the non-responding people are different from the responding ones in respect to some census variables, as this may create substantial bias in the estimates.
Calibration of the non-response adjusted design weights then took place, calibrating to the Q4 2024 population estimates at the level of sex, five-year age group, and NUTS 3 region using the Icarus-macro, developed by INSEE, for this purpose. To provide national population results, the survey results were weighted to represent the entire population.
The Pobal Haase-Pratschke Deprivation Index is used to analyse the data. The Index uses Census data to measure levels of disadvantage or affluence in a geographical area. More detailed information on the index can be found on the Trutz-Haase website.
The results are presented by quintiles, five equal-sized groups of households, with the first quintile representing the most disadvantaged area and the fifth quintile representing the least deprived/most affluent area. The five quintiles are described below:
Chronic diseases or chronic conditions represent one of the main public health concerns. They are a major cause of use of health care services. Measuring chronic morbidity, both the extent of the phenomenon and the types of diseases, is useful for overall evaluations in the domain of health status. It is also useful for the study of health care systems in terms of evaluation, policy formulation and assessment of need for health care. The full list of diseases and chronic conditions included in the health status module of the IHS are as follows:
Problems which are seasonal/intermittent, or which are absent due to medical treatment are included. The question is asked of chronic conditions or diseases experienced in the past 12 months.
The Personal Health Questionnaire (PHQ-8), 8-item depression screener, was selected as the instrument to monitor mental health and it encompasses a subset of the negative mental health dimension, or mental health problems. It is an instrument for assessing and monitoring the prevalence and severity of current depressive symptoms and functional impairment and to make tentative depression diagnosis. It is originally derived from the Brief Health Questionnaire, Depression Module (PHQ-9).
Mental health status is calculated using data from question thirteen of the questionnaire. In this question, there are eight items measuring various negative mental health effects experienced in the previous two weeks. Each of these items has four possible answers:
Each of these responses is then given a score; None of the days = 0, Several of the days = 1, More than half of the days = 2, and finally Nearly every day = 3. The respondent’s scores for each of the eight items are then summed, giving a maximum of 24. The levels of depression are identified by their final score, and the categories are as follows:
The WHO-5 is a self-report instrument measuring mental well-being. It consists of five statements relating to the past two weeks. Each statement is rated on a 6-point scale, with higher scores indicating better mental well-being.
The raw score is calculated by totalling the scores on each of the five questions. The raw score ranges from zero to 25, zero representing worst possible mental well-being and 25 representing best possible mental well-being.
To get a percentage score ranging from zero to 100, the raw score is multiplied by four. A percentage score of zero represents worst possible mental well-being; a score of 100 represents best possible mental well-being.
Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight, and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2). In the European Health Interview Survey, three BMI categories are present. These are:
Rates as calculated from the Irish Health Survey are not directly comparable with the Department of Health “Healthy Ireland” Survey rates, due to methodological differences between the two surveys but they may provide some insight into general trends.
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