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Health and Carers

Health and Carers

In 2022, poorer general health was associated with lower income

CSO statistical release, , 11am

This release is categorised as a CSO Frontier Series Output and is based on linking administrative income data with the 2022 Census population living in private households. When calculating household income, estimates for some households are underestimated, as not all income sources are included, such as undeclared employment income, inter-household transfers, and some foreign pensions. Throughout this release, the term administrative income will be used to describe the income sources covered.

Equivalised income allows for a more meaningful comparison of income across households by accounting for the number of adults and children living in the household, thus allowing for analysis at an individualised level. The term low-income threshold refers to households with an equivalised net administrative income of below 60% of the national median equivalised net income as derived from administrative data sources. In this release, the low-income threshold is deemed to be €16,271.

As a CSO Frontier Series release, particular care must be taken when interpreting the statistics in this release as it may use new methods which are under development and/or data sources which may be incomplete, for example, new administrative data sources. For further information on the data sources, linking procedures and limitations of this report, see the Background Notes.

General Health

In Census 2022, people were asked to rate their general health on a scale from very good to very bad. This chapter presents an analysis of income based on self-perceived health status, broken down by the six Health Service Executive (HSE) Health Regions (HRs) as well as the twenty subsidiary integrated healthcare areas.

Household net administrative income is income from administrative sources, such as employment income from Revenue and social welfare income from Department of Social Protection, after tax and social insurance has been deducted. Equivalised net administrative income allows for a more meaningful comparison of income across households by accounting for the number of adults and children living in the household, thus allowing for analysis at an individualised level. For further information, see the Background Notes.

When analysing equivalised income by personal characteristics, it is important to remember that such estimates are derived from household income which is compiled from all persons within the household.

General health by HSE health region

Similar trends are observed across the six HSE health regions where, as self-perceived general health worsens, the proportion of the population with an equivalised net administrative income below 60% of the national median increases.

When considering only those persons who consider their general health to be very bad, the HSE West and North West HR had the highest proportion of people (35.1%) with an equivalised net administrative income under 60% of the national median in 2022, followed by HSE South West HR (30.3%). HSE Dublin and Midlands HR had the lowest proportion (27.2%) of people with self-defined very bad health under this low-income threshold in 2022.

Considering only those persons who consider their general health to be very good, the HSE Dublin and North East HR had the lowest proportion of people (10.5%) under this low-income threshold, followed by HSE Dublin and Midlands HR (10.6%). In the HSE West and North West HR, 14.9% of people with self-defined very good health had equivalised administrative income under 60% of the national median.

Figure 3.1 Population below the low administrative income threshold by general health and HSE health region, 2022

General health by HSE Integrated Healthcare Area

Analysis by HSE Integrated Healthcare Area (IHA) shows similar trends. Considering only those persons who described their general health as very bad, the HSE Mayo IHA had the highest proportion of people (40.2%) with an equivalised net administrative income under 60% of the national median. This was followed by HSE Kerry IHA (35.9%) and HSE Cavan Monaghan IHA (35.4%). HSE Kildare West Wicklow IHA had the lowest proportion of people (23.2%), who described their general health as very bad with an equivalised net administrative income under 60% of the national median.

Considering only those persons who described their general health as very good, the HSE Dublin North County IHA had the lowest proportion of people (7.9%) under this low-income threshold, followed by HSE Dublin South City and West IHA (8.6%) and HSE Dublin South and Wicklow IHA (8.7%). In HSE Donegal IHA, 21.6% of people who described their general health as very good were under the low-income threshold.

Map 3.1 Population below the low administrative income threshold by general health and HSE integrated healthcare areas, 2022

General health by age group

Analysis by age shows that, in general, there is an association between a person’s general health status with their income in adult life.

Among children aged 0–17, those in very good general health were less likely to have an equivalised net administrative income below the low-income threshold compared with children in poorer health. However, for children there was no clear pattern of progressively lower income as health status declines. For example, 21.0% of children with fair health had an equivalised net administrative income below the low-income threshold, a slightly higher rate than for children with very bad health (19.6%).

For adult groups the trend is clear. Persons who considered their general health to be very bad were at least twice as likely to be below the low-income threshold when compared to those who considered their general health to be very good.

Among adults (those aged 18 years or older) who described their general health as bad or very bad, the proportion living below the low-income threshold increased with age up to the 50-64 years age group. Notably, among adults in bad or very bad general health, the lowest proportion under the low-income threshold was observed in the cohort aged 65 and over.

Figure 3.2 Population below the low administrative income threshold by general health and age group, 2022

Long-lasting Condition or Difficulty

In Census 2022, people were asked to indicate the extent to which they experienced any long-lasting conditions or difficulties, such as blindness or vision impairment, or difficulty going outside the home. From the questions, it is possible to identify three categories reflecting the extent to which long-lasting conditions or difficulties were experienced:

  • Long-lasting condition or difficulty experienced to any extent.
  • Long-lasting condition or difficulty experienced to a great extent.
  • Long-lasting condition or difficulty experienced to some extent.

The category ‘to any extent’ is a combination of the two responses: ‘to a great extent’ and ‘to some extent’. Note also that the categories include functional difficulties experienced due to old age.

Analysis by ‘any extent’ shows that those most likely to be below the low-income threshold were persons experiencing difficulty working at a job or business or attending school or college (25.0%), followed by persons experiencing difficulty going outside the home (24.5%). Comparatively, those least likely to be below the low-income threshold were persons experiencing deafness or hearing impairment to any extent (17.4%), followed by persons experiencing blindness or a vision impairment (17.9%).

Table 3.1 Population below the low administrative income threshold by type and extent of long-lasting condition or difficulty, 2022

Long-lasting condition or difficulty by age group

Combining the experience of any type of long-lasting condition or difficulty and analysing by age group shows similar trends as was observed in the analysis by general health. For adults aged 18 and over, the proportion of persons under the low-income threshold increased as the extent of any long-lasting condition or difficulty experienced increased. Almost one in three (31.3%) of adults aged 50-64 who experienced any long-lasting condition or difficulty to a great extent were under the low-income threshold.

Figure 3.3 Population below the low administrative income threshold by long-lasting condition or difficulty and age group, 2022

Long-lasting condition or difficulty by HSE health region

One in five persons (20.4%) who experienced any long-lasting condition or difficulty to a great extent in the HSE Dublin and North East health region were under the low-income threshold, compared with 28.8% of such persons in the HSE West and North West health region.

Figure 3.4 Population below the low administrative income threshold by long-lasting condition or difficulty and HSE health region, 2022

Long-lasting condition or difficulty by HSE Integrated Healthcare Area

One in six persons (16.4%) who experienced any long-lasting condition or difficulty to a great extent in the HSE Dublin North County Integrated Healthcare Area (IHA) were under the low-income threshold, compared with one in three (33.2%) of such persons in the HSE Donegal IHA.

Map 3.2 Population below the low administrative income threshold by general health and HSE integrated healthcare areas, 2022

Working-age households

Working-age households, as defined here, are those that contained at least one working-age person. A working-age person is defined as a person aged 18-64, excluding students aged 18-24; retired persons; and persons aged 60-64 who are not working and where the majority of household income is from pensions.

The income of working-age households was generally lower in households that contained at least one person, of any age, who was experiencing any long-lasting condition or difficulty to any extent. The median net household income in 2022 for working-age households containing at least one person who was experiencing any long-lasting condition or difficulty to any extent was €57,749, compared with €61,835 for households with no such person.

Table 3.2 Working-age household income by experience of long-lasting condition or difficulty, 2022

Working-age households containing at least one person experiencing a long-lasting condition or difficulty were more likely not to contain a person in employment (15.6%), compared with households without persons with a long-lasting condition or difficulty (5.5%).

Table 3.3 Number of working persons in working-age households by experience of long-lasting condition or difficulty, 2022

Working-age households containing at least one person experiencing a long-lasting condition or difficulty received an average of 18.0% (€14,804) of their mean gross household income from social transfers, compared with 7.8% (€7,324) for households without such a person.

Table 3.4 Composition of working-age household income by experience of long-lasting condition or difficulty, 2022

Carers in Receipt of Supports

Matching with administrative data from the Department of Social Welfare allows for the identification of carers in receipt of carer’s allowance or carer’s benefit.

Overall, persons aged 18 and over who were in receipt of carer’s supports in 2022 had a lower rate of being under the low-income threshold than those not in receipt of such supports: 13.2% compared with 14.3%. However, this varies by age. Persons aged 35-40 and in receipt of carer’s supports were more likely to be under the low-income threshold (14.7%) when compared to those not in receipt of such supports (12.8%). The difference in persons aged 65 and over is significant, wherein 7.7% of persons in receipt of carer’s supports were under the low-income threshold, compared with 16.6% of persons not in receipt of such supports.

Table 3.5 Population below the low administrative income threshold by carer status and age group, 2022

Restricting the analysis to working-age persons, as defined above, those in receipt of carer’s supports were more likely to be under the low-income threshold (14.9%). This compares with 13.4% of persons not in receipt of such supports.

Carers in receipt of supports by HSE Health Region

Analysis by HSE Health Region (HR) shows working-age persons in HSE West and North West HR and in receipt of carer’s supports are most likely to be under the low-income threshold at 18.4%.

Figure 3.5 Population below the low administrative income threshold by carer status and HSE health region, 2022

Carers in receipt of supports by HSE Integrated Healthcare Area

By HSE Integrated Healthcare Area (IHA), working-age persons in HSE Donegal IHA and in receipt of carer’s supports were most likely to be under the low-income threshold at 21.7%, followed by HSE Sligo Leitrim IHA (18.3%) and Cavan Monaghan IHA (18.0%). Working-age persons in both HSE Dublin South City and West IHA along with HSE Dublin South West IHA, and in receipt of carer’s supports, were least likely to be under the low-income threshold at 12.4%.

Map 3.3 Working-age population below the low administrative income threshold by carer status and HSE integrated healthcare areas, 2022