St Patricks Day is celebrated by Irish and non-Irish communities across Britain with a confidence and inclusiveness that was unimaginable decades ago. It is a celebration of being Irish and of what Irishness means in an increasingly diverse society. While the Irish are very visible this week, they are almost invisible the rest of the year. Clearly they are active in all parts of British society, especially as members of local communities. However, at macro level, their health and social needs are neglected by policy makers, researchers, commissioners and service providers who claim to espouse justice and equality.
I could write volumes about Irish health in Britain but suffice to say we have among the highest rates of cancer in England and Wales. UK cancer is reducing, but decline is slower among the Irish and rates are increasing for some cancers. There are excesses of long- term illness, common mental disorders and high rates of suicide which are not declining. High levels of heart disease, hypertension and stroke create ill-health and also increase the risk of vascular dementia. Irish organisations are daily faced with people with memory loss, mostly undiagnosed and finding mainstream dementia services unable to cater for them with cultural sensitivity. The Irish have an older age profile than the general or BME populations, many live in areas of multiple deprivation experience social disadvantage and like other BME groups have problems accessing health and social care in an equitable or timely manner.
Yet, these issues are persistently neglected. Admittedly, much of the research is dated, but the absence of evidence does not mean the absence of a problem. But how to get the evidence is a conundrum as there is no commitment to do the research or consult community organisations. Even when Irish agencies make representations and provide evidence to DH, NHS, major charities or relevant bodies and facilitate access for research or consultation, inclusion is not guaranteed. Recent mapping of Irish communities in JSNAs, shows that although many acknowledge local Irish populations, few identify specific health needs or link with Irish organisations for partnership.
Ten years ago, I would have said that a focus on skin colour notions of ethnicity meant that the (largely) white Irish were rendered invisible in equality debates. Today I’m sceptical and blame those who commission services or research, whose purpose seems best served by at best aggregating the Irish in the overall White category. This renders the Irish invisible and probably masks the extent of inequality which exists between visible minorities and the general population. I also blame researchers who lack commitment to understand minority ethnic communities. I accept there are hidden groups, but my experience of Irish and BME research is that if researchers can be bothered to engage with key individuals or organisations, marginalised people can be reached and their voices heard. I am frequently told that surveys and consultations include everybody, but rarely see much effort to contact those who because of disability, language, suspicion or digital exclusion are unable or unwilling to participate. Irish and other BME organisations reach into their communities, speak their language and can access those whom the mainstream can’t reach. We aim to do the best for our communities but must be proactively consulted and our contribution rewarded if we are to continue to provide for vulnerable people. We are proud to be part of a diverse society but and deserve to be evident all year round and not just during the month of March!
Dr Mary Tilki is Chair of Irish in Britain. She has researched and published widely on cultural competence, health inequalities, ageing, ethnic elders and the health of Irish people in Britain. She has extensive experience in the third sector providing diverse culturally sensitive services to the Irish in Britain.