Introduction

The aim of the Healthy Communities Programme is to identify specific areas in which high risk factors to the health and wellbeing of the population are particularly prevalent, with a view to implementing targeted initiatives to tackle these challenges from within these communities. This will be achieved through partnership with a range of stakeholders and through the provision of dedicated services to build sustainable improvements in the health and wellbeing of those of all ages living in these communities.

Scope

The social determinants of health are the non-medical factors that influence health outcomes. These are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. Research has shown that the social determinants can be more important than health care or lifestyle choices in influencing health (World Health Organisation WHO, 2021).
The social determinants identified by the WHO, which can influence health equity in positive and negative ways include:

• Income and social protection
• Education
• Unemployment and job insecurity
• Working life conditions
• Food insecurity
• Housing, basic amenities and the environment
• Early childhood development
• Social inclusion and non-discrimination
• Structural conflict

Access to affordable health services of decent quality.

Those involved in the Sláintecare Healthy Communities will be working those that live, work and socialise in the nominated communities to target positive influence on the social determinants of health.

Identification of Target Areas

In Ireland, there is a strong link between poverty, socio-economic status and health. Data on demographics and health status indicate that 22.5% of the population are exposed to disadvantage and the prevalence of chronic illness is higher in more deprived areas, including stroke (2.2 times higher), coronary heart disease (2.5 times higher) and diabetes (1.4 times higher). Hence, area-based approaches was agreed to identify the most disadvantaged areas to target the health communities programme at in the first instance. A total of 19 target sites across the country were identified.

Sites identified in Westmeath were agreed to be the two RAPID areas in Athlone and Mullingar based on the small area level statistics where deprivation levels are highest in the two largest towns in the county

Local Implementation

Westmeath County Council is one of only 2 councils to have retained the RAPID Programme; along with the Area Implementation Teams in Athlone & Mullingar.

Importantly these Implementation teams made up of community representatives, local groups and statutory agencies work in partnership to address the issues and challenges that are identified through a RAPID Community Forum. These structures facilitate early and ongoing identification of needs coming directly from the communities.