The Irish health disadvantage in England: contribution of structure and identity components of Irish ethnicity

Background. Irish people living in Britain face a significant health disadvantage when compared to the white British host population. Objectives. Using recent survey data, determine whether there is an 'Irish health disadvantage' independent of socio-economic factors and explore whether there is an Irish ethnic identity effect which operates on health. Design. Data from the Census 2001 Individual Licensed SARs was analysed using binary logistic regression to study the relationship between the self-reported Irish ethnicity measure (which is presumed to reflect self-identification with Irish culture and community), considering country of birth subgroups, and the self-reported health measures of general health and limiting long-term illness. The analysis was adjusted for key demographic and socio-economic factors. Results. When compared to the white British reference population, the self-reported 'white Irish' population overall, the Irish born in Northern Ireland, and UK-born Irish, show a significantly increased risk of both self-reported poor general health and limiting long-term illness. The increased risk of poor health of the Irish born in the Republic of Ireland is greatly diminished after the socio-economic adjustments, and only statistically significant in the case of general health. Finally, the Irish born in Northern Ireland who self-report as Irish are significantly more likely than those who self-report as British to report poor general health, which may suggest an Irish ethnic identity effect. Conclusions. The findings demonstrate a persistent ethnic health disadvantage for first generation and UK-born Irish people living in England with respect to self-reported general health and limiting long-term illness, which cannot be fully explained by demographic and key socio-economic factors. Aspects of ethnicity related to both structure and identity may affect Irish self-reported health