Disability and Population Health Discussion Paper

People with disabilities, their families, carers and advocateshave traditionally focused on striving to develop adequate andresponsive specialist support services to meet their needs. Thiswork continues today. However, the mechanisms and channels throughwhich this can happen are changing. Changes are occurring in thehealth services and other state agencies that have a responsibilityto provide services that meet the needs of people withdisabilities. The voluntary disability sector has continuouslyresponded to this change in a timely and professional manner. ThisDiscussion Paper on Disability and Population Health is anotherexample of how the disability sector is responding to thatchange.

Health policy was once thought to be about little more than theprovision and funding of direct medical care and intervention. Withthe emergence and development of the social model of health this isnow changing. The concept of Population Health is taking centrestage, internationally and nationally, in the strategic developmentof health and social care services. The Irish health care system isexperiencing a time of change, not only in terms of service designand delivery, but, perhaps more fundamentally, in relation tounderlying values, core principles and strategic thinking. Theestablishment of a designated Population Health Directorate withinthe Health Service Executive and the primacy of the approach withinthe Department of Health and Children should further energise andpromote the concept at national level. It is envisaged that theapproach will be central to the developing structures andconsequently service design at national, regional and localdelivery level.

People with disabilities are living longer. Many are survivinginto old age who in the past would not have survived. The generalpopulation is also living longer. What can our society do to reducethe incidence of disability, and to ameliorate its impact? Increased capacity in thediagnostic, genetic and information provision areas will meet upwith the moral, ethical, behavioural and social issues thatmainstreaming will throw up. We must not simply content ourselveswith only sorting out the current levels of unmet specialist needsand presume that disability as an issue has been dealt with onceand for all. We must develop a disability plan looking forward tothe next fifty years. The Population Health approach is key to anysuch plan.

This Discussion Paper is therefore very timely and relevant. Itprovides the cornerstone to our National Conference,''Disability and Population Health'', (Portlaoise, 5thand 6th October, 2005). It outlines DFI''s current positionregarding disability and the Population Health approach to healthpolicy. It sets out to define the concept, particularly within anIrish context, proceeds to develop key determinants for thedisability sector and finally makes recommendations for policydevelopment.

I wish to thank all those who contributed to the development ofthe Paper, in particular those individuals and organisations whocommented on and submitted responses to earlier drafts.

I am particularly grateful to Maria Fox, author of the Paper andto all the staff of DFI for their input. I would expect that theproposals contained in the Paper will contribute to the developmentand expansion of public health initiatives which will benefit notonly the disability sector, but all groups in the population.

John Dolan Chief Executive September 2005