Royal Irish Academy Conference: Spatial Justice and the Irish Crisis 23 April, 2013, Academy House The on-going crisis and associated responses to it (political, governance, popular etc.) provides an entry point for a wide-ranging exploration of spatial justice as a theoretical construct and a departure point for empirical analysis. Discourses of justice, equality and fairness remain central to a range of interconnected debates as Ireland seeks to recover from the interrelated collapses of the banking system and property markets and the knock on effects through the rest of society and the economy. Scale is an important dimension in framing and constructing popular discourses concerning issues of justice, e.g. the role of EU institutions in shaping Ireland’s treatment of banking debt or the impact of national budgetary measures on particular places. The focus of this conference is on understanding these spatially connected processes, how they are functioning at different scales, their impact on particular or specific places and spaces, as they give rise to new or evolving social and economic geographies.

1. Health and Spatial Justicep
R. Foley & A. Kavanagh (Geography, NUI Maynooth)
Royal Irish Academy: Spatial Justice, Housing and the Financial Crisis
Tuesday 23rd April 2013Tuesday, 23 April 2013

2. Layouty
1 M i H l h & W llb i1. Measuring Health & Wellbeing
2. Spatial Data & Justice in Ireland
3. Composition or Context
4 Health and Justice at National Scale4. Health and Justice at National Scale
5. Developing the KFIW Index
6 R l V i bl S i l S l6. Results at Variable Spatial Scales
7. Validation and Comparisons
8. Potential Uses for Spatial Justice

3. 1 Measuring Health & Wellbeing1. Measuring Health & Wellbeing
• Quantitative Approaches
• Qualitative Approaches
• Definitional Issues
• Spatial Scales of Analysis• Spatial Scales of Analysis
• Census Questions on Limiting Long‐Term Illness (LLTI)
and General Health Stat s (GHS)and General Health Status (GHS)
• Additional questions around disability

4. 2 Spatial Data & Justice in Ireland2. Spatial Data & Justice in Ireland
• Critical Aspects of Data Gaps and Absences
• Limited detailed geographyLimited detailed geography
• Census data on measure of spatial injustice and
deprivationdeprivation
• Additional routinely collected admin data
• New Question on General Health in 2011

5. Questions on Census Form.Q

6. 3 Composition or Context3. Composition or Context
• Debates within Medical/Health Geography
• Explaining health injustices
• Individual v Aggregate forms
• Administrative v Operational Units• Administrative v Operational Units
• New SA geographies
• Functional and Statistical Value

7. 4 Health and Justice at National Scale4. Health and Justice at National Scale

8. National General Health Data
General Health 2001/2 2011
% %
Rep. of Ireland*Rep. of Ireland
Good/Very Good No question 88.3
Fair No question 8.0
Bad/Very Bad No question 1.5
N th I l dNorthern Ireland
Good/Very Good 70 79.5
Fair 19.3 14.9
Bad/Very Bad 10.7 5.6
Scotland
Good 67.9 n/a
Fair 21.9 n/a
Not Good 10 2 n/aNot Good 10.2 n/a
England & Wales
Good/Very Good 68.6 81.2
Fair 22.2 13.1
/Bad/Very Bad 9.2 5.6
UK 3 point scale
(Good‐Fair‐Not 5 point scale (VG‐
Good) G‐F‐B‐VB)

9. National Health/Age BreakdownNational Health/Age Breakdown
Source: CSO

10. Health and Social Class
80 00%Source: CSO
60.00%
70.00%
80.00%
1 Professional
2 M i l
30.00%
40.00%
50.00%
2 Managerial
3 Non-manual
4 Skilled manual
5 Semi-skilled
6 Unskilled
0 00%
10.00%
20.00%
6 Unskilled
7 Other-unknown
0.00%
VG G F B VB NS

11. 5 Developing the KFIW5. Developing the KFIW
• Kavanagh‐Foley Index of Wellbeing (KFIW)
• Simple Calculation from Census 2011Simple Calculation from Census 2011
• =(% VGH*1)+(%GH*2)+(%FH*3)+(%BH*4)+(%VBH*5)
• Operational across scales
• Means and RangesMeans and Ranges
• Age‐Standardisation

12. 6. Results at Variable Spatial Scales6. Results at Variable Spatial Scales
National/RegionalNational/Regional
County/Local Authorities
LEA – Local Electoral Area
l l i i iED – Electoral Divisions
SA – Small AreasSA Small Areas
Settlements
Functional Areas, e.g. Local Health Offices (LHO)

13. KFIW Scores: Local Authority ScaleKFIW Scores: Local Authority Scale
LA Scale VG G F B VB KFIW Score LA Scale VG G F B VB KFIW Score
Dún Laoghaire-Rathdown 66.71 25.50 6.53 1.02 0.23 142.55 Clare 60.05 30.14 8.28 1.25 0.26 151.53
Fingal 65.63 27.21 6.01 0.95 0.20 142.89 Westmeath 60.46 29.42 8.47 1.34 0.32 151.63
Meath 65.09 27.23 6.54 0.94 0.21 143.93 Kerry 59.48 30.28 8.79 1.17 0.27 152.46y
Cork County 64.97 27.01 6.88 0.93 0.20 144.38 North Tipperary 59.88 29.46 9.07 1.34 0.25 152.63
Kildare 64.91 27.09 6.67 1.10 0.22 144.62 Offaly 59.86 29.63 8.82 1.38 0.31 152.66
Wicklow 64.16 27.07 7.46 1.09 0.22 146.16 Carlow 59.63 29.73 9.01 1.38 0.25 152.88
South Dublin 63.30 27.94 7.29 1.20 0.27 147.20 Sligo 58.99 29.71 9.59 1.44 0.26 154.28
Waterford County 63.08 27.80 7.86 1.06 0.20 147.51 Leitrim 58.34 30.42 9.80 1.20 0.24 154.59
Kilkenny 62.88 27.81 7.90 1.15 0.26 148.09 South Tipperary 58.65 30.11 9.46 1.49 0.31 154.70
Cavan 62.85 27.43 8.40 1.11 0.20 148.39 Dublin City 59.11 29.51 9.26 1.71 0.40 154.77
Limerick County 61.97 28.89 7.81 1.10 0.22 148.72 Waterford City 58.52 30.32 9.17 1.66 0.33 154.97
Laois 61.58 28.82 8.07 1.21 0.32 149.86 Donegal 58.76 29.40 10.05 1.48 0.30 155.15
State 61.66 28.58 8.20 1.28 0.28 149.92 Roscommon 58.52 29.66 10.01 1.48 0.33 155.44
Galway City 60.64 30.12 7.72 1.25 0.27 150.38 Longford 57.95 30.28 9.96 1.46 0.34 155.95
Galway County 61.05 29.00 8.46 1.22 0.26 150.66 Mayo 56.59 31.24 10.29 1.52 0.36 157.82
Wexford 61.21 28.54 8.59 1.37 0.28 150.98 Cork City 56.71 30.45 10.61 1.84 0.39 158.73
Monaghan 61.02 28.47 9.17 1.11 0.22 151.04 Limerick City 53.36 32.40 11.57 2.20 0.48 164.03
Louth 61.23 28.32 8.74 1.41 0.30 151.23

14. ED LevelED Level

15. SA Level

16. 7 Validation and Comparisons7. Validation and Comparisons
• Spatial Justice Geographies
• Established relationships between health andEstablished relationships between health and
a range of social indicators
A f f i l j i i• A form of spatial justice mapping
• Tested at a number of scales

17. KFIW and Deprivation (ED)KFIW and Deprivation (ED)
KFIW v HPI Scores
186
184
182
180
178
176
174
172
170
168
166
164
162
160
158
156
KFIW2011
156
154
152
150
148
146
144
142
140
138
136
134
132
130
128
126
124
122
HPI 2011
1817161514131211109876543210-1-2-3-4-5-6-7-8-9-10-11-12-13-14-15-16-17-18-19-20-21-22-23-24-25-26-27-28-29-30-31-32-33-34-35
120
118
116
114
112
110

18. KFIW and Unemployment (ED)KFIW and Unemployment (ED)

19. KFIW and Social ClassKFIW and Social Class
Kavanagh-Foley Index of Wellbeing
171.19
165.83
180.00
146.86
127.41
134.23
141.69
150.93
155.03
165.83
120.00
140.00
160.00
All social classes
SC1
60 00
80.00
100.00
KFIScore
SC2
SC3
SC4
SC5
20.00
40.00
60.00 SC6
SC7
0.00
Social Class

20. KFIW and DisabilityKFIW and Disability
Total persons 146.86
An intellectual disability 229.58
Difficulty in learning, remembering or concentrating 236.35
Deafness or a serious hearing impairment 236.94
Total persons with a disability 241.75
Blindness or a serious vision impairment 251.88p
Psychological or emotional condition 255.37
Total disabilities 272.10
Diffi lt i ki tt di h l/ ll 276 34Difficulty in working or attending school/college 276.34
Other disability, including chronic illness 276.84
Difficulty in participating in other activities 281.60
A condition that substantially limits one or more basic physical activities 286.98
Difficulty in going outside home alone 287.68
Difficulty in dressing, bathing or getting around inside the home 295.22

21. KFIW and Informal CareKFIW and Informal Care
Carer
(HPW) PVG PG PF PB PVB KFIW
Up to 14 54.00% 34.86% 9.28% 1.05% 0.18% 156.66Up to 14 54.00% 34.86% 9.28% 1.05% 0.18% 156.66
15 to 28 46.55% 38.26% 12.49% 1.62% 0.35% 168.76
29 to 42 45.87% 38.67% 12.72% 1.68% 0.32% 169.69
43 to 84 41.14% 40.51% 15.40% 1.91% 0.35% 177.75
84‐167 41.55% 40.42% 15.04% 2.08% 0.31% 177.42
168 36.03% 41.36% 18.42% 2.76% 0.65% 188.30
NS 42.99% 36.11% 15.61% 3.05% 0.75% 178.01
TOTAL 47.73% 37.10% 12.35% 1.69% 0.78% 169.65TOTAL 47.73% 37.10% 12.35% 1.69% 0.78% 169.65

22. 8 Potential Uses for Spatial Justice8. Potential Uses for Spatial Justice
• Potential Use for modelling changes
• Build local/community geographiesBuild local/community geographies
• Secondary Care Utilisation Patterns (HIPE)
• Primary Care Utilisation (GMS)
• Comparisons with Mortality data as itComparisons with Mortality data as it
emerges.
• Potential for other forms of spatial analysis:
MLM, Microsimulation

23. SummarySummary
• Valuable new data set that can inform studies of
spatial justice
• Operates at meaningful geographical scales
• Potential explanatory relationships identified withPotential explanatory relationships identified with
range of indicators
• Potential to inform health and social care planning• Potential to inform health and social care planning
• Link to improved administrative data capacity and
wider statistical analysiswider statistical analysis
• Important to ground truth v qualitative work too.